Planned Parenthood Improperly Uses “Telemedicine” to Increase the Reach of its Abortion Business
In a 2010 Iowa Public Radio interview, Barbara Chadwick, Director of Patient Services of Planned Parenthood of East Central Iowa, acknowledged that increasing chemical abortions is a “key element” to Planned Parenthood’s strategic plan.
NARRATOR: It’s the goal of Planned Parenthood to expand abortion services at its clinics nationwide over the next 5 years.
CHADWICK: We have been looking at initiating an abortion service as a core service of all Planned Parenthoods, part of the federation’s strategic plan for 2015.
NARRATOR: Medical abortions, Chadwick says, will be a key element in that strategy and signing up for the long-distance option will get her organization toward the goal faster.[i]
The “long-distance option,” that will get Planned Parenthood “toward the goal faster,” employs telemedicine to increase the reach of Planned Parenthood’s abortion business without having to increase its physicians or increase its investment in patient care.
As documented in AUL’s Report, The Case for Investigating Planned Parenthood, the use of telemedicine, or “telemed,” to distribute RU-486 violates FDA requirements for dispensing mifepristone. Dispensing the abortion drug regimen after videoconferencing in place of a face-to-face visit between doctor and patient,[ii] places women in greater jeopardy. At a minimum, a “virtual visit” cannot accurately assess the gestational age or rule out ectopic pregnancy.
Thus, it is concerning that part of Planned Parenthood’s strategic plan may be to expand its telemed abortion usage, which it began in its Iowa clinics in 2008.
State legislatures have begun to respond to this practice by introducing and enacting legislation that would, in accord with the FDA guidelines, require a physician to be physically present when the woman ingests the abortion pills. These efforts to ensure patient safety have been vigorously opposed by Planned Parenthood.
Testifying against a Nebraska bill requiring the physical presence of a physician during a chemical abortion,[iii] Tracy Durbin, Director of Quality and Risk Management for Planned Parenthood of the Heartland, argued that “there’s no medical evidence that the practice [of telemed abortions] is dangerous.”[iv] However, the practice of telemed abortions is fairly new. While there are no studies examining its use in a significant sample size,[v] there is ample evidence that chemical abortions are dangerous and that the FDA protocol is warranted.
Demonstrating that convenience—not safety—was Planned Parenthood’s key concern, Durbin stated, “It’s unfair that a woman in a rural part of our state does not have the same access to abortion care as a woman who lives in or near a city.” Fairness, as Planned Parenthood sees it, requires rejecting standards that safeguard a woman’s health if they would result in any disparity in the ease of obtaining an abortion. However, Planned Parenthood’s approach of experimenting with unapproved uses of chemical abortions, which has had a documented and tragic impact on women’s health and lives, is what is truly unfair to women.
In April 2012, Planned Parenthood of Wisconsin announced it was suspending its use of chemical abortions after the state enacted a law requiring that no abortion-inducing drug be administered to a woman unless the physician who prescribed the abortion pill is physically present in the room at the time of the abortion.[vi] The Planned Parenthood announcement declared that the Wisconsin law “interferes with the patient-doctor relationship and places an unprecedented burden on Wisconsin women and doctors.”[vii]
However, physicians are often required to adhere to certain standards in order to protect the well-being of their patients. Planned Parenthood’s routine opposition to every commonsense, abortion-related law and regulation as an “interference” with the doctor-patient relationship ignores the beneficial impact on women’s health.
In addition, former Planned Parenthood abortion clinic director, Abby Johnson, testified before the Texas Senate in 2011 that “there is no doctor-patient relationship” at Planned Parenthood clinics.[viii]Ms. Johnson recounts that for most chemical abortions, there was no physician on site, and neither was there an examination of the patient before the chemical abortion, or a follow-up visitation after the procedure.[ix] Her testimony buttresses the need for regulations ensuring the dangerous abortion-drug regimen will be administered with patient safety, not lower overhead costs, in mind.
Allegations made by another former Planned Parenthood employee familiar with telemed abortions support the claim that Planned Parenthood’s opposition to telemed restrictions is driven by the harm it will do to the organization’s profitability.
Sue Thayer, a former Planned Parenthood of the Heartland employee, was fired in 2008 after she began to voice safety concerns surrounding telemed abortions.[x] As she recalls, her supervisors rationalized telemed abortions by pointing to their lower overhead costs. Indeed, by removing doctors and medical equipment from the picture, Planned Parenthood was able to expand its abortion practice and boost its profit margins at the same time.[xi]
A money-saver for the abortion provider, Planned Parenthood’s use of telemed abortions dangerously discounts the health and safety of women.
