Maine Family Planning Expands Abortion Services Using Telemedicine Technology

February 29, 2016

AUGUSTA, ME -- Reproductive health clinics around the country are struggling to keep their doors open in the face of state-imposed restrictions, provider shortages, and hostile anti-choice environments. As of today, things look different in Maine.

Maine Family Planning, a nonprofit organization that has provided abortion care in Augusta for two decades, announced today that it will expand access to medication abortion to an additional 16 family planning clinics across the state through the use of telemedicine technology. With this expansion, patients who would otherwise have to drive long distances to access services in Bangor, Augusta, or Portland may now be able to access care closer to home.

With this expansion, Maine joins Iowa and Minnesota to become one of only three states where medication abortion services are known to be available via telemedicine. Despite its relative rarity, the American College of Obstetricians and Gynecologists (ACOG) has formally recognized that telemedicine “can help to bring this safe, effective method of reproductive care to the women who need it.”

How it works

Patients seeking medication abortion are screened over the phone and, if eligible, scheduled at a local family planning clinic. There, patients undergo a comprehensive, in-person counseling session and a thorough review of their medical history. A nurse practitioner and patient then connect with a licensed physician using an audio-visual telemedicine system. The physician prescribes a combination of two medications; the first, mifepristone, is taken in the clinic, and the other, misoprostol, is used by the patient at home or in another safe place. The patient then returns to the clinic for a follow-up visit about a week later. Medication abortion is extremely safe, with equally low rates of complication for procedures obtained via telemedicine or office visits, though telemedicine patients are often report higher satisfaction with their care due to shorter wait times and travel distances.

Expanding Access

For decades, Maine Family Planning, Mabel Wadsworth Health Center, and Planned Parenthood of Northern New England have provided abortion care in Augusta, Bangor, and Portland. These stand-alone, nonprofit centers remain vitally important, as they offer aspiration abortion—a procedure that 80% of patients who seek abortion currently choose.

For those who choose medication abortion, traveling to Augusta, Bangor, or Portland could easily require driving hundreds of miles for the two required visits. This presents a significant barrier, as patients may have to find child care or miss work, and have to pay for travel on top of the cost of the procedure—which an overwhelming majority of patients pay for out-of-pocket.

Maine Family Planning’s decision to provide medication abortion via telemedicine technology is driven by a commitment to access. While abortion is legal in the U.S., it’s not always accessible to those with few resources, and there are additional barriers for those who live in rural communities. “It’s not enough for abortion simply to be legal—people actually have to be able to access the services when they need it for that right to be meaningful.” said Executive Director George Hill. “Offering abortion care via telemedicine provides meaningful access throughout Maine.”

The Legal Landscape

Over the last 15 years, legal restrictions to abortion access have skyrocketed nationwide, taking a particularly devastating toll in Texas, where legal restrictions have closed dozens of clinics throughout the state.  An expansion of the number of medical facilities providing safe, legal abortion care in rural states like Maine and Iowa stands in stark contrast to this trend, and may be one answer to ensuring meaningful access to a constitutionally protected medical procedure.

Such efforts have been met with resistance, however. In 2013, Iowa’s Board of Health attempted to ban the use of telemedicine technology to provide abortion, citing safety concerns. The case was brought to the Iowa Supreme Court, and in 2015, the court overturned the ban, stating that the restriction placed an undue burden on women’s ability to exercise their reproductive rights. This hasn’t stopped 18 additional states from enacting similar bans on the use of telemedicine for medication abortion.

When abortion is harder to access, it doesn’t necessarily become rarer—it only makes obtaining health care more difficult and more expensive. Reducing barriers by using telemedicine technology to provide medication abortion—along with many other essential reproductive health care services-- means that women are more likely to be able to access the care they need safely and affordably, with fewer negative impacts on their lives.

“Maine Family Planning supports all Mainers in planning and raising their families with dignity,” said Leah Coplon, Maine Family Planning’s Director of Abortion Services.  “As clinics throughout the U.S. struggle to keep their doors open, the ability to increase access to abortion is even more meaningful. We are proud to be able to provide care to women throughout Maine and hope other states follow suit.” 

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