The latest report from #WeCount, a national effort to count the number of clinician-provided abortions in the United States each month, documents the increasingly important role of medication abortion care provided via telehealth.
In particular, the report presents new numbers from clinicians working with organizations in states with shield laws. Shield laws give some legal protections to clinicians who offer abortion care by telehealth to people living in states with abortion bans or telehealth restrictions — including Wisconsin. These numbers suggest that hundreds, if not thousands, of Wisconsinites have obtained medication abortion pills via telehealth from out-of-state shield law providers.
Wisconsin state law prohibits the use of telehealth to provide medication abortion care, even though extensive research documents that this model of care is safe and effective. Telehealth provision of medication abortion has never been offered through the formal healthcare system in Wisconsin. However, Wisconsinites can and do order medication abortion pills from other sources, including out-of-state organizations whose clinicians are protected under shield laws.
For over two years, the #WeCount effort has worked to document the number of abortions in the United States just preceding, then following, the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision that overturned Roe v. Wade and the federal right to abortion.
New with the October 2024 release, #WeCount expanded its data collection and now reports the number of medication abortion pill orders provided by licensed clinicians in states with shield laws, by state and by month, since July 2023. These numbers appear alongside the number of abortions (both medication and procedural) provided by brick-and-mortar facilities, such as Planned Parenthood. We present Wisconsin-specific figures here.
From July 2023, the first month for which shield law numbers are available, through June 2024, shield law providers mailed, on average, 128 medication abortion pill orders to Wisconsinites each month. In late September of 2023, Wisconsin brick-and-mortar abortion clinics in Dane and Milwaukee Counties started offering services again following a circuit court ruling about an 1849 law interpreted by many as an abortion ban. For over a year prior, abortion care had been unavailable in our state except to save the life of the pregnant person.
Notably, even when brick-and-mortar services resumed in Wisconsin, the number of medication abortion pill orders provided under shield laws did not decrease. In fact, the monthly average of orders increased slightly. In total, for the one-year period captured here, approximately 1,540 medication abortion pill orders were mailed to Wisconsinites by telehealth shield law providers.
Important note: not all medication abortion pills mailed by providers result in people taking the medication. Thus, readers must keep in mind that these telehealth numbers may overestimate the number of Wisconsinites who have an abortion. Nonetheless, these findings suggest that telehealth provision of medication abortion is an important, if not critical, resource for many Wisconsinites in need of abortion care.
Both procedural and medication abortions provided by brick-and-mortar facilities still accounted for a larger share of overall abortions than did telehealth provision. Put simply, the majority of abortions still take place in person. Nonetheless, these latest #WeCount numbers suggest that telehealth medication abortions may have constituted around one-quarter of the abortions in Wisconsin from July 2023 to June 2024.
Nationwide, the #WeCount data show that the proportion of abortions provided via telehealth has increased since 2022, including those provided under shield laws.
The findings suggest that telehealth provision of medication abortion is an important, if not critical, resource for many Wisconsinites in need of care.
People may choose telehealth services for a variety of reasons, even when brick-and-mortar services are available.
- Driving distances to care can be substantial, if not impossible, especially for those living in rural areas and those without access to a car or accompanying driver.
- Because of crippling insurance prohibitions (including no abortion coverage under Medicaid or for state employees in Wisconsin), many people must pay out-of-pocket for abortion care in the state. Some people cannot afford those costs. Shield law providers offer comparatively affordable care.
- Research also suggests that Black women and others who face systemic racism and oppression (for example, trans and gender-non-binary patients) may also prefer medication abortion care over in-person procedural abortion care due to prior experiences of discrimination in healthcare interactions.
For all these reasons and more, people need a variety of ways to access abortion care, which is a fundamental component of reproductive healthcare and an essential health service.