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Iowa Supreme Court: Telemedicine Abortion Ban Is Unconstitutional

Jessica Mason Pieklo

The unanimous ruling protects a practice designed to improve abortion access in rural parts of the state.

The Iowa Supreme Court ruled Friday that telemedicine abortions in the state may continue, handing reproductive rights advocates a victory that was years in the making.

The justices ruled unanimously that regulations put in place in 2013 by the Iowa Board of Health, effectively banning Planned Parenthood of the Heartland’s telemedicine system over purported safety concerns, created an undue burden on abortion rights.

Planned Parenthood of the Heartland’s video-conferencing technology was the first in the nation to deliver abortion care to rural patients and has been the target of anti-choice activists in Iowa from its inception. The remote-controlled technology allows physicians at rural clinics to use a closed circuit video-conferencing system to see patients and dispense abortion medications.

The Iowa Board of Health in 2010 determined Planned Parenthood’s telemedicine practice was safe and consistent with prevailing standards of care.

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Following the Iowa Board of Health’s 2010 decision, Gov. Terry Branstad (R), an outspoken opponent of abortion rights, replaced the entire health board with new members, all of whom are anti-choice, including a Catholic priest.

The new board members in August 2013 reversed the Board of Health’s 2010 determination that Planned Parenthood’s telemedicine practice was safe. It also moved to ban the practice with an administrative rule that requires in-person meetings between doctors and patients for the provision of medication abortions and direct after-care services.

Planned Parenthood of the Heartland sued to block the rule in October 2013, arguing it was politically motivated and directly and improperly targeted Planned Parenthood of the Heartland’s telemedicine practice.

An Iowa judge ruled against Planned Parenthood of the Heartland, finding that board did not abuse its authority in passing the rule. Planned Parenthood of the Heartland appealed that decision to the Iowa Supreme Court, which in September issued a stay, allowing Planned Parenthood to continue with its telemedicine practice while its appeal of the Iowa ruling proceeded.

But on Friday, the Iowa Supreme Court ruled the medical board’s 2013 rule imposed an unconstitutional undue burden on abortion rights. The court noted that national standards of care do not require a physician to perform a physical examination on a woman before providing a medication abortion.

The state failed to provide proof that an in-person exam by a doctor would “provide any measurable gain in patient safety,” according to the court.

“This ruling is a big victory for Iowa women,” Cecile Richards, president of Planned Parenthood Federation of America, said in a statement following the decision. “Similar restrictions and bans on abortion are being pushed through in other states, and this ruling sends a strong and clear message to politicians across the country. Restrictions and bans on abortion are unconstitutional and deeply unpopular, and we will continue to fight them in every state in this country.”

“We applaud the court for ruling to protect women’s access to safe, legal abortion. Medical experts opposed this law because it harms women by blocking access to safe medical care,” said Suzanna de Baca, president and CEO of Planned Parenthood of the Heartland. “When it comes to health care, politics should never trump medicine.”

The American Congress of Obstetricians and Gynecologists (ACOG) had urged the court to block this rule, writing in a brief that the ban is “not justified by any medical evidence” and “undermines its own stated purpose ‘to protect the health and safety of Iowans.’”

ACOG also urged the court to block the rule because it would “result in immediate and significant harm to Iowa women’s health, dramatically curtailing their access to safe healthcare and unnecessarily exposing them to increased risk of serious clinical complications and other health risks.”

More than one-third of Iowans live in rural areas. Had this rule been allowed to take effect, it would have imposed multiple trips of up to 400 miles round-trip to access medication abortions.

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