Federal Judge Shoots Down Indiana's Ban on Telemedicine Abortions

A federal judge has shot down Indiana’s ban on telemedicine 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.

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.

Indiana officials told the Associated Press that medication abortions accounted for a majority of all abortions in the state for the first time in 2020, making up roughly 55 percent of the 7,756 recorded abortions.

Barker issued a permanent injunction against the ban on telehealth and the requirement that in-person exams precede an abortion, as well as on recent state laws that women seeking an abortion be told that life begins when the egg is fertilized and that a fetus might feel pain before 20 weeks. She also shot down the state’s ban on second-trimester abortions outside hospitals or surgery centers.

State Attorney General Todd Rokita vowed to appeal the decision, saying the state would “continue to fight to defend Indiana’s commonsense abortion laws and to build a culture of life in Indiana.” The ruling was also panned by Indiana Right to Life, while the Whole Women’s Health Alliance, which had filed suit against the laws, praised it.