As our nation addresses the COVID-19 pandemic, some abortion advocates are pushing to eliminate chemical abortion regulations in an effort to send abortion pills through the mail.
Unchallenged by the media, they claim existing federal protections are antiquated, and at-home abortions minimize travel and the use of scarce resources such as personal protective equipment. They propose a system where a woman could video chat with a doctor who would either mail the pills to her home or call them into a pharmacy or clinic where someone could pick them up.
The nation’s current version of “telemed abortion” achieves none of their goals, except, of course, terminating a pregnancy, so they have proposed a regime that removes already limited safeguards and places women in real danger.
The “chemical abortion pill” is actually a regimen of two drugs, mifepristone and misoprostol. In most states, a woman takes the first pill on-site and the second pill later at home. As the world-renowned University of California, San Francisco, Health Center states, “a medical abortion involves at least two visits to a doctor’s office or clinic.”
In a telemed abortion, a woman goes to a clinic to obtain an ultrasound with a technician. There she consults with a physician by video chat, and if she is determined to be a medically appropriate candidate for the drug, the doctor remotely unlocks a drawer and sees her take out the pills.
One to three weeks after taking the pills, the woman returns to her provider for a follow-up visit. This follow-up visit is so critical the Mayo Clinic states that “medical abortion isn’t an option if you … can’t make follow-up visits to your doctor or don’t have access to emergency care” [emphasis in original].
To recap, under the current regime, a “telemed abortion” still involves at least two visits to a healthcare provider, whether that is the prescribing doctor or an ultrasound technician before the abortion and the doctor again for follow-up care. Each visit requires travel from the woman’s home to the clinic and use of personal protective equipment.
The solution then, if you ask the abortion advocates, is to simply send the pills directly to the woman in the mail after she video chats with a doctor. But the cost savings of travel and protective equipment become the woman’s health and safety.
It takes a pretty shoddy doctor to run roughshod over federal regulations and send out any type of pill without any confirmation of whether the woman is a medically appropriate candidate for the drug or even whether the recipient is the one who takes it.
There are a number of factors that determine whether a woman is medically eligible for the chemical abortion pill: medical history, gestational age of the pregnancy, and ruling out an ectopic pregnancy.
Chemical abortion is ineffective in terminating an ectopic pregnancy and cannot be used after the first 70 days of pregnancy due to the heightened risk to the woman’s health. Neither of these critical factors can be determined at home by the woman herself, which is why under current “telemed abortion” protocol she has an ultrasound prior to receiving the pills.
Even if the woman is a medical candidate for the abortion pill, the doctor must confirm she is not being coerced by a partner, parent, or abuser. The doctor must also ensure that she is the one who will be taking the pills and that it is not a straw purchase for someone else.
This is why at least 20 states require that the pills be supplied directly from the physician in the clinic. Traffickers and abusers love the idea of relaxing telemed abortion because it becomes easier to use chemical abortion to cover up their crimes. Remember that time a man ordered abortion pills online from India for a New York Times story?
It is impossible to reach the medical or social certainty needed to prescribe abortion pills through video chat. Telemed abortion without limitation would increase the likelihood of coerced abortion or that the pills are taken by someone who is not medically eligible for the drug regimen, raising the rate of severe health complications.
After a chemical abortion, it is imperative the woman visit a clinic for follow-up care. The doctor must check that the pregnancy is fully terminated and assess whether the woman is suffering from any physical or psychological effects of the abortion and treat them. This is especially important as most Americans self-quarantine, which can exacerbate anxiety and depression. Now more than ever, post-abortive women cannot be left to suffer alone.
Ultimately, loosening chemical abortion regulations only benefits unscrupulous doctors and abusers, at the cost of the physical and emotional health of women and girls.
While telemedicine has many beneficial applications, especially during this period of national crisis, abortion is not one of them.
Katie Glenn (@KatieGlenn_) is a contributor to the Washington Examiner’s Beltway Confidential blog. She is the government affairs counsel at Americans United for Life (@AUL).
