A new website that provides women with medication abortion pills over the internet launched this week, allowing patients to terminate a pregnancy without having to visit a doctor in-person.
Women who visit the site, called Aid Access, first receive an online consultation with a doctor who walks them through the process before sending them the abortion pills mifepristone and misoprostol by mail. From there, women can administer the pills on their own. Aid Access is backed by Rebecca Gomperts, the doctor behind Women on Waves, a group that brings reproductive health services to women in countries with strict anti-abortion laws via a ship that serves as a portable clinic, and Women on Web, the online medical abortion service she founded in 2005.
Abortions via telemedicine has long been popular in countries like Ireland—where abortion was illegal until a recent referendum—as a means by which to obtain an abortion illegally, but safely. In the US, more than ten states allow for telemedicine abortions, and Planned Parenthood clinics in those states have expanded access to their patients by giving patients the option of video-chatting an abortion provider to receive abortion pills, but still require patients to physically visit a clinic and have a member of its staff hand over the medication.
The practice has recently gained more widespread attention in the US amid concern for a future without Roe v. Wade, which reproductive rights activists worry is closer than ever now that Brett Kavanaugh, known for his anti-choice record, has been confirmed to the Supreme Court.
But medical professionals who advocate for telemedicine abortion say it's not solely a back-up plan in the event of Roe v. Wade getting overturned—it's a practical solution to a present where abortion rights don't necessarily equal abortion access for a wide swath of the population.
"The fact of matter is that Roe v. Wade has not guaranteed abortion access for many people for a long time," Yamani Hernandez, the executive director of the National Network of Abortion Funds, a group that helps supplement abortion expenses, tells Broadly. "We think access to medical abortion is part of a vision for the future where people can have the most access possible."
Even with Roe on the books, Hernandez explained, accessing an abortion can be exceptionally difficult for low-income women, women who live in rural areas, or for women who live in states with only one abortion clinic, of which there are seven.
Hernandez's organization tries to account for these gaps in access not just by providing women with financial support, but also by offering them rides to their clinics if they don't have transportation, or offering them places to stay if their abortion clinic is far away and requires multiple appointments. These obstacles often mean women waiting much later to have abortions than they'd like, making the cost of getting one much higher and prohibitive: Being able to obtain an abortion safely, in the comfort of your own home, on your own schedule, could transform women's lives, Hernandez says.
"We’d like to see people not struggle to pay for their health care and we think telemedicine is a huge part of how to make that possible," she says. "Most people want to have choices and flexibility in when and how they have their abortions and make these decisions on their own terms."
Medication abortion, or the practice of terminating a pregnancy with the use of pills, isn't a new phenomenon: The US Food and Drug Administration approved medication abortion in 2000, and in the years since, medication abortion has come to account for at least one-third of all abortion procedures, according to Guttmacher Institute. And telemedicine abortion, which uses medication abortion as its method, has been found to be safe and effective: Last year, The BMJ, a medical research journal, published the results of a study that found 95 percent of telemedicine abortions were successful, with less than 10 percent of women reporting any complications; any who did said they sought supplemental medical help.
Still, as telemedicine abortion becomes more widely discussed, it's become more highly regulated. Guttmacher reports 19 states currently have laws in place requiring doctors to be physically present when administering medication abortion, effectively placing a blanket ban on telemedicine abortion.
Jill Adams, the chief strategist at the SIA Legal Team—an organization devoted exclusively to helping women self-manage their abortions—is working on beefing up both defensive and offensive strategies to anticipate and combat these regulations. In the coming weeks, Adam says the SIA Legal Team is launching a legal help line people can call if they fear being questioned by police or run into any legal trouble when trying to obtain a telemedicine abortion.
But another big part of her work involves education—getting people to see that telemedicine abortion isn't a shady back-alley practice akin to a coat-hanger abortion, but a tried and true method of terminating a pregnancy that can allow women to feel a greater sense of agency and control over their bodies.
"Some people hold a perspective that anything other than care received in-person from someone wearing a white coat is somehow less-than," Adams says. "But there are growing number of people who feel this is more-than.
"It’s not a regression, it’s a progression," Adams continues. "Putting tools and power into people’s hands is an advancement. "