Tennessee’s legislature is joining a few other Republican-led states in advancing new restrictions on abortion pills, which have grown more common than surgical abortions. A bill approved by the Senate Judiciary Committee on a party line vote Tuesday night would add criminal penalties.

During the pandemic, telemedicine became far more common — even for abortion, in some states. And pills have become more common than surgical abortions, according to data collected by the Guttmacher Institute.

Tennessee law, however, still requires in-person visits for abortion medication.

“This law has been on the books for some time, that you have to be in the physical presence of the patient to do this,” says Will Brewer of Tennessee Right to Life, which helped write the legislation. “But there is no penalty or fine.”

South Dakota is considering a similar bill. It would require a woman to make three trips to the doctor to get medication for an abortion.

Followup and reporting requirements

Tennessee’s bill (SB2281) is sponsored by Sen. Mike Bell, R-Riceville, and extends far beyond penalizing prescriptions by mail. It requires doctors to give out the pills rather than sending patients to a pharmacy. It also requires them to schedule followup visits with patients seven to 14 days later, and to tell them  that medication abortion can be reversed, a claim that doctors say “is not based on science.”

Tennessee already requires patients to visit doctors twice before getting an abortion.

And there are certain abortion complications that have to be reported, which has some physicians concerned.

Dr. Katrina Green, who supports abortion rights, says she treats many women in the emergency department for heavy bleeding related to miscarriages. And she doesn’t know whether those have been medically induced or not.

“If the patient doesn’t volunteer that information to me, I wouldn’t know to report that,” she says. “So am I liable? And I going to be fined and face jail time?”

The legislation would make violations punishable as a low-level felony, with fines of as much as $50,000 and possible sanctions from the state medical board.

The House version of the bill has yet to begin advancing.