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The New Abortion Landscape

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This shift accompanies another one in how people get abortions. In states that have banned or restricted access, clinic-based procedures fell in July and August, according to other new research. As a result, women are carrying pregnancies they didn’t plan or want. The increase in women seeking pills, however, mostly offset the drop, The Times reported. (Most, though not all, requests for pills to Aid Access end up being filled.)

Clinics in states like Colorado, Illinois and New York have also seen more patients as women travel out of state for abortions. But the shift to telemedicine makes sense for practical reasons. First, having an abortion with pills at home, which has the physical effects of miscarrying, is as safe and effective in the first trimester as going to a clinic.

Second, a quarter of women of childbearing age in the United States live — or will soon live — at least 200 miles from an abortion clinic. That distance is likely to pose an insurmountable obstacle for a significant number of people, especially those with low incomes. The telemedicine option is far cheaper than traveling. Aid Access asks patients for $105 to $150 and will accept less or nothing from people who can’t afford to pay. By contrast, a trip out of state for an abortion often takes a few days and can run to $1,500 or more.

It’s also notable that abortion by telemedicine has risen in states that have not restricted abortion access, suggesting that more women are choosing it for “comfort and privacy” as well as necessity, said Abigail Aiken, a public health researcher at the University of Texas at Austin and a co-author of the study of the Aid Access data.

Providing abortion pills via telemedicine, across state lines, raises legal questions. The Dutch physician Dr. Rebecca Gomperts, the founder of Aid Access, writes prescriptions for abortion pills for women in red states, using her Austrian medical license. I wrote a cover story for The New York Times Magazine last month about the efforts of American doctors and midwives to work with Gomperts. “I just want to scream, ‘This is a public health emergency!’” one of the doctors, Linda Prine, texted me while I was reporting. Abortion opponents, on the other hand, say their state laws should bind out-of-state providers.

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