At-home abortion pills are being tested in four states

Sending medical abortion pills to women by mail to ingest in the comfort of their own homes (following a video consultation with a medical professional) isn’t a new phenomenon, but it’s new to the US. The benefits of such a program are currently being tested being tested in Hawaii, New York, Oregon and Washington as part of the TelAbortion study, which is funded and organized by the non-profit Gynuity Heath Projects.

Abortion pills, which include two drugs (mifepristone and misoprostol) that work together to induce a miscarriage, can be used in the US through the first 10 weeks of a pregnancy, but can currently only be obtained at a hospital or clinic. Since mifepristone was approved by the FDA in 2000, over 2.5 million women have had medical abortions.

However, the pills have been available by mail and over-the-counter in places like Australia, British Columbia, and the Netherlands for years, and this practice is widely considered safe by medical professionals.

According to a statement by the American Congress of Obstetricians and Gynecologists (ACOG), “Medical abortion can be provided safely and effectively via telemedicine with a high level of patient satisfaction; moreover, the model appears to improve access to early abortion in areas that lack a physician health care provider. Despite the medical evidence, several states have passed legislation that bans the use of telemedicine to provide abortion.”

Serious side effects occur in less than 0.5% of patients, and in the TelAbortion study, women are required to have taken a blood test and an ultrasound before recieving the pills in addition to a video consultation with a doctor both before and after.

Of the first 12 women who participated in the study, 11 had safe, complication-free, in-home abortions (one elected not to take the pill). Ten of them said they would be likely to recommend the service to a friend, which is in keeping with data from similar studies.

Unfortunately, thanks to the current political climate — namely, a president who has openly stated that he wants to repeal Roe v. Wade and a vice president who has basically made a career out of crusading against a woman’s right to choose — it seems kind of unlikely that telemedicine for abortions will be a thing in the US any time soon. But some advocates still remain hopeful.

“People can and do have safe abortions at home when they have access to quality pills, accurate instructions, and reliable backup medical care in the unlikely event of a complication,” says Jill E. Adams, the Executive Director of the Center on Reproductive Rights and Justice at the UC Berkeley School of Law. “When lawmakers and judges are presented with the full picture of how safe and effective abortion pills are, we expect to see changes in the law to support this practice.”

While the FDA signed off on the study, in order to distribute the pills outside of a clinical trial, Danco Laboratories, the company that manufactures them, would have to seek the FDA’s approval to do so. A spokesperson for Danco told the New York Times that they have no plans to do this in the near future, as “abortion is a politically charged issue in this country, and there is an extra degree of caution.”

Meanwhile, even if the FDA were to allow for abortion via telemedicine, it would still be illegal in 19 states.

This sucks, because as any woman who has visited an abortion clinic knows, they’re not usually the most pleasant of places — and what’s more, many of them are quickly disappearing, especially in red states.

The ones that still exist in these areas are often swarming with protesters. They often involve a long wait both to get an appointment and on the day of care. In rural areas, there’s likely to be significant travel time. For many women, going to an abortion clinic means taking a day off work, finding childcare and figuring out transportation, and these things aren’t always easy to do.

The stress of dealing with these matters also adds to what is often an already emotionally fraught experience. Regardless of a woman’s own beliefs about or reasons for seeking an abortion, we live in a society that attempts to place guilt on women who exercise their right to choose. The fact that it’s still considered “brave” for a female celebrity to openly discuss having an abortion shows how far we still have to go in terms of real acceptance.

Unfortunately, the more abortion is taboo and difficult to access, the more we’re placing women in danger. According to the ACOG, about 21 million women a year have illegal, unsafe abortions, and resulting complications add up to about 50,000 deaths annually. If clinics continue to vanish, this number will only increase. Telemedicine provides an incredible opportunity to ensure that this doesn’t happen.

“The FDA already has procedures that permit people to self-administer medications by following instructions and seeking appropriate follow-up care,” Adams notes. “The legal system needs to catch up to the current reality that medication abortion is safe and effective and allow for pregnant people to have more control over their abortion experience.”

Giving women the option to end unwanted pregnancies with the kind of privacy, comfort and dignity — not to mention access — that telemedicine can provide would be a big step in the right direction. It’s not a revolutionary notion. And the fact that we’re being bullied by politicians and anti-choice groups into thinking this way is something to be angry about.