Why Aren't Telemedicine Abortions More Popular?

Finally, there's some good news about abortion access in 2016. Earlier this week, reproductive health organization Maine Family Planning introduced a telemedicine abortion option, making Maine just one of three states with clinics routinely offering the service. Unlike traditional abortion procedures, which require visits to doctors that may be hundreds of miles away, telemedicine abortions allow healthcare providers to prescribe abortion drugs via videoconference, thereby eliminating hurdles like travel expenses and surgical costs that make abortion inaccessible to so many women in America.

Although most states require abortions to be provided by a doctor, the telemedicine procedure is designed to eliminate the need to travel all the way to a clinic with an on-site physician, which are increasingly difficult to find in most states. Rather than making an in-person visit to a clinic that provides abortions, patients simply visit a medical office or clinic where the doctor video conferences with them. After explaining what to expect, side effects, and so on, the doctor unlocks a drawer containing an abortion-inducing pill (typically Mifeprex) and supervises the woman during her first dose before sending her home, where she finishes the medication as instructed.

Needless to say, such a procedure is hugely important for rural women who live in areas where abortion providers simply can't be reached — like many of the women serviced by Maine Family Planning (MFP), which is why they announced on Monday that they would begin offering telemedicine abortions immediately.

"Some of our patients were traveling three or four hours... Women without resources should still have access to basic health care," MFP director of abortion services Leah Coplon told Mother Jones.

It's important to note that medical abortions aren't the same thing as emergency contraception, which makes it less likely you'll get pregnant after sex. The abortion pill is for women who are already pregnant, and it's effective during the first nine weeks of pregnancy. Despite its name, the pill is actually two medications: Mifepristone, which breaks down the lining of the uterus, and misoprostol, which induces contractions to expel the tissue.

Not only is the abortion pill is highly effective, safe, and relatively cheap, it also accounts for nearly a quarter of abortions performed in the United States. Furthermore, although they're still relatively new, there's evidence that some women prefer telemedicine abortions to traditional procedures — but they're not widely used. In fact, 18 states have adopted laws requiring physicians to be physically present when providing abortions, and in one of the only states to routinely allow telemedicine abortions, Iowa, efforts to implement similar policies went all the way to the state Supreme Court before they were unanimously struck down. So what gives?

As Mother Jones points out, it largely comes down to anti-abortion pressures and the cost of maintaining a clinic, even one without a physician present. Although the clinic providing telemedicine abortions may not require an on-site doctor, it still needs staff capable of determining the presence of a pregnancy — and costly equipment to do so. In states like Maine, where public funding of abortion is only available in cases of life endangerment, rape, or incest, clinics providing abortion struggle to keep their doors open, let alone expand their methods. (Mother Jones reports that MFP was able to begin offering telemedicine abortions thanks to private grants.)

In all likelihood, however, the dearth of telemedicine abortions can be traced to the rise of anti-abortion sentiment among lawmakers and legislation in recent years. From defunding Planned Parenthood to implementing laws that make getting an abortion increasingly emotionally taxing and logicistically nightmarish, reproductive rights are endangered in ways that they haven't been in decades, especially if you're a low-income woman in a rural area.

As the Iowa Supreme Court remarked in their decision to strike down the ban on telemedicine abortions, "It is difficult to avoid the conclusion that... medical concerns about telemedicine are selectively limited to abortion."

Well said, Iowa Supreme Court. Well said. Here's hoping that more clinics will have the opportunity to offer telemedicine abortions in the future — but if the current trends continue, we'll be waiting for a long time.