For the first time, women in Massachusetts are now eligible to get abortion services via telemedicine without having to leave their homes.
Massachusettsjoined a federal study in late January that allows anyone living in a participating state to access telabortion services if they are under 10 weeks pregnant. All they need is an ultrasound from a primary care doctor and a telehealth visit with a provider that participates in the study. Then, the abortion medication is mailed to their home.
The telabortion study began in 2016 with just a handful of states to review the validity of FDA regulations that require the abortion medication, Mifepristone, be given in person by a clinician.
“We really see telabortion as just an expansion of options for people. We don’t really see it as replacing anything,” said Leah Coplon, who oversees the federal telabortion study for Massachusetts patients. “It’s just one more way to make abortions accessible to folks.”
Coplon is the program director at Maine Family Planning, one of the providers under the federal study. She’s been offering telabortions to Maine residents since 2017 and helped open up the service to Massachusetts residents earlier this year. Joining the study did not require any action by the legislature or the governor, merely a trained provider in the study and a licensed physician in the state.
There are several reasons why patients decide to choose this option, Coplon said, and privacy is a big one.
“As much as we work to de-stigmatize abortions, we recognize that for some folks there is a lot of stigma around it. If they can get what they need at home without having to interface with a healthcare facility and walk past protestors or drive by protesters, then that feels like the most safe and secure way for them to do it,” Coplon said.
Dr. Jennifer Childs-Roshak, who heads Planned Parenthood in Massachusetts, said telabortions also help address disparities that too often impact minority and low-income women.
“By providing ways for folks to receive abortion care in a way that doesn’t require taking time off from work, traveling long distances, having to find child care, putting their livelihood in jeopardy, it improves health equity,” Childs-Roshak said.
Telabortions are also cheaper. A medication abortion in a Massachusettts clinic can cost $500 to $700 — two or three times the cost of a telabortion.
This type of service, Childs-Roshak said, is also more critical for Bay State women than one might think.
“One might be surprised that even here in Massachusetts people must travel up to or more than 100 miles to access abortion," she said. "This is a tremendous barrier for people on the western part of the state and the Cape and Islands.”
Recent interest in this national study has also expanded well beyond Massachusetts. Since the pandemic began, the number of states that participate has jumped from 10 to 17, plus Washington, D.C. Patient numbers also tripled in the first few months of the pandemic. But there are limits on which states can participate: It is currently illegal to mail Mifepristonein 19 states.
Tara Shochet, of Gynuity Health Projects, which runs the federal study, said a major factor in this increased demand is that pregnant women have been nervous about getting COVID-19 or spreading it.
“Folks didn’t want to go into places anymore," Shochet said. "All sorts of medical establishments were cutting back on the number of people who could be inside at any time. Mandatory stay-at-home orders [were] in place. You add all these things to it, and this really turns into a very important way to access abortion care."
But some doctors urge caution. Dr. Kerry Pound, an ER pediatrician and vice president of Massachusetts Citizens for Life — a group that opposes abortion — argues that FDA regulations requiring in-person distribution of Mifepristone exist for a reason. She believes the drug can be dangerous, possibly leading to hemorrhaging, vomiting and sharp pains.
“We are deserting women at this very vulnerable time when they should have care and supervision,” Pound said. “We don’t want to be by ourselves suffering, possibly bleeding severely — we are leaving them alone.”
Over 1,700 patients have participated in the telabortion study since 2016. Exit interviews have shownlittle if any difference in safety or effectiveness between dispensing the drug in-person and mailing it.
Paige Sutherland is a Boston-area freelance reporter.
