Women’s healthcare company carafem is now facilitating at-home abortions through its virtual assistant, Cara.

Patients in Georgia, Virginia, Illinois, Maryland, New Jersey and the District of Columbia can now receive medication abortions via carafem with around-the-clock emotional and medical support from Cara.

Cara (1-855-SAY-CARA) is a text-based virtual assistant that is designed to work as a traditional care team. It provides real-time answers and support for concerns people might have while taking the abortion pill at home. If needed, Cara can connect patients to a live member of the carafem medical team who can view their medical records for more informed support.

"carafem’s mission is to improve access for abortion services while ensuring clients receive the highest quality, medically supported guidance throughout their entire telemedicine journey," Melissa Grant, COO of carafem, said in a statement.

"Right from their home, or where they feel most comfortable, people can use the abortion pill with personalized support via 'Cara,' a 24/7 text-based support system. Cara works like a personalized team of experts that goes with you wherever you go, and not just during normal business hours."

To receive an at-home medication abortion through carafem, users set up a virtual visit with a provider to establish a care plan. Then the company mails the medication within two to four business days. From there, patients follow the included instructions with support available from Cara and follow up with the carafem care team once the abortion is completed.

The medication costs between $250 and $375, since carafem is currently unable to accept insurance or Medicaid for abortion pills by mail. The company does offer financial assistance to qualifying patients, to be determined during the virtual visit.

WHY THIS MATTERS

Just this week, the Food and Drug Administration said it will allow abortion pills to be sent by mail for the duration of the public health emergency.

Janet Woodcock, the acting commissioner for the FDA, sent a letter on Monday to two reproductive health organizations saying the administration would "exercise enforcement discretion" regarding mail-order abortion pills.

Medication abortions involve taking two prescription drugs, mifepristone and misoprostol, which together induce the equivalent of an early miscarriage. The first, mifepristone is typically taken in person at a clinic under the supervision of a certified healthcare provider. The second dose, misoprostol, can be taken at home up to 72 hours after the first dose.

The new FDA guidelines counter a January Supreme Court decision that reinstated a federal requirement that people seeking medication abortions must pick up mifepristone in person from a hospital or medical office.

“We applaud the Food and Drug Administration (FDA) for lifting restrictions on the ability to receive mifepristone by mail to improve the health and safety for people choosing this option during a public health emergency,” Grant said.

“There is absolutely no scientific or medical justification for requiring pregnant people to travel to a hospital, clinic, or medical office during COVID-19 to access the abortion pill.”

The use of telemedicine abortion services has been studied over recent years, and a board of researchers said that it is “safe, effective, and acceptable, and supports the claim that there is no medical reason for mifepristone to be dispensed in clinics as required by the Food and Drug Administration.”

THE LARGER TREND

Relaxed policies around at-home abortion care have led to a number of new telemedicine abortion clinics. Besides carafem, there’s Just The Pill for Minnesota residents, Choix for people in California and Hey Jane for patients in New York and Washington.

Planned Parenthood has begun updating its services to reflect an increasingly digital healthcare system. Last April, it expanded its telehealth services to include all 50 states, so patients can virtually access some birth control needs, sexually transmitted infection testing, gender-affirming hormone therapy, pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), urinary tract infection screening and the morning after pill.

Prior to that, the nonprofit launched its Abortion Care Finder that helps people find the closest abortion center that suits their specific needs.

Planned Parenthood also has a chatbot of its own, called Roo that can answer questions about sexual health and puberty for teens.

ON THE RECORD

“Via Cara, our medically supported at-home abortion care services are now within reach of people [who] have been traditionally unable to access abortion care,” Grant said.

“Medically supported at-home abortion pills represent a form of reproductive freedom and a critical tool to increase access – giving people the opportunity to make choices that are best for them, comfortably and conveniently, even those living in more isolated rural communities.”