Racial and Demographic Trends in Telehealth Abortion Use in Minnesota Gestational Duration, 2021-2024

• In Event: Social Equity in Health Care: Policy, Access, and Digital Systems

Abstract

Objective: Little is known about populations utilizing recently expanded access to telehealth or how structural determinants may continue to exacerbate access inequities. The objectives of this study are to 1) assess demographic trends in abortion method and modality for patients with pregnancies 11 weeks or less in Minnesota and 2) assess disparities among Minnesota patients choosing telehealth abortion who are eligible. Understanding these patterns is important for evaluating whether telehealth expansion is reaching populations most affected by access barriers and for informing equitable policy design.Study Design: We conducted a retrospective cohort analysis using Planned Parenthood electronic health record data of Minnesota abortion patients at 11 weeks gestation or less between 2021–2024. Descriptive statistics and multinomial logit model results are reported using relative risk ratios.Results: A total of 20,360 abortions at or less than 11 weeks gestational duration transpired during the study period. 64.9% of abortions were in-clinic medication, 27.6% procedural abortion, and 7.6% were telehealth medication. Telehealth medication patients were older, more likely to be white and live in rural counties, and have a history of previous abortion compared to patients who received abortion care in person. These findings provide additional context on how different populations utilize available care modalities within existing structural and geographic constraints.Conclusions: Telehealth abortion can reduce access inequities but is mostly utilized by those who are well off suggesting telehealth expansion may not reach communities most impacted by barriers. People who self-identify as Black, Hispanic, or multi-racial, as well as those whose primary language is not English, are more likely to opt for in-clinic care. As access to clinic-based abortion care continues to face challenges, our research underscores the need for a balanced approach that expands and retains both telehealth and in-clinic options. These findings further inform policy discussions on how to design and implement telehealth services in ways that promote equitable access across diverse populations.

Author

• Asha Hassan, University of Minnesota - Twin Cities
  Presenting Author