The Texas Attorney General is complicit in perpetuating violence against women.

This situation exemplifies a form of domestic violence, where a woman's autonomy is denied, and her life, health and safety are compromised. The state of Texas is not only enabling this abuse but is complicit by actively contributing to the harm inflicted on this woman.

It is well-documented through scientific research that telemedical abortions, including those facilitated by mail, are a safe and effective alternative to in-clinic procedures. ^{[1] [2] [3]}

Denying women the right to seek an abortion, whether by a partner or the state, has serious consequences for their life, health and well-being. ^[4]

The Case for Telemedical Abortion

• Prevention of severe Maternal Morbidity: The United States has one of the highest rates of maternal morbidity, with 122 blood transfusions per 10,000 deliveries (1 in 82 births) In contrast, the risk of severe morbidity from medical abortions is far lower. Among 233,805 medical abortions performed in 2009-2010, there were only 114 blood transfusions, (1 in 2040 abortions). This highlights the stark difference in health risks between childbirth and medical abortion. ^{[5] [6]}
• Prevention of maternal Mortality: The maternal mortality rate in the U.S. is higher than in many countries with an estimated 22 deaths per 100,000 births (or 1 in 4545 women). For women without health insurance and or living in poverty, the risks are even greater—three to four times higher than for insured women. ^{[7] [8]}  Particularly those women need the option to access to telemedical abortions to save their lives as it is 78 times safer than giving birth.  ^{[9] [10] [11] [12] [13] [14] [15]}
• Access and Affordability: Research consistently shows that the most common reasons women seek telemedical abortion services are the inability to afford in-clinic care (73.5%), concerns about privacy (49.3%), and the distance to a clinic (40.4%). A significant portion of those who use telemedical services live below the federal poverty level, making them particularly dependent on such services.^{[16] [17] [18] [19] [20] [21] [22] [23]} 

We hope that the woman who suffered from the partner and state abuse in this case and all women, particularly those in Texas, can find a safe space free from this kind violence and fear.

Thankfully, women in Texas can not be criminalized for seeking an abortion, ^[24] and we stand firm in supporting their right to make decisions about their own bodies without interference or harm.

Aid Access

References

[1] Daniel Grossman and Kate Grindlay, Safety of Medical Abortion Provided Through Telemedicine Compared With In Person, 130 Obstetrics & Gynecology 778 (2017), doi: https://doi.org/10.1097/AOG.0000000000002212.

[2] Ara Aiken etal, Effectiveness, safety and acceptability of no-test medical abortion (termination of pregnancy) provided via telemedicine: a national cohort study, BJOG 2021 Aug;128(9):1464-1474.  doi: 10.1111/1471-0528.16668. Epub 2021 Mar 24.

[3] Abigail R.A. Aiken et al., Safety and effectiveness of self-managed medication abortion provided using online telemedicine in the United States: A population based study, The Lancet Reg’l HealthAmericas (2022) doi: https://doi.org/10.1016/j.lana.2022.100200. 

[4] https://journals.lww.com/greenjournal/fulltext/2023/02000/all_cause_mortality_in_reproductive_aged_females.2.aspx

[5] https://www.cdc.gov/reproductivehealth/maternalinfanthealth/severematernalmorbidity.html

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3711556/

[7] https://www.who.int/bulletin/volumes/93/3/14-148627.pdf

[8] https://www.hrsa.gov/sites/default/files/ourstories/mchb75th/mchb75maternalmortality.pdf

[9] https://www.ansirh.org/sites/default/files/2022-11/mifepristone_safety_11-15-22_Updated_0.pdf

[10] https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm

[11] https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2022/maternal-mortality-rates-2022.pdf

[12] Abigail R A Aiken , Jennifer E Starling , James G Scott,  Rebecca Gomperts, Requests for Self-managed Medication Abortion Provided Using Online Telemedicine in 30 US States Before and After the Dobbs v Jackson Women's Health Organization Decision, JAMA 2022 Nov 1;328(17):1768-1770. doi: 10.1001/jama.2022.18865.

[13] Johnson DM, Madera M, Gomperts R, Aiken ARA., The economic context of pursuing online medication abortion in the United States, SSM Qual Res Health. 2021 Dec;1:100003. doi: 10.1016/j.ssmqr.2021.100003.

[14] Sajal Sanan, E. Godfrey, R. Gomperts, Nikeeta Shah, A. Fiastro, Affording telemedicine medication abortion: Examining a sliding-scale payment option and patient’s ability to pay, Published in Women's Health 1 March 2022, DOI:10.1370/afm.20.s1.3208

[15] Abigail R. A. Aiken, MD, PhD; Jennifer E. Starling, PhD; Rebecca Gomperts, MD, PhD Factors Associated With Use of an Online Telemedicine Service to Access Self-managed Medical Abortion in the US , JAMA Netw Open. 2021;4(5):e2111852. doi:10.1001/jamanetworkopen.2021.11852

[16] https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2022/maternal-mortality-rates-2022.pdf

[17] https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31470-2.pdf

[18] https://www.who.int/bulletin/volumes/93/3/14-148627.pdf

[19] https://www.hrsa.gov/sites/default/files/ourstories/mchb75th/mchb75maternalmortality.pdf

[20] Abigail R A Aiken , Jennifer E Starling , James G Scott,  Rebecca Gomperts, Requests for Self-managed Medication Abortion Provided Using Online Telemedicine in 30 US States Before and After the Dobbs v Jackson Women's Health Organization Decision, JAMA 2022 Nov 1;328(17):1768-1770. doi: 10.1001/jama.2022.18865.

[21] Johnson DM, Madera M, Gomperts R, Aiken ARA., The economic context of pursuing online medication abortion in the United States, SSM Qual Res Health. 2021 Dec;1:100003. doi: 10.1016/j.ssmqr.2021.100003.

[22] Sajal Sanan, E. Godfrey, R. Gomperts, Nikeeta Shah, A. Fiastro, Affording telemedicine medication abortion: Examining a sliding-scale payment option and patient’s ability to pay, Published in Women's Health 1 March 2022, DOI:10.1370/afm.20.s1.3208

[23] Emily M. Godfreya , Erin K. Thayer  , Anna E. Fiastroa , Abigail R.A. Aiken , Rebecca Gomperts,  Family medicine provision of online medication abortion in three US states during COVID-19, Contraception 2021 Apr 30;S0010-7824(21)00142-6. doi: 10.1016/j.contraception.2021.04.026.

[24] https://statutes.capitol.texas.gov/Docs/HS/htm/HS.170A.htm#170A.002