I imagine that most pro-life Americans would guess that since Roe v. Wade was overturned in 2022, fewer unborn lives are being ended in this country.
They would be wrong.
The statistics show the opposite, and the numbers are staggering. Estimates show that roughly 100,000 to 200,000 more abortions are happening annually compared to pre-Dobbs levels. That’s more than 1.1 million lives ended annually, and rising.
The damage goes even deeper than the death of innocent children: it includes the wounding of their mothers and fathers, and a culture increasingly inured to violence and growing ever harder of heart.
While there are multiple factors behind the appalling statistics, the mechanics have all to do with method. Long gone are the days when most abortions took place in dingy Planned Parenthoods in urban strip malls for many hundreds of dollars. The days of “an abortion is between a woman and her doctor” are also far in the past. Now, most abortions (about 70%) are chemical, not surgical, and of those, about 40% are administered via Telehealth.
Disturbingly, when researchers evaluated 865,727 abortions through prescriptions of mifepristone from 2017 to 2023 (as reported in insurance records), they found a serious complication rate of almost 11%, with mothers suffering hemorrhage requiring transfusion, overwhelming infection, follow-up surgery, and even death. The FDA reported 36 maternal deaths through 2024, probably an undercount since adverse-effect reporting is no longer required.
Rough math suggests that in 2025, more than 300,000 abortion pills were dispensed by mail, and no physician or nurse personally interacted with the patient, or examined her, or took a careful history, or looked for signs of abuse or coercion. In fact, in a Telehealth abortion, there is usually no video consultation or even a live call.
This is how it works:
A woman, or a young girl, or a man bent on destroying his offspring with or without the consent of the mother, visits a website like Aid Access. A simple questionnaire is filled out, providing details about the date of the last menstrual period and estimated weeks of pregnancy, some medical history, and a shipping address. No identification is asked for and no personal details beyond what’s needed for delivery. Pills ship from a pharmacy to all 50 states and the cost is a very low $150.
Stop for a moment and consider the many devils in these details. For one, these are dangerous drugs, which even when used properly and under full physician supervision can cause severe maternal bleeding, overwhelming infection, and even death. Contraindications to their administration include a baby more than 10 weeks old and a pregnancy outside the uterus (ectopic pregnancy), but the only way to reliably date the baby and locate him or her is with ultrasound.
Nowhere in a Telehealth abortion does ultrasound occur — an ultrasound that could save the mother’s life. Also, some maternal conditions make the procedure very risky, like adrenal insufficiency, long-term steroid therapy, bleeding disorders, and allergies. Even Planned Parenthood emphasizes that these drugs are not appropriate for self-diagnosis of pregnancy location, age, or complications.
Dispensing in this way also puts abusive men in the driver’s seat. In one case, a Texas man who used Aid Access to obtain 10 pills crushed them and put them in a cup of hot chocolate he served his pregnant girlfriend. Their baby died and she sued him for wrongful death. Another man in Texas did the same with cookies and has been charged with capital murder.
As a result, Telehealth providers, in the interest of maximizing “access,” have created a Wild West environment that claims lives. Eighteen states, including California and New York, have enacted “Shield Laws,” which protect pill providers who send them to men in Texas, or to 13-year-old girls in Florida. Under these Shield Laws, enforcement actions against the irresponsible pill-pushers are blocked, even when they have led to coerced abortions.
But the devil that is driving up abortions is the demon of moral hazard: when people take bigger risks, thinking there is a safety net that protects them from the full consequences.
When Roe v. Wade made abortion legal, unintended pregnancies increased as risky sex, disconnected from the safe haven of marriage, skyrocketed. With the cheap and logistically easy addition of Telehealth chemical abortion added to the mix, it is no wonder that hundreds of thousands of more unloved children are being terminated year over year.
For those of us who care about the dignity of life and hope for a society in which children are welcomed as a blessing, these are hard realities. But in a democracy like ours, why shouldn’t our elected officials be buried under a pile of emails and phone messages reminding them that these drugs should be regulated and controlled at least as strictly as the decongestants we can’t grab freely from the pharmacy shelf?
We may be years of education and evangelization away from a culture of life in the U.S. But there are small regulatory changes that could save countless lives and prevent innumerable heartbreaks in the meantime, and we should be demanding them loudly.