In her “whistleblower” lawsuit filed against Planned Parenthood of the Heartland, Ms. Thayer alleges that, lacking the ability to care for these women at their own facilities, Planned Parenthood’s telemed abortion patients who later experienced significant bleeding were told “to go to an emergency room and report that they were experiencing a spontaneous miscarriage.”[xii]
On top of being unethical, encouraging a woman to be dishonest jeopardizes her health. Lying to a healthcare provider about the cause of the patient’s condition leads to a host of obvious problems including inappropriate care and inaccurate reporting of abortion complications. The allegations in Ms. Thayer’s lawsuit highlight the problems associated with telemed abortions and the need for state regulations of the RU-486 regimen.
Chemical abortions are “easier” to provide than surgical abortions (particularly when ignoring important health and safety laws and regulations), but they are not safer.[xiii] Planned Parenthood claims to be advancing the cause of women when it bypasses FDA protocol and opposes legislation that could impact ease of “access” to chemical abortions. However, just the opposite is the case; prioritizing expansion over safety victimizes women.
[i] Iowa Planned Parenthood in Tailspin Over Telemed Abortions, Operation Rescue, (June 8, 2010), http://operationrescue.org/audio/nr100521AbortionProtestPiece.mp3 (last visited Sept. 11, 2012).
[ii] Dickinson, Faraway doctors give abortion pills by video, Des Moines Register (May 16, 2010),available at http://www.9news.com/news/local/article.aspx?storyid=140688&catid=188 (last visited Mar. 26, 2011).
[iii] See Require the Physical Presence of a Physician Who Performs, Induces, or Attempts an Abortion, LB 521, 2011 Sess. (Neb. 2011), available athttp://nebraskalegislature.gov/bills/view_bill.php?DocumentID=12513 (last visited Sept. 11, 2012).
[iv] Transcript Prepared by the Clerk of the Legislature: Hearing on LB461, LB521, and LB690 Before the Judicary Committee, 2011 Leg., 102nd Sess. 45 (Neb. 2011) (statement of Tracy Durbin), available at http://www.legislature.ne.gov/FloorDocs/Current/PDF/Transcripts/Judiciary/2011-03-09.pdf (last visited Sept. 11, 2012). Durbin stated that while Planned Parenthood did not have immediate plans to provide abortions via telemed in Nebraska, it opposed the bill, “due to the potential that some medical groups may seek to provide these services in the future.”
[v] In July 2011, Dr. Daniel Grossman of the University of California, San Francisco, conducted a study of 578 women who sought abortions at Planned Parenthood clinics in Iowa, only 223 of which were telemed abortions. Daniel Grossman, Effectiveness and Acceptability of Medical Abortion Provided Through Telemedicine, Obstetrics & Gynecology, August 2011, 296-303. While the Grossman study reported 91 percent of patients in its small sample size being “very satisfied,” 25 percent of these telemedicine patients reported that they would have preferred being in the same room as the doctor.
[vi] See Senate Bill 306, 2012 Sess. (Wis. 2012), available athttp://docs.legis.wisconsin.gov/2011/proposals/sb306 (last visited Sept. 11, 2012).
[vii] See Teri Huyck, Special Notice for Patients Seeking Medication Abortion Health Care, Planned Parenthood of Wisconsin, (April 20, 2012), available at http://www.plannedparenthood.org/Wisconsin/files/Wisconsin/Statement_on_Act_217_website.pdf (last visited Sept. 11, 2012).
[ix] See Alexa Garcia-Ditta, Pro-Life Convert Takes the Floor in Sonogram Debate, Texas Observer, (Feb. 9, 2011), available at https://www.texasobserver.org/tags/senate/itemlist/category/46-observations?start=14 (last visited Sept. 11, 2012).
[x] See Sue Thayer, Planned Parenthood’s Big Lie, Washington Times, (Jan. 31, 2012), available athttp://www.washingtontimes.com/news/2012/jan/31/planned-parenthoods-big-lie/ (last visited Sept. 11, 2012).
[xii] Second Amended Complaint at 45, United States and Iowa ex rel Thayer v. Planned Parenthood of the Heartland, No. CV00129 (S.D. Iowa July 26, 2012).
[xiii] Jamie Walker, Abortion pill ‘less safe than surgery’, The Australian, May 7, 2011, available athttp://www.theaustralian.com.au/national-affairs/abortion-pill-less-safe-than-surgery/story-fn59niix-1226051434394 (last visited Sept. 11, 2012).