Health

‘Telabortion’ helps pro-choice advocates evade abortion bans

A coalition of pro-choice advocates is expanding abortion services via shipments of do-it-yourself medications and telemedicine in several states including Georgia, which recently banned the practice after a fetal heartbeat is detected.

Clinicians from Gynuity Health Projects, Planned Parenthood and other family planning groups are offering “telabortion” services in eight states in an effort to increase access to abortion.

“State legislatures have passed many unnecessary laws to restrict abortion care, sometimes forcing clinics to close and women to travel sometimes 50 miles or more to the nearest clinic,” said Meighan Mary Tarnagada, a program research associate for Gynuity Health Projects.

“Some women have to cross state lines. Some women have to take flights to get to a quality abortion provider,” she said. “It’s a hardship for women.”

But Eric Scheidler, executive director of the Pro-Life Action League, questions the morality of telemedicine abortion services.



“Perhaps it would increase abortion access. But my question would be, why is that such a great thing?” Mr. Scheidler said. “From the perspective of somebody who recognizes a fellow human being — albeit at a very early stage of life, but no less a member of the human family deserving of protection and concern — I can’t see increasing abortion as a good thing.”

The telabortion effort is being introduced as some states move to enshrine abortion rights into their laws and constitutions while others have enacted restrictions or outright bans against the procedure. Such legislative action has been driven in part by ideas that the new conservative majority of the Supreme Court would overturn the 1973 Roe v. Wade decision that legalized abortion nationwide.

Julia Kohn, national director of research, evaluation and data analytics for the Planned Parenthood Federation of America, said its ongoing telemedicine program can help reduce barriers that make it harder for women to access abortion services such as securing transportation, child care and time off work.

The telabortion team has sent more than 400 packages containing medications to women in Hawaii, Oregon, Washington, Maine, New York, Colorado, New Mexico and Georgia.

Women who participated in the study had video conferences with a study clinician, pretreatment lab tests and ultrasounds. Packages with mifepristone and misoprostol were mailed to those who were eligible. The women received instructions for using the abortion medications and had follow-up tests and consultations with clinicians by phone or videoconference.

Several states, including Alabama, Louisiana, Ohio, Missouri, Georgia and Arkansas, have new restrictions against abortion. Many of these states have enacted “heartbeat” laws that ban abortions once a doctor can detect a fetal heartbeat in the womb.

Officials in Georgia did not return calls Tuesday seeking comment on the telabortion effort.

Meanwhile, Illinois, New York, Vermont and Maine are taking action to protect or expand abortion services.

“We’re seeing the states going in opposite directions,” Mr. Scheidler said.

He called telabortion “troubling” and said the medical procedure is more dangerous without a doctor. The larger question of safety needs to be addressed, he said.

In the initial telabortion effort, clinicians mailed abortion medications to 248 women in five states and recorded outcomes for 190 participants. Of those, 177 completed an abortion without a clinical procedure.

Of the 248 women, 217 provided follow-up information. The data showed that one woman was hospitalized for postoperative seizure and another for excessive bleeding. A total of 27 women had unscheduled clinical encounters, 12 of which resulted in no treatment.

A total of 159 women (64%) who received abortion medications expressed satisfaction with the telabortion services, according to a study published this month by Contraception.

Randall O’Bannon, director of education and research for National Right to Life, said complications associated with abortion are “not trivial and hardly safe to ignore.” He noted that the study’s researchers don’t know the outcomes for 58 of the 248 women (23%) who were mailed abortion medications.

“Their own data show a process with a lot of problems and unresolved issues — too many missing patients, too many missing pills, too many safety concerns,” Mr. O’Bannon said in an opinion article.

Ms. Mary Tarnagada said Gynuity Health Projects did not see higher rates of adverse outcomes for women who participated in telabortion than in-clinic visits.

“I believe strongly that it’s a woman’s choice in what she wants to do with her body. So I believe strongly that abortion care is essential. It should be one of the general health care options for women. They shouldn’t have to go through hurdles,” she said. “Choices can do nothing, but be a better thing for women.”

She said Gynuity Health Projects hopes to add three or four states to the telabortion effort. She emphasized that abortion is legal in all 50 states and that many of the abortion bans do not go into effect until much later.

States should set their own rules for abortion, said Mr. Scheidler, adding that both sides can agree with the idea of taking the issue out of federal politics and moving it closer to home.

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