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Editorial: Keep telemedicine abortion intact

BY DI EDITORIAL BOARD | JULY 01, 2013 5:00 AM

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The Iowa Board of Medicine has responded to a petition seeking new state regulations on the practice of doctors administering abortions via videoconference.

The board voted 8-2 on June 28 to initiate the state’s rulemaking process. Although the vote does not prohibit “webcam abortion” — as critics of the practice are wont to call it — it allows for a public comment period along with a final vote by the board later this year.

The petition was initiated by 14 medical professionals, including at least five Iowa doctors, and is backed by Iowa Right to Life — a Des Moines group opposed to abortion. Despite the objections of its legal director and representatives from the Iowa Attorney General’s Office, the Board of Medicine pushed ahead with this new rule.

The board should not act to restrict telemedicine abortion in Iowa.

Iowa was actually the first state in America in 2008 to use a remote-controlled pill-dispensing system to increase the availability of abortions in areas without doctors to administer them. The board’s ruling could be a step backward in ensuring equal access to health care among all populations, as well as in the advancement of medicine.

Currently, Planned Parenthood of the Heartland is the main organization that provides pregnancy-terminating drugs using a video-conferencing system. The patient takes the drug with a Planned Parenthood staff member present and while in video contact with a doctor. The patient then receives a second drug and instruction on how to take it within 24 to 48 hours. A follow-up visit is scheduled within two weeks.

Petitioners claim that this method of administering is not consistent with standards of medical practice and that it goes against Food and Drug Administration guidelines for dispensing the drug.

“Given the risks associated with inducing an abortion with an abortion-inducing drug, it is inappropriate for a physician to provide such a drug remotely by use of a webcam or other telemedicine device,” the petition states.

However, the petitioners’ claims are not substantiated by any accredited medical studies.

On the other hand, a study published in the American Journal of Public Health last December shows the positive effects that telemedicine can have.

According to the study, the abortion rate decreased in Iowa after the introduction of telemedicine. The study also found a decline in the number of abortions done in the second trimester, when the risk of complications is higher.

Furthermore, women who obtained abortions via telemedicine are satisfied with the procedure.
Another study published in the journal Obstetrics and Gynecology pointed out the effectiveness and acceptability of telemedicine abortions in comparison with a face-to-face visit with a Planned Parenthood affiliated physician.

Of all the study’s participants, the proportion with a successful abortion was 99 percent for telemedicine patients versus 97 percent for face-to-face patients. In addition, telemedicine patients were found more likely to say they would recommend the service to a friend compared with face-to-face patients. Only 25 percent of telemedicine patients said they would have preferred to be in the same room with the doctor; this preference was strongly associated with younger age, less education, and the number of times the woman had given birth before.

Overall, the study proved that telemedicine abortions are effective and widely accepted by women who pursue such abortions.

There were 1,020 abortions performed by telemedicine in Iowa during fiscal 2010.

Telemedicine has made available abortions to numerous women who were very unlikely to obtain surgical abortions because of a variety of reasons, such as the lack of clinics offering abortions in rural Iowa.

The practice should be encouraged, and steps should be taken to further improve the condition under which such abortions are provided so that more women who may still not have access to an abortion in the state will no longer lack a choice.


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