New research from CORE postdoctoral scholar Jane Seymour in the American Journal of Public Health suggests that over 3.5 million more people in the U.S., and 250,000 people in Wisconsin, could have access to abortion services if telemedicine for medication abortion bans were removed and site-to-site services were expanded. Telemedicine for medication abortion (TMAB) has been shown to be safe and effective. This study finds it also makes abortion more accessible for people living in rural areas or who live far distances from clinics currently offering abortion. However, nineteen states, including Wisconsin, currently ban telemedicine for medication abortion, despite research documenting its safety and efficacy.
Seymour and colleagues at Boston School of Public Health, Ibis Reproductive Health, and Temple University’s College of Public Health examined how the removal of TMAB bans and expansion of site-to-site TMAB to additional Planned Parenthood health centers could affect abortion accessibility in the United States. Using epidemiologic and geographic information systems (GIS) methods, they determined the proportion of US women age 15-44 years old living within 30, 60, and 90 minutes of an abortion-providing facility, respectively. [This study relied on Census data, which only included women, not other people who use abortion services.] The researchers then considered hypothetical telemedicine for medication abortion ban removal and TMAB programming changes and their effect on abortion accessibility.
Seymour and colleagues found that removing all TMAB bans and expanding site-to-site TMAB services to all Planned Parenthood health centers that did not offer abortions in 2018 could result in an additional 3.5 million women aged 15-44 years living within 30 min of an abortion-providing facility.
Even with these changes, many people would lack abortion accessibility. In some states, even with the removal of TMAB bans and greater use of TMAB at clinics, more than 50% of the reproductive-aged population still would not have adequate abortion accessibility.
As states including Wisconsin lose legal, local abortion provision, telemedicine abortion, including site-to-site TMAB, will likely take on increasing importance. Some states have enacted restrictions that effectively ban direct-to-patient TMAB, but may allow for site-to-site TMAB, including some states where abortion remains legal.
This work demonstrates the importance of expanding site-to-site telemedicine for medication abortion services for abortion access. Removing bans on telemedicine for medication abortion is critical to ensuring a range of abortion provision options.