Iowa Judge Stops Shut-Down of Nation’s Largest Telemedicine Abortion Program

November 14, 2013

Thursday, November 14, 2013,  by Amelia Serrat
On November 5, 2013, Polk County District Judge Karen Romano temporarily suspended a ban on Planned Parenthood of the Heartland’s telemedicine abortion program in Iowa.  The ban, which was set to go into effect on November 6th, was passed by the Iowa Board of Medicine on August 30th.  The rule requires that a physician be physically present when a woman takes an abortion-inducing drug.  The rule effectively bans the use of telemedicine abortion, whereby a rural woman telecommunicates with an urban doctor while in the presence of a nurse practitioner.
Telemedicine is “the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status.”  Telemedicine is used to allow patients to consult with their doctors from the comfort of their homes, to send test results from rural hospitals to be examined by urban doctors, and to allow for doctors to monitor a patient’s vital signs remotely.  It is notable that while telemedicine is being used in a variety of fields, the only field in which it is currently being regulated is abortion.  Judge Romano recognized this fact and wrote, “With respect to the lack of an in-person meeting, it is peculiar, as petitioners point out, that the board would mandate this for abortion services and not any other telemedicine practices in Iowa.”
Iowa is home of the nation’s first and largest telemedicine abortion program.  Planned Parenthood of the Heartland has provided over 3,000 medication abortions to rural women in the state since the program’s start in 2008.  Supporters of the ban argue that the new standards are needed to protect the health and safety of women seeking medication abortions.  However, Judge Romano was not persuaded by their arguments.  She wrote that the Iowa Board of Medicine has not provided “any evidence whatsoever that telemedicine abortions are unsafe or negatively impact public health….There is simply no evidence the court can rely on to come to the conclusion that the telemedicine abortion procedures, which have been offered for five years without issue, do not ‘protect the health and safety of patients.’”
Judge Romano’s decision is based in part on studies cited by Planned Parenthood, which show that “telemedicine can be used to provide medica[tion] abortion in an effective and highly acceptable manner.”  A notable study surveyed nearly 600 women who obtained both face-to-face and telemedicine medication abortions through Planned Parenthood clinics in Iowa.  Follow-up data was obtained for 226 face-to-face patients and 223 telemedicine patients who visited Planned Parenthood clinics between November 2008 and October 2009.  The rates of women who had a successful abortion were very similar: 99% of telemedicine patients and 97% of face-to-face patients.  Rates of adverse effects were similar among both groups of patients.  Ninety-four percent of telemedicine patients were very satisfied with the process, while eighty-eight percent of face-to-face patients had the same level of satisfaction.
Judge Romano’s stay is only temporary pending further judicial review of the Iowa Board of Medicine’s ban.  Both pro-choice and anti-choice advocates will be watching Iowa in the coming months to see how the courts decide the fate of telemedicine abortion.  Advances in technology, including telemedicine, are influencing the country’s practice of medicine in countless ways.  Will these advances be allowed in the field of abortion?  Looks like we’ll have to wait and see.