After 20 years in the U.S., medication abortion is finally widely accessible through telehealth. But a looming Supreme Court ruling could change all that.
BY RUTH READER
In April of this year, when some of Minnesota’s already few abortion clinics started to close because of the pandemic, a new organization popped up with a novel idea: It would bring abortion services to Minnesotans using a mobile clinic. Called Just The Pill, its goal was to connect the state’s most rural corners with medication abortion care, a two-pill regimen that can end a pregnancy.
In the past, it’s been hard for sexual health groups to get medication abortion to people in remote areas. The Food and Drug Administration restricts one of the medications, mifepristone, in several ways. Patients must take the pill at a clinic, for example. On top of that, states have their own rules that can further encumber access. However, the medical data overwhelmingly shows the abortion pill is safe, even to take at home alone. Health experts say politics—not data—are informing these rules.
Both abortion advocates and opponents have used the COVID-19 crisis to further their policy goals.
Carrie N. Baker
Sep 21, 2020
The gendered dimensions of the political response to the COVID-19 crisis are manifesting clearly in efforts to close abortion clinics, as well as in campaigns led by doctors, lawyers, and reproductive rights advocates to expand access to telemedicine abortion during the pandemic and beyond.
Anti-abortion politicians in states across the country have used the COVID-19 pandemic to attempt to restrict abortion, arguing that abortion is not essential health care and that banning the procedure will conserve personal protective equipment for COVID-19 cases. In March and April of 2020, 12 states tried to restrict abortion, including Alaska, Iowa, Louisiana, Mississippi, and West Virginia, among others. Legislators in Kentucky passed a bill to allow the state’s Attorney General to block abortion access during COVID-19, but the Kentucky governor vetoed the bill.
Changes to medical technology will change the politics of the country’s original culture war
Sep 19th 2020 edition
When women used to tell Susan Long (not her real name), a doctor in Washington state, that they wanted to terminate a pregnancy, she would refer them to an abortion clinic. Today, they need not even walk into her office: after an online consultation, she prescribes two pills, which she posts, along with instructions on how to take them several hours apart.
It is difficult to exaggerate the benefit for “innumerable” women of being able to have an abortion at home, without having to arrange a trip to a clinic, she says, describing some of them. The university student living with her conservative parents, hundreds of miles from the nearest abortion clinic. The woman whose violent husband is vehemently pro-life. Single mothers, strapped for cash and child care. Those whose frail health prevents them risking exposure to covid-19 at a doctor’s office.
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.
Telemedicine Abortion Gains Momentum During Pandemic
— But FDA regulations on mifepristone still limit access
by Amanda D'Ambrosio, Staff Writer, MedPage Today
June 2, 2020
As access to in-person abortion clinics dwindled during the COVID-19 pandemic, providers have seen increased demand and awareness of another method of abortion care: telemedicine.
Melissa Grant, chief operating officer of carafem, a national abortion and birth control clinic, said that "there's definitely been a marked increase" in telemedicine abortions since stay-at-home orders were put in place.
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.
From Poland To Uruguay, What The Pandemic Means For Abortion
Michaela Kozminova, WORLDCRUNCH
Across the globe, swamped hospitals and shelter-in-place measures have impacted people's access to healthcare for any number of non-COVID-19 issues. One of them is abortion, a time sensitive procedure that is also — even the best of times — both emotionally and politically charged.
Now, in the face of the coronavirus pandemic, some countries have used emergency decrees to change their policies related to pregnancy terminations. While several have extended access to abortions in an effort to ease pressure on women and guarantee their rights, others have seen the situation as an opportunity to make abortions more difficult to access.