State medical board outlaws telemed abortions

The Iowa Board of Medicine voted 8-2 Aug. 28 to outlaw telemedical abortions in the state, leading to mixed reactions locally.

During a telemed abortion, which is also referred to as a webcam abortion, a patient communicates with a doctor via a webcam and is given two pills, one taken immediately, which ends the pregnancy by breaking down the lining of the uterus, and the second, taken three days later to empty the uterus by ejecting the fetus. A telemed abortion can be conducted if the pregnancy is less than nine weeks along, compared to a surgical abortion, which is done up to 13 weeks.

According to Planned Parenthood of the Heartland President and CEO Jill June, about 50 percent of abortions in the state are done medically, while the other half is surgical. Of the 50 percent of medical abortions, 55 percent are done through telemedicine in the 15 Planned Parenthood locations in Iowa, including Red Oak, where a health clinic is not available.

The Health Side

June said telemed abortions include the same medicine, exams prior to taking the pill and conversations with the doctor. The only thing, she added, that is different is there is no handshake with the doctor afterward.

A medical abortion, according to June, is the safer option for a woman who has made the decision to terminate a pregnancy, and the Board’s decision, which is scheduled to take effect Nov. 6, would limit abortion access for women in rural communities where clinics are not available.

 “Women will have to travel to a health center with in-person service and then again at a later date for a follow up. Doing so could delay a woman, who has already made her decision, from attaining the abortion, which could lead to an increased need for a surgical abortion. While safe, surgical abortions do come with greater risks the further along the pregnancy is,” she said.

Local Pro-Life groups, though, claim telemed abortions are harmful to women.

“People tend to trivialize it, like they’re just taking ababy Aspirin, when really it ejects the baby and the woman actually sees the dead baby in the toilet,” local 40 Days for Life leader Rod Goodemote said. “A woman could bleed to death and die; it’s not a small thing.”

While he has never been directly involved in the abortion process, Red Oak Obstetrician/Gynecologist Chris Johnson said he too is uneasy with the idea of a telemed abortion from a health standpoint.

“In my own practice, I’m old school; when in doubt, go to the patient’s bedside,” Johnson said. “So from a medical and legal standpoint, telemedication does make me nervous, and I’ve never felt comfortable with it.”

However, like June, Johnson said limiting access to any type of medical care can also be dangerous.

“It’s a two-edged sword because medical abortions are best done in person in case of complications, but at the same time, you don’t want to limit access to people where they may take it upon themselves,” he said. “People who are unhappy with the decision are so because they think it will limit access, and it will. Interest in patient safety is paramount, though, too.”

The Political Side

Telemed abortions began in the state in 2008, and some sources claim Iowa was even the pilot state for the system.

Now, 11 states, including Missouri and Nebraska, outlaw the practice.

The recent Board of Medicine’s decision came two years after the telemed system was re-examined and deemed safe in the state, despite complaints from abortion opponents. During the two years, the 10-member board was replaced by Pro-Life Gov. Terry Branstad.

“This decision is a political attack aimed at restricting access to abortion in Iowa,” June said. “Proponents of this rule aren’t against telemedicine technology; they are against safe, legal abortions and are unjustly targeting our system with no scientific information or evidence to back their claims.”

While she would not divulge specifics, June said Planned Parenthood will be fighting the ruling.

“I will say we aren’t going to sit by and watch this horrible decision play out,” she said. “Planned Parenthood is a strong advocate for the health and welfare of women and we will work tirelessly at this. The women of Iowa do not deserve to be punished by the board of medicine.

“As a rule this will be harmful to women because it creates barriers. Telemedicine is an asset, especially to rural women. Those who are morally opposed to abortion are using the government and the board of medicine to attack telemedicine and are willing to ban it to ban abortions. To them, it’s do the ends justify the means?”

Pro-Life/Pro-Choice Side

For both political and moral reasons, Goodemote said the board’s decision is a step in the right direction for the ongoing abortion debate.

“It’s a victory for the country as a whole since Iowa was the first,” he said. “I think it’s also just a great victory for women, families and especially babies.”

While the fight isn’t over, Goodemote said the decreased access to abortions will likely limit their prevalence.

“I think there certainly will be fewer abortions,” he said. “When something is convenient and readily accessible, there will always be more.”

June, however, said she doesn’t see the number of abortions decreasing because of the ruling; rather, they will just be more difficult for a woman to attain. 

In fact, she added, abortions numbers have actually decreased since the telemed technology was introduced, but the number of births did not, implying more women are likely practicing protective sex or using contraceptives. 

Johnson said he is unsure of whether the ruling will impact the number of women seeking an abortion.

“I don’t think we can know the exact effect [of the ruling],” he said. “I don’t see a huge impact here. When patients come in [seeking abortions] I direct them to places like Omaha and they do receive that care they want.”

Despite what he called a victory, Goodemote said the 40 Days for Life group is still going strong and are gearing up for the next campaign, which starts with a kick off ceremony Sept. 22 at 6 p.m. at the Assembly of God church in Red Oak.

Iowa Right to Life Executive Director Jenifer Bowen will be the guest speaker.