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Iowa board moves to limit abortion access for patients in remote areas

The AP

Iowa’s medical board has moved to end a system in which doctors use a video-conferencing system to distribute abortion-inducing pills to patients at clinics in remote areas across the state.

The system allows Planned Parenthood of the Heartland to offer the pills at clinics in 15 remote locations where the organization doesn’t have doctors who can meet with patients in person. Instead, a doctor, typically based in Des Moines, meets with patients using an Internet video system before the women receive the drugs.

Planned Parenthood established the Iowa program in 2008, and it was the first such system in the U.S. Several other states have since taken steps to prevent the practice.

Earlier this summer abortion opponents petitioned the Iowa Board of Medicine to halt that state’s program. Efforts to legislate against the practice have failed in Iowa, where the Legislature is politically divided, but the board has the authority to make such policy decisions.

The medical board approved the change on an 8-2 vote in late August. The new rules require that a doctor be physically present with a woman when an abortion-inducing drug is provided, and they earliest they could go into effect would be Nov. 6.

The change puts Iowa in the company of other states with Republican governors or GOP-controlled legislatures that have been passing legislation designed to restrict abortion access in recent years. Since Planned Parenthood began the Iowa telemedicine program, the state has elected a Republican governor who replaced all of the members of the medical board. The GOP also controls the Iowa House, though Democrats control the Senate.

Experts say there appear to be few other programs like this in the U.S. Planned Parenthood in Minnesota has offered a much more limited version since 2010, with women who go to clinic in Rochester able to meet with a doctor in St. Paul.

Since 2011, 16 states have enacted laws barring telemedicine abortions, though not all of those laws are currently in effect, said Elizabeth Nash, state issues manager for the New York-based Guttmacher Institute, a reproductive rights think-tank. The institute said Iowa was the only state where opponents were trying to bar this system through the medical board.

Planned Parenthood says the program benefits women in rural locations and that it’s received no complaints from patients. But board members said they had concerns about the process and the care women were receiving; they said the goal wasn’t to restrict abortion access.

“How can any of us possibly find that a medical abortion performed over the Internet is as safe as one provided by a physician in person?” the board’s chairman, Dr. Greg Hoversten, asked.

A spokesman for Republican Gov. Terry Branstad, an anti-abortion Catholic, praised the board’s decision.

“Women deserve high quality medical care, and a standard of care designed to protect their health regardless of the procedure at issue,” spokesman Tim Albrecht said in an emailed statement. “The board made this decision based on the standard of health care that women deserve.”

Planned Parenthood of the Heartland President Jill June declined to say if the group would sue, saying only that the group is keeping its options open.

“We will not roll over and play dead. The health and welfare of rural women is too precious,” June said.

Planned Parenthood says the Iowa program works like this:

Staff members at the remote clinics perform any necessary testing. A doctor, usually in Des Moines, reviews the patient’s records before talking with her over a video-conferencing system. If the doctor decides the woman is a proper candidate for abortion-inducing medication, he remotely triggers a drawer to open in front of the woman with two sets of pills. She takes the first dose at the clinic and the rest of the pills later at home.

The U.S. Food and Drug Administration approved the use of an abortion drug in 2000. The medication is typically offered to women in the first nine weeks of pregnancy.

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