Telehealth is becoming more and more important in our lives. These visits are also used for abortions, but the rules vary from state to state, and even at the federal level.
“In March of last year in 2020, at the height of the pandemic, I found out I was pregnant in the state of Ohio,” Larada Lee explained.
Soon after, she made the decision to have an abortion.
“I also had to go to three different dates and it was really, really difficult because people couldn’t come with me,” she explained.
Telemedicine appointments were not an option in her condition.
“I kind of had to risk my life to go get abortion pills when I was going to do the other half of the procedure at home anyway,” she said.
It’s a state-by-state decision, and in Ohio, as in other states, laws prevent medical professionals from prescribing abortion pills through telehealth.
“I got the first half of my abortion pill at the clinic and took the other half home,” Lee said.
Nineteen states require the clinician providing a medical abortion to be physically present when the pill is administered, meaning there is no telehealth to prescribe remotely.
Last year, as the pandemic spread, a federal judge blocked the FDA’s federal requirement that a patient meet with a doctor in person before being given abortion pills. Then, in January, the Supreme Court restored those federal rules. However, in April, the FDA announced a temporary halt to law enforcement.
“The FDA released this letter saying it will exercise its discretion in enforcing the in-person dispensing requirement,” said Dr. Daniel Grossman, director of Advancing New Standards in Reproductive Health and professor at the ‘University of California at San Francisco. “A letter from the FDA does not take precedence over any state law.”
This puts many states, like Ohio, in the middle of the debate.
“Telemedicine is extremely helpful in many ways, but dangerous drugs like the abortion pill are not one of those things that should be distributed remotely,” said Allie Frazier of the Ohio Right to Life pro-life organization.
“We believe that no woman should run the risk of having to go through the agonizing process of chemical abortion on her own, perhaps within hours of the doctor who prescribed these drugs for her,” she said.
“There are just a lot of things that this in-person visit with the doctor could avoid a lot of trouble and definitely help this woman,” said Carol Tobias, chair of the National Right to Life Committee.
Pro-life representatives have said this lack of in-person communication, coupled with the fact that women may live far from emergency medical care, is dangerous. However, Dr. Grossman disagrees.
“We have 20 years of safety data in the United States and this is a very well researched product. It’s very, very safe, ”he said.
And in areas where access is possible, demand is increasing.
“In Illinois, we have been able to use telemedicine in different ways over the past six to nine months,” said Dr. Colleen McNicholas, chief medical officer of Planned Parenthood in the St. Louis area.
“We have certainly seen the number of medical abortions increase,” she said.
In Illinois, the pills can even be shipped directly to a woman’s home.
“People are increasingly choosing drugs over suction procedures,” said Dr. McNicholas.
Each state is looking at different regulations when it comes to telehealth abortion appointments. For clinicians like Dr. McNicholas, this is just another avenue a woman can take to make a decision.
“For some people, a demedicalized abortion experience from their couch is exactly what they need and want. For others, they want to be at the health center and be able to physically get their hands on a provider. Both of these options are important. So this is just another way to open access consistent with what drugs and scientific evidence shows us to be safe, ”said Dr McNicholas.
“The lifting of the telematic ban on the abortion pill does a lot for accessibility, I mean we are not just talking about the barriers that previously existed in terms of abortion, we are also talking about a pandemic,” said Larada Lee. .