Medication Abortion and Telemedicine: Innovations and Barriers During the COVID-19 Emergency
Amrutha Ramaswamy, Gabriela Weigel, Laurie Sobel
Jun 08, 2020
State actions in response to the COVID-19 crisis have highlighted their divergent approaches to abortion access. Some states classified abortion as a non-essential service, effectively banning services, while others have clarified that abortion is an essential service. In a handful of states, some clinics have begun to offer medication abortions using telemedicine. This approach maintains access to abortion while social distancing, preserving personal protective equipment (PPE), and limiting in-person health care visits and risk of exposure.
In 2017, 39% of all abortions in the U.S. were medication abortions (also known as abortions induced by pills). These abortions are provided using two medications, mifepristone and misoprostol. While public knowledge about medication abortion is very low, even fewer people may be aware that telemedicine can aid in the provision of this service. Research shows that providing medication abortion by telemedicine is clinically feasible and safe, but COVID-19 has highlighted the impact of new and existing federal and state restrictions on providing abortions using this approach.
Coronavirus pandemic is fueling efforts to increase access to abortion pills
Marie McCullough - The Philadelphia Inquirer (TNS)
May 29, 2020
The pandemic is helping U.S. abortion-rights advocates achieve a long-standing goal: Make it easier for women to use pills to end pregnancies up to 10 weeks.
Federal and state regulations have restricted access to “medication abortion” ever since the Food and Drug Administration approved it two decades ago. Nonetheless, use of the two-drug regimen has grown steadily, accounting for at least 40% of all abortions, even as the national abortion rate has fallen to historic lows, data show.
Feminist Multi-Front Battle to End FDA’s Abortion Pill Restriction
by Carrie N. Baker
Feminists have been fighting a defensive battle to protect abortion rights for years—but today some are taking the offense, pushing to expand abortion access by calling for the removal of FDA restriction on the abortion pill mifepristone.
Formerly known as RU-486, mifepristone ends pregnancy by blocking the effects of the hormone progesterone, which sustains pregnancy. Used in combination with another drug—misoprostol, which causes contractions to complete an abortion—mifepristone is extremely safe.
Could Coronavirus Make Telemedicine Abortion the New Normal?
Clinics are expanding access with virtual visits and sending pills by mail.
By Anna Louie Sussman
May 19, 2020
Terri first realized she was pregnant in late March. She was isolating at home with her boyfriend in rural upstate New York, where she runs a housecleaning business. At 46, she was sure she didn’t want to become a 60-year-old parent to a teenager. “I was like, ‘No, that’s not going to happen,’” says Terri, who asked to be identified by her first name only. She called the nearest Planned Parenthood clinic, a 40-minute drive away, and took the first appointment available, which was a week-and-a-half later. Uninsured, Terri says she planned to show up at the clinic and “throw [herself] at their mercy.”
But before her appointment, she read about telemedicine abortion. All that was required was a phone consultation with a doctor to establish whether she was less than 10 weeks pregnant (the limit for medication abortion’s approved use by the U.S. Food and Drug Administration). Once proven, the clinic would deliver abortion pills by mail, allowing for a quiet, non-surgical procedure at home. For Terri, this was a far better option than potentially exposing herself to COVID-19 at a clinic.
No-Test Medication Abortion Increases Safety and Access During COVID-19
A new study proposes an innovative, no-test medication abortion protocol that would enable clinicians to safely administer medication abortion to patients without any preliminary tests or in-person encounters
by Carrie N. Baker
Imagine a world where women could access safe and supported abortion health care without ever leaving their homes. In this world, after a phone call or video conference with a health care professional, women could receive the abortion pill in the mail, which they could take safely in the privacy of their own homes under the supervision of a clinician.
No invasive, time-consuming pelvic exams or blood tests. No state-mandated ultrasounds or waiting periods requiring multiple visits. No walking past lines of screaming anti-abortion protesters. No driving long distances, having to find and pay for child care, or taking time off from work. No exposure to COVID-19.
Amid Covid-19, a Call for M.D.s to Mail the Abortion Pill
For decades, the consensus has been that F.D.A. regulations require that the abortion pill be obtained in a clinic. But that’s changing.
By Patrick Adams
May 12, 2020
Last fall, months before America’s first outbreak of the coronavirus, Francine Coeytaux and Elisa Wells, co-founders of the abortion rights advocacy group Plan C, were reaching out to doctors with a question they said was urgent:
“Would you be willing to mail the ‘abortion pills’ to women in their homes?”
For many women, abortion access was already limited. Then COVID-19 hit
Coronavirus—and restrictions on “elective procedures” in states like Texas—have made accessing reproductive healthcare harder than ever. But providers are getting creative.
By Pavithra Mohanlong Read
On a Thursday in early April, Shanthi Ramesh saw three patients back to back. They were all healthcare workers on the front lines of the coronavirus pandemic. Two of them worked in a local emergency room, while the other was driving up to New York the next day to volunteer at a hospital.
They had another thing in common: All three women had gone to Ramesh’s clinic to get an abortion.
Abortion by Telemedicine: A Growing Option as Access to Clinics Wanes
The coronavirus has created a surge in demand for telemedicine of all types — including for a quietly expanding program for terminating pregnancies.
By Pam Belluck
April 28, 2020
Ashley Dale was grateful she could end her pregnancy at home.
As her 3-year-old daughter played nearby, she spoke by video from her living room in Hawaii with Dr. Bliss Kaneshiro, an obstetrician-gynecologist, who was a 200-mile plane ride away in Honolulu. The doctor explained that two medicines that would be mailed to Ms. Dale would halt her pregnancy and cause a miscarriage.
Abortion clinics expanding virtual options during pandemic
Providers say they're trying to work around restrictions that limit telemedicine abortion.
By MOHANA RAVINDRANATH and ALICE MIRANDA OLLSTEIN
Abortion providers say they’re seeing heightened demand for telemedicine abortions during the coronavirus pandemic, and providers are preparing for a growing number of virtual visits as social distancing measures continue.
These clinics are looking to video call apps like Facetime and AI-powered chatbots to make prescribing abortion medication almost entirely virtual during the pandemic. Some providers are dialing back in-person visits and forgoing ultrasounds and pelvic exams they’ve typically required before prescribing abortion pills virtually.
The Coronavirus Pandemic Is Forcing Abortion Providers to Make Impossible Decisions
Mar 24, 2020
The Choices Memphis Center for Reproductive Health, a small clinic in Tennessee, had two doctors providing abortion care until a few days ago. The center, which draws patients from all over the region, sees anywhere between 20 and 40 patients a week, according to its assistant director Katy Leopard: They come from Mississippi, where there is only one clinic providing this kind of care, and from Arkansas, where abortions can be hard to come by, and sometimes from even as far as Kentucky.
In the United States, an estimated 11.3 million women live more than an hour’s drive from an abortion provider, and often doctors will split their time between clinics to provide more geographically comprehensive care. Last year, the Los Angeles Times shadowed a provider who performed 50 abortions in 60 hours when she “commuted” from California to Texas, a feat that now given a roiling pandemic and orders from state governments to “just stay home” seems difficult, if not impossible, to imagine. But clinic workers and reproductive health advocates are trying to manage, considering that even in moments of global crisis, unwanted pregnancies don’t stop.