When the phone rings at 2:00 a.m., the voice on the other end is rarely calm. As a former 911 dispatcher, I spent years trained to be the steady anchor in someone’s darkest hour. But nothing in my emergency services career prepared me for the harrowing calls I field now on an abortion pill help line.
I speak every day with women and girls in moments of fear, pain, and confusion — often in the middle of the night, when no one else is willing to answer the phone. Over the past year, I have noticed a troubling pattern that should concern anyone who cares about women’s health, parental responsibility, and basic medical ethics.
The number of calls from women related to chemical abortions is increasing, as is the confusion. Women ask whether the amount of blood they’re losing is normal. They aren’t sure if they took the pills correctly, or at the right time, or in the right dose. Many don’t know how many weeks pregnant they are. They were told this would be simple, private, and empowering. In reality, it is often chaotic and isolating.
One call still haunts me.
“Jenny” was 17 years old when she told the boy she’d known since she was 12 that she was pregnant. His response was blunt: get an abortion. When she told him she couldn’t afford the pills, he suggested she drink rubbing alcohol. When she refused, he blocked her number.
Jenny turned to her mother. Still a minor and financially dependent, she hoped for protection or guidance. Instead, she was told they couldn’t afford a baby. Her mother ordered abortion drugs online.
By the time the drugs arrived, Jenny was 16 weeks pregnant. Four months pregnant and well past when it is considered “safe” to take abortion drugs.
She delivered a baby far more developed than she was told to expect. Two months later, Jenny called our helpline. She was still grappling with trauma, grief, and the realization that this was never truly her choice. Access did not give her autonomy. It gave her scars.
Stories like Jenny’s are becoming more common as abortion activists, protected by so-called “shield laws” in blue states, mail high-risk abortion drugs across state lines with virtually no oversight. During the pandemic, the FDA’s long-standing safety protocols, or Risk Evaluation and Mitigation Strategies (REMS), were rolled back, allowing the distribution of mifepristone without essential medical screenings. In 2023, abortion drugs accounted for 63 percent of all abortions.
These drugs don’t just reach women who actively seek them. They end up in the hands of minors, coercive parents, and abusive partners — angry boyfriends or husbands who pressure, manipulate or even administer them without consent.
Last month, in the early hours of the morning, I received a call from a teenage boy who was in the middle of forcing abortion drugs into his girlfriend’s vagina.
“Is two enough,” he asked, “or do I need to put in another one?”
When I asked where he got the drugs, he said, “I don’t know. One of the top two search results.”
He couldn’t find the website again. There were no clear instructions. No medical supervision. No accountability. This is what happens when policy turns every home into a makeshift abortion center and leaves women and girls to deal with the fallout alone.
Major online distributors of abortion pills advertise “medical support” hotlines, but the details matter. The hours are limited. If something goes wrong late at night — when many of these crises occur — there is no one to help.
These same organizations promote themselves in glossy media articles celebrating abortion at home as progress. Yet even their own stories reveal women receiving unmarked drugs in brown paper bags without instructions. The industry either vastly overestimates the medical knowledge of its audience or knowingly exploits it. Either way, women pay the price.
Some callers are actively discouraged from seeking emergency care because of cost or inconvenience. Others are told to lie — to say they’re having a miscarriage rather than admit they took the drugs. This isn’t health care. It’s damage control.
Women in rural and impoverished communities are especially vulnerable. Many lack reliable internet, transportation or nearby emergency rooms. As an emergency responder myself, I know that a phone assessment is only as good as the caller’s ability to describe her symptoms, often while bleeding, panicked and alone.
Even Americans who support legal abortion recognize the danger here. A majority oppose mailing abortion drugs without an in-person doctor visit because they understand this is not safe.
We are told these drugs are compassionate and necessary. From where I sit, answering the phone in the dark, they look like a growing public health crisis — one that sacrifices women like Jenny and calls it progress. The calls abortion activists celebrate as victories are the same calls that follow me home at night.
The question we should be asking is simple: how many women and their babies are an acceptable casualty?
