How telemedicine can fill the void left by ‘abortion deserts‘

Today, we use the internet to find everything – new restaurants and bars, the closest movie theater, and the most efficient route to our friends’ houses. Finding health information and researching health care providers is no different, and that includes finding the closest provider for abortion care. But unlike many other health care services, where a Google search will produce a multitude of local options, people logging on to try to find an abortion provider are met with a harsh reality: In order to reach the closest abortion clinic, they may need to travel hundreds of miles.  

New research released last week revealed just what this user experience is like. Through systematic searches, we learned what the average person would find if they “Googled” “abortion clinic near me” in every state and major city in the United States, and the results were daunting. We knew that abortion access would vary around the country, but the results showed just how starkly your zip code can dictate your ability to access care. For example, if you live in the Midwest, you’re also living in the region with the fewest number of clinics per capita, and if you live in Kentucky, Mississippi, Missouri, North Dakota, South Dakota, or West Virginia, you live in a state with only one abortion clinic. If the clinics in those six states were to close, almost 4 million women would have to travel out of their home state to get abortion care.

The research revealed 27 “abortion deserts,” cities in the U.S. that are 100 miles or more from an abortion clinic. These 27 cities are spread out across 15 different states in the Midwest and South. Some states require women to come for pre-abortion counseling and then mandate a waiting period of up to 72 hours before the abortion, requiring two round-trips to the clinic. For what other basic medical care would we think it’s ok for people in the U.S. to travel 400 miles? These barriers are frankly too much for some women to overcome, but by examining technological advances in medicine, we can find one way to alleviate these concerning results. 

We are increasingly seeing health care systems turn to telemedicine to provide care in areas where there are gaps. Telemedicine has incredible potential to expand as an integral part of healthcare provision, and abortion should be part of that. Telemedicine for medication abortion has become an exciting option for increasing access to abortion care for early abortion; it can be used in the first 10 weeks of pregnancy and involves taking two types of pills 6-48 hours apart. To date, this model allows people seeking abortion to conduct a video or phone consultation with a remote healthcare provider from either a local community clinic that does not have an abortion provider or from home. If women meet the medical screening criteria, the pills can be provided at the clinic or mailed to them. 

Unfortunately, legislatures nationwide are trying to prevent the expansion of telemedicine for abortion, despite its . In Kansas, for example, lawmakers recently passed the , which allows for insurance reimbursement for telemedicine services, but explicitly excludes abortion. It also has a clause that allows the entire law to be nullified if the abortion ban clause is struck down, making access to reproductive health care a bargaining chip in the effort to expand healthcare more broadly through new technology. Since women and young people are more likely to look for (compared to men or people over 50) and there’s been a documented increase in in the past few years, we must adjust our health care system to meet the changing way we seek health care. The future of healthcare will be increasingly digitized, online, and delivered remotely. Including abortion care in these models has the potential to reduce abortion deserts in the places where access is most needed. 

Alice Cartwright is a Project Director at (ANSIRH), a collaborative research group at the University of California, San Francisco. Her research interests include abortion access and the intersection of reproductive and digital health.