Biden Administration to Lift Restrictions on Telemedicine Abortions

April 13, 2021 - The Biden Administration is supporting the use of telehealth to facilitate medication abortions during the coronavirus pandemic.

Acting US Food and Drug Administration Commissioner Janet Woodcock told the American College of Obstetricians and Gynecologists this week that the agency would be lifting restrictions on prescribing abortion-inducing medications, allowing healthcare providers to prescribe mifepristone and monitor the procedure via telehealth.

"Those in need of an abortion or miscarriage management will be able to do so safety and effectively by acquiring mifepristone though the mail — just as they would any other medication with a similarly strong safety profile," ACOG Chief Executive Officer Maureen Phipps told Politico, which broke the news on Monday.

The announcement comes on the heels of a March ruling by the US Supreme Court that put back in place FDA guidelines that require in-person exams before providers can use telehealth to prescribe mifepristone. That ruling was in response to a July 2020 federal district court ruling that eliminated the in-person exam during the public health emergency, saying it imposed a “substantial obstacle” to access to care.

The announcement only applies to the public health emergency created by the pandemic, which will likely remain in place through this year.

Mifepristone was approved for use in 2000, but shortly afterward was placed on the FDA’s Risk Evaluations and Mitigation Strategies (REMS) protocol, which requires that drugs determined to be risky be dispensed in a healthcare setting under the direct supervision of a certified care provider, and that patients be advised of the drug’s dangers.

Telehealth advocates and pro-abortion rights groups like Planned Parenthood say telehealth should be an integral part of abortion care, both in allowing providers to conduct medication abortions and remotely monitor patients, because many women in underserved and rural areas don’t have access to in-person treatments.

“The decision by the FDA to lift the medically unnecessary restrictions on mifepristone until the end of the global public health crisis is in line with what our community of physician advocates knows to be true and has known to be true before the pandemic: abortion care is safe, and restrictions on abortion care only harm people accessing this essential care,” Kristin Brandi, board chair of Physicians in Reproductive Health and a New Jersey-based ob/gyn, said by e-mail today.

“Medication abortion care is safe to administer via telehealth,” she added. “We knew this before the pandemic, and during this ongoing emergency telehealth became a critical way for health care providers to offer this essential care while we all attempted to reduce exposure to the virus.”

“There is no scientific or medical justification for requiring women to travel to a hospital, clinic, or medical office to pick up the medication, especially during a pandemic,” added Melissa Grant, COO of carafem, a provider of medication abortion care and services that includes virtual care, in a separate e-mail. “While we welcome this temporary change, we urge the FDA to continue to review the evidence and scientific data and permanently lift unnecessary restrictions beyond the public health emergency.”

Opponents say telehealth should not be a part of the abortion process because it’s unsafe and separates the caregiver from the patient.

Demand for medication abortions had been growing, due to aggressive efforts to shut down clinics and outlaw the procedure and the stresses placed in in-person care by the pandemic. According to the Guttmacher Institute, almost 40 percent of all abortions were conducted with medication in 2017, up from only 5 percent in 2001.

Roughly 19 states now ban or severely restrict the use of telemedicine in abortions. Ohio lawmakers had voted to join that group, but a state court blocked that law just this week. According to Politico, Similar bills are making their way through state Legislatures in Indiana, Arkansas, Iowa, Alabama, Texas, Oklahoma, Wyoming and West Virginia.