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Telehealth abortions now account for nearly 1 in 5 in US, with thousands accessed under shield laws each month, report says

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Most abortions in the United States are medication abortions, and telehealth has become an increasingly common way to access abortion pills — especially since the US Supreme Court’s Dobbs decision revoked the federal right to an abortion.

In the last few months of 2023, nearly 1 in 5 abortions nationwide were medication abortions in which the pills were mailed to a patient after a remote consultation with a clinician. When data collection began in April 2022, about 4% of all abortions were medication abortions provided through telehealth.

Medication abortion is a method by which someone ends their pregnancy by taking two drugs — mifepristone and misoprostol — rather than having a surgical procedure. The regimen is approved for use up to 10 weeks gestation.

During the Covid-19 pandemic, broader access to medication abortions through telehealth was allowed. Options for fully remote screening and use of mail-order pharmacies became more widely available in 2021.

Telehealth abortions have surged in recent months due to newer policies offered in states with abortion bans or restrictions. Shield laws have been enacted in five states to allow providers to prescribe medication abortion drugs via telehealth to people living in states with bans or restrictions.

More than 40,000 people accessed telehealth abortions under shield laws in the second half of 2023. By December, nearly a 10th of all abortions in the US were telehealth abortions provided under shield laws.

Research has consistently found that medication abortion is safe and effective, including when accessing it through telehealth appointments.

A recent study found that the experience of receiving medication abortion through the mail was timely, acceptable, and maintained confidentiality for patients. The medication abortion was reported to be medically successful in about 98% of cases, with rare adverse events unrelated to mail-order dispensing.

Recent data shows that in 2023, there were 1 million abortions in the US, the highest rate in over a decade and a 10% increase from 2020.

The report supports these findings and highlights the challenges in accessing in-person abortion care in states with bans. It estimated that there would have been about 145,000 more in-person abortions if not for the bans in 14 states.

Medication abortion, including telehealth abortion, has become a more common option than ever. Telehealth abortion removes barriers and offers lower costs compared to traditional in-person care.

However, telehealth abortion still faces restrictions in some states, such as requiring in-person ultrasounds or counseling.

Primary care physicians can play a crucial role in expanding abortion access through clinics or telehealth, especially for individuals in non-metropolitan areas or low-income communities.

Legal threats, potential changes in mail service management, and Supreme Court decisions could impact the future of telehealth abortion. The need for innovative strategies to help people access abortion care remains crucial.