Webcam Abortions on Trial: Fighting for Life and Women's Safety at the Iowa Supreme Court

By Marisa Lengor Kwaning, CP Guest Contributor Friday, March 20, 2015

In what is emerging as a national test case, the Iowa Supreme Court heard oral arguments last week in Planned Parenthood of the Heartland Inc. v. Iowa Board of Medicine, which challenges the 2013 state medical board's decision to require the physical presence of a physician when a patient is given an abortion-inducing drug.

Telemed abortion, otherwise known as a webcam abortion, is a procedure in which an expectant mother gets a chemical abortion when there is no doctor physically present.

The physician consults the patient via webcam and, after the doctor explains the procedure to the patient, the physician remotely activates a drawer that opens.

The expectant mother is then provided with two abortion-inducing drugs – mifepristone and misoprostol – as part of the RU-486 protocol, administered by a nurse or clinical staff member who may or may not be licensed.

There is no physical examination of the patient by the physician on the other end of the webcam; after drugs are dispensed, the patient likely never sees that physician again.

Iowa Solicitor General Jeffrey Thompson defended the state Board of Medicine's safety concerns in court. "This is a unique drug," he said, describing RU-486. "This is not a typical prescription pharmaceutical."

"The FDA, in approving the drug, specifically provided a protocol for what they were saying was safe and effective use of the drug," Thompson elaborated. "[The FDA] expressly disclaims they are not finding the evidence shows safety or efficacy for any other use."

Webcam abortions have become appealing to Planned Parenthood largely because they reduce their cost burden. They are also less messy for abortion centers – though incredibly traumatizing for the patient who has to deal with hemorrhaging, as well as the remains of a dead human being at home.

Based on their argument of abortion being a "fundamental right" under Iowa's Constitution, Planned Parenthood of the Heartland sued the state medical board. A Polk County district court upheld the medical board's decision.

Planned Parenthood appealed the decision and, as a result, the case was heard by the Iowa Supreme Court on March 11.

The Iowa Board of Medicine ban is based on their concern for the health risks to women involved in webcam abortions. According to Matthew Heffron, an attorney with the Thomas More Society, "This is a national test case. [Planned Parenthood] is trying procedure here. If they are successful in this case, they will probably attempt to spread the practice in other states."

Planned Parenthood's assertion in this case – since abortion is a "fundamental right," it should not matter how the procedure takes place – should trouble anyone concerned about women's health. Their legal fight is to preserve the practice, no matter the human cost.

Concerns over patient safety have even been expressed by former Planned Parenthood of the Heartland employees like Sue Thayer, who witnessed the issue firsthand at clinics: how cutting the cost of medical care often trumps the value of an expectant mother's life.

In December 2014, University of California – San Francisco (UCSF) released an extensive study on abortions funded by Medicaid in California.

While ostensibly reinforcing pro-choice talking points ("Major Complication Rate After Abortion Is Extremely Low" declared the UCSF press release), Stanford University Ph.D. Michael New and his team found something different when they explored the full data set.

"This study of more than 50,000 abortion patients confirms the finding that telemed abortions are a lot more risky than surgical abortions," said New in a recent Bound4LIFE interview.

"Their data shows the number of follow-up visits and emergency room visits are much higher for women having telemed abortions – the procedure has four times more risk of complications."

Teri Kohl, Co-Director of the Heartland House of Prayer, expressed her concerns on how the court hearing proceeded.

"The opening arguments strayed from focusing on the safety of women receiving webcam abortions, which is the heart of the issue," said Kohl.

Because abortion is legal in Iowa and throughout the United States, Planned Parenthood making their case based on the legality of the overall practice – rather than the safety or legality of webcam abortions – becomes a distraction from the real issue.

Kohl led a group of local women and men in prayer, who gathered at a church one block from the Iowa Supreme Court as arguments were presented by lawyers on both sides.

Webcam abortions are currently banned in 16 states due to concerns for the health of the patient, a national trend that validates the Iowa medical board's ban.

According to the latest polls, two-thirds of all Iowans agree that the practice of telemed abortions should be banned.

Heffron concludes, "The real issue is protecting women's lives. Webcam abortions are dangerous, and the Iowa Board of Medicine's ban should be upheld."

While keenly aware that this case could have negative ramifications on a national level, Teri Kohl remains encouraged as a woman of prayer.

"Iowa is the pilot state, the first state using chemical drugs to abort babies," Kohl says. "The reality is this is unsafe. We believe that our prayers for the justices and over this case will have an impact. I feel very hopeful about the final outcome of this case."

Marisa Lengor Kwaning is a writer, editor and health policy analyst who resides in Washington, D.C. She has worked in public health, disaster management, as well as foreign and domestic health policy. She earned a Masters degree in Public Policy from George Mason University and currently consults at Final Draft:Writing Services.