As with many aspects of healthcare, the coronavirus crisis has pushed many would be in-person doctor visits to become virtual visits, and abortions are no different.
All but 18 states allow abortion medications like mifepristone to be prescribed virtually, and as of late more and more abortion providers have reported a rise in demand from women seeking medication abortions via virtual telehealth visits. This comes as no surprise as a recent survey showed that 36% of patients would actually leave their provider for one that offered telehealth services.
“I think what [patients are] seeing is that most of their health care has moved to an online or a tele-platform, so we are constantly getting folks asking questions about that.” Dr. Colleen McNicholas, an abortion provider in Illinois, Kansas, Missouri, and Oklahoma, told NPR.
Unfortunately for Dr. McNicholas’ patients in Missouri and Oklahoma, the prescribing clinician must be in the physical presence of the patient according to state laws. In New York, however, where the abortion laws are different, the use of telehealth for early stage abortions and other reproductive health care procedures has increased due to COVID-19.
That said, federal law in the United States still restricts how mifepristone is distributed. According to NPR, “Mifepristone is regulated by the Food and Drug Administration under what’s called a Risk Evaluation and Mitigation Strategy, a designation the agency uses for extra safety oversight that affects how a medication is distributed.” The Risk Evaluation and Mitigation Strategy, or REMS, restrictions “mean that mifepristone is not available in commercial pharmacies,” and therefore a physician can’t prescribe it for pickup at a local CVS or Walgreens.
Instead, a patient needs to go to a clinic or hospital that is a designated mifepristone distributor, and sign a release form that says she understands the risks associated with taking the medication. Even that’s still more convenient than the alternative in Missouri, Oklahoma, and 16 other states.
Dr. Meera Shah, Chief Medical Officer of Planned Parenthood Hudson Peconic in Mount Vernon, New York said she “had a patient the other day who is an an emergency responder who was sitting in her ambulance and accessed abortion care via telemedicine and then drove her ambulance to our health center to pick up the meds.”
Regarding patient outcomes, a 2019 study which assesed the outcomes of medication abortions provided through telemedicine versus with standard medication abortion at Planned Parenthood health centers in four U.S. states concluded that “outcomes for medication abortion provided through telemedicine are comparable with standard provision of medication abortion.”
While abortion may be a polarizing topic, this use case demonstrates the transformative potential of telemedicine both now and in the future. After all, telemedicine can be an effective tool for any doctor in addressing a variety of conditions.