Videoconferencing Is Used to Administer Abortion Drugs

June 9, 2010 5:45 PM

Abortion Drugs Given in Iowa via Video Link. "The situation has played out hundreds of times. From his office here, a doctor asks a woman on the computer screen before him one final question: Are you ready to take your pill? Then, with a click of his mouse, a modified cash register drawer pops open in front of the woman seated next to a nurse in a clinic — perhaps 100 miles from this city — with mifepristone, the medicine formerly known as RU-486, that is meant to end her pregnancy." [Via]
posted by homunculus (46 comments total)

Note that dibs has already been claimed on the term e-bortion.™
posted by homunculus at 5:46 PM on June 9, 2010 [2 favorites]

Cue the faith-based DDOS in 5.. 4.. 3.. 2..
posted by Hardcore Poser at 5:50 PM on June 9, 2010

So, does that mean that Cisco is doing the devil's work, too?
posted by Cool Papa Bell at 5:52 PM on June 9, 2010

When will abortionists stop screwing around and just start punching pregnant women in the bellies? I have to say these abortionists are not very efficient at what they do, which is abort babies as fast as humanly possible.
posted by GuyZero at 5:54 PM on June 9, 2010

“You are removing the doctor-patient relationship from this process. And think about it: With this scheme, one abortionist sitting in his pajamas at home could literally do thousands of abortions a week. This is about expanding their abortion base.”

Ugh, I'm sure these physicians wish just as much as anyone that abortions weren't necessary but assholes like this Troy Newman paint them as psychopathic murderers. Vulgar and dishonest but unfortunately in many places they can probably drum up enough emotional fervor to further limit women's options.
posted by ghharr at 5:54 PM on June 9, 2010

Medicine should never be practiced this way.
posted by gjc at 5:57 PM on June 9, 2010

...one abortionist sitting in his pajamas at home...

Pfft. Everyone knows abortionists have to put on the black robes and satanic headgear before performing the rite.
posted by PlusDistance at 5:58 PM on June 9, 2010 [11 favorites]

Medicine should never be practiced this way.

Why not? They're in a doctor's office, so presumably medical care is available in an emergency. The vast majority of these will be incredibly routine. The main reason this is even happening is just that local doctors wont, or are (rightfully, given Dr. Tiller and others) scared to, "perform" the abortion.

Most of my doctor's visits, the doctor doesn't have direct physical contact with me. Tests are run by nurses or technicians. The doctor could easily be on video chat and it would make no difference.
posted by wildcrdj at 6:02 PM on June 9, 2010 [12 favorites]

Medicine should never be practiced this way.

Why not? The article points out that this is for women in rural or isolated communities. Video-conferencing seems like a great alternative to "no doctors."

Abortion opponents say they are alarmed, fearful for the safety of women who undergo abortions after consulting with doctors who have never actually been in the same room with them.

Why do I find that hard to believe? Oh, right, because the consequence of their ideal world is abortions performed in back alleys with clothes hangers.
posted by Solon and Thanks at 6:02 PM on June 9, 2010 [20 favorites]

Heh. Jinx, wildcrdj.
posted by Solon and Thanks at 6:03 PM on June 9, 2010 [2 favorites]

assholes like this Troy Newman paint them as psychopathic murderers.

Not just psychopathic murderers, but psychopathic murderers in pajamas!
posted by homunculus at 6:05 PM on June 9, 2010 [1 favorite]

living in oklahoma, i support any move that gets access to abortion to those who are often shit out of luck.
posted by nadawi at 6:07 PM on June 9, 2010 [6 favorites]

Getting medical care can be a problem in rural areas. If a doctor can use technology to provide acceptable care (with the in-person assistance of a nurse/NP/physician's assistant) to people hundreds of miles away who might be otherwise unable to receive help then I'm all for it.
posted by ghharr at 6:07 PM on June 9, 2010 [2 favorites]

Medicine should never be practiced this way.

tell that to dr neilsen.

(side note: i hadn't heard of her passing. sad.)
posted by nadawi at 6:10 PM on June 9, 2010 [1 favorite]

Medicine should never be practiced this way.

