Telehealth Played Role in Medication Abortion Spike

In 2020, medication abortions accounted for 54 percent of all abortions performed in the US, a growing trend supported by the increase in telehealth use, according to a new report.

Released by the Guttmacher Institute, the report includes data from a survey conducted every three years to collect information about abortion services nationwide, including the number of medication abortions provided. The survey collecting information for 2019 and 2020 is ongoing, but the institute has published preliminary data obtained from approximately 75 percent of US clinics that provided abortion care in 2020.

The preliminary data shows that medication abortions have risen significantly in recent years, from 39 percent in 2017 to 54 percent in 2020.

A major reason for this jump is the spike in telehealth use during the COVID-19 pandemic. In April 2020, the Food and Drug Administration announced it would allow abortion pills, like mifepristone, to be mailed to patients for the duration of the pandemic. This enabled the prescription of medication abortions via telehealth. Last December, the FDA made this temporary allowance permanent.

But some states are restricting access to medication abortions in various ways, including requiring clinicians who administer medication abortions to be physicians and banning the use of medication abortions after seven weeks of pregnancy, even though at the federal level, medication abortions are allowed through 10 weeks of pregnancy.  

Not only that, but some states are also limiting medication abortion access through telehealth. Nineteen states require the clinician providing medication abortions to be physically present when the medication is administered, which prevents clinicians from prescribing the drug through telehealth and allowing the patient to take it in their homes.  

Further, mailing abortion pills to patients is banned in Arizona, Arkansas, and Texas.

Courts have blocked similar mailing bans in Montana, Oklahoma, and South Dakota. Still, bills have been introduced to enforce the mailing ban in other states like Georgia, Kentucky, Maryland, Massachusetts, and Nebraska.

Eight states — Georgia, Iowa, Kentucky, Massachusetts, Minnesota, Nebraska, South Dakota, and Tennessee — have introduced legislation prohibiting the use of telehealth to provide medication abortions.

"Looking at this landscape, states with policies supportive of abortion rights must redouble their efforts to further codify, reinforce and expand those protective policies," report authors wrote. "Federal action is also needed to put a stop to the barrage of state-level restrictions and attempts at outright bans on the use of medication abortion."

With the possibility of Roe v Wade, the landmark abortion rights case, being overturned by a conservative-majority Supreme Court this year, abortions rights providers and activists are working to ensure continued care access, including through telehealth.