This September 2010 photo shows bottles of the abortion-inducing drug RU-486 at a Planned Parenthood of the Heartland clinic in Des Moines, Iowa, where doctors can remotely prescribe it using a telemedicine terminal.
While the pills are typically taken at home, Food and Drug Administration restrictions have long mandated that one of the drugs, mifepristone, be dispensed in a medical setting. In practice, that means patients must travel to an abortion clinic ― often many miles away ― to pick up a drug that could just as easily be mailed. Leading medical groups oppose the FDA requirement, saying it is especially harmful to poor and rural women.
Daniel Grossman, a professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco, said it was impossible to know how many clinicians providing medication abortion have started mailing mifepristone or how many patients are eligible. Allowing patients to skip coming into the clinic and providing the service through telemedicine is the safest model of care right now during the COVID-19 pandemic, he added.
“All of these barriers may make it difficult for patients to get into a clinic before the 10-week gestational age limit for medication abortion,” Grossman said. “One of the things that we did early on during the pandemic was to talk about how we can provide abortion care that is very patient-centered and less clinically centered,” Mark said.
In 18 states, clinicians must be physically present when medication abortion is administered to patients, barring the use of telemedicine. Those states include ones where COVID-19 is on the rise, such as Oklahoma, Missouri and Nebraska. Even with the federal injunction, patients in those states must still go to a clinic to get the pills. In other states where telemedicine is not explicitly banned for abortion, clinics are treading carefully to ensure they are complying with all the rules.
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