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Abortion access is limited everywhere. Telehealth could change that

Nineteen states still block women from getting medication abortion through telehealth; the pandemic has presented an opportunity for change.

Abortion access is limited everywhere. Telehealth could change that
[Source photo: gpointstudio/iStock]

It’s been nearly a month since Texas’s abortion ban went into effect. A month of women unable to get the abortion care they need, being forced to leave the state and travel to obtain timely and essential care. As we face relentless attacks on abortion in Texas—with other states sure to follow—advocates and policymakers have the ability to make abortion more accessible and available for women in the comfort of their own home, through telehealth that expands access to medication abortion care.

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Different from an in-clinic abortion procedure, medication abortion is a non-invasive option to end a pregnancy up to 10 weeks by using prescription medicine. Telehealth holds tremendous promise to revolutionize access to abortion, especially for those who are often marginalized by our health systems, including people of color, young folks, rural people, and those struggling to make ends meet. But this advance will only be possible if policymakers end medically unnecessary restrictions that keep this care from being delivered via telehealth.

Since being approved by the Food and Drug Administration (FDA) in 2000, more women are deciding to use medication abortion care. Using telehealth, a patient can virtually consult with a health provider and then have the prescription mailed to her.

Medication abortion has a more than a 99% safety rate. What’s more, research from the U.S. and United Kingdom makes it clear that using telehealth for medication abortion is as safe and effective as getting in-person care, and may result in women accessing care earlier in their pregnancy. There is no medical reason to deny a woman the ability to receive medication abortion in the way that best meets her needs—whether at a health center, pharmacy, or having a prescription delivered to her home.

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However, under outdated FDA rules, a patient seeking medication abortion care can’t get it from a regular pharmacy. She may not even be able to obtain it from her regular healthcare provider. She can only access it from certain providers or health centers—restrictions dramatically limiting her options for care.

During the pandemic, the FDA temporarily allowed medication abortion care to be provided via telehealth to prevent the spread of COVID-19. The agency is considering making this change permanent.

Yet, even with this potential progress, 19 states currently block patients from using telehealth for medication abortion care. In these areas, a woman is still forced to see a health provider in person. In 32 states, only physicians can provide this care, despite medical authorities like the American College of Obstetricians and Gynecologists affirming it is safe for other clinicians, such as nurse practitioners, to dispense.

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These obstacles also come on top of an unprecedented surge of other medically unnecessary state regulations—from arbitrary waiting periods to bans on insurance coverage of abortion—which apply to both abortion procedures and medication. These restrictions delay access to care and add costly hoops for women to jump through, such as arranging and paying for travel, housing, and childcare. For people already struggling to receive quality healthcare, these hurdles can be impossible to clear.

Telehealth is more popular than ever for people of all ages, genders, and races. It holds the potential to reduce environmental, economic, racial, and other barriers that worsen health disparities, including for abortion care. For example, some women seeking abortion live where the closest provider is at least 50 miles away. Studies show that telehealth can help them obtain care earlier in pregnancy and eliminate unneeded testing, reducing their costs to get abortion care.

As federal leaders consider lifting barriers to telehealth-provided medication abortion, state policymakers must also do their part. We all should benefit from innovations that will continue building bridges to safe and effective forms of healthcare. Medication abortion care is among these crucial services. It’s time to follow the science, center equity, and bring medication abortion within reach of everyone, when and where we need it.

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Dana Northcraft is Director of Innovation and Partnerships at Expanding Medication Abortion Access (EMAA) Project, which seeks to improve the way the medications prescribed for medication abortion care are dispensed in the United States, to make the process consistent with the medical and scientific evidence and to meet women’s needs.

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