How technology could preserve abortion rights

Abortion rights advocates are exploring how technology might preserve or even expand women’s access to abortion if the Supreme Court scales back Roe v. Wade.

A nonprofit group is testing whether it’s safe to let women take abortion pills in their own homes after taking screening tests and consulting with a doctor on their phones or computers. Because the study is part of an FDA clinical trial, the group isn’t bound by current rules requiring the drugs be administered in a doctor’s office or clinic.

The group, called Gynuity Health Projects, is carrying out the trial in five states that already allow virtual doctors to oversee administration of the abortion pill, and may expand to others. If the trial proves that allowing women to take the pill at home is safe — under a virtual doctor’s supervision — the group hopes the FDA could eventually loosen restrictions to allow women to take pills mailed to them after the consult.

If FDA took that step, it could even help women in states with restrictive abortion laws get around them, potentially blurring the strict boundaries between abortion laws in different states if — as is likely — the Senate confirms a high court justice who is open to further limits on Roe.

Telemedicine “will become much more of a flashpoint because medication abortion is a method so many patients [are] looking to use,” said Elizabeth Nash of the Guttmacher Institute, a research group that supports abortion rights.

Right now, even in states that allow a licensed provider to administer the abortion pill by video hookup, the provider must watch, in person or by video, as a woman takes the first medication in a clinic or other health care setting. The drugs abort the fetus without surgery but are safe and effective only in the first 10 weeks of pregnancy. If the group’s study shows it’s safe for women to administer the drug themselves after an online consultation with a health care provider, it will petition the FDA to lift the requirement.

If that were to occur — a big “if” under a Republican administration — states with more permissive abortion laws could expand access to the procedure to clinics served by video hookups, effectively reducing the long distances many women often travel to find a provider.

But it could also potentially boost access for women living in states with more restrictive laws as they might have an easier time obtaining prescriptions by mail, besides having a greater number of telemedicine clinics to go to if they were able and willing to travel across state lines.

“We know even now that some women are accessing these medications online — it may not be strictly legal, but people are doing that,” said Daniel Grossman, a University of California, San Francisco researcher who has studied the safety of telemedicine abortions. “It would be a hard thing to crack down on.”

Grossman notes that women in other countries that prohibit abortion have used the internet to buy abortion pills by mail and get around restrictions.

Not everyone is convinced, however.

“It could open some doors,” Nash said. “Still, people [in restricted states] would have to jump through hoops.”

For example, restrictions on waiting periods and a counseling requirement would apply, and doctors who prescribe the pills would still have to be licensed in the state where the patient resides — though patients don’t usually face penalties for failing to comply with state abortion laws.

“All of the burden falls to the provider,” she said. “But if the state wanted to, there’s potential for women to be charged in some way.”

Anti-abortion lawmakers in Texas wouldn’t speculate on whether they might change state law to impose penalties on patients if the FDA loosened regulations on telemedicine abortion, but they believe existing restrictions in the state’s telemedicine law, which are being challenged in court, would prevent women from obtaining the medicines remotely.

Gynuity, which is currently enrolling patients in Maine, Hawaii, Oregon, New York and Washington state, plans to expand the telehealth-abortion study to women in other states where telemedicine for abortion has not been outlawed.

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