Iowa ban on telemedical abortions declared unconstitutional

The Supreme Court of Iowa unanimously ruled last Friday to strike down a state-wide ban on so-called webcam abortions. The court’s decision in Planned Parenthood of the Hearthland v. Iowa Board of Medicine will permit clinics to continue using a telemedical system wherein doctors can prescribe a two-dose medication to patients after a simple video conference.

In 2013, the Iowa Board of Medicine, then stacked with conservative and pro-life personnel by Gov. Terry Brandstad (R), issued a regulation requiring any doctor prescribing abortifacients to conduct in-person physical examinations of their patients, and to remain in the room with the patient when the drugs were taken.

Prior to the ban on telemedical abortions, Planned Parenthood of the Heartland used a system designed to accommodate patients in rural communities. Women who might otherwise have to travel 400 miles to receive care could instead meet with a physician’s assistant or nurse at their local clinic before talking with a prescribing doctor at the Des Moines Planned Parenthood branch via video chat.

If, after reviewing the patient’s relevant medical information, no conditions (an ectopic pregnancy, for example) preclude the safe use of the abortion-inducing drugs mifepristone and misoprostol, then doctors could prescribe the medications. As the National Law Review details in a recent write-up of the Supreme Court’s decision, “the doctor would press a button that would unlock a drawer in the clinic, allowing the nurse or physician’s assistant to access the drug and dispense it to the patient.”

More than 7,200 women have used the video-coferencing system since 2008, and according to a 2011 study of approximately 600 abortion-seeking patients who had interacted with Des Moines’ Planned Parenthood of the Heartland, “No serious complications have occurred in Iowa involving telemedicine patients, and patients report high levels of satisfaction with the process.” Indeed, according to that same study, telemedicine and in-person patients had comparable outcomes, and 94 percent of the former “reported being ‘very satisfied’ with the procedure.”

Regardless, when introducing the ban, the Iowa Board of Medicine cited safety concerns echoed by pro-life advocacy groups. “Planned Parenthood and other abortionists must be held to basic medical standards of care, and little is more basic than an in-person examination by a physician before a procedure that poses serious health risks,” said Natalie Decker, Legal Counsel at Alliance Defending Freedom, a pro-life organization that filed a friend-of-the-court brief in November 2014.

On Friday, June 16, Iowa’s Supreme Court agreed that the Board regulators had ignored other telemedical health services to specifically target abortion, noting that national standards do not require women to undergo physical examinations before receiving a medical abortion.

“It is difficult to avoid the conclusion that the board’s medical concerns about telemedicine are selectively limited to abortion,” wrote the court, who did not agree that an in-person exam would “provide any measurable gain in patient safety.” The court declared the Board’s restriction unconstitutional in agreement with Planned Parenthood’s suit, which claimed the ban blatantly discriminated against women, the only demographic that seeks abortions.

“This unanimous ruling says that a state cannot single out abortion with a different set of rules that don’t apply to any other health care procedure, and that a state cannot prevent women from accessing safe, legal abortion,” said Cecile Richards, the president of Planned Parenthood Federation of America. “Similar restrictions and bans on abortion are being pushed through in other states, and this ruling sends a strong and clear message to politicians across the country. Restrictions and bans on abortion are unconstitutional and deeply unpopular, and we will continue to fight them in every state in this country.”

The Court’s decision can be read in full here.