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Mail Order Abortion: Strategies for an Effective Response

Since the end of Roe vs Wade, the landscape of reproductive health has changed significantly. In some states abortion has become widely available to all ages and is provided through taxpayer funding. In others, abortion has been highly restricted, or even outlawed altogether. Regardless of where your center is, we are all facing a similar issue: a growing number of clients are taking advantage of the easy access of mail order abortion pills. Some opting to order pills in preparation, even before a pregnancy occurs.

These pills can be ordered through legal FDA-approved sites like Plan C, Aid Access and Hey Jane by simply answering a quick questionnaire and submitting payment. Abortion medication can also be obtained from international sources that may not have any screening process or disclaimers about potential complications. These medications are then discreetly shipped to the woman’s home in just a few days with little  or no health history, no consultation and no exam. In fact, many sites such as the National Women’s Health Network, state that “At home, medication abortion care is safer than Tylenol.” So it makes sense that our potential clients feel they are being responsible by having these drugs at the ready? 

What many centers are discovering is that women are taking even less precautions and are not open to talking about the decision because the pills are already in their possession. I’ve been told countless times in recent consultations with advocates that “They already have the pills and they just don’t want to come in” and “The client asked if I could help her figure out dosing. I told her no and she hung up.” Veterans of our movement, especially in restrictive states, are finding that it’s much more difficult to book clients with the abortion pill so readily available. So what's the answer? How do we get them into the center? It starts with understanding her better and knowing how to highlight the services that will meet her immediate needs.


At first glance the abortion determined woman is cold, inflexible, and at times confrontational. Why? Because she feels she has already made her choice and is often ready to argue the point. The problem is, that if she pre-ordered pills, she may have made that choice when another human being’s life was not actually on the line. While she may be willing to charge ahead like the typical abortion determined woman, she is also likely to be uncertain on some level. Moreover, we can expect that she will have some fears or apprehensions, though she may struggle to articulate or even recognize those fears.

After working with countless post-abortive women and men, and having gone through an abortion myself, those fears almost always boil down to the same two questions: What will I experience? And will I regret it later? Despite the woman being practically prepared with pills in hand, she is wildly unprepared for the physical and emotional aftermath that is ahead. This is where the center comes in.

Offering Valuable Support

If we can market our services in a way that appeals to her, and if we are able to offer judgment-free reassurance, support with no strings attached and within a timeframe that meets her desperation, then we just may be able to change her heart. Being able to offer the following things will be of extreme value to her and when offered in the right way, will draw her into the center.

  1. Immediate Availability: Being available right when she is in that desperate moment is crucial. If she has to wait hours or even days for a conversation or an appointment, this will be a detriment to our ability to help her. Our willingness to talk after hours by call and text will initially earn her trust. So will a same or next day appointment. If she’s too early, or if your schedule doesn’t allow for an ultrasound, a standalone consultation will provide her with the immediate information and counsel she desperately needs and will hopefully halt her decision to take the pills right away. 

  1. Education: Offer that you can provide her with unbiased, accurate medical information on exactly what she can expect from taking the pills, including how long the process takes, what self care might look like, expected side effects, and complications that necessitate emergency room visits. Many women are also unaware that the abortion pill has failure rates and is not indicated for those with certain medical issues. Offering this information will validate her unrealized concerns and show her the importance of taking a step back and gathering more information. 

  1. Ultrasound: Explain that ultrasound is a smart first step if she is planning on abortion. She needs to hear that only ultrasound can accurately track the gestation of the pregnancy and rule out dangerous pregnancy complications. Tell her that an ultrasound is not just about seeing a baby but that it’s a diagnostic tool that offers her a safeguard from potential health complications and can also help her to protect her finances if she is further along than she thinks, or isn’t pregnant at all.

  1. Access to APR: Briefly covering the basics of Abortion Pill Reversal and providing her with access to a hyperlink where she can call or chat with a nurse if she’s taken the pills, will further reinforce that this is not a decision to be taken lightly. 

  1. After-Care Consultations: It's uncommon for an abortion provider to offer a follow-up appointment even for a surgical procedure.  However, you can inform her that your center can offer a consultation or referral to detect common complications such as anemia or RPOC that might go unnoticed after an abortion. She will feel unconditional support and this will allow your advocates an additional opportunity to speak into her life even if she goes through with the abortion. Offer safe counsel for negative emotions that often follow pregnancy termination, education on fertility awareness and next steps for protecting herself moving forward. 

Each of these things provide her with what feels like unconditional support and gives her the answers she is looking for. But more importantly, her acceptance of these services will allow advocates opportunities to speak into her present and her future. 

So when potential clients call asking for instructions on how to obtain pills online or how to take the pills she’s already obtained, don’t waste the opportunity. Make your center valuable, and offer her these 5 powerful tools that just might change her heart and save her baby’s life.


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