The overturning of Roe v. Wade has dramatically reshaped access to abortion care in the United States, pushing many people toward at-home self-managed abortions. The Miscarriage and Abortion (M+A) hotline, staffed by medical professionals, has become a vital lifeline for individuals navigating this landscape, offering confidential medical support and legal guidance.
The Rise of Self-Managed Abortion
Since 2022, the number of self-managed abortions—using pills accessed without a physician’s direct oversight—has increased, alongside a surge in telehealth abortions where medication is prescribed remotely. These methods are safe and effective, but they also come with new anxieties, particularly in states with restrictive abortion laws.
Before Roe fell, concerns centered on pain management. Now, callers to the M+A hotline fear legal repercussions more than physical discomfort. “The anxiety around a medical provider knowing they’re pregnant… the concern about legal safety – that anxiety is much more prevalent,” says Dr. April Lockley, a family medicine doctor and medical director of the M+A hotline.
A Critical Infrastructure
The M+A hotline was established in 2019, anticipating the potential erosion of federal abortion protections. Today, it receives around 80 calls and texts daily, assisting people with questions ranging from ibuprofen usage after pills to managing bleeding concerns. The service is staffed by over 100 volunteers, including physicians, nurses, and midwives, operating seven days a week.
The hotline is not just for those seeking immediate assistance: it also serves those who are unsure how to proceed, including teenagers lacking comprehensive sex education. Dr. Lockley often begins by assessing basic understanding of pregnancy and reproductive health.
The Legal Tightrope
Despite self-managed abortion being legal in most states, criminalization remains a threat. Some callers worry about emergency room visits triggering legal scrutiny, and even healthcare providers are facing lawsuits from restrictive states. The hotline refers callers with legal concerns to the Repro Legal Helpline.
The M+A hotline received over 14,000 calls last year, with a disproportionate number originating from the Southeast, where bans are most severe. The service helps connect people to safe physicians or clinics for follow-up care, including confirming successful terminations.
“In order to help protect people and help keep people safe, we want to give them accurate information so that they can decide for themselves if this is something that they want to do and what their options are,” says Dr. Lockley.
The M+A hotline and similar services fill a critical gap in reproductive healthcare, especially as legal and medical access continue to narrow. The need for confidential support and accurate information remains essential for individuals navigating abortion care in the post-Roe era.
For confidential medical support, call the Miscarriage and Abortion Hotline at (833) 246-2632. For legal information, contact the Repro Legal Helpline at (844) 868-2812.
