Planned Parenthood Files Appeal Against Ruling in Case Challenging Iowa Telemedicine Abortion Ban


Planned Parenthood of the Heartland and its medical director, Jill Meadows, have filed an appeal of a ruling limiting what evidence they could present in their lawsuit challenging an administrative rule that requires a physician to be physically present at the time an abortion-inducing drug is provided to a patient. The rule also requires an in-person physical examination before and a follow-up appointment after an abortion-inducing drug is provided.

Last August, the Iowa Board of Medicine voted to approve the rule that effectively banned telemedicine abortions in the state. The move directly targeted a very successful practice developed by Planned Parenthood of the Heartland that allowed it to expand abortion access to rural parts of the state, where access to reproductive health care is limited. Planned Parenthood sued to block the rule, and in November an Iowa judge stayed enforcement of the rule while the lawsuit challenging it moved forward.

According to Planned Parenthood, the rule is unconstitutional in part because it was passed with an improper political purpose to directly target the group’s practice of telemedicine abortion. In support of that argument, Planned Parenthood had filed with the court an appendix detailing that the vast majority of medical professionals view telemedicine abortion to be a safe and effective means of delivering reproductive health care to patients. But, in a hearing in late March, the court struck much of that evidence from the record, including, Planned Parenthood of the Heartland claims, evidence that demonstrates collusion with the governor’s office by outside groups that drafted this rule, evidence of political or ideological motives of board members, and the board’s own practices and recommendations regarding telemedicine in contexts other than abortion.

The ruling held that only evidence that had been directly communicated to members of the Iowa Board of Medicine could be included in the appendix, a decision that Planned Parenthood argues unnecessarily narrowed the scope of the lawsuit. The excluded evidence, Planned Parenthood argues, substantially affects the group’s right to a meaningful judicial review and allows the agency to hide behind its staff by limiting the scope of evidence to only communication to the board members directly.

“We believe the judge’s ruling was unnecessarily narrow under the specific circumstances of this case, and we are asking the appellate courts to clarify that this evidence should be admitted in this case,” explained Mike Falkstrom, general counsel for Planned Parenthood, in a statement following the appeal.

It’s not guaranteed that the appeals court will grant Planned Parenthood’s request. The lower court has scheduled a hearing on the merits of Planned Parenthood’s challenge to the telemedicine abortion ban for May 30. Planned Parenthood has asked that the hearing be stayed should the court take up its appeal on the evidentiary ruling.

CORRECTION: A version of this article incorrectly attributed the above statement to Jill Meadows, medical director for Planned Parenthood of the Heartland. In fact, the statement was from Planned Parenthood attorney Mike Falkstrom. We regret the error.

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  • Ingrid Heimark

    Shouldn’t ALL women have an ultrasound by a doctor before an abortion so to rule out ectopic pregnancy? How is this safety rule accomodated by telemedicine? As far as I can see, if Is hould block out the baby and just think about the woman, telemed abortion is NOT safe due to the risk of ignoring an ectopic pregnancy

    • cjvg

      An ectopic pregnancy is treated with the same medication and the same protocol when found at this time of gestation. Even if it was an ectopic pregnancy it would not be treated any different! Obviously you are throwing out a non pertinent red herring again!

      It would behoove you to actually get some form of reproductive education before you attempt to argue that you know better then the doctors who are stating that this is a perfectly safe and acceptable way to treat an early unwanted pregnancy

      • Ingrid Heimark

        Not true, women have died because they thought the pain was normal post-abortion, and didn’t recognize the symptoms of ectopic pregnancy. Also, the treatment is not the same, medical abortion with methotrexate is the same, but usually you use mifepristone, which does not end an ectopic pregnancy, the ones who need to read more, are you. But yeah, trying to educate pro-aborts about facts are not easy, won’t happen again.

        • Arekushieru

          Are you confused? First you say that a medical abortion does not treat a pregnancy outside the uterus. then you say it does. And, usually, the ones who need to be educated are the anti-choice crowd. Like is obviously the case, here. We are not Pro-Aborts, because we are not anti-choice like you.

