A new report from the Guttmacher Institute indicates a growing reliance on virtual abortion care. While this might seem positive given the restrictions following the overturning of Roe v. Wade, it’s crucial to interpret this trend cautiously.
Telehealth is undoubtedly valuable. My organization pioneered telemedicine abortion services in 2009. Since the FDA relaxed regulations on abortion pills, we’ve expanded our virtual care to ten states. However, virtual care alone isn’t a comprehensive solution or a substitute for genuinely accessible care.
Optimal abortion care requires a comprehensive approach, offering choices. True access means providing individuals with options, whether at a clinic or remotely. Both are necessary. Clinics are essential for abortions after 12 weeks, meaning a sole focus on pills and telemedicine neglects those with later-term pregnancies or those needing more extensive pain management.
The rise in online abortion services highlights the vital role virtual providers play amidst increasing bans and diminished access. Telehealth can reduce barriers by shortening travel, lowering costs, and mitigating stigma. However, this is only part of the picture.
Guttmacher’s data reveals that most abortions still occur in physical clinics. Despite the optimism surrounding telemedicine, in-person care remains the norm. Furthermore, virtual care isn’t always accessible, particularly for those in states with bans, who must still travel out of state. Accessing virtual abortion care also requires a device, internet, payment method, and a secure environment. These requirements can be as challenging as reaching a clinic for those facing domestic violence, housing insecurity, or financial hardship.
Our clinicians, both in-person and virtual, assist patients navigating an increasingly complex and expensive system. Black and Latina women, young people, and hourly workers are disproportionately affected. Our data reveals a preference for in-person care among patients of color, while virtual care is more common among white and Asian patients, highlighting that telemedicine isn’t universally accessible.
Fewer individuals can afford out-of-state abortion care, leading to delays or complete denial of care. Recent reports, including Guttmacher’s data, haven’t adequately addressed the impact of funding.
For example, after the Dobbs decision, The Abortion Access Fund (TAF), managed by Resources for Abortion Delivery (RAD), covered the full cost of abortion care for those traveling from states with bans to states like Illinois, Colorado, Florida, North Carolina, and New Mexico. This support was transformative, providing free procedures and allowing local abortion funds to focus on travel, lodging, and other practical needs.
However, funding has decreased, following cuts from the National Abortion Federation Justice Fund. These cuts have had immediate consequences, straining existing abortion funds and limiting the number of patients who can travel or receive comprehensive care. Affordability now often determines whether someone can access abortion, regardless of location or method. The economic impact of this funding loss cannot be ignored.
People should be able to use insurance or Medicaid for abortion care, rather than relying solely on donations or grants. Donations shouldn’t cover costs that insurance could easily handle. We navigate complex regulations to accept insurance and Medicaid in several states, but reimbursement systems are inconsistent, and many individuals live where public or private coverage is unavailable for abortion care.
As independent abortion providers, we are committed to helping our patients. Dedicated staff assist patients in accessing available funding, coordinating between $5,000 and $10,000 in financial support daily. However, with funding cuts and strained local resources, it’s never enough.
Discussions about telemedicine as “the” solution often overlook these financial realities and the practical support needed. Even if the procedure is fully funded, patients may still lack the resources for travel, lodging, or childcare. These are the underfunded areas that require urgent attention.
To ensure genuine abortion access, we must prioritize economic justice, invest in patient support infrastructure, and focus on those most impacted by restrictions. This means investing in both in-clinic and virtual care, as well as Medicaid and mutual aid. Anything less risks perpetuating existing inequalities.
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