In the past year and a half since COVID-19 swept the country, businesses in nearly all sectors that were deemed “non-essential” took an alarming hit, even causing hundreds of thousands of business closures across the country.[1]

 

While many businesses and services have been shut down and even failed as a result of COVID-19 restrictions, others have thrived. Companies selling sanitation products, in-home workout equipment, virtual communication services, and more were among those in higher demand due to the shut downs and stay at home orders.[2]

 

There were however, some less obvious sectors that expanded during the COVID-19 crisis. Of those, is the expansion of the abortion industry, specifically through chemical abortions, also known as the abortion pill.

 

Chemical abortion occurs in the first trimester and requires women to ingest pills containing Mifepristone (RU-486) and Misoprostol,[3] a labor inducing drug used to extract the aborted fetus from the woman’s body.[4]

 

Chemical abortions involve considerably less provider-patient interaction than other abortion methods and in some states, it is not even required that the pill be provided by a medical practitioner. Due to the blurry regulations on the abortion pill, access and expansion is steadily increasing. You can refer to a previous article on abortion pill access and regulations in the footnote below.[5] The inconsistent and varying approaches to the abortion pill regulation state-to-state resulted in a wide array of regulatory responses to COVID-19.

 

Some states have classified abortion as a non-essential service, which effectively banned abortion services entirely in the state during statewide stay-at-home orders, while other COVID-19 restrictions and new protocols added to the inevitable expansion of the abortion pill. States like California, New York, and Virginia have classified abortion as an essential service and have redesigned the abortion facility protocols to reflect that. The newly developed protocols have been established to maintain access to abortion while “social distancing, preserving personal protective equipment (PPE), and limiting in-person health care visits and risk of exposure.”

 

Abortion facilities in some states have taken it a step further and developed new protocols to minimize face-to-face interaction as much as possible through the utilization of telehealth.

 

The abortion lobby, including reproductive healthcare research entities and providers from Gynuity Health Projects, Advancing New Standards in Reproductive Health (ANSIRH) at UCSF, and the Society of Family Planning, among other organizations working to advance the expansion of abortion access, have utilized the COVID-19 pandemic, to further their own abortion access agenda. They developed a “Telehealth for Medication Abortion Care” protocol, also known as a “no-test abortion” protocol, and used the pandemic restrictions as a fast-action strategy to implement the usage of telehealth quickly and without much question.[6]

 

The telehealth protocol enables patients to obtain abortions without any in-person pregnancy testing, pelvic examinations, ultrasound or labs. Utilizing telehealth protocol, abortion providers evaluate patients remotely through a “virtual visit” over video or phone call. From the virtual consultation, providers determine whether the patient is clinically eligible, primarily based on age and gestational age (only given by the patients themselves). Once eligibility is determined, patients typically pick-up the abortion pills curbside with no further consultation and take orally at home. A virtual follow-up is then conducted weeks after the pills are taken.[7]

 

Prior to the COVID-19 shutdowns, there had already been several statewide bans of telehealth usage for abortions due to the high risks and safety issues. However, with the urgency presented by the pandemic response many regulations were implemented without much question or research at all.

 

The simplicity of telehealth protocols and the lack of attention given to these newly implemented protocols is alarming and poses an incredible risk to women seeking abortions. The lack of in-person consultations and testing allows women to gain access to abortion pills without true determination of eligibility and poses greater risks to their health.

 

The abortion pill alone poses several great health risks to women, which is discussed in further detail in the article mentioned in footnote 5. The usage of telehealth increases those risks by simplifying the process, and severely downplaying the impacts of chemical abortions on women by deregulating the process all together and displaying it as a simple “over-the-counter” method that does not require physician provision. Women are being severely misled on what to expect, and left to deal with the side-effects and complications at home with little to no medical guidance. This puts the medical liability on the patient without any regard to the severity of the common effects.

 

Some of the most alarming risks that telehealth abortions cause are due to the ease of access without proper medical evaluation.

 

The most important factor in determining eligibility of a patient to receive a chemical abortion is the gestational age, which determines how far along a woman is in her pregnancy. Gestational age is calculated from the first day of a woman's last menstrual period (LMP) to the current day and technically, includes the two weeks prior to conception. Parents are not always certain of when conception occurs, and those seeking abortions are even less likely to know especially if they are seeking abortion due to an unplanned pregnancy.[8] This would mean that the abortion provider, which is not necessarily even a physician, is basing the eligibility on a “best guess” of many patients.

 

This can be extremely dangerous. The abortion pill can only be legally provided in the United States up to 70 days gestation and as the gestational age increases the percentage of risks and complications also rises. After 70 days gestation, the likelihood of incomplete abortions spikes posing great risk for infections and other bodily complications.[9]

 

The only true way to confirm the gestational age of the fetus is through ultrasound, and without in-person examination women are being given a serious and dangerous medication without proper medical examination and are then left to manage effects and complications on their own.[10]

 

There are many other concerning factors with the unregulated expansion of telehealth usage for abortions including the lack of monitoring that can allow improper usage of the medication, usage by individuals who were not determined eligible, and improper medical waste disposal following the abortion.

 

The abortion lobby has without a doubt used the COVID-19 pandemic as a means to push through their abortion expansion agenda through telehealth protocols, and we can expect to see a legal battle in the coming months and years on the already inconsistent and blurry regulatory state of chemical abortions in the United States.

 

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[1] https://fortune.com/2020/09/28/covid-buisnesses-shut-down-closed/

[2] https://www.forbes.com/sites/forbestechcouncil/2020/12/18/industries-thriving-during-the-pandemic/?sh=39dce3027a03

[3] https://www.liveaction.org/news/these-are-the-4-most-prevalent-abortion-procedures-in-america/?gclid=CjwKCAjw0qOIBhBhEiwAyvVcf-Nq29uwBq624thjjeGRZ0yiGhzxm51jbMFau9bT5cxHFpKA6azpExoCC7IQAvD_BwE

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760893/

[5] SP/06/03/21/abort-pill-access/karmie | societyofstsebastian

[6] https://www.kff.org/policy-watch/medication-abortion-telemedicine-innovations-and-barriers-during-the-covid-19-emergency/

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161512/

[8] https://www.verywellfamily.com/gestational-age-2371620

[9] https://www.ncbi.nlm.nih.gov/books/NBK559071/

[10] https://www.verywellfamily.com/gestational-age-2371620

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