NYC’s public hospitals to offer abortion pills via telehealth, despite uncertainty in courts

Starting this week, NYC Health + Hospitals will offer patients the option of getting a medication abortion from home by consulting with a clinician via telemedicine and then receiving the pills in the mail. It’s the first public health system in the country to offer this option, rather than requiring an in-person appointment to get a prescription for the pills, according to City Hall.

The Adams administration’s decision to provide telemedicine abortions comes at a crossroads when the method is growing in popularity nationally but also faces a threat of being restricted by the Supreme Court.

“Access to safe, legal abortion care is the cornerstone of public health,” Mayor Eric Adams said Monday at a press conference on the announcement at City Hall. “In New York City, it will always be. We will not stand idly by while these attacks continue and the far right seeks to strip our citizens of their basic rights.”

Adams said the move was an effort to use technology to address “a major demand.” The service will be available via NYC Health + Hospitals’ Express Care program seven days a week between 9 a.m. and 9 p.m., the mayor added. NYC Health + Hospitals will only mail pills to addresses within New York City, but hospital officials acknowledged that people from out-of-state could potentially work around that restriction by having pills mailed to friends or family here.

Abortion, including via telemedicine, is currently restricted or banned in many parts of the country, but since Roe v. Wade was overturned, Adams and other local officials have sought to position New York City as a haven for access, such as when City Hall paid for billboards to advertise abortion services to people in other states.

Planned Parenthood of Greater New York is also launching its own virtual health center this week, Wendy Stark, the organization’s CEO, announced at the press conference. But the organization is not currently offering telehealth for abortion.

An uncertain future for telemedicine abortion

Before COVID-19, abortion pills were already the most common method of ending a pregnancy, but patients had to visit a clinician in person to get them. Then, during the pandemic, the U.S. Food and Drug Administration began allowing abortion pills to be prescribed via telemedicine and delivered by mail to ensure continued access. The Biden administration made the change permanent at the start of 2023. These rules facilitated the growth of online services like Hey Jane, a New York-based start-up that offers telemedicine abortions in addition to other sexual health care.

Early research has found that telemedicine abortions in the U.S. have a similar rate of safety and efficacy as those provided in person. Hey Jane also released a white paper last month reporting a 99% success rate for its telemedicine abortions.

But the method is at risk due to concerns raised by anti-abortion groups. One group called the Alliance for Hippocratic Medicine made headway this year in its efforts to use federal courts to restrict access to mifepristone, one of the two pills used in medication abortions.

A federal appeals court ruled in August that the U.S. Food and Drug Administration must roll back rules expanding access to mifepristone, including the option to prescribe it via telemedicine. However, the Biden administration and the company that makes mifepristone quickly petitioned to have the Supreme Court hear the case. The Supreme Court has paused any changes to mifepristone access – including telemedicine restrictions – until it weighs in.

Even if mifepristone is restricted, providers will still be able to mail out misoprostol, the other common pill involved in medication abortions. While misoprostol is effective on its own, the two-pill regimen is recommended by the American College of Obstetricians and Gynecologists. It’s unclear whether NYC’s municipal government would continue to provide abortions via telemedicine if the practice is restricted by the Supreme Court. City officials did not directly address this possibility at Monday’s press briefing, but Adams said his administration will not “sit on our hands” while abortion access is under attack.

Traditionally, telemedicine has been provided within a given state. But Gov. Kathy Hochul signed a law into effect in June seeking to provide legal protections to New York clinicians who offer telehealth abortions to people in other states with greater restrictions.

Those seeking abortion pills by mail can scope out the options available to New Yorkers and residents of other states by visiting Plan C, a site that vets different providers and offers price comparisons.

This story was updated to correct a statement about Planned Parenthood’s virtual services.