Five years ago, Iowa became the only state in the nation to have telemedicine abortion. That title may soon be removed.
Iowa Board of Medicine voted Aug. 30 to set rules for telemedicine health care, including a provision that all patients would have to meet with a doctor before being supplied a drug to abort a pregnancy (see definition of telemedicine abortion, right).
Pat Pokorny, a member of Crest Area for Life, agrees with the decision.
“We’re just praying for the babies, and the mothers, and those that work in the clinics that they will realize just how precious life is,” said Pokorny.
Crest Area For Life is a group of local people who attend an informal prayer group. The group meets regularly outside of the Planned Parenthood office in Creston to protest abortion.
According to Planned Parenthood administrators, using the telemedicine system is uncommon at Planned Parenthood clinic in Creston. The average telemedicine abortion statistic in Creston is less than six per year.
Two reasons for the low statistics, said administrators, could be because people are used to traveling to Des Moines for health care, or they want anonymity. Prices for abortions are the same at clinics in Creston and Des Moines.
The prayer group pickets Planned Parenthood to protest its abortion services by praying, rain or shine.
“It was some ladies from Lenox who were in a prayer group that were concerned that the Planned Parenthood in Creston was doing the webcam abortions and were referring women to other clinics to have abortions,” said Pokorny. “So, we just felt like we needed to voice our concern for unborn children and for life and for the mothers who may be influenced to have an abortion.”
Women between the ages of 20 and 29 are the most likely to receive an abortion in the state of Iowa. This demographic is consistent in rural Iowa.
Iowa Board of Medicine received a petition June 25 signed by 14 health-care providers that laid out language to ban telemedicine abortion.
“They had no process or procedure that they followed. They received a petition from members of organizations ... who opposed abortion,” said Jill June, president and CEO of Planned Parenthood of the Heartland. “The Board of Medicine adopted that language in its entirety.”
A hearing was held Aug. 28, when board members heard both sides of the argument. The board voted and passed the ban Aug. 30.
“We feel the board of medicine has been deliberately stacked with individuals that would vote against our telemedicine program,” said June. “The opponents who have been pushing the Board of Medicine to do this will admit themselves that they don’t object to telemedicine, but that they object to abortion.”
According to a Des Moines Register story, Dr. Greg Hoversten, chairman of Iowa Board of Medicine, said after the vote was cast, he believed a medical abortion done through technology isn’t as safe as one done in the presence of a physician.
“The woman essentially goes home and labors and delivers a fetus,” Hoversten was quoted as saying in the Register story. “It’s very bloody. It’s painful. There’s cramping, pelvic cramping. ... How can any of us possibly find that a medical abortion performed over the Internet is as safe as one provided by a physician in person?”
The rules laid out in the telemedicine abortion ban would require the patient meet with a doctor in person before being provided abortion pills, and to schedule in-person follow-up visits.
“It denies them (women) access to technology based on no fact-finding or investigation whatsoever by the board of medicine,” said June. “It will mean they will have to leave their own communities for health care, when it can be available to them via telemedicine. And, it locks them out of the progress that is being made nationwide in expanding health care into rural communities.”
Unless Planned Parenthood of the Heartland appeals the decision, the rules, voted on by the 10-member board appointed by Gov. Terry Branstad, will take effect in November.
“The rule is scheduled to take effect Nov. 6, and Planned Parenthood is considering all options available to assure rural women can receive all health care in their communities via telemedicine,” said June. “We will continue to resist the enactment of this rule.
What is telemedicine abortion?
Telemedicine abortion begins with a conversation between a patient and physician via video call. The patient can ask questions, and when the questions have been answered, the physician pushes a button from the computer on his or her end of the video and a drawer opens on the patient's end. In the drawer is the abortion medication mifepristone, and the physician watches the patient take the pill.
After taking mifepristone, the patient will take up to three days' worth of misoprostol, which is a drug that "softens the cervix and causes the uterus to contract and empty," according to a Planned Parenthood pamphlet. This is essentially a miscarriage.
A surgical abortion requires a procedure and can occur during various stages of pregnancy. The abortion pill must be taken within 63 days of pregnancy. According to June, the earlier in the pregnancy a termination occurs, the safer it is for the woman.
Planned Parenthood has performed more than 3,000 telemedicine abortions since 2008, when the telemedicine abortion system was incorporated in Iowa.
Without the telemedicine abortion service, women will drive to the nearest health center to obtain medication directly from a physician. They will then have to schedule a follow-up appointment with the same physician at the same facility.
Whether the medication is distributed n person by the physician or by telemedicine, the woman leaves the clinic and the procedure is completed in-home.