Access to medication abortion is expanding — and conservative states want it stopped


Research shows the procedure is extremely safe and allows an alternative to in-office care. 

During the first year of the coronavirus pandemic, the use of telemedicine became very widespread, and consumers want to keep it that way. Telemedicine use also expanded for medication abortion, but that expansion also seems to be fueling increased attacks on telehealth access.

The Trump administration went all the way to the Supreme Court seeking to block the FDA from suspending in-person dispensing requirements during the pandemic for a drug used in a medication abortion. In January 2021, it succeeded, with the Supreme Court ruling 6-3 in its favor. However, since President Joe Biden has taken over at the White House, the FDA has issued guidance waiving in-person dispensing requirements for medication abortion drugs for the duration of the pandemic, finding no "serious safety concerns" with doing so.

While Biden's administration might seem like it's creating a favorable landscape for better access to abortion, there is also a backlash brewing as conservative legislators increase their efforts to ban the use of telemedicine for abortion. 

For example, in Indiana, medication abortions accounted for the majority of abortions in 2020, with 54% of procedures being nonsurgical. That's a big leap from 2019, when only 43% of abortions in the state were medication abortions. Conservatives in the Indiana Legislature responded in April 2021 by banning the use of telehealth for medication abortions. That ban was just overturned by a federal judge, prompting an anti-abortion group, Indiana Right to Life, to say that the ruling "will directly lead to a massive expansion of chemical" abortions in Indiana and that it "jeopardizes the health and safety of women. 

The opposite is true. Medication abortion is extremely safe, with less than 0.4% of patients having any serious complications. Further, the use of telemedicine for abortion is also very safe and provides an alternative for people who can't obtain an abortion in person. 

That may be why telemedicine for the procedure has come under fire in multiple states. Montana passed a ban on telehealth abortion services earlier this year, and Planned Parenthood has just sued to block the law. Ohio's telemedicine ban, signed into law in January 2021 in the very heart of the coronavirus pandemic, was blocked by a judge in April 2021.

While the overall number of abortions in the United States has declined, the percentage of abortions that are medication abortions is increasing. New research shows that abortion rates drop dramatically as the distance to a clinic grows. That same research focused on "spatial inequalities" — that access to abortion isn't evenly offered across the country, but is especially tenuous in rural, sparsely populated areas. 

Telehealth medication abortions solve this problem by making abortion available anywhere in a state, regardless of distance from a clinic. That's precisely why it may represent such a threat to anti-abortion activists and legislators.

Published with permission of The American Independent Foundation.