Residents of D.C., Maryland, and Virginia can now access at-home abortion services without stepping foot in a doctor’s office.

Planned Parenthood of Metropolitan Washington announced that the organization is offering medication abortion services remotely to any resident in the three jurisdictions, marking the second Planned Parenthood affiliate in the country to offer the completely at-home care.

“We know that medication abortion is a very safe procedure to have done, and that abortion in general is very common,” says PPMW Medical Director Dr. Serina Floyd. “And so having access to a procedure that is so common, that is so safe is very important, particularly when we’re talking about our patients who are coming from marginalized communities.”

The process begins with a screening to determine eligibility, where patients will be asked a series of questions to determine whether they can be exempt from an ultrasound, bloodwork, or other clinical testing that is normally performed before an abortion. If a patient fits the criteria for the at-home abortion medication, they will meet virtually with a clinician, and then receive the medication in the mail to take at home. Follow-up care is also conducted remotely in the weeks after a patient takes the medication.

According to Floyd, PPMW had been exploring more telehealth options for reproductive care for years. The need to expand services for at-home abortions became all the more imperative, she says, when the threat of COVID-19 added an additional hurdle to abortion service — care that already comes with systemic and financial obstacles, especially for low-income and residents of color. While PPMW did not fully restrict in-person abortion services, staffing constraints and the need to minimize COVID-19 exposure did reduce the volume of patients that providers could see on a daily basis; PPMW began shifting some appointments, like in-takes or follow-ups, to phone calls or video appointments.

“Where [the pandemic] has presented challenges for some people, it’s also most certainly opened opportunities for us,” Floyd says. “People really had to make a decision of whether or not they wanted to come in, and then how they were going to navigate that…with the respect to exposure to COVID and what that might mean for their own exposure, [and] exposure to their loved ones. So that definitely played a part into how people may make decisions, and even for us, how we had to proceed with how we were looking at delivering care.”

PPMW began offering the at-home abortion pill, mifepristone, on Aug. 12, but only offered telehealth appointments for the service on a limited basis as a means of working out any last logistical kinks. Now, the service is fully available to anyone who is physically in D.C., Maryland, and Virginia at the time of their remote visit, and who provides a mailing address in any of three jurisdictions. Patients can also pick up the medication at one of PPMW’s health centers.

Floyd says the recent near-total ban on abortions in Texas underscores the need for at-home and telehealth abortion services to expand nationwide. According to the Guttmacher Institute, medication abortions accounted for 39% of all abortions administered in the U.S. in 2017, but 19 states require a clinician to be physically present at the time the medication is taken.

“We, unfortunately, see cases of folks who — just because they’ve had to navigate all of those logistics of transportation, and time off work, and the finances — they get further along into the pregnancy until they’re at a point where either they’re not a candidate for medication abortion or in some extreme cases are not a candidate for abortion all,” Floyd says. “So being able to have timely, convenient, safe, and very compassionate care is really important for for our patients that we take care of, as well as patients, any patient who is in need of abortion care anywhere.”

Per PPMW, the cost of the abortion medication and telehealth visits is $525. Organizations like D.C. Abortion Fund collect and distribute money for locals and visitors seeking an abortion in the region.