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Maine Becomes 1 of 3 States to Offer Abortions Through Telemedicine

Maine Family Planning announced Monday that it’s offering women medication abortions without requiring them to do an in-office consultation with a doctor.

Instead, they can connect through a telemedicine network. Maine is now one of three states that offer the online service at a time when many other states are further restricting access to abortion.

Maine Family Planning’s Director of Abortion Services Leah Coplon says the health care provider has been offering medication abortions through telemedicine for more than year as part of a pilot program. She says Maine is home to three independent nonprofit abortion providers, but many women still have to travel several hours to get to one.

“And what we find is with these hurdles of missing work, child care, and transportation costs, something that’s safe, legal and effective really becomes out of reach for many Maine women,” Coplon says.

The state’s three providers are Planned Parenthood in Portland, Mabel Wadsworth Health Center in Bangor and Maine Family Planning’s headquarters in Augusta. As of Monday, Coplon says, a woman now has 16 more options, because she can go to one of Maine Family Planning’s clinics across the state.

“And she would meet there with staff, including a nurse practitioner,” she says. “She would do counseling, lab work, have an ultrasound to confirm she was a good candidate for medication abortion.”

The center’s staff would then connect her with a physician through telemedicine. The doctor would talk to the patient, review the information and decide whether it’s appropriate to proceed. If it is, the patient would take a first round of medication in the office.

A few days later, she’d take more medication at home, then return to the clinic a week or two later for a follow-up visit.

“Medical abortion services are very safe. There’s an extremely low complication rate. Less than 1 percent,” says Dr. Peter Manning, the Maine section chair for the American Congress of Obstetricians and Gynecologists, or ACOG, which supports medication abortion through telemedicine. “ACOG supports services that are legal for women, and so currently, abortion is legal for women.”

But access has been restricted in recent years. Some states have tightened regulations to the point that clinics have been forced to close.

While there are three states known to provide medication abortion through telemedicine — Iowa, Minnesota and now Maine — Elizabeth Nash of the Guttmacher Institute says 18 states have specifically prohibited it.

“So what we’re seeing states do is really increase access to telemedicine, and it’s this new wonderful technology that’s going to bring medical access to all people around the country,” she says. “And people find this is a very exciting development, except when it comes to abortion.”

A legal battle over this type of remote service played out recently in Iowa, where Planned Parenthood of the Heartland started offering medication abortion through telemedicine in 2008. Two years later, says spokesperson Angie Remington, the legislature in that state unsuccessfully tried to pass a law banning the practice.

Then the Iowa Board of Medicine issued a new rule prohibiting it. Planned Parenthood sued, and last summer the Iowa Supreme Court found in its favor.

“Our hope is that the Iowa case would set a precedent for other states to start implementing telemedicine programs,” Remington says.

She says Planned Parenthood of the Heartland has provided between 7,000 and 8,000 medication abortions through telemedicine.

Patients choose the telemedicine option when they can, Remington says, but it hasn’t increased the total number of abortions. It’s a shift in when and how a woman receives one.

“We’ve actually found that the rate of abortion has declined in Iowa and in other states over the past few years,” she says.

Leah Coplon of Maine Family Planning says she doesn’t expect the number of abortions to go up here either. The goal, she says, is to ensure that women’s health care choices aren’t limited by where they live.