Responsibly and taking advantage of technological advancement to reach out to under/unserved populations?
posted by fuq at 6:15 PM on June 9, 2010 [4 favorites]

one abortionist sitting in his pajamas at home

Doctors seem to prefer it when someone in the room is wearing less clothing than they are. Think about it: if you're in for a visit, they're wearing a suit, but you're wearing an assless gown. If you're having surgery, they're wearing pajamas, but you're naked. That's why I think the e-bortionists are probably wearing full tail tuxedos. No matter what the patient on the other end of the screen is wearing, the doctor is wearing more.
posted by mattdidthat at 6:24 PM on June 9, 2010 [11 favorites]

So online help for people who are pregnant is irresponsible? Is that the stance of the anti-abortion folks?

They should probably start by shutting down services like this.
posted by el io at 6:25 PM on June 9, 2010

Since the overwhelming majority of abortions occur naturally, the pro-life crowd should be protesting God for being the biggest abortionist of all time.
posted by mattdidthat at 6:38 PM on June 9, 2010 [4 favorites]

I think this is a reasonable system for drugs that don't have clear potential for abuse. I mean, you obviously wouldn't prescribe Ocycontin or Vicodin this way.
posted by mccarty.tim at 6:40 PM on June 9, 2010

Medicine should never be practiced this way.

It's called telemedicine. A good friend is a nurse practitioner whose specialty is HIV/AIDS. Many of her patients are incarcerated. Because of the program she works for, those prisoners get better and more frequent care than they would if they had to wait to see a practitioner in person.
posted by rtha at 6:42 PM on June 9, 2010 [3 favorites]

Medicine should never be practiced this way.

It is absolutely being practiced this way more and more. It makes services more accessible to patients, makes communication easier, helps the doctor treat more people, saves money, etc.

Monitoring diabetics at home.
Pace maker checkups by phone.
E-mailing your doctor.
Diagnosing and prescribing for a UTI via a phone call.

The internet: not just for abortions anymore.
posted by SLC Mom at 6:42 PM on June 9, 2010 [8 favorites]

psychopathic murderers in pajamas!

This was my idea for a musical children's show, but then somebody tweaked it a little and beat me to market.
posted by Kraftmatic Adjustable Cheese at 6:42 PM on June 9, 2010 [4 favorites]

Medicine should never be practiced this way.

One of the reasons why this is necessary is that many states, including Iowa, require that misoprostol and mifepristone to be administered by a physician, instead of an advanced practice clinician. This is not a regulation based in medicine or science, but anti-abortion ideology designed to reduce access by restricting the options of women, specifically low-income women with limited mobility.

Abortion is the most common surgical procedure in America. Yet it is regulated in incredible and ridiculous ways by grandstanding state legislators with no consideration for facts. You say medicine should never be practiced this way, but it is practiced this way because a single procedure, one of the safest in the country, is incessantly targeted by a vocal and violent minority group, without concern of the safety of patients. Unnecessary laws are continually passed that are designed to force clinics out of business (one state even regulates the height of the grass outside of abortion clinics. Of course, no other medical procedure gets this oversight). When regulation doesn't shut down clinics, daily harassment at clinics and the homes of doctors move the ball further. When that doesn't work, there's always murder, a threat that lurks all to presently in the minds of those brave enough to provide compassionate care during a difficult time.

Imagine if Christian Scientists aggressively lobbied to pass laws that required that every insulin injection that Diabetics receive had to be administered by a licensed physician. Would you be upset if people figured out a way to make it easier for patients to tele-conference in order to improve their lives? Lay blame where it belongs - on outrageous laws that are designed to restrict access as much as possible.
posted by allen.spaulding at 6:44 PM on June 9, 2010 [56 favorites]

Since the overwhelming majority of abortions occur naturally, the pro-life crowd should be protesting God for being the biggest abortionist of all time.

Not to draw this out, but the entire premise of religious anti-abortion views is that God has the right to give and take innocent life, but humans don't. While snappy and catchy, pointing out the frequency of natural abortions doesn't really address the underlying belief.
posted by verb at 6:52 PM on June 9, 2010

posted by allen.spaulding Abortion is the most common surgical procedure in America.

