Free Abortion Access in Rural Areas

In rural areas, there may be greater difficulty than in urban areas in obtaining an abortion. Limited access to reproductive health care and the lack of health service providers in the rural area mean patients often have to drive long distances to receive the care they need, sometimes up to several hours or across state lines to find a safe and legal abortion provider.

According to a 2020 report by the Guttmacher Institute, almost 90% of counties in the U.S. do not have an abortion provider. And, since 2022, many areas have faced additional difficulties accessing abortion providers because of changes to federal protections for abortion. Many individuals in rural areas, small towns, and other remote areas do not know how they can obtain abortion services only sometimes, which can be very discouraging.

Rural communities still have access to abortion services through expanded options for providing telehealth appointments and through medication abortion. Those who cannot travel easily to receive abortion services may use telehealth services when needed to receive care from a licensed provider remotely and to have the medication (abortion pill) shipped to their home.

What Are Abortion Pills, and Are They Safe to Use at Home?

The use of Medication Abortion (also referred to as abortion pill) has become very common as a medically approved option for ending the pregnancy early (before 12 weeks).

There are two medications that go along with this procedure:

• Mifepristone is used to block the production of progesterone (pregnancy hormone)
• Misoprostol causes contractions and helps to expel the pregnancy.

Medication abortion can be utilized throughout early part of the first trimester, up to ten (10) or (11) weeks, and has been studied considerably; when completed per your doctor’s instructions and medical protocol, medication abortion is a safe and efficacious means of terminating an unwanted pregnancy with close to a (95%-98%) success rate.

Medication abortion also gives patients who reside in rural areas access to an earlier option to terminate their pregnancy through the comfort of their homes and via telehealth or by communicating with their physician.

While undergoing medication abortion patients frequently experience cramping and bleeding, which are often similar to miscarriage symptoms.

The medical provider (doctor, nurse, etc.) will provide patients with specific information about what to expect during the medication abortion process, how to help manage associated discomfort, and when to go to the medical facility if they need further attention.

How Telehealth Abortion Works for People in Rural Areas

With telehealth services, women who want to end their pregnancy have the ability to do so easier than before. They can talk to their doctor online or over the phone to get the initial consultation needed to start the abortion process, without leaving home.

The following is an example of how each process would look in an ideal world, although specific processes will be a little different depending on which telehealth provider a patient uses:

Complete an online intake form

A patient completes a secure online questionnaire that asks for her medical history, what symptoms she is experiencing, and what other medications she is taking. This questionnaire helps the telehealth provider determine whether or not a medication abortion will be appropriate for the patient.

Generally, patients can complete this intake form whenever they want (after work, etc.) and therefore are more likely to do so if they have responsibilities at home and work and want to get through the first piece of the telehealth process.

Consult with a licensed provider from home

Once a patient has completed the intake form, she can set up an appointment with her telehealth provider (via video chat, telephone, or secure messaging). The provider will perform the following tasks:

• Review the patient’s medical history.
• Establish the gestation period.
• Discuss available abortion options.
• Answer any questions regarding the medication abortion process.

After this step is completed, the provider will specify a medical recommendation for the patient so that treatment may be initiated.

If a telehealth abortion care provider determines that medication abortion is appropriate for a patient, he/she will prescribe or order a prescription via mail to have it delivered to the patient’s residence or the telehealth provider location for delivery to the patient.

Receive abortion medications by mail

When appropriate, a medical provider will prescribe medications that are needed for a patient to perform a medical abortion through the mail. The package typically does not have any identifiable information on it that will indicate it contains medication used for a medical abortion.

The package will also contain medications to help relieve nausea and alleviate pain in addition to the medication needed for a medical abortion.

Ongoing support throughout the process

Throughout the entire abortion procedure, staff will be available to help answer any questions or provide assistance by phone or secure messaging. After an abortion is performed, a patient will need to confirm the success of the procedure by completing an online check-in process or following the instructions in the box provided.

Telehealth abortion services can improve access to medical care for people who live in rural communities since they allow you to obtain the care you need without having to travel long distances.

Why Abortion Pills by Mail Help People in Rural Areas

In the past, some barriers have prevented women living in rural communities from accessing medication abortion services; however, due to telehealth and medication abortion by mail, these barriers have now been reduced. Now patients can connect directly with a healthcare provider providing pregnancy termination services remotely, without having to drive hundreds of miles to a provider.

1. Accessibility and convenience

For many rural patients, accessing health care often requires traveling some distance to a provider. Depending on how far away you live from your nearest abortion provider, you could travel for many miles just to get to them.

Some considerations when travelling to a remote healthcare provider include:

• The need to take time off work
• Finding childcare arrangements
• Covering transportation and lodging costs
• Scheduling multiple visits to the healthcare facility

Receiving an abortion medication via mail can help alleviate some of the barriers related to long-distance travel to receive medical services because it allows the patient to receive medical care from home through telehealth after speaking with a healthcare provider.

Telehealth will also make it easier for patients to schedule their appointments at times that work for their other daily responsibilities.

2. Privacy and discretion

In small communities, there are concerns about privacy as a rural patient may have to travel into a metropolitan area (where there are larger concentrations of abortion providers) to receive their medical services.

Citizens in small towns may know each other well; consequently, they may feel uncomfortable about travelling to a metropolitan area and asking the abortion services provider for an abortion.

Telehealth can contribute to increased levels of patient privacy, as they can communicate with the physician through telehealth and receive their prescription in plain, unmarked boxes through the mail. Because many patients are concerned about confidentiality when using telehealth services, they feel more secure and confident in their decision to use these types of services.

3. Affordability

Many rural patients have to travel long distances for healthcare, resulting in additional costs related to acquiring their care.

