Abortion clinics go mobile, seeking flexibility amid disparate state restrictions

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Dozens of states have cut access to abortion, forcing reproductive health care providers to scramble. Some clinics are going mobile, hoping that the flexibility of being able to move along state borders with severe abortion bans or limits will reduce costly and time-consuming burdens for patients forced to travel hundreds of miles for health care. health.

Decoupling physical sites should allow mobile clinics to go where the need is greatest, as providers try to adapt to the rapidly changing abortion access map in the United States. United. In some states, the legality of the procedure has been reversed several times since last month. Court decision in Dobbs v. Jackson Women’s Health Organization.

Nonprofit Abortion Access Just the Pill plans to build a fleet of mobile clinics offering mobile procedural abortion “for the first time in US history,” the nonprofit organization said.

The program, called Abortion Delivered, responds to patient demand, which increased following the Supreme Court’s decision to overturn Roe v. Wade. Just the Pill normally receives between 20 and 25 requests for abortion pills per day from patients. But in just three days after the Dobbs decision, there were more than 260.

Just the Pill, which was founded in 2020, provides reproductive healthcare in Colorado, Minnesota, Montana and Wyoming. Some of their services include medical abortion, which usually consists of a two-pill regimen of mifepristone and misoprostol.

The group currently operates two mobile clinics in Colorado and plans to expand its network of vans and roll them out to states where abortion is legal but neighboring states have banned the procedure, such as New Mexico, Pennsylvania and Illinois.

“Our mobile clinics will travel to certain parts of these states based on where the need is greatest,” Julie Amaon, medical director of Just The Pill, told Healthcare Dive.

Just the Pill’s long-term plan is to operate 30 clinics across the United States, with a timeline dependent on fundraising, Amazon said.

A van, which is currently being renovated to serve Illinois, is Just the Pill’s largest to date, with two exam rooms and a recovery room. It cost over $500,000.

Mobile clinics, which provide contraception in addition to abortion care, are also bulletproof.

Mobile health clinics have been touted as a way to reduce costs and expand access to health care, especially in underserved or marginalized communities. A 2009 study in Boston found that a mobile health clinic, The Family Van, had a return on investment of $36 for every dollar invested in the program. Mobile clinics can also provide primary and preventive care, an important feature given that many parts of the United States lack access to health care.

Currently there is approximately 2,000 mobile clinics in America, providing nearly 7 million visits each year.

“Mobile clinics remove three of the biggest barriers to care: distance, time and cost,” while building trust within specific communities, said Mollie Williams, executive director of The Family Van, a mobile health clinic. associated with Harvard Medical School which does provide abortion services.

“With the pandemic and recent changes in abortion access laws, it’s really reinforced that barrier of trust,” Williams said.

Advocates hope the mobile health model can provide an alternative portal to the health system for medically disenfranchised patients who are unable to access abortion services due to their state of residence.

Currently, 15 states prohibit abortion before the Roe fetal viability line of 24 weeks gestation, according to a Healthcare Dive tracker.

The Dobbs decision resulted in patchy access to abortion in the United States

Legality of Abortion by State

Reproductive health providers Hey Jane and Choice also have geographic and clinical expansions in work following Dobbs.

One-year-old Hey Jane performs medical abortion in New York, California, Washington, Illinois, Colorado and New Mexico. The provider saw site traffic increase tenfold and patient demand more than double after the Supreme Court ruling, boosting the company’s expansion plans, CEO Kiki Freedman told Healthcare Dive.

Choice, which was founded in 2020 and offers medical abortions in California, Colorado, Illinois and New Mexico, saw a 600% increase in web traffic the day Roe fell, and continues to see traffic higher than normal, said CEO Cindy Adam.

Choice is focused on adding more providers to its team and plans to expand to all states where abortion is legal by the end of 2023.

The pills, which can be prescribed in other states and returned to a patient’s home (or other address), are an important mechanism for continuing to access safe abortions, advocates say. The pills, approved by the Food and Drug Administration for more than two decades, currently represent more than half of all abortions.

Conservatives have focused on restricting abortion pills and using telemedicine to prescribe them as next step of the anti-abortion campaign. Currently, 19 states already require clinicians performing medical abortions to be physically present, according to the Guttmacher Institute.

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