Allison Case, a family medicine physician, spends much of her time working in a hospital where she delivers babies and provides reproductive health care services, including abortions.
Case lives and works in Indiana, where a ban on most abortions took effect for a week in late September until a judge temporarily halted the ban. The state has since appealed the judge’s order and asked the Indiana’s high court to take up the case. Meanwhile, Case is also licensed to practice in New Mexico, a state where abortion remains legal.
Before Indiana’s abortion ban took effect, Case would use her days off to provide reproductive health services, including abortion care, via telemedicine through a clinic that serves patients in New Mexico. Many of them travel from neighboring Texas, where abortion is banned.
Some travel solo, she says, and others have their children with them.
“Some people are [staying in] hotels, others might have family or friends they can stay with, some are just sleeping in their cars,” Case says. “It’s really awful.”
During a telemedicine appointment, doctors, nurses or other qualified health professionals review the medical history of the patient and ensure eligibility for a medication abortion. They give the patient information about how the two pills work, how to take them, what to look out for as the body expels the pregnancy, and when to seek medical attention in the rare instance of complications. The medications are then mailed to the patient, who must provide a mailing address in a state where abortion is legal.
In the U.S., more than a dozen states severely restrict access to abortion, and almost as many have such laws in the works. Across the country, since Roe v. Wade was overturned, clinics that do provide abortions have seen an increase in demand. Many clinics rely on help from physicians out of state, like Case, who are able to alleviate some of the pressure and keep wait times down by providing services via telemedicine.
But as more states move to restrict abortion, these providers are finding themselves navigating an increasingly complicated legal landscape.
Is abortion by telemedicine legal? Experts differ
Medication abortions work for most people who are under 11 weeks pregnant, and research suggests medication abortion via telemedicine is safe and effective. Yet many states have enacted legislation to ban or limit access to telehealth abortions.
But it’s not always clear what that means for doctors like Case who are physically located in a state with abortion restrictions but have a license that enables them to provide care via telehealth