Telehealth abortions comprise close to 20% of US abortions, with thousands obtained under protective legislation every month, according to a recent report.
Recently, around a fifth of the nation's abortions - approximately 17,000 monthly - involved medication abortions where pills were mailed to patients following an online consultation with a healthcare professional, according to a recent report by #WeCount, an initiative spearheaded by the Society of Family Planning. Following the beginning of the COVID-19 pandemic, this type of abortion increased swiftly. In April 2022, medication abortions facilitated through telehealth accounted for around 4% of all abortions.
Medication abortions involve taking two drugs, mifepristone and misoprostol, instead of undergoing a surgical procedure. These drugs were approved by the US Food and Drug Administration (FDA) more than two decades ago and can be used up to 10 weeks into a pregnancy. The pandemic prompted the FDA to relax regulations to permit more extensive access to medication abortions done remotely, which was a radical shift from the usual pre-pandemic model that necessitated in-person visits to clinics for ultrasounds or other medical examinations.
Shield laws implemented in multiple states between late 2022 and 2023 have played a significant role in the recent growth of telehealth abortion. These laws enable healthcare practitioners in regions where abortion is legal to prescribe abortion medication through telehealth to individuals living in areas where the procedure is prohibited or severely restricted.
Over the past year, nearly 40,000 people reached out for telehealth abortions facilitated by shield laws. By December, these telehealth abortions accounted for approximately 9% of all abortions in the country. This figure excluded abortions that took place in the five states with legalized abortion where such laws were enacted.
A plethora of studies has established medication abortion's safety and reliability. The report underlines that telehealth medication abortions are both safe and effective, with over 98% of the cases concluding in medical success. Unfortunately, not more than 5% of those who encountered adverse events sought medical attention. The remaining 95% were not connected with the pills' mail-ordering.
As of 2023, the Guttmacher Institute reports that there were a million abortions in the United States—the most significant number in over ten years and a 10% surge from 2020. The #WeCount report aligns with these findings, showing a rise in abortions nationwide, with shield laws excluded from the statistic.
"Though the overall national number of abortions has increased, it's crucial to remember how vastly clinic-based care has decreased in states where abortion is unlawful," remarked Dr. Alison Norris, co-chair of #WeCount and a professor at The Ohio State University College of Public Health, "This signifies a substantial loss for many people within certain regions."
In the aftermath of the Dobbs decision, approximately 145,000 in-person abortions would have occurred if abortion had not been banned in 14 states, central to estimates from the #WeCount study.
Telehealth abortions, however, have become a go-to option instead of in-person procedures. "The ease with which barriers disappear with telehealth abortions is astonishing," remarked Dr. Ushma Upadhyay, co-chair of #WeCount and a professor at the University of California, San Francisco's Advancing New Standards in Reproductive Health. "Being able to offer abortion at a cheaper rate is a considerable advantage, too."
While telehealth is a promising solution, fostering greater knowledge about and confidence in it continues to present a challenge. By the end of 2023, nine states with legalized abortion still restricted telehealth abortions in certain ways, such as mandating an in-person ultrasound or counseling session prior to the abortion.
"Telehealth is particularly powerful for individuals residing in areas outside of major cities, living in low-income communities, or where pristine reproductive and maternal healthcare services are insufficient due to legislative constraints," said a group of family medicine physicians in an editorial that appeared in JAMA Internal Medicine on Monday. "Primary care doctors are a largely unrealized resource when it comes to providing abortion access via clinics or telehealth."
Lastly, it's noteworthy that medication abortion, including the remote or telehealth variant, is ascending as the preferred choice over in-person procedures. "It's remarkable how many obstacles are eliminated through telehealth abortions," said Dr. Ushma Upadhyay, co-chair of the #WeCount project and a professor at the University of California, San Francisco's Advancing New Standards in Reproductive Health. "Not only is it convenient, but it's also far less costly."
However, the promotion of telehealth abortions and the building of broader confidence in this alternative technique continues to be a challenge. Despite nine states with legalized abortion still establishing certain constraints on their use, such as requiring an in-person ultrasound or counseling session before the abortion. Family medicine physicians view primary care doctors as an "untapped resource" that can help promote access to abortion through clinics or telehealth platforms.
However, legal challenges also threaten the future potential of telehealth abortion services. As the federal government oversees mail delivery, a shift in administration could endanger postal delivery of abortion pills and individuals who receive them, as mentioned by Upadhyay.
In March, the US Supreme Court debated a case that has the potential to heavily restrict access to mifepristone, the main medication used for abortion pills.
“Remote access to medication abortion is growing in significance for abortion care across the United States - even as the Supreme Court ponders the future of this method. To ensure people still have access to this essential medical service, we need providers, activists, and legislators to work together to create new ways around potential restrictions,” Upadhyay emphasized in a statement.
CNN's Jen Christensen contributed to this article.
Read also:
- No food or coffee for three days, just juice, juice, juice instead: a field report
- How to get rid of the flu if you have caught it
- Doctors warn of penis fractures and other injuries during the Christmas season
- Corona or flu epidemic? These pathogens are making us cough and sniffle right now
In the report, medication abortions facilitated through telehealth increased significantly following the COVID-19 pandemic, accounting for about 4% of all abortions in April 2022. Shield laws implemented in various states between late 2022 and 2023 contributed to this growth, enabling healthcare practitioners to prescribe abortion medication through telehealth to individuals in areas where the procedure is prohibited or restricted.
Source: edition.cnn.com