That's not entirely accurate.
posted by mattdidthat at 6:53 PM on June 9, 2010

Did you not see d&c right there? I mean, there's some dispute because many people actually mean "most common surgical procedure performed in a hospital" which is probably circumcisions or caesareans, given that most abortions in America are performed in clinics. But you cited a link that includes in its list abortions.

But that's neither here or there. We're talking about medical abortions here, induced by the ingestion of pills.
posted by allen.spaulding at 6:56 PM on June 9, 2010 [1 favorite]

Didn't House save some woman stranded in the arctic or something over video conference? From across the globe, he totally knew she didn't have lupus. So don't tell me this can't work.
posted by kittens for breakfast at 7:04 PM on June 9, 2010 [2 favorites]

I think this is a great idea. For one thing it circumvents all of those pharmacists and nurses who don't want to give patients the medicine prescribed for them by the doctors.
posted by Secret Life of Gravy at 7:06 PM on June 9, 2010 [4 favorites]

This is about expanding their abortion base

And this is why the world will be better when we stop giving these fucking wingnuts any airtime whatsoever. In their mind, the goal of doctors who, amongst other services, provide abortions is to forcibly give every woman who ever gets pregnant an abortion. They actually think this is the case, and promulgate it.
posted by dirtynumbangelboy at 7:07 PM on June 9, 2010 [4 favorites]

posted by allen.spaulding Did you not see d&c right there?

Yes, I did. That's why I used the link. Saying "Abortion is the most common surgical procedure in America" is just plain inaccurate. The doctors in my family hear this argument all the time and they just roll their eyes, because both sides of the abortion debate use that meme to bolster their position(s). There isn't one procedure that's been labeled as, "the most common surgical procedure in America."
posted by mattdidthat at 7:13 PM on June 9, 2010 [2 favorites]

Sadly, it's only a matter of time before the same group of know-nothings goes after this, too. They'll outlaw telemedicine, or require that they have a superimposed image on the screen of a cartoon fetus crying, or require that the woman's neighbors have to operate the camera or some other theater-of-cruelty.
posted by PlusDistance at 7:42 PM on June 9, 2010 [1 favorite]

Learning (from the NYT article) that celebrityshoesize.com exists should not have surprised me - yet somehow, it did.
posted by Bora Horza Gobuchul at 7:47 PM on June 9, 2010

Matt - I don't really mean for this to be contentious. This is one of the items that is relatively easy to measure and we have good data. D&C, one of the most common of the various methods of surgical abortion, was listed by one hospital as the most common surgerical procedures in America. When you include aspiration, the numbers rise even more.

There are slightly more than 1.2 million abortions performed in the US every year. Medical abortion ranges from 10-15% of all abortions, which means that between 1 and 1.08 million surgical abortions are performed every year.

Let's look at the next two contenders. There were 4.2 million children born in the U.S. While the sex ratio at birth is close to 1.05:1, let's just be nice and say there are 2.2 million boys born in the U.S. The circumcision rate is dropping, but a recent estimate that's widely cited put it at 56% That would put circumcision at 1.23 million a year, a number that's ahead of surgical abortion.

As for cesareans, similar estimation problems exist. Recent estimates by the National Center for Health Statistics put the number around 32%, the highest ever. Given the 4.2 million number cited above, this would put c-sections in the lead, with 1.39 million.

So in recent years, as the c-section rate has gone up while the abortion rate has gone down, combined with the invention of medical abortion, it's probably safe to say that surgical abortion is the second or third most common surgical procedure, although certainly very close. Occasionally people will argue that catarct surgery is more common, although a whole range of non-surgical treatments are usually lumped into that grouping.

Of course, there's another concern, which is how we conceive of an independent surgical procedure and what we mean when we say the most common procedure. After all, anesthesia is not normally thought of as its own procedure, but perhaps it should be. I've heard people argue that circumcision is not a surgical procedure (I think they're wrong) and so on. It's all fairly moot, we're talking about the same ballpark here. It's not a huge difference, it's not central to the point, and it's not like I just pulled this shit out of my ass.
posted by allen.spaulding at 7:49 PM on June 9, 2010 [1 favorite]

Crap. Apologies - that shoe reference was meant to for the NY Times article in this thread, not this telemedicine one. Consider it an accidental piece of unintended humor to defuse the possibility of a tendentious conversation.
posted by Bora Horza Gobuchul at 7:54 PM on June 9, 2010

Medicine should never be practiced this way.

