Pro-lifers received some disappointing news last Friday when the Iowa Supreme Court unanimously struck down Iowa’s telemed abortion ban. In 2013, the Iowa Board of Medicine issued administrative regulations that required physicians to perform in-person examinations (rather than webcam consults) on women before prescribing abortion-inducing drugs. These regulations would have effectively banned the webcam abortion practice in Iowa, in which a woman could receive the abortion-inducing drugs through a remote-controlled drawer after speaking to a doctor via webcam. However, these administrative rules set off a flurry of legal challenges. In August 2014, a Polk County District Court judge ruled to uphold the ban. However, in September the Iowa Supreme Court issued a stay on the decision, allowing telemed abortions to continue.
The Iowa Supreme Court’s reasoning was puzzling. In their ruling, they stated that a physical exam “does not provide any measurable gain in patient safety.” However, there is very good public health research which demonstrates that chemical abortions, also known as medical or medication abortions, pose considerably greater health risks than surgical abortions. For instance, a December 2014 study which appeared in the journal Obstetrics and Gynecology was very comprehensive, analyzing a dataset of over 50,000 Medicaid patients in in the state of California who had abortions in either 2009 or 2010. It tracked both hospital and emergency room visits among these women.
The study found that the complication rate with chemical abortion was 5.2 percent. This is more than twice as high as the overall complication rate. Furthermore, this complication rate would doubtless be higher when chemical abortions are performed without any direct medical supervision. This study nicely demonstrates that efforts by Iowa pro-lifers to restrict telemed abortions are based on very sound public health policy.
This is an issue that could rapidly gain salience elsewhere. At least 16 states have bans on telemed abortions. However, Iowa is the first state to find such a law unconstitutional. The number of surgical abortion facilities has declined significantly in the past twenty years and there are very few doctors willing to perform abortions in many Southern and Midwestern states. As such, supporters of legal abortion may promote webcam abortion as a way to increase access to abortion. They may also pursue more aggressive legal challenges to telemed abortion bans in other states. Pro-lifers, as always, would do well to be diligent.
Michael J. New is an Assistant Professor at The University of Michigan – Dearborn and an Associate Scholar with the Charlotte Lozier Institute. Follow him on Twitter @Michael_J_New