PPH “is trying the procedure here. If they’re successful, they will probably attempt to spread the practice to other states,” Heffron predicted.
During oral arguments, Iowa Solicitor General Jeffrey Thompson told the state justices that the Board of Medicine made the right decision. The RU-486 protocol used in webcam abortions “is not a typical prescription pharmaceutical,” he pointed out. “The FDA, in approving the drug, specifically provided a protocol for what they were saying was safe and effective use of the drug.”
But Alice Clapman, a lawyer for Planned Parenthood, argued that “the board had no medical evidence to support its decision.”
Justice Thomas Waterman asked Clapman if the court should overrule the medical board’s physician majority. “We went to law school, not medical school,” he reminded her. She replied that the court has oversight of all state agencies, including the Board of Medicine.
In September 2013 on an 8-to-2 vote, the board joined 15 other states that have banned webcam abortions because they pose a health risk to women.
“The practices used by physicians who prescribe and administer abortion-inducing drugs using telemedicine are inconsistent with the protocols approved by the U.S. Food and Drug Administration (FDA) and the manufacturer of the drugs,” the board said in a statement.
The board noted that webcam abortions delegate physicians’ responsibility “to non-physician persons who do not have appropriate training to confirm or discover contraindications or to perform an ultrasound to determine the age and location of the embryo.”
“Physicians who prescribe and administer abortion-inducing drugs using telemedicine may never meet with the patient in person and may never see the patient again for a follow-up appointment,” the board added.
Iowa state law only allows physicians to perform abortions. Any non-physician who terminates a human pregnancy is guilty of a felony.
PPH - which offers webcam abortions in ten locations in Iowa in addition to its four facilities that perform surgical abortions - sued the board, claiming that the rule was politically motivated and an attempt to ban access to a legal medical procedure.
On Aug. 8, 2014, Polk County District Court Judge Jeffrey Farrell upheld the Board of Medicine’s decision, noting that “the board has the power to establish standards of practice for the medical profession” and that it “followed the rulemaking process established in the statute.”
“While the record is not completely clear on this point, it appears that PPH’s use in Iowa of doctors participating in medical abortions by video-conferencing was the first in the nation, and there is no evidence that the same protocol is used in the same way in other states,” Farrell noted.
Planned Parenthood appealed the case to Iowa’s high court, claiming that the rule “bans a safe program for the telemedicine delivery of medication abortion services” and “drastically reduces access to abortion.” It thereby jeopardizes women’s health and inhibits their “fundamental right” to an abortion under Iowa’s state Constitution.
The Thomas More Society filed an amicus brief on behalf of the Catholic Medical Association and other pro-life groups in the case, arguing that the Iowa Board of Medicine’s rule “is rationally related to protecting patients from significant dangers” related to drug-induced abortions, and that “neither the Iowa Legislature nor the Iowa courts have recognized a right to abortion under the Iowa Constitution.”
A 2014 study by the University of California-San Francisco found that “medication abortions” - which have been billed as a safer alternative to surgical abortion - actually had a higher complication rate than surgical first-trimester abortions.
Women who had a chemical abortion were four times more likely to require a subsequent trip back to the clinic or emergency room for complications, including infection, hemorrhaging or “incomplete abortions” requiring surgical intervention.