Reproductive telehealth company expands to New Mexico

Nov. 7—As abortion bans in neighboring states have sent more women seeking care to clinics in New Mexico — a state with some of the least restrictive laws in the nation but only a few facilities providing surgical abortions — organizations have stepped in to offer an alternative option.

Most recently, Wisp, a reproductive telehealth company, and Juniper Midwifery, a New York-based clinic run by two midwives, have opened up shop in the state, offering so-called abortion pills by mail.

"New Mexico, for now, is a state that is friendly toward abortion and is a little bit of an island in the region," said certified nurse midwife Marisa Poverman of Juniper Midwifery.

Juniper began offering services in New Mexico in July, just after the U.S. Supreme Court issued a decision that overturned Roe v. Wade. But the company's plans to expand to the state started a year earlier.

"The timing of when we were ready to start serving people was somewhat coincidental in terms of the landscape of things," Poverman said. "I would say some of what pushed us to start our own practice was really COVID. In a lot of ways, COVID was limiting care for people."

Restrictions imposed by the coronavirus pandemic limited patients' access to in-person health care, which prompted significant growth of telemedicine. This paved the way for a new method of delivering reproductive health care after the Supreme Court ended abortion protections and a slew states began banning the practice.

Health care companies like Wisp and Juniper connect patients with medical professionals who can prescribe a combination of medications that induce abortion — mifepristone and misoprostol — and offer guidance on how a patient will go through the process at home.

The option of having pregnancy-ending medication sent by mail is relatively new in the United States. The Food and Drug Administration lifted restrictions on mifepristone in 2020, allowing physicians to prescribe the drug online and have it sent to patients.

Previously, Poverman said, patients had to go to a specialized clinic to receive the combination of medications. It is still unavailable at most pharmacies, such as Walgreens and CVS, so providers rely on just two U.S. companies authorized to send the pills by mail.

As of 2020, medication abortions accounted for 54 percent of all abortions in the U.S., according to data from the Guttmacher Institute, a pro-abortion rights research group.

However, a number of states have restricted how the medications can be prescribed or have outright banned them along with the surgical procedure.

New Mexico is one of 18 states where advanced practice clinicians, including nurse practitioners and physician assistants, are allowed to prescribe pregnancy-ending drugs.

In many states, patients still must acquire the pills directly from a clinic, and in some, like Arizona, they must also go through in-person counseling and wait 24 hours before receiving the medication.

Poverman said soon after the high court's Roe v. Wade-ending decision, she realized how important it was to bring additional services to New Mexico, which neighbors states with bans and restrictions.

"I'm originally from the Southwest; I'm from Tucson, so it's a landscape that I care about, and it's familiar to me," she said. "There are states with restrictions on telehealth and abortion being provided by telehealth. ... There are also a number of states that restrict care being provided by anyone except for a physician. So that's a limitation for us."

Wisp, which launched its medical abortion services in August and expanded to New Mexico in October, said in a recent statement it provides a range of health services to 100,000 patients a month. The company's goal, said CEO Ahmad Bani, is to broaden access to abortion care while easing patients' fear and stigma.

The company was "born out of frustrations with traditional health care," Bani said, adding, "sexual and reproductive health are two of the most stigmatized and taboo areas within health care overall."

New Mexico "ties in so closely to our core mission of expanding access to these important health care services," he said. "Especially given everything that's happened this year, that importance has only increased."

Bani noted New Mexico has been one of the states with the highest growth for Wisp's telehealth services.

Most telehealth providers like Wisp will offer services to people who live out of state as long as they can provide a physical address in New Mexico where medications can be sent. Because some patients may live in states where they could face legal consequences for inducing an abortion, Bani said Wisp has taken a number of precautions to protect patients' privacy, such as collecting as little information as is needed, disabling the ability for marketing companies to track services and placing strict limits on who has access to patient information.

"Ultimately, patients who come through the Wisp medical abortion service really will have almost no exposure to their data at risk," Bani said.

As laws continue to change throughout the country, the future of abortion care in the U.S. remains uncertain.

Bani said he believes medical abortion through telehealth is going to play an increasingly important role.

"I think that there are going to continue to be changes both at a state level and federal," he said.

Poverman said she still has hope for changes that will again make abortion accessible across the U.S.

"Abortion has always existed, and it will always exist," Poverman said. "I think eventually, with enough stories and enough human compassion, we will get through this. I do think part of the future is abortion at home becoming much more normalized."