Iowa Board of Medicine Faces Challenge to Newly Adopted Medical Abortion Rule

A recently adopted rule that bans telemedicine delivery system for abortion-inducing drugs (medication abortions) by requiring in-person examinations is under fire by Planned Parenthood of the Heartlands. On August 30, 2013 the Iowa Board of Medicine voted to adopt the rule that establishes standards of practice for physicians who prescribe or administer abortion-inducing drugs to terminate a pregnancy. On September 30, 2103,  Planned Parenthood of the Heartland and Jill Meadows, MD, its medical director, filed for judicial review of the rule and a motion for a stay, asking for the rule to be ineffective during litigation. If the rule goes into effect as scheduled, Planned Parenthood of the Heartland will be forced to suspend telemedicine delivery for medication abortions at 15 health centers in Iowa.

The Adopted Rule

According to a statement issued by the Iowa Board of Medicine on September 27, 2013, the rule, which is scheduled to go into effect on November 6, requires a physician to conduct an in-person medical interview, a physical examination of the patient, be physically present with the woman when the abortion-inducing drug is provided, and provide follow-up care 12 -18 days after the woman’s use of an abortion-inducing drug was provided to confirm the termination of the pregnancy and evaluate the woman’s medical condition. Among the principal reasons the board cited in support of the rule are: (1) the practices used by physicians who prescribe and administer abortion-inducing drugs using telemedicine are inconsistent with the protocols approved by the U.S. Food and Drug Administration and the manufacturer of the drugs, (2) nonphysician persons who do not have appropriate training to confirm or discover contradictions or perform an ultrasound are performing the examinations to determine the age and location of the embryo, and (3) the physicians who prescribe and administer abortion-inducing drugs using telemedicine may never meet with the patient in person. The Board of Medicine also provided its reasons for overruling the oppositions arguments against the rule.

Planned Parenthood of the Heartland’s Position 

In response to the rule, Planned Parenthood of the Heartland said that “the Board of Medicine’s decision not only bans its telemedicine delivery system for medication abortion, it also requires unnecessary medical services prior to receiving medication abortion.” According to Meadows, medication abortion is a very safe way to end a pregnancy before nine weeks and telemedicine delivery is a safe and effective way to provide medication abortion to Iowa women. She added that over the past five years, Planned Parenthood of the Heartland physicians provided medication abortion through telemedicine to more than 3,000 women in Iowa and received no patient complaints during that time. Andrew Harris of Bloomberg reported that according to a copy of the petition provided by Planned Parenthood “under the existing practice, a doctor can electronically release the drugs Mifeprex and Misoprostol to women pregnant for 63 days or less, after a video-consultation and after the patient has been checked for gestational duration, blood pressure and other factors affecting eligibility to take the drugs.”

Jill June, President and Chief executive Officer of Planned Parenthood of the Heartland stated that the Board of Medicine’s “unwarranted decision” jeopardizes the health of women in our state and creates unnecessary barriers for a woman to obtain the safe health care she needs.” She claims that “the decision was based on politics,” and added that “there was no medical evidence or information presented to the Board that questions the safety of [Planned Parenthood of the Heartland’s] telemedicine delivery system.”