using telemedicine to do abortions in Iowa
Woman and Her Monitor
By Randall K. O'Bannon,
It was long suspected, but
recent press reports have confirmed that Planned Parenthood of the
Heartland, one of the national organization’s Iowa affiliates, has
been facilitating chemical abortions via telemedicine since July
2008. This first of its kind in the nation system is supposed to
make it possible for women in remote areas to obtain abortions
without ever having to actually physically meet a doctor.
About 1,500 women have used
the video conferencing system for abortion so far. Other
abortionists are taking a close look at the project and Planned
Parenthood expects other states to follow in offering telemedicine
abortions soon (Des Moines Register, 5/16/10; KCCI.com, 5/19/10).
Sixteen of PP Heartland’s 19 clinics offer these telemedicine
How does this work? Planned
Parenthood tells the Register that a woman comes in and takes a
pregnancy test at the clinic and then, if the test comes back
positive, has an ultrasound. The images are sent electronically to
the doctor in another city.
Clinic staff counsel the
woman about her options, give her printed information about the
abortion pill, and then have her watch an eight-minute video
prepared by Planned Parenthood (see http://www.plannedparenthood.org/health-topics/abortion/abortion-pill-medication-abortion-4354.htm).
The video talks about the
abortion process and side effects such as cramping and bleeding, but
tells women these are similar to what is experienced in a “heavy
period.” She is assured that the procedure is safe. Then the video
offers a re-enactment of a follow up visit two weeks later. In it
the clinicians tell the woman she is not pregnant anymore and she
responds, “That’s great. I really would like a baby sometime. But
right now, we just can’t afford it. I’m really glad we had this
After watching the video,
the woman is asked if she’d like to obtain the drugs using an
electronic conferencing system. If she says yes, she is seated at a
desk in front of a computer monitor with a camera where she can
teleconference with the doctor, who could be as many as 190 miles
The doctor goes over her
medical history and talks to her about the pills she will be taking
and how they will work. After giving her a chance to ask questions,
the doctor enters a command on a computer keyboard and a drawer in
the desk where the woman is seated opens to reveal two bottles of
The first contains
mifepristone, which she is instructed to take in the office while
the doctor observes via the monitor. It will starve the child over
the next couple of days. The second set of pills, which she is given
to take later at home, are misoprostol, a prostaglandin that will
stimulate powerful uterine contractions to dislodge and expel the
Women are told in the video
that they should feel normal a day after taking the misoprostol at
home. If they are not, or if they are experiencing other problems,
they are told to call Planned Parenthood’s 24-hour hotline.
Planned Parenthood tells
women the drugs are “safe and effective.” There is no mention on the
video or on the web site that at least 11 women are known to have
died after taking the dangerous drugs or that at least a thousand
women have suffered serious complications.
Nor does the video tell them
that women have bled to death or that hundreds of women have
hemorrhaged and required emergency medical care. Women are given
something to help manage pain and told of other side effects like
diarrhea and vomiting, but the video does not say that these have
put women in the hospital.
Planned Parenthood mentions
the possibility of infections, but the video does not explain how
the symptoms of these are hard to distinguish from the bleeding,
cramping, and gastrointestinal distress that often accompanies these
abortions. They are told to contact Planned Parenthood if they have
a fever, but the deadly infection that killed many of these women
often comes without a fever.
Of course, women can call
Planned Parenthood if they have a problem, but exactly what are they
to do when the doctor is a couple of hundred miles away? Even if she
makes it to a nearby emergency room, doctors there may be unfamiliar
with the chemical abortion process or its risks or complications.
Even if they are fortunate
enough to avoid hemorrhage or infection, for a certain percentage of
women, these pills do not work. These women, if they are still
determined to abort, will face a surgical procedure. Is Planned
Parenthood expecting women from these rural areas to travel to Des
Moines to complete their abortions?
generate buzz and open up a whole new customer base in locations
where Planned Parenthood can’t afford to post an abortionist. It
gives some of their smaller offices a chance to bring in a very
profitable product without having to make a lot of changes or buy a
whole lot of new equipment.
If there are problems, they
become other people’s problems, because there is no doctor and the
clinic isn’t equipped to do surgery or handle some of the more
Chemical abortions, even in
locations where there is a live doctor present, are a much neater,
cleaner enterprise—for the clinic, at least. Though women bleed
profusely and cramp violently and pass the child’s emaciated body,
they generally do so at home, not the clinic.
Planned Parenthood’s Iowa
affiliate participated in U.S. clinical trials of RU486 and was one
of the early adopters of the method after its approval in September
of 2000. And the numbers show the impact.
According to Iowa Right to
Life, Planned Parenthood did nearly 2,000 more abortions in 2008
than in 2002 (4,492 versus 2,898), and chemical abortions in 2008
exceeded surgical ones (2,582 abortions with RU486, against 2,210
Those numbers will certainly
get worse with the advent of telechemical abortions.
The illusion of an abortion
decision made “between a woman and her doctor,” her concerned
personal physician, is shattered by the new telechemical abortion.
Now, a woman’s life is in the hands of a person she never meets and
the death sentence of her child is handed down when a distant doctor
who, miles away, merely clicks a button.
This isn’t progress. It’s
one of those science fiction horror films.