          Also. you used guidelines from NORWAY. That is NOT the US, and there are no international guidelines. Oops. You said it, yourself, after all. Abortions, there, are done in hospitals with a doctor present. QUITE unlikely that there WOULD be any guidelines for telemedicine abortions, then, in that country, now WOULD there? Whoops, again?

          • Ingrid Heimark

            Nope, the standard medication abortion protocol is mifepristone, which does not treat ectopic pregnancy, even my link at women on waves said that. The only medication abortion regime that treats ectopic pregnancy is methotrexate, and that is not what is the most used. What would do you good is read what I actually write before you dismiss what I say. And read the link form your own side, Women on waves

          • Arekushieru

            “medical abortion with methotrexate is the same,” and “A medical abortion does not treat a pregnancy outside the womb!”

            So, perhaps YOU should read what you write. If you are not talking about the treatment of an ectopic pregnancy when you said this “Also, the treatment is not the same,”, perhaps you should have used the latter phrase either in a different manner AND/OR somewhere else in the same or another paragraph, instead of right next to the first one, because either of which would imply that they’re related, no? Reading comprehension, peeps!

            It seems I WAS reading what you wrote, however, I wasn’t dismissing what you said on that bare fact alone. So sorry. Perhaps it would behoove you to do more than just skim people’s comments, next time, to TRULY understand what they are saying.

            What you say is based on facts? You have yet to provide the medically accredited, peer-reviewed citations I asked for. Because, unlike the anti-choice, I don’t believe something just because it comes from a website that just happens to support my own viewpoint. Kthxbainow.

          • Ingrid Heimark

            Ok, just give mifepristone to women without an ultrasound and see how long it takes for someone to die

          • cjvg

            Again please address the FACT that any women seeking a telemed abortion receives a ultrasound and exam by a licensed nurse as per planned parenthood guidelines!

          • Arekushieru

            Um, then why are you addressing my comments? Because I never said I disagreed with you. I merely said, like most rational people would, that you should provide me with a link to a peer-reviewed, medically accredited journal that states this. (And, no, dismissing does not mean disagreeing, kthx.) I also was simply addressing your very contradictory-seeming statements.

          • cjvg

            Please address that all telemed consultations include an ultrasound and an exam by a registered nurse! As I explained to you before and as you conveniently ignored because it just annihilates your fake concerns!

          • Ingrid Heimark

            Ok, you were actually so hostile that I didn’t bother to read your comment correctly. I apologise for that. But for me, its is not a fake concern, I know women almost killed by ectopic pregnancy. And the bg difference between a medical abortion and orenatal care is that if you get stomach pain during early pregnancy, you seek help, in medical abortion, you may think it is just the way it is supposed to be.

          • Arekushieru

            Um, actually, I believe that’s the other way around. Have you never read stories like Angie Jackson’s? She had a son. She also had a telemedicine abortion. She felt very little pain, describing it as being similar to a heavy period. Therefore, if someone is experiencing such severe pain, it should more commonly be associated with a normally-developing pregnancy than an abortion. She’s also been diagnosed with social anxiety. Which would also severely restrict her access to an in-person physician.

          • Ingrid Heimark

            I ave also heard stories about medical abortions where the pain is excrutiating. Excrutiating pain is not common in pregnancy and is a serious symptom something is wrong, thus the normal thing is to seek a doctor.

            Also, if a person with severe anxiety are seeking an abortion medically without doctor present, that would be malpractice. How is this doctor gonna make sure the woman is safe if there are complications? What about if the woman has an incomplete abortion? Wat about follow-up care?

          • cjvg

            Excruciating pain can be common and harmless, for instance when the position of the baby pinches a nerve, you’ll scream!

          • Arekushieru

            Yeah, sorry we’re so hostile when our comments are continuously ignored but then lead to us being erroneously accused of the same thing. Yeah, sorry we’re so hostile when we provide links to medically accredited and peer-reviewed sites that get ignored in favour of pseudo-news sites, then get told that WE’RE the ones who aren’t basing things on FACTS. Yeah, sorry we’re so hostile when we provide information based on practices from/near our own countries then get told that someone from a different country knows our medical practices better than WE do. Then, yeah, finally, sorry we’re so hostile when we point out that there is more reason to be concerned with these symptoms occurring during pregnancy than abortion, and give you those very REASONS for it, then get told that we aren’t sincerely concerned about women’s health, when, actually, the REVERSE is true.

            Btw, nice fake apology, too!

          • Ingrid Heimark

            Everything I have said here in this thread are out of concern for women, whether or not you believe me, I don’t care. As a pro-lifer, I believe in abortion to save one when two would otherwise die, or choosing between two lives, I prioritize the woman, but only then. But you may assume my apology were insincere, but it wasn’t. Yes, I think you are rude, and yes, I apologize for not readind leading to me continuing to state my case without knowing PP did that. I still don’t think that is enough, and I still hope the one here who believe Mifepristone is safe without confirming intrauterine pregnancy is NOT a doctor http://www.rxlist.com/mifeprex-ru486-drug/overdosage-contraindications.htm

        • cjvg

          Actually you are only partially right, the most effective way to treat an ectopic pregnancy is application of both mifepristone plus methotrexate as several studies have shown unerringly! (“Diagnosis and Management of Ectopic Pregnancy,”1 by Drs. Lozeau and Potter that appeared in the November 1, 2005, issue of American Family Physician, the success rate of combination therapy was 83.0 percent compared with 38.5 percent in those receiving methotrexate alone ) But hey just keep on obfuscating and twisting the facts, like all anti choicers you are good at it.

          Also please address why denying women treatment when no doctors are within a reasonable distance, is better for them since more women die from pregnancy and child birth complications then from ANY FORM OF ABORTION currently available!

          The guidelines in Norway are not the ones used here, Norway has much better access and protections of reproductive choice then America !

          Dishonest and uneducated statements made to display some obvious fake concerns are just not cutting it!

          • Ingrid Heimark

            Since I have known women almost killed by ectopic pregnancy, calling it a fake consern sems pretty stupid

          • cjvg

            Show me proof!

            I can show you plenty of real proof that childbirth and pregnancy as well as denying abortions is much less safe then having an abortion!

            How about this study on which even fox news had to admit it was safe http://www.foxnews.com/health/2012/01/24/abortion-safer-than-giving-birth-study-says/

            The complete study can be found in the journal Obstetrics & Gynecology: June 2012 – Volume 119 – Issue 6 – p1271–1272
            The Comparative Safety of Legal Induced Abortion and Childbirth in the United States, Raymond, Elizabeth G. MD, MPH; Grimes, David A. MD

            Some excerpts;
            -”Researchers found that women were about 14 times more likely to die during or after giving birth to a live baby than to die from complications of an abortion.”

            -”The researchers on the new study combined government data on live births and pregnancy- and abortion-related deaths with legal abortions performed in the U.S. from the Guttmacher Institute, which conducts sexual and reproductive health research and education.”

            -”Dr. Elizabeth Raymond from Gynuity Health Projects in New York City and Dr. David Grimes of the University of North Carolina School of Medicine, Chapel Hill, found that between 1998 and 2005, one woman died during childbirth for every 11,000 or so babies born.”

            -”That compared to one woman of every 167,000 who died from a legal abortion.”

            -”In their report, published in the journal Obstetrics & Gynecology, The Dr’s Raymond and Grimes write that the findings aren’t surprising given that women are pregnant for a lot longer when they decide to have a baby and so have more time to develop complications.”

            -”Dr Harwood said previous studies have also shown the safety of legal abortions.”

            -”Harwood said that laws regarding what’s said between the doctor and a woman seeking an abortion often hamper doctors’ attempts to inform patients in a not medically sound, accurate and balanced way, increasing the risk of complications”

            -” the new report, which helps dispel “misinformation” and “lies” about abortion risks included in some state laws — such as the idea that abortion is linked to cancer.”

            -”a study from the CDC (Centers for Disease Control and Prevention) which found that, from 1998 to 2001, the most common complications associated with pregnancy — including high blood pressure, urinary tract infections and mental health conditions — happened more often in women who had a live birth than those who got an abortion.” http://www.cdc.gov/

            Obviously these sites and these researchers are all respected fully licensed health care professionals and doctors, so you might want to dismiss their knowledge as irrelevant in favor of your anti-choice sites since they are more likely to agree with you

          • cjvg

            The fact that more women die from childbirth and pregnancy related complications then from an abortion clearly demonstrates the insincerity of your “concern”

            If you really where that concerned about women’s health you would insist that every women would have an abortion instead of carrying to term

      • Ingrid Heimark

        One fo the links about this http://www.womenonwaves.org/en/page/3348/what-is-an-ectopic-pregnancy-and-how-do-you-know-you-have-one

        A medical abortion does not treat a pregnancy outside the womb!

        • cjvg

          What do you think methotrexate is? magicall fairy dust?

          PS: Mifepristone was the first progesterone receptor antagonist developed and initially the only one available to treat ectopic pregnancy other then surgery

          • Ingrid Heimark

            Read that again, and you will know it is wrong. Methotrexate is chemotherapy, a cytostatic

          • cjvg

            Please do me the curtesy of at least reading what I write, I stated that “Mifepristone was the first progesterone receptor antagonist developed and initially the only one available to treat ectopic pregnancy other then surgery”

            PS: Methotrexate is an antifolate (inhibits the action of folate, thereby inhibiting DNA/RNA synthesis and repair and protein synthesis = no growth) and an antimetabolite(cytostatic) it is used for much more then just cancer theraphy

          • Ingrid Heimark

            I know, it is also used in treating arthritis in severe cases. But since I read multiple times that methotrexate is the treatment for ectopic pregnancy, and mifepristone is cintraindicated, I simply cannot believe you still say this. That Mifepristone is used for ectopic pregnancy, it is a false statement, no matter how many upvotes you get. Progesterone-antagonists works in the uterus, and on one other thing that has nothing to do with abortions, not in the tube.

          • cjvg

            Maybe you should actually READ the research done by actual DOCTORS and OBSTERICIANS that recommend the use of Mifepristone with methotrexate when treating an ectopic pregnancy since it is more then double as effective! (see previous post you did not bother to read AGAIN)

            Of course you are much better equipped then doctors who actually treat patients to determine what is safe and effective. Women’s lives, that is such silly concern, ensuring that an ectopic pregnancy is terminated in the most effective way is just silly right! What is your degree(s) again ?!

            By the way progesterone antagonist work on the whole body, not just the uterus!

            (“Diagnosis and Management of Ectopic Pregnancy,”1 by Drs. Lozeau and Potter that appeared in the November 1, 2005, issue of American Family Physician, the success rate of combination therapy (mifepristone and methotrexate) was 83.0 percent compared with 38.5 percent in those receiving methotrexate alone

          • Ingrid Heimark

            I am aware of that! The point being, medical abortion, by Mifepristone, are not done with methotrexate. I am not talking about the abortions done by both, I am talking about medical abortion by mifepristone, and as one of the links I showed from physicians for reproductive health, one woman died and 16 was injured after medical abortion not ending ectopic pregnancy unknown

          • cjvg

            Please address that any and all women seeking a telemed abortion receive an ultrasound and an exam by a licensed nurse, that is more then a women seeking prenatal care receive!

            Also please address that 14 times as many women DIEFROM CHILDBIRTH AND PREGNANCY complication then women die from all of every single abortion method currently provided.

            Obviously if your real concern was women’s health and their longlevity you would insist every women receive an abortion to increase the possibility of her staying alive.

            Yes you are deliberately and dishonestly using a fake concern that does not exist

          • Ingrid Heimark

            About my intentions, you are worng. When it comes to the actual process, I hope you are right, because every child that dies form abortion is a tragedy, and every woman that dies form abortion is a tragedy. Every abortion has at least one death, every birth does not. Even though every pregancy-related death, be it maternal or fetal, is a tragedy, related to abortion or birth.

          • cjvg

            Again read the research by the CDC as well as additional research by actual doctors and obstetrician backing up my statements that childbirth and pregnancy complications kill 14 times more women then every single form of abortion combined!
            Where is yours other then your I say so thus it must be?

            -You are a coward, you never actually read the responses and data/research by experts and the medical field that completely contradicts your ridiculous claims.
            -You are dishonest since you deliberately and willfully ignore any questions that expose you lies, I have still not gotten an answer on why you continue to claim that the “lack” of ultra sound and exam endangers a woman getting a telemed abortion. This is this is a bald faced lie, every woman gets one from a licensed nurse that is more then a woman receiving prenatal care gets.
            _ you are a professional victim player by claiming you can not read responses because they are so “hostile” not withstanding that you start your diatribe with the name-calling of pro abort.

            What do you not understand about CHOICE, as in, I respect women enough that I believe they are more then capable of making their own (medical) CHOICES that are right for them regardless if that means abortion or having children.

            You and the others like you is why I have zero respect for the anti choicers, lies, lies, lies and the inability to read as well as the complete disrespect to acknowledge responses to your statements.

            Abortion saves countless women’s lives and health, not one single pregnancy or childbirth can make that claim ever!

          • Ingrid Heimark

            You prob didn’t notice that the reason why I said I hope you are right, is that I saw about the telemed abortion being done with ultrasound, and I hope they do it, I hope they follow guidelines, no matter if they are PP or not, but my point that women HAVE DIED from ectopics after medical abortion, stands

            But yes, I am happy that at least that concern about telemed abortions can be crossed of the list

          • cjvg

            The fact that 14 times as many women die from child birth and/or pregnancy complications also stands.
            Again it is obvious that an abortion is always the safest choice when considering the risks to a woman’s life (your purported concern about telemed abortion

            Show me data, any data for your claim about ectopic pregnancy and death after a medical telemed abortion.

          • Ingrid Heimark

            I said a woman died after a medical abortion with an ectopic preganncy not found, as I say, I am aware that they do ultrasounds before, and then that should no longer be an issue. I didn’t know it when I started this discussion, some pro-life sites have even stated uktrasounds were not done, I see they do, and then no woman should experience that if followed correctly

          • cjvg

            Assuming without facts and then support attempts to pass laws on assumptions is beyond dishonest and idiotic.

            Maybe the anti choicers like you would look a little better if they would actually use facts instead of carefully protecting the lies that fit their agenda.

            If heard anti choicers like to starve babies after they are born, that is why they would like as many born as possible so they keep getting a fresh supply of victims. Lets pass a law mandating abortion for anti choicers! See how stupid it is to use rumors and assumptions to support laws?!

          • Ingrid Heimark

            It’s not my assumptions, I read it on the internet that they DID NOT use ultrasounds, maybe I should have checked it better, so be it. I know now, and thus will not make that statement again.

          • cjvg

            You read it on an anti abortion site! As demonstrated over and over these sites will lie, obfuscate, wrongfully insinuate and go through any length to promote their anti choice practices!
            Doing no research, seeking no government or provider information and relying on know liars is the same as assuming without a shred of proof. There are no abortion providers who do telemed abortions without an ultra sound and an exam by a licensed nurse!
            More women die from childbirth and pregnancy then from all forms of abortion available, so every abortion is defensive medicine! Ultrasounds for pregnant women under prenatal care are at the earliest offered at 3 months, continuing a pregnancy places you at a much higher risk of dying from an ruptured fallopian tube before it is found. Please refrain from spreading lies and deceptive information

          • Unicorn Farm

            “And the woman’s life thing, it is obvious if the pregancy threatens the mothers life, she is allowed to terminate”
            Is it so obvious? Cause you and your freak pals over at Live Action “news” constantly crow about how “abortion is never needed to save the life of the mother!one1″

          • lady_black

            It is also the “gold standard” in treating ectopic pregnancy.

          • Ingrid Heimark

            Correct, not mifepristone

        • lady_black

          You are correct in the sense that the medication most often used for medical abortion works by causing contractions that expel the pregnancy. However, you are incorrect in stating that ectopic pregnancy isn’t treated medically, because it is, if the doctor is interested in what would be best for his patient. That would be killing the embryo or fetus prior to tubal rupture, and that is done by using methotrexate.

    • Arekushieru

      Um, there is no ‘baby’ to be blocked out, either. Tell me do you talk about the safety of others who violate another person’s rights, especially if they happen to be women’s, rights? If not, you are certainly NOT a voice for the ‘voiceless’.

      • Ingrid Heimark

        Who are more voiceless than the unborn?

        • Arekushieru

          Women, because you want to deny them the same rights that everyone else has while granting fetuses more rights than anyone born. Thanks for playing, though!

        • cjvg

          The undead

        • lady_black

          You aren’t their voice. They don’t have a voice for a good reason. They have no thoughts to give voice to. And we aren’t interested in hearing your thoughts.

          • Ingrid Heimark

            I write whatever I want in my discus profile, or are you gonna interefere with my right to free speech ebcasue you disagree?

          • lady_black

            No, you’re free to write whatever you want. But as “the voice of the voiceless” you have zero credibility. You’ll need to deal with that.

          • Ingrid Heimark

            because you have already dehumanized them, something I refuse to do

          • lady_black

            No because, you know, science stuff. What part of “they have no thoughts” is confusing to you?

          • Ingrid Heimark

            I don’t reduce humanhood to your definitions, you can disagree, but I don’t care

          • lady_black

            The “blaks” actually did have minds and the ability to form thoughts. A fetus, not so much. You are the one who is reducing “humanhood” (actually I believe the word you’re looking for is humanity) to a single cell. I have a much more elevated view of what it means to be human than you do. It’s not a heartbeat that makes us human. It’s our brains. Our ability to reason and think beyond the animal instinct. Our ability to empathize. Our ability to render ourselves above the cruelty of nature and use science to improve our lives.You reduce it to mere DNA.

          • cjvg

            But you are reducing thinking breathing feeling women to voiceless embryo containers.

            Are you really trying to claim that being forced to undergo pregnancy and childbirth against your will is not a dehumanizing and degrading experience?! A woman who is fully cognizant sapient and aware of what is happening to her. At least be honest enough to acknowledge that reducing a woman to a voiceless and powerless thing that must submit to what you and other pro-choicers want to use her body for is an horrendous violation of her.

            You and these other anti-choicers took her choice and her body from her and are forcing her to live with this pain, and the life and health altering circumstances forced upon her completely against her will. Even women who chose pregnancy and childbirth suffer from PTSD and you are dishonest and exceptionally cruel by pretending that forced child birth and pregnancy will not have extremely harmful effects on a women suffering through that?

            Sick, just sick to claim that you are “respecting” life when in reality all you do is denigrating and humiliating as well as dehumanizing actual life in favour of a potential.

          • Unicorn Farm

            Is Lady Black the government? No? Then she’s not interfering with your right to free speech. She disagrees with you.

    • lady_black

      No. Doctors generally do not do ultrasounds, they read them. My daughter is in her childbearing years, and has never had an ultrasound to rule out ectopic pregnancy, and is now in her second pregnancy. Intrauterine pregnancy is presumed in the absence of symptoms to the contrary.

      • Ingrid Heimark

        And you don’t see the dangers in this when we talk about confusing sympt oms that may come from a medical “abortion” with a lacking intrauterine pregnancy?

        • lady_black

          No I don’t. If it’s not something routine for someone who intends to carry a pregnancy like my daughter, it doesn’t need to be required for someone who is having an abortion.

          • Ingrid Heimark

            obviously at least one woman died as a result of this, many more injured