For example, patients may have to pay for multiple items, including:

• Travel, including fuel costs or public transportation cost
• Lodging
• Daycare for children
• Taking off work

Women have the ability to get their care from home through telehealth for abortion services and avoid the costs of travel.

There are also financial assistance programs available through many healthcare providers, including sliding fee scale pricing, payment plans, and financial assistance programs that reduce the price women have to pay for their abortion services from providers.

There are also several different abortion funds and non-profit organisations that assist women with obtaining financial assistance for medical care and travel-related expenses.

4. Comfort of home

Many women find it easier to take medication for their abortion from the comfort of their own home versus going to the clinic.

A familiar environment allows a person to:

• Relax more
• Have control over their surroundings
• Have access to their social supports

Many people prefer to maintain confidentiality surrounding their personal circumstances and receive supportive emotional assistance when ending a pregnancy at home.

Healthcare practitioners provide information regarding the process of medication abortion, as well as the ability for the patient to contact the practitioner with any questions during the process.

Are Abortion Pills Legal in Rural States?

Abortion laws differ greatly throughout the United States. Many states have different laws regarding the legality of abortion procedures. The state where a person is located will determine whether abortion is permissible in that state or not.

Some states have laws supporting a woman’s right to obtain an abortion, while other states have laws restricting or prohibiting women from obtaining an abortion. It is imperative to check back periodically for updated law information before you attempt to use any abortion-related services (including the procurement of an abortion).

If a patient lives in a state that does not have access to abortion services, many women will need to travel outside of their home state to obtain the necessary services. If an individual is planning to obtain an abortion in either Illinois or New York and must leave their home state where abortion is restricted for care. They will have access to the necessary legal protections and safe placement of abortion services. Learn more about how to access abortion care in Illinois if you are considering traveling for services.

Patients will also be able to reach out to local reproductive health providers and/or to organizations specializing in reproductive health care for assistance in determining their reproductive health options based on their specific whereabouts.

Tips to Prepare for an At-Home Abortion in a Rural Area

Preparing for an at-home medication abortion can make this process more efficient, especially if you are in a rural area where there isn’t a local available location for the abortion.

Here are some ideas for you to try:

Check phone and internet access

Confirm that your phone and/or internet service is working before your telehealth appointment.

Your telehealth appointment may take place via video or by phone so you will want to verify that you have the right type of service available before scheduling the appointment.

It is necessary to have reliable internet service and/or phone service for any telehealth appointment in case you need help.

Identify the nearest emergency room

Medication abortion may lead to rare, but serious complications, so if you need to get help from one of those facilities, be sure to know the location of the closest hospital or urgent care center; don’t try to drive yourself there if an emergency happens.

Plan for mail delivery

Plan ahead for delivery of your abortion medication by placing priority on having your UPS, FedEx or USPS package delivered as soon as possible. Use information from your city or town government about whether or not your specific addresses are located within the “limited delivery area”.

Consider these alternatives for delivery of your abortion medication through local pharmacies.

• A trustworthy friend or family member
• An alternative pickup point
• An address at your workplace

Gather comfort supplies

Prepare some things (supply) that will make you comfortable during the time you’re taking your medication for your abortion.

• Some nonprescription pain relievers.
• Heating pad (you might want to check and see if these products are allowed before you bring them into the facility).
• Beverages and food (the medication may make you feel sick).
• Comfortable clothes.
• Sanitary pads.

Taking time and resources to set up a comfortable, quiet environment where you can rest after taking the medication will help create a good environment for you to heal after your medication abortion is finished.

Prepare your space

Make sure the room you choose to wait for the medication provides a comfortable and calming atmosphere. Many people like to have a blanket or pillow and some sort of activity to keep them entertained while they’re waiting to take their medication.

Arrange support if needed

You may also want to find someone that you trust to be there with you while you wait for your medication; a partner, parent, or close friend can help calm any nerves you might have during this time.

Abortion Care Options Through Serenity Choice Health

Telehealth or in person services are available from lots of healthcare facilities and providers that offer reproductive/abortion care to rural women who are searching for care. Below are examples of the ways in which a patient may choose to receive care:

Serenity Choice Health offers services offering abortion services and reproductive health care options in Illinois, Indiana, and New York to women unable to get to a health care facility.

Examples of services offered are:

• Telehealth consult for providing abortion services
• Medications (abortion pills)
• Abortion pills can be sent in the mail as appropriate
• Reproductive health care services are provided in person

The patient has the option to choose a provider after discussing their individual situation with their medical history and options for care. By using telehealth, a woman who lives in a rural area can connect with a qualified medical professional without needing to drive a long distance. To get started, schedule an appointment with a provider today.

The Bottom Line

Obtaining reproductive health care and health care services related to pregnancy termination is often challenging in rural areas. Because there are fewer places that provide these services, individuals may need to travel very long distances and may also be concerned about the privacy of the abortion service. As a result, it can be difficult for individuals to obtain reproductive health care when they live in rural areas.

The new models of health care that exist today allow many people to access health care services related to pregnancy termination. Telehealth appointments via video and mailing medication abortion are two examples of new models of health care that expand access to abortion and, therefore, increase the number of individuals who can obtain reproductive health care.

Ultimately, there will be many more options available to individuals for reproductive health care services when they use telehealth, including telehealth video appointments with certified health care professionals and receiving medication abortions by mail when appropriate.

In order to be able to access reproductive health care services, individuals need to be aware of their options and have access to trusted providers, so they can receive reproductive health care services regardless of their current location. Patients seeking in-clinic abortion services can also find compassionate, professional care at our Matteson, IL location.