Assuring Access to Abortion

Abstract

Over the spring of 2020, numerous states announced measures suspending abortions in response to COVID-19. Banning abortion during the pandemic proved counterproductive. Not only did bans fail to preserve health care resources, prohibiting access to abortion care exacerbates the strain on the health care system. People who lack access to abortions will travel to neighboring states, induce their own abortions, or carry pregnancies to term. More importantly, the people hit hardest by suspending abortion care are those for whom the pandemic already has had devastating effects. Lifting legal restrictions on medication abortion, and expanding telehealth abortion services specifically, can conserve health care resources and reduce unnecessary provider-patient contact. To these ends, in July 2020, a federal district court enjoined a U.S. Food & Drug Administration restriction, for the duration of the pandemic, that requires in-person collection of the first drug (mifepristone) of the medication abortion regimen at a health care facility. However, the Supreme Court stayed the injunction pending the appeals process. In addition, eight states carve out exceptions for abortion in their telemedicine policies, and 19 states require in-person administration of abortion services, thereby prohibiting remote care indirectly. The result is a country divided by legal permission for teleabortion: around half of states permit remote care and the other half prohibit it. Policymakers and executive officials can eliminate barriers to safe abortion services now and in the future. Although not without limitations, telehealth for medication abortion can ease the burdens on pregnant people, health care workers, and health systems in light of the unprecedented challenges presented by COVID-19. This paper was prepared as part of the COVID-19 Policy Playbook: Legal Recommendations for a Safer, More Equitable Future, a comprehensive report published by Public Health Law Watch in partnership with the de Beaumont Foundation and the American Public Health Association.