Why Increasing Access Doesn't Increase Abortions

The Iowa Board of Medicine heard public testimony Wednesday regarding whether the state should ban the practice of distributing abortion-inducing pills via a video-conferencing system. The video-conferencing system has been controversial, with opponents arguing its detriment to women's safety, despite the studies that show it is just as effective and safe as a traditional face-to-face procedure.

Another interesting finding? The annual number of abortions has dropped 30 percent in the state. Since the system was implemented in 2008, abortions have decreased from 6,649 in 2007 to 4,648 in 2012.

Only three of Iowa's 17 abortion clinics have an on-site physician. The video-conferencing system has tripled the number of Iowa towns where women can obtain abortions, allowing doctors in Des Moines to dispense abortion pills to women in clinics in more remote areas of the state.

As The Cut explains, women have to walk into one of the 17 clinics, see a nurse and a counselor, have an ultrasound, and then can consult a doctor from one of Planned Parenthood's three larger urban locations video chat. The doctor has the ability to then remotely unlock a container holding the abortion pills. One is taken in-office and the other at home, where the abortion happens over several days.

Opponents of the technology say they are concerned about the safety of patients who use the system.

"We can do both, can't we?" said Jenifer Bowen, executive director of Iowa Right to Life. "We can care about women, and we can care about babies."

According to a study of 449 women seen at Iowa Planned Parenthood clinics, the rate of successful abortion for women who use the video-conference technology is actually higher (99 percent) than those who seek face-to-face visits (97 percent). Furthermore, there was no difference in the rate of serious side effects, which were seen in just over one percent of women in each group.

Perhaps the most striking response to the safety criticism, however, comes in the form of an anecdote from Jill June, CEO of Planned Parenthood of the Heartland.

A profile piece in the American Prospect details a night June spent lying awake, channel-surfing. The CEO happened upon a news program where a woman was relaying the details of her recent heart-valve replacement. A doctor in another wing of the hospital had performed the procedure using a robotic arm as part of the new technology called telemedicine. "I just thought to myself," June recalled to the American Prospect, "they’re using telemedicine for open-heart surgery. Why can’t we hand someone a pill?"

June also offered an explanation for the declining abortion numbers in Iowa that differed slightly from Bowen's, who credited the decrease to prayer vigils outside abortion clinics, "crisis pregnancy centers," and increased use of sonograms.

June said the decline is due to more women using long-acting contraceptives, including hormone devices implanted in women's arms and intrauterine devices. Planned Parenthood and other Iowa organizations took part in the Iowa Initiative project, a five-year demonstration project that recently ended. The project, funded by the late wife of Warren Buffet, provided free long-term contraceptives to women.

Over the course of the project, Planned Parenthood of the Heartland implanted more than 3,400 contraceptives per year — a staggering statistic when compared to the approximate 470 implanted annually in previous years. June said the implants are appealing to many women because they're reliable and reversible.

"Most women don't decide not to get pregnant; they decide not to get pregnant now," June said. She added that in some cases, the implants were given to women who had just had abortions, so they wouldn't need repeat procedures.

The earliest the board could adopt new rules barring the video-conferencing system is Friday.