More and more people are having abortions at home. Here

April Lockley often fields calls as a volunteer miscarriage hotline provider while caring for her 3-year-old daughter at home. It can be difficult to juggle hotline calls while also entertaining your little one, but Lockley believes her daughter understands what she’s doing on some level.

“She still doesn’t really know the concept of abortion. We’re working on the uterus right now,” Lockley laughed in a phone conversation with News themezone. “But she knows that mom helps people.”

Lockley, family physician, abortion provider and medical director of the M+A hotlineprimarily monitors text messages and calls from his apartment in New York City. But she’s received calls to the hotline from the back of an Uber, while shopping for groceries and even sometimes while getting her hair done. She typically works a four- to six-hour shift alone, during which she can answer dozens of questions.

Some people call with simple questions: “Can I take ibuprofen after using abortion pills?” Others need immediate support while managing an abortion at home: “Am I bleeding too much?” “Am I not bleeding enough?” Some calls can be heartbreaking: “I had a positive pregnancy test but now I’m bleeding. Am I having a miscarriage?”

Since Roe v. Wade, many callers are filled with worry: “If I go to the emergency room, will they call the police?”

Lockley has been on the M+A hotline since 2020 and has seen a marked change in callers’ needs before and after the 2022 Supreme Court decision that struck down federal abortion protections. Previously, most callers were worried about the amount of pain they might experience. Now, the biggest fears revolve around criminalization.

“The anxiety of a medical provider finding out you’re pregnant, the concern about legal security, that anxiety is much more common,” she said. “‘I went to the doctor, now my doctor knows I’m pregnant, are they going to hand me over to the police?’ “We get those questions all the time.”

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Lockley only refers people to an emergency room if necessary, as the emergency room can be frightening for people self-managing their abortion in a state that bans the procedure. Despite self-managed abortion, when people access abortion pills without the help of a doctor — be legal in almost all statesmany people have been criminalized for the results of their pregnancy.

Reproductive health experts saw the evidence after the first Trump administration: It wasn’t about Yeah Federal protections against abortion would fall, but when. Faced with this imminent reality, a group of doctors created the M+A hotline in 2019.

Almost four years after Roe was overturned, 21 states have enacted restrictions on abortion, including 14 near-total bans. But the number of people having abortions in the United States has actually increased. increaselargely due to telehealth abortion care. Telehealth abortions (when a doctor virtually prescribes abortion pills to a patient and mails the medication) now represent a quarter of all abortions in the country. Self-managed abortions with pills, when people access abortion pills without the help of a doctor — also increased post-Roe.

Both types of abortions are safe and effective, and have become a lifeline for people in states where care is prohibited. But Republicans across America are increasing his efforts to restrict them.

“We recognize that abortion access has never been good in this country, but after the first Trump administration, we knew it was going to get worse and worse,” Lockley said. “This hotline was an important piece of infrastructure to continue helping people and answering their questions during their abortion or miscarriage.” (The M+A hotline refers callers with legal concerns to Reproduction Legal Helpline.)

Last year, the M+A hotline received just over 14,000 phone calls, or about 40 calls per day. Additionally, the hotline receives about 40 text messages a day. It is open seven days a week and has more than 100 volunteers, almost all of them doctors, nurses, midwives or other health professionals.

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Everyone’s abortion experience is different, and Lockley has had a wide range of online conversations that reflect this. Some callers ask if they can continue taking their regular medications along with the abortion pills. Others do not have health insurance and receiving abortion pills through the mail is the only way they can afford to have a miscarriage. Sometimes Lockley receives calls from people who support someone undergoing an abortion, such as a parent or friend. Increasingly, he answers medical questions from people who undergo abortions late in pregnancy because they couldn’t get an appointment at the clinic.

Some of the most rewarding but emotionally complex calls are from teenagers who have never received fact-based sex education. Lockley usually starts calls with the same questions: Have you had sex? Have you ever taken a pregnancy test? Do you know how your menstrual cycle works? From there, you can ask if there is a safe place where they can receive mail or if they have a trusted adult in their lives.

Most of the callers live in the Southeast, where several states enacted near-total abortion bans just after Roe fell, according to an anonymous survey that callers were eligible to take after contacting the hotline. For people in red states, Lockley offers referrals to safe doctors or clinics where they can make sure their telehealth abortion worked. Many former abortion clinics in states such as Texas, Oklahoma and Tennessee are still open and offer reproductive health services, including pregnancy tests and ultrasounds to confirm that the pregnancy termination was successful.

The threat of criminalization is also very real for doctors. Although state laws protect providers who prescribe abortion pills by mail, a handful of red states have defendant blue state abortion providers. Lockley and her colleagues on the hotline do not prescribe abortion pills, but they often educate callers on how to access them.

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“To help protect people and keep them safe, we want to give them accurate information so they can decide for themselves if this is something they want to do and what their options are,” Lockley said. “Because when people feel like they don’t have options, they’re more likely to do something dangerous or get into legal trouble.”

If you or someone you know needs help self-managing a miscarriage or miscarriage, call Miscarriage and Miscarriage Hotline at (833) 246-2632 for confidential medical support or at Reproduction Legal Helpline at (844) 868-2812 for confidential legal advice and information.