Temporary stay will allow 'telemed' abortions to continue in Iowa

No evidence procedures do not 'protect the health and safety of patients'

March 28, 2014 | 10:59 pm

UPDATE: Planned Parenthood of the Heartland won a preliminary victory Tuesday in its effort to stop an Iowa Board of Medicine rule that effectively would curtail doctors’ ability to dispense abortion-inducing pills via a video-conferencing system at the private provider’s clinics in Iowa.

Polk County District Judge Karen Romano granted Planned Parenthood’s request for a temporary stay that blocked a board rule that was slated to take effect Wednesday. The judge’s stay order will be in place while the issue of whether to permanently allow or bar the proposed rule to decided by the court.

“Our No. 1 priority is the health and safety of our patients,” Planned Parenthood of the Heartland President and CEO Jill June said in a statement. “Allowing the rule to be ineffective during litigation will ensure that Iowa women can continue to receive safe health care, without delay, from the provider they trust.”

June said there have been no complaints from more than 5,000 women who have utilized Planned Parenthood’s telemedicine delivery system for medication abortion at 15 health centers. She added that there was no medical evidence or information that questioned the safety of her agency’s system or indicated that the board’s ruling was based on the health and safety of Iowa women.

Mark Bowden, the board’s executive director, disagreed, saying the court’s decision to stay implementation of the rule perpetuates what state regulators believe is “inadequate health care and treatment” for Iowans who seek medical abortions.

“The board believes that a physician must establish an appropriate physician-patient relationship prior to the provision of a medical abortion,” Bowden said in a statement. “The physician’s in-person medical interview and physical examination of the patent are essential to establishing that relationship.”

In her 16-day ruling, Romano said she acknowledged the board’s expertise in regulating the provision of medical care in Iowa, but was not entirely persuaded that the board’s proposed rule achieves its stated goal of ensuring the safe and healthy administration of health-care services.

“With respect to the lack of an in-person meeting, it is peculiar, as petitioners point out, that the board would mandate this for abortion services and not any other telemedicine practices in Iowa,” Romano wrote. “There is simply no evidence the court can rely on to come to the conclusion that the telemedicine abortion procedures, which have been offered for five years without issue, do not ‘protect the health and safety of patients.’

“Further, the court strains to understand how decreasing the number of apparently effective and safe abortion services offered to Iowa women pending the resolution of this case supports the public’s interest in receiving ‘adequate’ healthcare,” she added.

“If anything, the opposite is true; women who would be unable to attend one of the five remaining clinics that could maintain chemical abortion services despite the implementation of (the proposed rule) would not receive adequate healthcare as they would likely be unable to access those services,”  the judge wrote in her stay order.

Romano said that denying access to telemedicine abortion would increase the need for surgical abortion which, she concluded, would be much more invasive and risky.

“Women may even choose to self-terminate their pregnancies if they are left with no other option, which is undoubtedly the least safe method of abortion,” the judge wrote. “In light of the hardships such woman would face, the court is not convinced that the public’s interest in promoting safe, healthy, and adequate medical services in Iowa is furthered by (the proposed) rule.”

The board, which oversees and regulates physicians and medical practices in Iowa, voted 8-2 last August to adopt a rule that effectively would stop Planned Parenthood clinics from dispensing abortion-inducing pills via a video-conferencing system.

A majority of the board members cited concerns over the medical care being provided to rural women. The proposed administrative rule would establish standards of practice for physicians who prescribe and administer abortion-inducing drugs. The revised rules would require in-person meetings between doctors and patients along with direct after-care services.

At issue is a practice whereby licensed physicians use a remote-controlled system to conduct medical assessments with patients in rural Iowa clinics. They then are able to dispense Mifepristone, also known as RU-486, in the early stages of a pregnancy.

Proponents say Planned Parenthood’s practice – implemented in 2008 -- is safe and patients get the same level of care as those who see a doctor in person. They contend telemedicine procedure was thoroughly researched to ensure it was in full compliance with Iowa law and service helps women in remote parts of the state.

Abortion opponents asked the state board to block the program, saying it violates state medical standards and poses a health risk to women because it doesn't entail a face-to-face meeting with the doctor.

Jenifer Bowen, executive director of Iowa Right to Life, said there is ample medical evidence to indicate that telemedicine abortions are unsafe. She contended the Food & Drug Administration has documented 2,207 adverse events involving U.S. women who have had medical abortions, including 14 deaths and 612 hospitalizations.

“It is devastating that Judge Romano and the abortion industry in Iowa are ignoring the health and well-being of women to push their own agenda and continue to make this about abortion access, and about politics,” Bowen said in a statement. “These abortions, where a woman never physically sees a doctor, who goes home to hemorrhage for days and ultimately deliver her dead baby, is not empowering women,” she added. “Today's decision by Judge Romano is simply one more difficult, heart-wrenching step in the battle we are ultimately going to win.”

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