Medication Abortion
Including three that enacted measures this year to limit access to medication abortion, 19 states now restrict this commonly used first-trimester abortion method (see Medication Abortion).
- Banning telemedicine. Although telemedicine is increasingly used to expand access to health care in underserved areas, states have moved aggressively in recent years to ban its use for medication abortion. This year, Arkansas and Idaho adopted new restrictions, join 16 other states in barring this use of telemedicine. In mid-June, the Iowa State Supreme Court struck down a regulation banning the use of telemedicine for medication abortion, saying that no evidence supported the imposition of such an undue burden on women; the regulation had not been in effect pending the court decision.
- Requiring FDA protocol. Arkansas enacted a measure requiring use of the outdated protocol that appears on the FDA label for mifepristone that was approved in 2000. The newer evidence-based regimen uses less medication, involves fewer side-effects and visits to the provider and is less expensive; this new regimen is routinely used and is widely recognized as the standard of care for performing medication abortion. Including Arkansas, four states nonetheless require use of the outdated FDA protocol.
- Counseling on reversing medication abortion. Arizona and Arkansas adopted a new type of medication abortion restriction: Under these laws, abortion providers are required to inform women that it is possible to stop a medication abortion by giving the woman a large dose of hormones after the mifepristone has been administered, but before the woman takes the misoprostol. However, very little evidence indicates that this works to stop the abortion procedure or that it does not entail medical risks. The Arizona law has been challenged in federal court and is not being enforced.
Targeted Regulation of Abortion Providers (TRAP)
Four states enacted measures that impose restrictions on abortion providers beyond what is necessary to ensure patients’ safety. Typically, these laws take two approaches: establishing physical plant and staffing standards, and requiring abortion providers to have a formal relationship with a hospital (see TRAP Laws Gain Political Traction While Abortion Clinics—and the Women They Serve—Pay the Price). Including the new measures enacted this year, 25 states have some form of TRAP law (see Targeted Regulation of Abortion Providers).
- Admitting privileges. Five states require providers of either medication or surgical abortion services to have admitting privileges at a local hospital. Another 10 require the provider to have either admitting privileges or another type of relationship with a hospital (such as an agreement with a physician who has privileges). This year, Arkansas adopted a new restriction that requires only medication abortion providers to have an agreement with a physician who has admitting privileges; the law does not include a parallel requirement for surgical abortion providers. Arkansas is the only state to have such a requirement. Continuing its longstanding effort to require abortion providers to have a relationship with a hospital, the state adopted a new law that requires proof of such a relationship as a condition of obtaining a license to operate in the state.
- Physical plant standards. Legislation adopted by Tennessee in May would require surgical abortion facilities to meet all the requirements for licensure as an ambulatory surgical center; implementation of the law is blocked pending resolution of a legal challenge. Twenty-two states impose standards on abortion providers that are comparable to those for ambulatory surgical centers.
- Disposal of fetal remains. Arkansas and Indiana now require abortion providers to either incinerate or bury fetal remains.
For more information:
Guttmacher Institute State Center:
About the Guttmacher Institute
Now in its fifth decade, the Guttmacher Institute continues to advance sexual and reproductive health and rights through an interrelated program of research, policy analysis and public education designed to generate new ideas, encourage enlightened public debate and promote sound policy and program development. The Institute’s overarching goal is to ensure the highest standard of sexual and reproductive health for all people worldwide.
The Institute produces a wide range of resources on topics pertaining to sexual and reproductive health, publishes two peer-reviewed journals, Perspectives on Sexual and Reproductive Health and International Perspectives on Sexual and Reproductive Health, and the public policy journal Guttmacher Policy Review. In 2013, the Institute was awarded a prestigious Population Center grant by the National Institutes of Health (NIH) in support of the Guttmacher Center for Population Research Innovation and Dissemination. Guttmacher is one of only two non-university-based institutions out of the two dozen receiving such funding.
Editor's Note:
Just before my second marriage I went to Planned Parenthood for contraception advice and decision making; we had no health plan at that point of time. My future husband had been drafted and was going to serve in the US Air Force and eventually Viet Nam, so a health plan was soon to be available for both of us. We just celebrated our 49th wedding anniversary.
Beyond the information above about Planned Parenthood, we felt that what has happened through state legislatures might be just as important as to the steps being taken to restrict access to birth control information and other steps in family planning. The reports are from the Guttmacher Institute.
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