By Dan Russo
Editorial
If you knew a sex trafficker or abusive partner could more easily force a victim to have an abortion against her will, would you do something about it? That’s one of the key questions we should all be asking ourselves in light of the rise of telehealth abortions in the United States.
Two of the leading medications used in telehealth today to perform abortions are being sent through the mail in increasing numbers. In the months before the Dobbs ruling overturning Roe v. Wade was handed down in 2022, about 1 in 20 abortions in the United States was accessed by telehealth. During the last three months of 2024, it was up to 1 in 4, according to the WeCount project of the Society of Family Planning, an advocacy group which supports abortion access.
A lot of the current controversy surrounds the decision of The Food and Drug Administration (FDA) in 2021 to permanently remove a requirement that mifepristone be dispensed in person at a clinic or doctor’s office. Mifepristone, when used together with another pharmaceutical drug called misoprostol, can be used to end a pregnancy through 10 weeks, according to FDA regulations. Telehealth abortion advocates say meetings online with healthcare professionals before the medicine is prescribed and subsequent follow up make this is a safe process. They cite studies over the past 20 years that have consistently reported that serious complications occur in well below 1% of all medication abortions using mifepristone. The Catholic Medical Association (CMA) is among the many pro-life organizations sharply disputing these safety figures, arguing that the instance of serious complications is much higher, according to other data they cite.
In a document released last year called Telemedicine Chemical Abortion: A Catholic Medical Association Policy with Recommendations, the CMA pointed out another danger of telehealth abortions that has nothing do with drug safety.
“The lack of direct medical supervision in telemedicine chemical abortions creates opportunities for coercion, particularly by abusive partners, family members, or sex traffickers,” reads the position paper. “Without an in-person visit, abusers can more easily procure abortion pills for a woman without her consent or under pressure to terminate her pregnancy. In domestic abuse scenarios, women often have limited control over their healthcare decisions, and telemedicine allows perpetrators to exploit the system while concealing their actions. Healthcare providers have an ethical obligation to protect patient autonomy, yet telemedicine chemical abortions remove essential safeguards that could shield vulnerable women from forced or coerced procedures.”
There are websites such as Aid Access where people can obtain abortion drugs through the mail without even a video consultation taking place, according to Dr. Grazie Pozo Christie, a Catholic physician who has written several pieces on telehealth abortion for Angelus News, a media outlet of the Archdiocese of Los Angeles.
“Nowhere in a telehealth abortion does ultrasound occur — an ultrasound that could save the mother’s life,” she writes. “ … Dispensing in this way also puts abusive men in the driver’s seat. In one case, a Texas man who used Aid Access to obtain 10 pills crushed them and put them in a cup of hot chocolate he served his pregnant girlfriend. Their baby died and she sued him for wrongful death.”
The CMA, Dr. Pozo Christie and other health experts are advocating for the re-instatement of in person physical exam requirements before abortion medications are prescribed. This should be done. It would reduce the medical risks of medication abortion and make it harder for these drugs to be used by bad actors for abuse and exploitation.
Dan Russo, editor
