Planned Parenthood Challenges Montana's Ban on Telemedicine Abortions

Planned Parenthood is suing the state of Montana over recently-passed legislation that would ban the use of telehealth in abortions.

The national organization’s Montana chapter has filed a 57-page lawsuit that seeks to overturn four bills passed by the state Legislature and approved by Governor Greg Gianforte this past year. One of those bills is HB 171, which prohibits telemedicine consults in medication abortions, prohibits the dispensation of abortion-inducing medications through the mail and mandates at least two in-person appointments – with 24-hour waiting periods in between – for patients seeking an abortion.

“These laws are nothing more than poorly disguised attempts to chip away at Montanans' access to safe and constitutional abortion,” the lawsuit states. “They will reduce the number and geographic distribution of locations in Montana where women can access safe and effective abortion care. Their combined effect is particularly cruel and prohibitive-pushing women seeking abortion later into pregnancy and also cutting off access to abortion at an earlier gestational age.”

The suit seeks a permanent injunction against the four bills, which are set to become law on October 1.

According to Planned Parenthood, which operates five of the state’s seven clinics, 715 women underwent a medical abortion with the aid of telehealth during the fiscal year spanning 2020 and 2021, primarily by having the procedure done in a clinic and engaging in virtual visits with a care provider. The organization has said in the past that three-quarters of all abortion in the state are done with medication.

Gianforte has often touted the state’s adoption of telehealth, though not for abortion services. In April, he signed legislation that permanently expands coverage of and access to telehealth services that were put in place during the pandemic. At that same time he signed the four bills now being challenged by Planned Parenthood.

Abortion advocates say telemedicine abortions – in which doctors use a virtual care platform to prescribe mifepristone and misoprostol to terminate early pregnancy – are vital to women who can’t easily access health clinics, particularly in rural and remote parts of the country or regions where abortion services are denied. They often point to a 2019 study conducted by researchers from Ibis Reproductive Health and University of California San Francisco’s (UCSF) Advancing New Standards in Reproductive Health (ANSIRH), which found that telemedicine abortions are as safe as those conducted by a doctor in a clinic.

Opponents have said the procedure is unsafe, noting the drugs used are included in the US Food and Drug Administration’s Risk Evaluations and Mitigation Strategies (REMS) protocol, which requires that drugs determined to be risky be dispensed in a healthcare setting under the direct supervision of a certified care provider, and that patients be advised of the drug’s dangers.

Demand for medication abortions had been growing, due to aggressive efforts to shut down clinics and outlaw the procedure and the stresses placed in in-person care by the pandemic. According to the Guttmacher Institute, almost 40 percent of all abortions were conducted with medication in 2017, up from only 5 percent in 2001.

Supporters of the Montana bills argue that medication abortions are unsafe, regardless of whether telehealth is used.

“I don’t even think of it really as an anti-abortion bill,” Rep, Sharon Greef, who sponsored HB 171, told the Montana Free Press after the lawsuit was filed. “This is a bill that protects women.”

Montana’s attorney general, Austin Knudsen, vowed to fight the lawsuit.

“Montana voters overwhelmingly rejected Planned Parenthood’s … and the Democrats’ extreme pro-abortion positions,” he told the Free Press. “I look forward to defending these clearly valid statutes and to protecting the lives of the unborn.”

The lawsuit comes just days after a federal judge in Indiana ruled against that state’s efforts to ban the use of telemedicine in abortions.

US District Judge Sarah Evans Barker ruled on Tuesday that state laws banning telehealth and requiring in-person exams by a doctor prior to a medication abortion aren’t Constitutional, and that a state that is using telehealth for so many other services hasn’t proven that it’s unsafe in this case.

“The State’s attempt to explain its basis for excluding the far-reaching benefits of telemedicine from this category of patients is feeble at best, especially given the widespread use of telemedicine throughout Indiana as well as the overall safety of medication abortions,” she wrote in a 158-page ruling issued on August 10.