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 shared.
Shortly after, she made the decision to have an abortion.
“I also had to go to three different appointments and it was really, really hard because people couldn’t come with me,” she explained.
Telemedicine appointments were not an option in his condition.
“I kind of had to risk my life to go get some 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 well as other states, there are laws preventing medical professionals from prescribing abortion pills via telehealth.
“I received the first half of my abortion pill at the clinic and took the other half home,” Lee said.
Nineteen states require the clinician providing medical abortion to be physically present when the pill is administered, which means there is no telehealth to prescribe remotely.
Last year, as the pandemic grew, a federal judge blocked the FDA’s federal requirement that a patient meet with a doctor in person before receiving abortion pills. Then, in January, the Supreme Court reinstated those federal rules. However, last April the FDA announced a temporary halt to the app.
“The FDA has issued this letter indicating that it will exercise its enforcement discretion regarding the in-person delivery 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 state laws.”
This puts many states, like Ohio, at the center of the debate.
“Telemedicine is extremely helpful in so many ways, but dangerous drugs like the abortion pill aren’t one of those things that should be administered remotely,” said Allie Frazier of pro-life organization Ohio Right to Life.
“We believe that no woman should be put at risk of having to go through the harrowing process of chemical abortion alone, perhaps hours away from the doctor who prescribed these drugs,” she said.
“There’s just a lot of things that this in-person visit with the doctor could prevent a lot of problems and certainly 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 it’s a very well-studied product. It’s very, very safe,” he said.
And in areas where access is possible, demand is growing.
“In Illinois, we’ve been able to use telemedicine in different ways over the past six to nine months,” said Dr. Colleen McNicholas, chief medical officer for Planned Parenthood of the St. Louis area.
“We have certainly seen the number of medical abortions increase,” she said.
In Illinois, the pills can even be sent directly to a woman’s home.
“People are increasingly choosing drugs over suction procedures,” Dr. McNicholas said.
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 when making a decision.
“For some people, a safe 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 it’s just another way to help open up access consistent with what medicine and scientific evidence shows us to be safe,” said Dr. McNicholas.
“Removing the telemedical ban on the abortion pill does a lot for accessibility, I mean we’re not just talking about the barriers that existed before in terms of abortion, we’re also talking about a pandemic,” said Larada Lee. .