Abortion laws have faced quite the crackdown in the past few years. But if a recent Iowa Supreme Court decision stays, it could change the game for clinics.
Last Friday, the court ruled that telemedicine abortions in the state could continue, striking down a ban on the practice put in place in 2013. The decision marks a victory for pro-choice activists years in the making—and it might boost the efforts of activists in other states as well.
Planned Parenthood of the Heartland (the organization’s chapter serving Arkansas, Nebraska, Iowa, and eastern Oklahoma) launched their telemedicine abortion program in July 2008; the first of its kind in the U.S. It allowed doctors to video-conference with their patients who lived in rural communities—cutting down on long wait times and trips to the clinic that for some people might mean traveling hundreds of miles—and provide them with counseling, as well as medicated abortions. But that was soon reversed, as The Des Moines Register reports:
State regulators, appointed by Iowa’s anti-abortion governor, ruled in 2013 that the system should effectively be banned because of purported safety concerns. The ban was put on hold while Planned Parenthood appealed in court. A district judge sided with the regulators in 2014, but the [State] Supreme Court disagreed Friday.
The justices decided 6-0 that the Iowa Board of Medicine’s rule violated women’s constitutional rights. The court noted that telemedicine is being used to provide many other types of health care. But the medical board only focused on telemedicine’s use for abortion when it imposed a requirement that doctors personally perform physical exams on patients, the justices wrote. “It is difficult to avoid the conclusion that the board’s medical concerns about telemedicine are selectively limited to abortion.”
And now that it’s got one victory under its belt, pro-choice activists could have a case in other markets. Right now 16 states have bans on telemedicine abortions, with Arkansas and Idaho enacting laws later this year against it. If telemedicine abortions are indeed being unconstitutionally banned, Planned Parenthood could start rolling out the program across the country.
That could be a profound relief for abortion providers in places like Texas, where the Fifth Circuit recently approved a law that would severely limit the number of clinics in Texas. The Texas Tribune writes:
A three-judge panel of the U.S. 5th Circuit Court of Appeals ruled that the state’s requirement that abortion clinics meet ambulatory surgical center standards — which include minimum sizes for rooms and doorways, pipelines for anesthesia and other infrastructure — did not impose an undue burden on a “large fraction” of Texas women seeking abortions.
Only a handful of Texas abortion clinics — all in major metropolitan areas — meet those standards [in H.B. 2], which are costly to implement. Immediately following the ruling, the Center for Reproductive Rights and Texas women’s health care providers announced their plan to appeal the case to the U.S. Supreme Court.
After H.B. 2 is passed, opponents fear that only 8 of the 41 providers across Texas would be left, leaving many potential patients hundreds of miles away from their nearest provider. While some may see telemedicine as a new, untested form of healthcare, for people in Texas, or the one-third of the Iowa population living rural conditions, telemedicine abortions present a fast, safe, and cheap alternative, as Time reports:
In 2012 Grossman and a team of researchers found that remote medication abortions did not increase the number of overall abortions in Iowa and that the number of abortions taking place in the second trimester, when the risk for complications is higher, dropped slightly.
“We also found that women were more likely to recommend it compared to women who underwent an in-person procedure,” said Grossman. “In some of the interviews, women decided to go to a telemedicine site because it meant they could have it done sooner. If they waited, they would have to have a surgical abortion.”
Of course telemedicine’s fate isn’t a done deal, even in Iowa. The state’s Board of Medicine to discuss the opinion at next month’s meeting. But just last week, a federal district court in Texas enjoined the state’s medical board from enacting a rule that would severely curb telemedicine in Texas, a state where telemedicine has been a similarly long-fought battle. The road for telemedicine is far from done, but if these rulings show anything it’s that the tide may be shifting.