Get Adobe Flash player
On the first visit, the patient’s medical history and ultra- sound report are sent to the offsite physician. By video- conference, the doctor reviews her medical information then enters a password on the computer that unlocks a drawer in front of the patient containing the mifepristone and misoprostol tablets. Using an off-label protocol, the physician observes the patient swallow the mifepristone tablets and instructs her to take the misoprostol tablets in two days. A two-week follow-up visit is scheduled where a repeat ultrasound is performed and, if still pregnant, she is given the option of taking more pills, scheduling a surgical abortion or continuing her preg- nancy, knowing that birth defects are possible. Induced Abortion: A Basic Human Right? The Iowa clinics’ primary motivation presumed that women need to have ready access to abor- tion. Some abortion proponents assert that in- duced abortion is a basic reproductive right and should be easily available to every woman. Why should this procedure merit special status? Some men want vasectomies, must there be a urologist in every town? People need root canals, yet we don’t hear a public outcry about insufficient num- bers of endodontists. Further, the vast majority of abortions are non-emergent, elective procedures. A woman who decides to abort her pregnancy is not being compelled or required to do so, but is simply choosing that outcome for her pregnancy. It is her right under the law, but that does not translate into a basic human right. Better for the Patient–or the Doctor? The second rationale for the telemedicine program was to “reduce physician travel to outlying areas.” So, there was not an actual lack of providers, just a lack of willingness to drive. Instead, the woman suf- fering complications is forced to drive or see a stran- ger. What reputable physician performs a procedure on a patient but doesn’t provide emergency cover- age? This used to be called patient abandonment. Former abortion clinic director Abby Johnson recalls how medication abortions were handled in her clin- ics: “In our Gulf Coast of Texas Planned Parenthood clinics during 2008-09, doctors routinely authorized medication abortions remotely. They would be sent the ultrasound images, the patient’s vital signs and would then text back, “Okay for abortion,” on their BlackBer- rys while sitting on the beach in Cancun, Mexico.” 15 This brings new meaning to the term, “Beach bum.” 28  T oday ’ s C hristian D octor     F all 13 How Safe Is It? A 2011 prospective cohort study of the Iowa group found no significant differences between the telemedicine group and the face-to-face group in overall satisfaction or adverse event rate, but 25 percent of the telemedicine group said that they would have preferred to be in the same room with the physician. 16 This small study does little to inform about the true safety of telemedicine abortions in remote areas, but does expose an important point: many women want to sit eye-to-eye with their physicians. Women consider- ing abortion don’t need less professional contact, they need more. If complications arise, a virtual doctor just doesn’t cut it. Second Chances Some women who begin a medication abortion regret their decision and are desperate for a chance to save their babies. Family physician Dr. George Delgado met one of these women in his office and wanted to help. The patient had taken mifepristone, but not misoprostol. Dr. Delgado hypothesized that administration of progester- one might outcompete mifepristone for the progesterone receptors, thus restoring the integrity of embryo’s attach- ment to the uterus. He has developed a protocol of ad- ministering intramuscular injections of progesterone in oil, and in his small series, two-thirds successfully deliv- ered healthy infants at term. Dr. Delgado is looking for physicians who are willing to help women in their com- munities who want a second chance. For more information, visit www.abortionpillreversal. com.