Post-Roe's Impact On Abortion Medicine Via Telehealth

Many people are expected to seek out abortion medication from a Telehealth appointment after the overturning of Roe. When we talk about what that looks like: a doctor has a virtual appointment and then a pharmacy fills in the medication for a patient.   

A doctor, or nurse practitioner will prescribe a patient two prescription pills: They’re called mifepristone and misoprostol.  

Harry Nelson is a Health Care Regulatory Lawyer at Nelson Hardiman. 

"The FDA, under the Biden administration, has taken the position that the medication could safely be prescribed across a virtual encounter by telemedicine, and the medication can safely be mailed directly to the patient allowing for for medication, abortion to in theory take place anywhere," Nelson said. 

Mifepristone stops the supply of hormones that maintain the interior of the uterus. When the hormone is absent, the pregnancy can't continue, and the uterus will expel its contents. 

Misoprostol is a medicine that is FDA approved for stomach ulcers. It causes contractions and bleeding which empty the uterus.  These are for patients up to 10 weeks pregnant.  

Medication abortions made up more than half of us abortions in 2020, according to Abortion Rights Advocacy and Research Group The Guttmacher Institute.  

Legally, telehealth for abortion is subject to state laws. Before Roe, 19 states already banned it. With Roe’s reversal, that could mean patients driving across a state border for a virtual appointment in a car, or having the pills mailed to a P.O. box near the state border.  

Nelson says a provider could be at risk of losing their license, or criminal charges. Organizations like Austria-based Aid Access also prescribe and then mail to the states. Enforcing that would be very challenging.  

Nelson expects more advocacy organizations both inside and outside of the U.S. could step in.  

"Non physicians who dispense the medication are at much lower risk. And it raises the whole question of whether this should even be a prescription medication in the first place. And I think there's a pretty good chance that we're going to see the FDA decide that this medication is appropriate for over-the-counter dispensation without a physician prescription."