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Editorial: New abortion rule too political

BY DI EDITORIAL BOARD | OCTOBER 11, 2013 5:00 AM

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The recent controversy over telemedicine abortion in Iowa illustrates the dangers of allowing a partisan body to make regulatory decisions concerning medical care. With respect to telemedicine abortion, the process by which a physician remotely administers medication to induce an abortion, the state has placed a greater value on politics than medicine.

On Monday, a legislative committee voted along partisan lines to move forward with a new rule that bans telemedicine abortion in Iowa. Five Republicans voted to uphold the ban, which would take effect on Nov. 6, four Democrats voted against the ban.

The telemedicine abortion ban was originally approved by the Iowa Board of Medicine at the end of August by an 8-2 vote. That board is made up entirely of individuals appointed by Republican Gov. Terry Branstad.

Now that the rule has been approved by two partisan votes, it can be overruled only by the courts. Legal proceedings are underway, but it is unclear whether judicial action will stop the new rule from taking effect next month.

Currently, telemedicine abortions are provided by Planned Parenthood of the Heartland at 15 clinics around the state. Physicians consult with patients via teleconference prior to remotely administering drugs that terminate pregnancies. Since 2010, these clinics have provided more than 3,000 medical abortions.

Medical abortions, an alternative to surgical abortions, were approved by the Food and Drug Administration and are, by most accounts, very safe. Between 2000 and 2011, according to the FDA, approximately 1.5 million medical abortions were administered in the United States. During that period, 14 women died of complications from the medication.

There is little reason to believe that telemedicine medical abortions are any less effective than medical abortions provided in person. A study published in the journal Obstetrics and Gynecology pointed out the effectiveness 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 more likely to say they would recommend the service to a friend compared with face-to-face patients.

Concerns about the procedure posed by the Board of Medicine were mostly based on semantics. The members argued that because telemedicine abortions are not administered directly by a physician, they do not meet the basic safety requirements for abortions in Iowa.

And yet, the board did not present any evidence that physician-supervised remote abortions have led to any medical problems that would not have occurred during a face-to-face procedure.

While the negatives criticisms of telemedicine are mostly hypothetical, the benefits are real. A study published in the American Journal of Public Health in December 2012 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.

Telemedicine can also improve access to abortion services in parts of Iowa where physicians may not be readily available.

The benefits of telemedicine abortion are myriad, the drawbacks minimal. Opposition to the procedure amounts to little more than an injection of partisan politics into legitimate medical practices.


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