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How Telehealth Widens Access to the Abortion Pill

First of all, I don't juice. I'm all natural. No hormones for me! No thank you.

Plus I got 1, 2, 3, 4, 5, six, SEVEN charts here. No extra charge for that. A 3rd grader could understand this stuff. Well not the reproductive content but the colored graphs.

How Telehealth Widens Access to the Abortion Pill

Without telehealth, one in seven women would have to drive over 200 miles to the nearest provider

By Kara Dapena, WSJ

Updated March 27, 2024

The Supreme Court heard oral arguments on Tuesday over how patients can access mifepristone, commonly known as the abortion pill. The justices suggested that protecting the doctors who filed the suit wasn’t enough justification to roll back access to the drug, but several states already have telehealth restrictions in place.

Telehealth for medication abortion became available in 2020 when the Food and Drug Administration stopped enforcing its in-person dispensing requirement and allowed certified mail-order pharmacies to ship pills to patients during the pandemic. These changes became permanent in 2023, when the agency also allowed certified bricks-and-mortar pharmacies to dispense the pills for the first time.

In September 2023, some 16% of all abortions within the formal U.S. healthcare system were performed via telehealth, according to WeCount, an abortion-data project sponsored by the Society of Family Planning, which supports abortion rights. Twenty-six states and D.C. allow telehealth for medication abortion. The remaining states have restrictions that supersede federal guidance: 14 ban abortion throughout pregnancy, and the remaining 10 have various combinations of in-person requirements, such as mandatory ultrasounds and visits to doctors and counselors.

Patients in states that don’t permit abortions can currently turn to telehealth providers in many other states. Providers in some states are protected by so-called shield laws designed to protect them from liability or prosecution if they provide pills to patients from states where abortion is banned. Some telehealth shield laws only protect the provider if the patient travels to the provider’s state to terminate the pregnancy, and others protect the provider regardless of what state the patient is in. Seventeen states plus D.C. have shield laws that pertain to telemedicine, according to Reproductive Health Initiative for Telehealth Equity & Solutions, an organization that advocates for telehealth in reproductive healthcare.

Fourteen states currently ban abortion throughout pregnancy. This has put further distance between providers and many patients compared with before the Dobbs v. Jackson Women’s Health Organization case that eliminated a federal right to an abortion. The court could reinstate protocols that required patients to see a doctor in person three times to receive the pill regimen, effectively blocking telehealth nationwide. If pills could no longer be mailed, women would be forced to travel out-of-state for an abortion.

If the Supreme Court rolls back the FDA’s prior decisions, telehealth for medication abortion and receiving pills via mail would be prohibited, leaving patients to find providers who stock and dispense the pills themselves.

In the states that ban nearly all abortions, 59% of reproductive-age women must drive at least 200 miles to the nearest abortion provider, according to January figures from Caitlin Myers, an economist at Middlebury College who studies the effects of abortion access and maintains a database of abortion facilities. That is up from 3% in the months before the Dobbs decision. Nationally, about 14% of reproductive-age women live at least 200 miles from the closest abortion provider, now.

Despite greater driving distances for many patients compared with pre-Dobbs, the U.S. abortion rate has ticked up since the Dobbs ruling, and an increased share of abortions are via medication, growing from 53% of U.S. abortions in 2020 to 63% in 2023, according to the Guttmacher Institute, a research group that supports abortion rights. A Supreme Court ruling is expected in June.

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