Growing Controversy Surrounds 'Telemed' Abortions

As activists from both sides of the abortion debate mark Saturday's 38th anniversary of the Supreme Court ruling of Roe v. Wade, abortion remains one of this country's hot-button issues. In the time since the landmark ruling, procedures have evolved significantly. An Iowa clinic now offers so-called "telemed" abortions, where a doctor remotely dispenses a drug capable of ending an early pregnancy. Host Michel Martin speaks about the controversial new procedure with Dr. Vanessa Cullins, vice president for Medical Affairs at Planned Parenthood Federation of America.

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MICHEL MARTIN, host:

I'm Michel Martin, and this is TELL ME MORE from NPR News.

Today, thousands will gather here in Washington, D.C. and many thousands across the country will also observe the 38th anniversary of the Supreme Court decision that legalized abortion, Roe v. Wade. There will be demonstrations in support of and against that decision. And although the decision is nearly four decades old, the issue of abortion is not settled.

Just last week, the speaker of the House John Boehner opened new debate on the topic with the introduction of the No Taxpayer Funding for Abortion Act.

Representative JOHN BOEHNER (Republican, Ohio; Speaker of the House): Today we're here to talk about another promise that we're keeping, and that is ensuring that tax dollars are never used to fund elective abortions. A ban on taxpayer funding of abortions is the will of the people and it ought to be the will of the land.

MARTIN: Today, we decided to spend much of the program talking about new and ongoing issues and reproductive and sexual health. And we should tell you that some of this program might not be appropriate for some listeners. That's an issue in which reasonable can disagree.

Later in the program we will ask why Latinas have a higher rate of the virus that causes cervical cancer. We'll talk with our regular contributor on matters of health, Jane Delgado. We'll ask why the increase in the rate of HIV/AIDS, why it's continuing to go up in one particular group. We'll go to Milwaukee for that conversation because health officials have just done a new study there.

But first, a discussion about a new method of delivery of abortion services. We'll hear two perspectives on that. Later, we'll hear from Iowa representative Steve King. He is an opponent of the procedure that we're going to hear about now. First, we speak with Dr. Vanessa Cullins. She is vice president for medical affairs at Planned Parenthood Federation of America. Thank you so much for joining us, Dr. Cullins.

Dr. VANESSA CULLINS (Vice President for Medical Affairs, Planned Parenthood Federation of America): Thank you for having me.

MARTIN: The immediate subject of discussion here is so-called telemed abortions. They're being performed at Planned Parenthood of the Heartland, which operates several clinics in Iowa. This is the only place in the country where this is now occurring. Please tell us what this is.

Dr. CULLINS: Well, first, I think it's important for readers and listeners to understand that many fields of medicine, including cardiac care, asthma care, pediatric care and dental care are using telemedicine to deliver care. And telemedicine is really part of efforts by health care providers across the country to provide both primary and specialty care to people living in areas where there is limited access to care.

Planned Parenthood of the Heartland, which used to be named Planned Parenthood of Iowa, has been providing telemedicine medication abortion services for the past couple of years.

MARTIN: And this is not the same as the so-called morning after pill -emergency contraception? This is different.

Dr. CULLINS: This is definitely not the same thing as emergency contraception or the morning after pill. What we're talking about is safe, legal provision of medication abortion.

MARTIN: And how exactly is this done? How is this actually delivered?

Dr. CULLINS: A woman who generally is in a rural setting or setting where there is very limited physician access, will visit a health care center and meet with a Planned Parenthood of Heartland nurse practitioner. That nurse practitioner who is highly skilled and qualified to provide reproductive and sexual health care will perform both the history, a sonogram will be done and the physical exam.

The physician will meet the woman through secure Internet-based video conferencing, two-way live conferencing. And it is through this modality that the woman is able to have any questions that she has about the process answered. She can inquire of possible side effects and what to expect as it relates to the medication abortion process. And at the same time, the physician is able to confirm that this woman is indeed a candidate for medication abortion.

MARTIN: I understand. Dr. Cullins, I'm sorry, I think we need to get to the bottom line, which is that there are those who oppose this who believe that is not only on faith that it is medically unsafe, that it's also inappropriate for a procedure that has so many implications both psychologically and emotionally. And I'd like to ask you if you would address that question.

Dr. CULLINS: Medication abortion is highly safe, highly effective. And the woman who is being served is not only being served by the physician, but she's being served by the nurse practitioner and other staff within the affiliate. She is receiving high quality, expert care. There's absolutely no evidence that provision of medication abortion through telemedicine is any way dangerous. In fact, the record of Planned Parenthood of Heartland is not only that it is highly safe and effective, but women are highly satisfied with abortion being provided through telemedicine services.

MARTIN: Have any serious complications occurred or any complications at all occurred in Iowa involving these video conference patients who've received abortion services this way?

Dr. CULLINS: No serious consequences or complications have occurred to date. In general, medication abortion is extremely safe and the complication rate is much less than 1 percent.

MARTIN: And finally, can I ask if federal funds have been used? Because federal funds sometimes are used to provide telemedicine services. Have they been used in this procedure?

Dr. CULLINS: No federal funding whatsoever has been used to develop this program of provision of telemedicine abortion services. In fact, the program is provided on the basis of private donor funding.

MARTIN: OK, that's Dr. Vanessa Cullins. She's vice president for medical affairs at Planned Parenthood Federation in the Heartland. It's formerly Planned Parenthood of Iowa. And she was with us from member station WJCT in Jacksonville, Florida. Thank you so much for joining us.

Dr. CULLINS: Thank you very much.

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