Background After having one of the most restrictive abortion laws worldwide, Ireland legalised abortion in January 2019. We examine how legalisation impacted on demand for online telemedicine outside the jurisdiction. Methods We analysed anonymised data from 534 people from Ireland seeking online telemedicine abortion prior to legalisation (January–March and October–December 2018) and in the first 3 months following legalisation (January–March 2019). Numbers, characteristics and reasons for seeking the service before and after legalisation were compared. Content analysis of emails from people seeking the service following legalisation explored reasons for seeking care. Results Half as many people contacted Women on Web in the 3 months immediately after legalisation as compared with contacts 12 months prior (103 vs 221). Of these, the proportion receiving the service reduced, from 72% prior to legalisation to 26% after legalisation (p≤0.001). After legalisation, access related reasons for seeking online telemedicine featured less while reasons relating to privacy, stigma and avoiding protestors featured more. Conclusions People continued to seek abortion through online telemedicine after legalisation, though the number of contacts reduced by half and the proportion receiving the service decreased considerably. To address access issues, policy measures should promote normalisation of abortion, legislate for safe zones around providers, and consider access in situations of coercive control or abuse including the role of telemedicine in the local model of care. Abortion provided through online telemedicine continues to be an important part of providing safe, accessible abortion even after legalisation. Data may be obtained from a third party and are not publicly available. Women on Web (www.womenonweb.org) hold these data and may make fully de-identified data availble to researchers on application.

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在爱尔兰共和国堕胎合法化后在管辖范围外进行堕胎

背景 在拥有全球最严格的堕胎法之一之后，爱尔兰于 2019 年 1 月将堕胎合法化。我们研究了合法化如何影响司法管辖区以外的在线远程医疗需求。方法 我们分析了来自爱尔兰的 534 人在合法化之前（2018 年 1 月至 3 月和 10 月至 12 月）和合法化后的前 3 个月（2019 年 1 月至 3 月）寻求在线远程医疗堕胎的匿名数据。比较了合法化前后寻求服务的人数、特点和原因。对合法化后寻求服务的人的电子邮件内容进行分析，探讨寻求护理的原因。结果 与 12 个月前的接触相比，在合法化后的 3 个月内，在网络上联系女性的人数减少了一半（103 对 221）。这些，接受服务的比例从合法化前的 72% 下降到合法化后的 26% (p≤0.001)。合法化后，寻求在线远程医疗的访问相关原因较少，而与隐私、污名和避免抗议者相关的原因较多。结论 合法化后人们继续通过在线远程医疗寻求堕胎，但接触人数减少了一半，接受服务的比例大幅下降。为了解决准入问题，政策措施应促进堕胎的正常化，为提供者周围的安全区立法，并考虑在强制控制或滥用情况下的准入，包括远程医疗在当地护理模式中的作用。通过在线远程医疗提供的堕胎仍然是提供安全、即使在合法化之后也可以进行堕胎。数据可能从第三方获得并且不公开可用。Women on Web (www.womenonweb.org) 持有这些数据，并且可能会在申请时向研究人员提供完全去标识化的数据。