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Telemedicine abortions offer cheaper options but may also undermine critical clinics

1 5 1
08.09.2021

Allison Hansen had just gone through a breakup with her boyfriend last year when she discovered she was pregnant. She already had an 8-year-old son and did not want another child.

Hansen called the Planned Parenthood facility near her home in Savannah, Georgia, to inquire about abortion services and was told the procedure would cost $500 and require four to six hours at the clinic.

Hansen didn't have that kind of time. Her son was at home, attending school online, and needed supervision. While Googling for alternatives, she came across Carafem — a nonprofit that delivers abortion pills to a patient's home after a telemedicine visit for $375 or less.

"It just seemed almost too good to be true," Hansen recalled.

Patients like Hansen have benefited from a quiet but monumental shift in abortion access enabled by the covid-19 pandemic. In July 2020, in response to advocates' concerns about the risks posed by in-person visits in a pandemic, a federal court placed on hold a long-standing FDA rule that required mifepristone — the first pill in a two-step regimen used in medical abortions — to be dispensed in clinics. After the Trump administration appealed that decision, the conservative-majority Supreme Court agreed to reinstate the rule, with Chief Justice John Roberts writing that courts should defer to government experts who set the rules. The Biden administration put the rule back on hold in April during the remaining public health emergency and said it is reviewing the agency's restriction.

In the meantime, telemedicine abortion operations are growing in some places, although not in such states as Texas and Alabama with strict laws designed to curb or end abortions.

A new slate of digital abortion options like Just the Pill, Hey Jane, Abortion on Demand and Choix proliferated, mailing abortion pills to patients in many states after a telemedicine visit. Carafem, which had been mailing the pills to patients in Georgia before the pandemic as part of a research project, streamlined its process for patients who are eligible for medical abortions.

These services can be a lifeline for patients who haven't hit the 10- or 11-week threshold typically used for medical abortion and who can't get to a clinic or need a less expensive choice. But reproductive health advocates worry that telemedicine abortion options don't reach the........

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