The Iowa Board of Medicine voted Friday to end a unique system in which doctors use the Internet to distribute abortion-inducing pills remotely to patients at clinics across the state.

Planned Parenthood of the Heartland has used this program since 2008 to supply thousands of pills to woman in 15 remote locations. It was the first such program in the U.S., and several other states have since taken steps to prevent the practice. Anti-abortion activists petitioned the Iowa medical board earlier this summer to establish rules to halt the program.

The medical board voted 8-2 Friday during a public meeting in favor of rules requiring that a doctor be physically present with a woman when an abortion-inducing drug is provided. The earliest the change could go into effect would be Nov. 6.

Planned Parenthood of the Heartland attorney Mike Falkstrom, who attended Friday's hearing, declined to say afterward if the group would sue but said it's keeping its options open.

The organization says the program benefits women in rural locations and that it's received no complaints from patients.

But the medical board's chairman, Dr. Greg Hoversten, who opposes abortion rights, said he was concerned about the care the women were receiving.

"How can any of us possibly find that a medical abortion performed over the Internet is as safe as one provided by a physician in person?" Hoversten asked.

Opponents of the practice previously petitioned the medical board in 2010, but no official action was ever taken. Since then, Republican Gov. Terry Branstad, an anti-abortion Catholic, regained office and has replaced all of the board members with people who generally seem sympathetic to his views.

Since 2011, 16 states have enacted laws barring the practice, though not all of those laws are currently in effect, said Elizabeth Nash, state issues manager for the New York-based Guttmacher Institute, a reproductive rights think-tank.

The Food and Drug Administration approved the use of an abortion drug in 2000. The medication is typically offered to women in the first nine weeks of pregnancy.