Approximately 88% of U.S. counties don’t have an abortion provider and most of them are rural. Many women in America live hundreds of miles from their nearest abortion provider making it incredibly complicated for them to seek an abortion if they want one. Planned Parenthood of the Heartland, which serves Iowa and Nebraska, has begun a process that helps alleviate some of the complexity for its patients. In Iowa, they offer telemedicine abortions, meaning that after an in-person examination with a nurse practitioner and a video conference examination with a doctor; the medications used in a non-surgical abortion can be released to the patient while the doctor observes. This technique has been used in various medical procedures in numerous venues; including the U.S. Military when soldiers are stationed in remote areas without immediate access to medical care.
The procedure itself is considered safe and effective, especially with the lack of primary care physicians available in the U.S. The doctor, while being several hundred miles away, can use a web cam and specially designed equipment to give a patient the same kind of examination they would get in person. They can monitor heartbeats using a stethoscope connected to a computer; they can check ears, throats and noses using a camera attachment. A webcam can be used to inspect any injuries that need to be examined. The doctor can then prescribe any number of medications they are authorized to release. It’s a fairly simple process and is used by many specialties in Iowa including cardiology and dermatology.
When it comes to patients in rural areas, the benefits of telemedicine are hard to argue against. Since it is being used for abortions, the anti-abortion movement apparently feels the need to try. One argument they have is that a physical examination isn’t done because the doctor isn’t in the room with the patient. While it is true that the doctor is not physically present in the room, it does not mean no physical exam is done. Many aspects of a physical exam can and are done by a nurse practitioner. The results of these exams are then electronically sent to the doctor so they can review them; this includes the ultrasound verifying pregnancy. The rest of the exam and a consultation are done via a video conference with the doctor. A new study out of Iowa shows that not only is this method of abortion safe and effective, the women getting it are comfortable with it and don’t feel they are missing out on anything.
Another argument is that if there is no doctor present during the procedure the woman will have nowhere to turn for assistance if she experiences any complications. Medical abortions are incredibly safe and serious complications are rare. If a patient were to experience serious enough complications to warrant an emergency; she would be referred to her nearest ER, regardless of the doctor’s physical proximity. Abortion foes also like the argument that if a women experiences complications and goes to the ER, the doctors there may be unfamiliar with how to treat the side effects of a medical abortion.
The entire concept of that seems a little forced. I mean, correct me if I’m wrong but isn’t the entire purpose of an ER to treat whatever medical emergencies come through the door? If they happen to be unfamiliar with one particular situation, they should at a minimum know where to turn to get the information needed to treat the problem. (Check here for information on anti-abortion arguments against telemedicine for abortions, but FYI, it is a “pro-life” site.)
To me is seems just a little ridiculous to use these arguments to ban women from getting abortions via telemedicine but lawmakers in a number of states have tried, and in a few they have succeeded. Lawmakers in Arizona, Kansas, North Dakota, Nebraska, and Tennessee have passed legislation banning abortions through telemedicine. As of July 21st, a judge in North Dakota has issued a temporary restraining order blocking the law from being enforced, determining that the Center for Reproductive Rights (who represented Planned Parenthood in the case) raised “serious questions” and stated that “the public is best served if these questions are considered before the challenged provisions are enforced.” The formal hearing is scheduled to begin on August 29th.
For more information on the general practice of telemedicine, check out this video: