In July 2020, a federal district court lifted the U.S. Food & Drug Administration’s (“FDA”) restriction requiring patients to pick up the first drug of a medication abortion—mifepristone—at a healthcare facility. Soon after, an ongoing experiment with remote care for abortion expanded, as telemedicine did in other areas, and virtual clinics began offering no-touch abortions. Growth of virtual care stalled in January 2021 when the Supreme Court stayed a district court’s order pending the appeals process. But in April 2022, persuaded by the evidence of remote abortion’s safety and efficacy, the FDA suspended enforcement of the in-person rule for the course of the pandemic. On December 16, 2021, the FDA lifted the requirement that patients pick up mifepristone at a healthcare facility, clearing the way for supervised mail delivery and pharmacy dispensation.The expansion of virtual clinics, however, is not without significant limitations. First, questions remain about how to implement the new FDA regulation, specifically regarding certified pharmacies, and several FDA restrictions on mifepristone remain in place. Second, about half the country prohibits telehealth for abortion by either banning all abortion or by requiring the physical presence of a healthcare professional. Third, participation in telemedicine depends on various forms of privilege. Patients must have a stable internet connection or smartphone as well as an uncomplicated pregnancy, which, in part because of U.S. health disparities, is more likely for wealthier and white people. Even with the expansion of remote care, the need for clinical spaces will not disappear; in fact, it will come under increasing pressure.This Article maps the emergence of virtual abortion care and analyzes the potential trajectory of medication abortion access, given that the Supreme Court has overturned constitutional protections for abortion. It considers the limits of telehealth for abortion—who telehealth can reach and who it cannot. Those living in states that permit abortion will have new options for ending early pregnancies. Those residing in states hostile to abortion will have to seek cross-border care, carry pregnancies to term, or find other avenues to end pregnancies. But the portability of abortion pills, when mailed by prescribers or dispensed by certified pharmacies, will test how closely states officials (or anyone else) can police or impede access to medication abortion.

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远程生育权

2020 年 7 月，联邦地方法院取消了美国食品和药物管理局 (“FDA”) 的限制，该限制要求患者在医疗机构获取药物流产的第一种药物——米非司酮。不久之后，一项正在进行的堕胎远程护理实验扩大了，就像远程医疗在其他领域所做的那样，虚拟诊所开始提供非接触式堕胎服务。2021 年 1 月，当最高法院在上诉程序中搁置地方法院的命令时，虚拟护理的增长停滞不前。但在 2022 年 4 月，在远程堕胎的安全性和有效性的证据的说服下，FDA 暂停了针对大流行过程的现场规则的执行。2021 年 12 月 16 日，FDA 取消了患者在医疗机构领取米非司酮的要求，为受监管的邮件投递和药房配药扫清道路。然而，虚拟诊所的扩张并非没有重大限制。首先，关于如何实施新的 FDA 法规的问题仍然存在，特别是关于经过认证的药店，并且 FDA 对米非司酮的一些限制仍然存在。其次，大约一半的国家通过禁止所有堕胎或要求医疗保健专业人员在场来禁止远程医疗堕胎。第三，参与远程医疗取决于各种形式的特权。患者必须拥有稳定的互联网连接或智能手机，并且怀孕期间没有并发症，这在一定程度上是由于美国的健康差异，更有可能发生在富裕人群和白人身上。即使随着远程护理的扩展，对临床空间的需求不会消失；事实上，它将面临越来越大的压力。鉴于最高法院推翻了对堕胎的宪法保护，本文描绘了虚拟堕胎护理的出现，并分析了药物堕胎的潜在轨迹。它考虑了远程医疗对流产的限制——远程医疗可以覆盖哪些人，哪些人不能覆盖。那些生活在允许堕胎的州的人将有新的选择来终止早孕。居住在对堕胎持敌对态度的州的人将不得不寻求跨境护理，将怀孕延续至足月，或寻找其他途径终止妊娠。但是堕胎药的便携性，当由开处方者邮寄或由经过认证的药房分发时，