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Conservative state lawmakers target abortion pills prescribed over Internet

By Sandhya Somashekhar
Washington Post Staff Writer
Thursday, December 30, 2010; 10:07 PM

Conservative lawmakers in some states are taking aim at a practice that they say could greatly expand the number of women who choose to terminate their pregnancies: abortion pills prescribed over the Internet.

State legislators in Iowa and Nebraska have announced their intention to try to ban telemedicine abortions, which allow women to go to a branch clinic to consult via Internet videoconferencing with a physician located miles away. Then, with the push of a remote control, the doctor can open a drawer in the clinic that contains RU-486, known as the abortion pill.

Currently, telemedicine abortions are available only in Iowa, where more than 2,000 women have used the practice since 2008 through the state's Planned Parenthood affiliate. Previously, the organization provided abortions at half a dozen clinics, concentrated in the state's larger cities. Because of the telemedicine program, women in the first nine weeks of pregnancy can obtain abortion pills at most of the organization's 19 centers, which are scattered across the state.

Supporters say the program provides a vital service to women in the state's rural reaches, where abortions can be virtually impossible to obtain. They say the process is identical to an in-person appointment.

"The only difference is the point in time when the physician gets involved and reviews all the material and asks if she's ready," said Kyle Carlson, director of legal and lobbying for Planned Parenthood of the Heartland. "This is the future of medicine in all fields, not just abortion."

But abortion opponents in Iowa and elsewhere say they want to prevent the practice from gaining traction. They say they will push measures in several states where they have supportive legislatures - a number that has swelled since the Republican sweep of governor's mansions and statehouses in November.

"I'm not trying to inhibit telemedicine, but we're talking about chemical abortions here. It's not appropriate," said Nebraska state Sen. Tony Fulton (R). Nebraska's legislature is nonpartisan. He plans to introduce a bill when the legislature convenes next week that would require doctors to be physically present to administer an abortion pill. "RU-486 is not without controversy and has not been without complications. It seems to me we should leave these webcam abortions to the realm of science fiction."

Nebraska is among the states that have the most restrictive abortion policies. Last year, it became the only state to pass a "fetal pain" bill that bars the procedure after 20 weeks without an exception for the health of the woman. It is being viewed as a model for antiabortion lawmakers in other states.

Abortions are available at two sites in the state: in the large cities of Omaha and Lincoln. LeRoy Carhart, one of a handful of doctors in the country who perform late-term abortions, left the state after the fetal pain bill was passed. He now practices in other states, including Maryland.

Antiabortion activists say telemedicine will be one of their main focuses in 2011, in part because they oppose the use of the abortion pill. RU-486 is a combination of drugs and is marketed by Danco Laboratories under the brand name Mifeprex. It is 92 percent to 95 percent effective, according to the company, and is approved for use only in the first weeks of pregnancy.

The drug causes miscarriage by blocking a particular hormone necessary for a pregnancy to continue. More than 1 million women have used the pill since the government approved it 10 years ago, according to the company.

Antiabortion groups say 11 women have died from complications related to the drug, but the Food and Drug Administration has not definitively linked RU-486 to any deaths.

Proponents say the death rate for women giving birth is higher than that for the abortion pill. They say many women prefer it because of the ease of taking a pill, and because the final steps often occur privately, within the woman's home.

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