Loveland Reporter-Herald

States target medication access


About 40% of all abortions in the U.S. are now done through medication — rather than surger y — and that option has become all the more pivotal during the COVID-19 pandemic.

Abortion rights advocates say the pandemic has demonstrat­ed the value of medical care provided vir tually, including the privacy and convenienc­e of abortions taking place in a woman’s home, instead of a clinic. Abortion opponents, worried the method will become increasing­ly prevalent, are pushing legislatio­n in several Republican­led states to restrict it and in some cases, ban providers from prescribin­g abortion medication via telemedici­ne.

Ohio enacted a ban this year, proposing felony charges for doctors who violate it. The law was set to take effect next week, but a judge has temporaril­y blocked it in response to a Planned Parenthood lawsuit.

In Montana, Republican Gov.

Greg Gianforte is expected to sign a ban on telemedici­ne abortions. The measure’s sponsor, Rep. Sharon Greef, has called medication abortions “the Wild West of the abortion industry” and says the drugs should be taken under close super vision of medical profession­als, “not as part of a do-it-yourself abortion far from a clinic or hospital.”

Opponents of the bans say telemedici­ne abortions are safe, and outlawing them would have a disproport­ionate effect on rural residents who face long drives to the nearest abortion clinic.

“When we look at what state legislatur­es are doing, it becomes clear there’s no medical basis for these restrictio­ns,” said Elisabeth Smith, chief counsel for state policy and advocacy with the Center for Reproducti­ve Rights. “They’re only meant to make it more difficult to access this incredibly safe medication and sow doubt into the relationsh­ip between patients and providers.”

Other legislatio­n has sought to outlaw delivery of abortion pills by mail, shorten the 10-week window in which the method is allowed, and require doctors to tell women undergoing drug-induced abortions that the process can be reversed midway through — a claim that critics say is not backed by science.

It’s part of a broader wave of anti-abortion measures numerous states are considerin­g this year, including some that would ban nearly all abortions. The bills’ supporters hope the U.S. Supreme Court, now with a 6-3 conservati­ve majority, might be open to overturnin­g or weakening the 1973 Roe v. Wade decision that establishe­d the nationwide right to end pregnancie­s.

Legislatio­n targeting medication abortion was inspired in par t by developmen­ts during the pandemic, when the Food and Drug Administra­tion — under federal court order — eased restrictio­ns on abor tion pills so they could be sent by mail. A requiremen­t for women to pick them up in person is back, but abortion opponents worry the Biden administra­tion will end those restrictio­ns permanentl­y. Abortion-rights groups are urging that step.

With the rules lifted in December, Planned Parenthood in the St. Louis region would mail pills for telemedici­ne abortions overseen by its health center in Fairview Heights, Illinois.

A single mother from Cairo, Illinois, more than a two-hour drive from the clinic, chose that option. She learned she was pregnant just a few months after giving birth to her second child.

“It wouldn’t have been a good situation to bring another child into the world,” said the 32-year-old woman, who spoke on the condition her name not be used to protect her family’s privacy.

“The fact that I could do it in the comfor t of my own home was a good feeling,” she added.

She was relieved to avoid a lengthy trip and grateful for the clinic employee who talked her through the procedure.

“I didn’t feel alone,” she said. “I felt safe.”

Medication abortion has been available in the United States since 2000, when the FDA approved the use of mifepristo­ne. Taken with misoprosto­l, it constitute­s the so-called abor tion pill.

The method’s popularity has grown steadily. The Guttmacher Institute, a research organizati­on that supports abortion rights, estimates that it accounts for about 40% of all abortions in the U.S. and 60% of those taking place up to 10 weeks’ gestation.

“Beyond its exceptiona­lly safe and effective track record, what makes medication abortion so significan­t is how convenient and private it can be,” said Megan Donovan, Guttmacher’s senior policy manager. “That’s exactly why it is still subject to onerous restrictio­ns.”

Planned Parenthood of Southwest Ohio, which includes Cincinnati, says medication abor tions account for a quar ter of the abor tions it provides. Of its 1,558 medication abor tions in the past year, only 9% were done via telemedici­ne, but the organizati­on’s president, Kersha Deibel, said that option is important for many economical­ly disadvanta­ged women and those in rural areas.

Mike Gonidakis, president of Ohio Right to Life, countered that “no woman deser ves to be subjected to the gruesome process of a chemical abortion potentiall­y hours away from the physician who prescribed her the drugs. ”

In Montana, where Planned Parenthood operates five of the state’s seven abortion clinics, 75% of abortions are done through medication — a huge change from 10 years ago.

Martha Stahl, president of Planned Parenthood of Montana, says the pandemic — which increased reliance on telemedici­ne — has contribute­d to the rise in the proportion of medication abortions.

In the vast state, home to r ural communitie­s and seven Native American reservatio­ns, many women live more than a five-hour drive from the nearest abortion clinic. For them, access to telemedici­ne can be significan­t. Greef, who sponsored the ban on telemedici­ne abortions, said the measure would ensure providers can watch for signs of domestic abuse or sex traf ficking as they care for patients in person.

Yet advocates of the telemedici­ne method say patients are grateful for the convenienc­e and privacy.

“Some are in a bad relationsh­ip or victim of domestic violence,” said Christina Theriault, a nurse practition­er for Maine Family Planning who can perform abortions under state law. “With telemedici­ne, they can do it without their partner knowing. There’s a lot of relief from them.”

The group has health centers in far northern Maine where women can get abortion pills and take them at home under the supervisio­n of health providers communicat­ing by phone or videoconfe­rencing. It spares women a drive of three to four hours to the nearest abortion clinic in Bangor, Theriault said.

Maine Family Planning is among a small group of providers participat­ing in an Fda-approved research program allowing women to receive the abortion pill by mail after video consultati­ons. Under the program, the Maine group also can mail pills to women in New York and Massachuse­tts.

 ?? MARK WILSON / Getty Images ?? The U.S. Supreme Court is reflected in the glasses of pro-life protestor Kim Lockett who wears red tape that reads LIFE during the Right To Life March on Jan. 18, 2019 in Washington.
MARK WILSON / Getty Images The U.S. Supreme Court is reflected in the glasses of pro-life protestor Kim Lockett who wears red tape that reads LIFE during the Right To Life March on Jan. 18, 2019 in Washington.

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