But there is one procedure that, though it could be easily, safely, and cheaply administered via telemedicine, is widely unavailable: the termination of a pregnancy. Fifteen states have adopted bans on telemedicine abortion since 2010. The practice was only ever available in three states—Iowa, Minnesota, and Texas—though Texas now has banned it. In Iowa telemedicine abortion continues to be available, though is being challenged in courts, and in Minnesota the legislature passed a ban, which the governor vetoed.

Planned Parenthood of the Heartland (as the Iowa affiliate is known) first began offering abortions via telemedicine in June of 2008. Jill June, the affiliate’s longtime president, had seen a TV news report about complicated surgeries done through telemedicine, and started wondering if telemedicine would work as a way to administer a regimen of mifepristone and misprostol, which together are effective in ending pregnancies. The group has used telemedicine to treated 6,400 women since then, said Angie Remington, a spokeswoman for Planned Parenthood of the Heartland.

Here’s how it works: A woman goes into one of a handful of Planned Parenthood's health centers and talks with a nurse or medical assistant there. She then gets an ultrasound and some lab work done and is briefed on the specifics of the procedure. Finally, she has a video conference with a physician and the local clinician and decides whether a medically-induced abortion is the right course for her. If it is, the doctor checks a box on a computer screen, unlocking a cabinet holding the abortion medication. The woman takes the medication in the clinic while the doctor is watching and then takes the second pill at home 24 to 48 hours later.

“The intent was really for women to be able to receive the care they need without having to travel 500 miles round trip,” Remington said.

In Minnesota, where a clinic in Rochester uses telemedicine to link women to a doctor in St. Paul who can administer the drug, women have been grateful for the service, said Jennifer Aulwes, a spokeswoman for Planned Parenthood of Minnesota, North Dakota and South Dakota. They've reported that it allowed them to get the abortion earlier in their pregnancy, which they preferred. Getting the abortion earlier in the pregnancy also allows women to have a medicated abortion, rather than a surgical one.

“Through this program, there have been many women who have told stories like, ‘I don’t think I would have been able to get an abortion, if not through this service,’’’ she said.

But abortions did not increase in Iowa after telemedicine was introduced; instead, they decreased, part of a national trend in which abortions are decreasing, according to Daniel Grossman, a doctor and researcher at Ibis Reproductive Health.