By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research
When someone says “abortion clinic,” what comes to mind? Perhaps some brick and mortar facility, a suite in a medical building in an office park, or maybe a converted old house with a waiting room, receptionist, and a doctor performing abortions in the back room?
Those sorts of clinics still exist, but they are becoming a rarity, replaced by large regional mega-clinics and, thanks to chemical abortions and new government policies, something much less tangible and far more scary – the virtual clinic. The virtual clinic is one that exists only in cyberspace. It is a place where women never visit, never meet a doctor or any other medical professional in person, yet still serve as the source of terrible advice and all too real abortion pills which take the lives of their innocent children and put their own lives at risk.
The virtual clinic is pretty much just a phone number, an email address, or a website. There might be some connected small corporate office with a desk and a phone tucked away in some northeastern, midwestern, or west coast city, but just as likely it consists of someone sitting at home on their computer responding to an email, answering a cell phone, or maintaining a website.
Maybe they have some pills they keep on hand that they take down to the local post office and ship by overnight mail. Maybe they have an arrangement with the distributor and just call the order into a local warehouse and have them shipped from there. Maybe they fire off an email to a rogue Indian pharmaceutical manufacturer and have knockoff pills sent out on the next flight to America.
Perhaps there is a nurse or doctor involved somewhere in the process, reviewing and approving of the orders, technically responsible for making sure women understand the procedure, know the risks, and know what to do in the event of an emergency. But the company may be run by and the phones and computers staffed by people with little or no previous medical background.
These virtual clinics exist, if that is the right word for it, to make money for opportunistic entrepreneurs or to further the cause of chemical abortion, not to have someone there on hand to meet the medical, material, or social needs of their pregnant patients.
According to Advancing New Standards in Reproductive Health, a pro-abortion research institute out of the University of California, San Francisco, there were no virtual clinics offering chemical abortion in 2020. But by 2022, there were 69 such clinics, representing 9% of the facilities offering such abortions in the U.S.
These have become more prominent since Dobbs, the 2022 decision that returned power to regulate abortion to the states. One organization of the abortion providers, the Society of Family Planning, claims in its October 2023 “We Count” report that virtual clinics have risen 72% since that time.
This means that instead of going to see a doctor at a medical office, taking tests to confirm the pregnancy, having a physical exam and maybe undergoing an ultrasound to determine the gestational age and location of child in the womb, a woman simply goes online, or emails, or makes a phone call, answers a few questions, and has abortion pills shipped to her home in an overnight package.
If this were something innocuous like a common children’s cold or cough medicine, or an over-the-counter pain reliever, this might not be so alarming. However, these are drugs that work (when they do work) by causing bloody, painful abortions that put thousands of women (some studies estimate as many as 5-10% of users) in the emergency room. They come with issues such as failed abortions, hemorrhage, infections, or ruptured ectopic pregnancies. More than two dozen U.S. patients ended up in the morgue.
The abortion pill was originally approved in 2000 under very strict conditions. Those included specifying limits on gestational age, careful screening, a full briefing on process and risks, and requiring multiple in person visits. Democrat administrations, at the behest of their allies in the abortion industry, dropped most of these safeguards in March of 2016. Finally, in 2021, they abandoned requirements for in-person exams and visits.
Though virtual medicine (online visits with one’s doctor) became popular during the COVID pandemic, these changes in government policy were the real reason why virtual abortion clinics took off.
Though well-known abortion chains like Planned Parenthood, Carafem, and Whole Woman’s Health each have their own virtual clinics, these changes led to the creation and proliferation of many online abortion pill entities. They include Just the Pill, Hey Jane, Choix, Mayday Health, and the granddaddy of them all, Aid Access.
Some (though not necessarily all) of these involve a virtual consult of some kind. The woman may trade text or emails with a “provider,” or even have a phone or video conversation, who may at least ask a few pertinent questions about the date of a woman’s last period, any signs or symptoms of ectopic pregnancy, and any known drug allergies.
This is not near as precise or accurate as an in-person exam with a trained medical doctor or ultrasound that can confirm gestational age or confirm that they child is safely implanted in the uterine wall. But it is somewhat better than nothing.
It is critical to determine the date of the pregnancy and the child’s location in the womb as the effectiveness of drug decreases as gestational age rises, and the risk of complications increases the farther along the pregnancy. The standard drugs mifepristone and misoprostol do not work in situation of ectopic pregnancy, where the child is implanted outside the womb, e.g., in the fallopian tube.
Some of these online abortion pill promoters make some sort of modest effort to comply with federal guidelines and limit sales to states where such prescriptions are allowed, but others do not. There may be a doctor somewhere in the supply chain, maybe reviewing sales calls and authorizing prescriptions, but maybe not. Newer rules require only that the prescriber be a certified healthcare provider without specifying any particular level of medical education or training.
Aid Access, which may be the biggest provider of these pills, doesn’t even go that far. Aid Access sells pills which have never been tested by the U.S. Food and Drug Administration and brashly ships those pills to women in states where these are expressly forbidden.
Their compliance with gestational limits, their commitment to full screening and follow up, the arrangements they are supposed to have in place for emergency surgery or treatment are all uncertain and rather tenuous. They claim this level of testing and monitoring is not absolutely necessary.
It was during the pandemic that lots of people became aware of and comfortable with the practice of virtual medicine, understanding that for many medical exams and procedures, a visit to the doctor’s office wasn’t necessary. But abortion is quite different than an online interview about the symptoms one is experiencing of a cold, the flu, or even an irritating rash.
The removal of those guidelines, the screenings and examinations that accompanied the in person visit are all critical safety factors in a woman’s chemical abortion experience. They could mean the difference between her going home safely or bleeding to death on the way to the hospital.
Virtual clinics serve the interest of the abortion industry and line the pockets of the online abortion pill providers, but they are clearly not in the best interest of patients and surely not their unborn children.