Telemedicine abortion for early pregnancy is safe and technically feasible. Yet states across the nation have moved to ban remote abortion services. Many of the same states that ban telemedicine abortion have also capitalized on the COVID-19 crisis to close abortion clinics, endangering the lives and health of pregnant people.
Is Telemedicine Abortion Safe?
Telemedicine abortion might seem like an odd concept, especially to people who conceive of abortion as a surgical procedure. But the approval of medication abortions revolutionized pregnancy terminations. Fully 40% of abortions in the U.S. happen via pill. Most experts say the figure would be even higher if the FDA relaxed politically motivated restrictions on the abortion pill. In Europe, between 60 and 90% of abortions occur via pill.
Telemedicine abortion services pair a person seeking an abortion with a doctor who can evaluate whether medication abortion is safe. The woman then takes the pill in the comfort of her own home, and follows up with the telemedicine service if she has any questions or complications.
A 2017 study found that telemedicine abortion is just as safe as medical abortion performed in the presence of a doctor. In-person abortion patients had a complication rate of 0.32 percent. The telemedicine complication rate was lower, at 0.18 percent. None of the 8,765 telemedicine patients in the study died or required surgery.
Pregnancy complication rates are exponentially higher. Between 50,000 and 70,000 women each year suffer disabling and life-threatening pregnancy complications. The U.S. has the highest maternal mortality rate in the developed world.
How Access to Telemedicine Abortion Could Save Lives
The U.S. maternal mortality rate is rising. As COVID-19 further taxes a collapsing healthcare system, it will almost certainly skyrocket. Many hospitals are already forcing pregnant people to give birth alone, leaving them with no advocate—and because nurses cannot possibly be with a birthing person for the entirety of the birth, complications may go unnoticed. Now is a particularly dangerous time to give birth, even for a nation that’s already losing pregnant women at an alarming rate.
All birthing people face the reality that pregnancy can be fatal. For those denied abortions, the data is even grimmer. The Turnaway Study, which compares women who sought but were denied abortions because of state restrictions to women who underwent abortions, suggests significantly worse outcomes in those forced to continue their pregnancies. They have worse mental health, higher poverty rates, and are more likely to end up in abusive relationships.
The study found a 1% maternal mortality rate among people denied abortions—much higher than the national average of 0.02%. This figure is also likely to increase, particularly among the 6 to 9 percent of women with high-risk pregnancies. They may face long care delays, inadequate emergency treatment, and slow responses to birth-related emergencies.
Even for healthy people, the many medical appointments pregnancy demands present a serious risk during a pandemic. One recent study found that nearly 14 percent of pregnant women tested prior to giving birth had COVID-19.
Preserving the right to end a pregnancy early protects women from the many dangers of giving birth in an inadequate maternity care system. It may also save them from the many economic challenges of an unwanted pregnancy. At a time when our nation’s economic future is uncertain and unemployment rates are steadily increasing, this may mean the difference between a decent life and long-term poverty.
The State Push to Ban Telemedicine Abortion
In spite of evidence that telemedicine abortion is safe and counter to the mountain of data that proves abortion saves lives, 17 states have banned telemedicine abortion services. Even when telemedicine pregnancy terminations are legal, insurers may refuse to cover treatment. Conscience laws make it possible for pharmacists to refuse to fill prescriptions.
Anti-choice lawmakers know that banning abortion doesn’t end it; it just makes it unsafe. Eight percent of Texas women have already attempted to self-induce an abortion. Their concern has never been for the life of babies. That’s why they’re comfortable diverting funds for children to anti-choice clinics, why they continue to fight any attempt to cover healthcare for children and pregnant women, why they consistently oppose policies that could safely lower the abortion rate, and why they’ve pushed the death penalty for abortion.
The goal here is not to protect life. It’s to punish women.