Correction. Medicine shouldn't be forced into practicing this way.
posted by substrate at 8:13 PM on June 9, 2010 [1 favorite]

This is about expanding their abortion base.

I've never really understood the notion that doctors have some agenda of increasing the number of abortions they perform, given that a giving birth costs, what, like 10-50 times what an abortion does (numbers based a on some vague notions and brief internet research) - am I missing something here?
posted by naoko at 10:32 PM on June 9, 2010

The thing that really pisses me off about these pro-life activists is the word "abortionists". It's a bullshit ploy to delegitimize the operation. The proper word here is "doctor".
posted by daniel striped tiger at 10:34 PM on June 9, 2010 [6 favorites]

Terminating an undifferentiated lump of cells is not an abortion.

RU-486 is not an "abortion drug."
posted by bardic at 11:46 PM on June 9, 2010 [1 favorite]

Abortion opponents say they are alarmed, fearful for the safety of women who undergo abortions after consulting with doctors who have never actually been in the same room with them.

That's ridiculous. Abortion is FAR safer than going through with a pregnancy.

If they care so much about the safety of women we should be growing all our babies in test tubes.
posted by fshgrl at 11:59 PM on June 9, 2010

That's ridiculous. Abortion is FAR safer than going through with a pregnancy.

This.

I've never had an abortion. I've had four natural miscarriages, though, and they all sucked. But apart from the emotional component -- every one of those pregnancies was desperately wanted, and losing them tore my heart out -- all four of them added together did not come close to the misery and the discomfort, never mind the risk, that I endured during one solitary month of either the one pregnancy I've had that ended in a live birth nor the one I'm currently nearly halfway through. (Touch wood.) The experience of being pregnant on purpose made me far, far more strongly pro-choice even than I had previously been.

Terminating an undifferentiated lump of cells is not an abortion.

bardic, I'd have to disagree. If losing the pregnancy without intervention is a miscarriage (or "spontaneous abortion," which is how all my miscarriages including the one at 5 weeks were coded), losing it with intervention is an abortion. I would absolutely call RU-486 an abortion drug; it's a drug that causes an abortion.
posted by KathrynT at 12:25 AM on June 10, 2010

We should dispense Viagra this way. One at a time with full interview. Different doctor every time.
(Static-y drive-thru speaker) Doctor: Do you like sexxy sex?
Patient: Yes! Yes, I like sexxy sex!
Doctor: Well, okay then.
(click of drawer opening)
posted by hal9k at 3:40 AM on June 10, 2010 [1 favorite]

Jesus fuck, people. Mifepristone is not abortion.

Please review human reproduction 101.
posted by clvrmnky at 5:22 AM on June 10, 2010

Did you not see d&c right there?

D&C is a term used for more than just abortion. D&Cs can be done for many other reasons which have nothing to do with abortion.
posted by SuzySmith at 5:30 AM on June 10, 2010 [1 favorite]

D&C is a term used for more than just abortion. D&Cs can be done for many other reasons which have nothing to do with abortion.

I didn't say it was, but I was pointing out that even in Matt's gotcha list a procedure which forms part of the set of surgical abortions was included. I showed my math above. Again, it's a minor point, but there's little question that surgical abortion is one of the most common procedures and that the top contenders are all in the same ballpark.

And I think people are confusing what's happening here with emergency contraception/Plan B. Mifepristone is used as an abortifacient - which is what is happening in this article. Plan B is not an abortifacient, as it works to prevent fertilization from occurring.
posted by allen.spaulding at 5:35 AM on June 10, 2010

Jesus fuck, people. Mifepristone is not abortion.

What? Yes it IS. You take it when you are pregnant; it stops embryonic growth and allows you to become not pregnant any more. How is that not abortion? Are you confusing it with Plan B, which is only effective before implantation and which is a completely different drug?
posted by KathrynT at 11:26 AM on June 10, 2010

Louisiana Passes Pre-Abortion Ultrasound Requirement
posted by homunculus at 5:36 PM on June 17, 2010