COVID-19 Puts Medication Abortion in the Spotlight
Only patients in a limited number of states have access to “no-test” medication abortions. During the COVID-19 crisis, 12 states issued policies that attempted to limit abortion access during the outbreak, such as deeming abortion “non-essential.” Most of these state policies have been blocked by court order or lifted as states start to re-open. In Arkansas, patients must have at least one negative COVID-19 Nucleic Acid Amplification Test (NAAT) test in the 48 hours prior to the procedure.
These new restrictions are in addition to existing barriers to abortion services. In 18 states, telemedicine abortion has been effectively prohibited; 5 states explicitly ban telemedicine for medication abortion, while 13 states require the prescribing clinician be physically present with the patient. The “no-test” model is also not an option in the 14 states requiring patients receive an ultrasound before an abortion, and in the 13 states with in-person counseling requirements. This leaves 23 states in which the “no-test” model could be used to provide medication abortion.
Medication abortion via telemedicine is a method that can be used to safely provide women with access to abortion care while social distancing, preserving personal protective equipment, and limiting risk of exposure to coronavirus.
A new telemedicine protocol –“no-test” medication abortions– has been developed in response to COVID-19. This approach, based on studies conducted outside the US demonstrating its safety, enables many patients to safely obtain abortions without needing in-person tests or exams. This approach, along with other telemedicine protocols, however, would not be available in many states because of state laws and policies that prohibit its use.
Currently, in 23 states, providers could adopt this method to offer medication abortion because there are not laws or policies that prohibit its use. However, in other states, laws explicitly ban telemedicine abortions or make them impractical by requiring the prescribing clinician to be physically present with the patient, ultrasounds before abortions, or in-person counseling.
