This Viewpoint discusses the challenges and barriers involved in increasing access to telemedicine abortion services in the United States.
For many women in the United States, obtaining an abortion is unduly difficult. In 2008, a national survey found that 31% of patients in rural areas traveled more than 100 miles for abortion services.1 Subsequently, states have enacted hundreds of new restrictions on abortion, including limits on the construction of facilities, the qualifications for clinicians, and the procedures that are used for abortion.2 At present, Mississippi, Missouri, South Dakota, and North Dakota each have only 1 operational outpatient abortion clinic, and Wyoming has none. Once a woman reaches an abortion facility, she may encounter additional barriers, including verbal harassment by protestors and physical blocking of the clinic entry.3 This harassment is sometimes violent: in November 2015, 3 people were killed at a Planned Parenthood clinic in Colorado Springs, Colorado. The health consequences of impeding access to abortion may be serious: women may delay the procedure, which increases risk, or resort to unsafe abortion methods. Ultimately, some women may be unable to obtain an abortion at all, resulting in unwanted births.