"We just need to create as many avenues for access as we possibly can": Clinician and administrator attitudes toward telehealth medication abortion in the U.S. South.

Objectives: There is currently a gap in literature on the perspectives of sexual and reproductive health providers in the South toward telehealth abortion services. This research seeks to explore these perspectives to understand provider attitudes toward importance and priority of telehealth abortion to contribute to the development of a richer understanding of this in the South.

Study Design: This study conducts a secondary analysis of data from the Provider Readiness for Virtual Implementation and Delivery of Medication Abortion Services (PROVIDA) study. We collected qualitative data regarding perspectives of 20 providers toward importance and priority of telehealth abortion during a series of in-depth interviews that took place from June 2021-2022.

Results: We identified four main themes: telehealth abortion is important for patient benefit in mitigating physical, administrative, financial, and privacy-related barriers; telehealth abortion is important for clinic benefit in improving clinic flow and sustainability; the political climate affects personal prioritization of telehealth abortion; and staff hesitance affects clinic prioritization of telehealth abortion.

Conclusions: Our analysis revealed telehealth abortion to be particularly important in mitigating physical barriers for patients and for clinic sustainability. We found the political climate to be the most notable factor influencing personal prioritization of telehealth abortion, with most participants noting it made telehealth abortion less of a priority. Additionally, our analysis found participant perception of staff hesitation to implement telehealth abortion to be the most notable factor affecting clinic prioritization. Future research should utilize these findings to inform studies examining the implementation climate of telehealth abortion in the South.

Implications: Highlighting insights from SRH professionals in restrictive environments, this study emphasizes the potential of telehealth abortion to mitigate the unique barriers to access and provision that abortion seekers and providers face in the U.S. South. This has important implications for motivating implementation in states where abortion is still legal but telehealth abortion is prohibited.