By Liz Hildebrandt, BSN RN – Anchor of Hope Nurse Manager

My heart is breaking. How did we get here? 48 years ago, when our nation legalized abortion we wanted it to be “Safe, Legal, And Rare” because of our concern for women, but we are living in a culture where unrestricted legal access to abortion is far from safe or rare.  Abortion was for sale on the Black Market, but women now have increasing access to chemical abortion right in their own homes.  

With several states now allowing abortion by mail or telehealth abortions at home, a woman looking through the foggy, storm-filled lens of her immediate crisis may take a life-changing risk alone. Without the care of a doctor, she may pay for something that has dangerous and lasting consequences, hoping for a way out of the storm 

The women I know are strong, brave, and capable of far more that they think. Doesn’t a strong, intelligent, capable woman deserve safe and informed care when an unexpected pregnancy threatens to change her set vision for life?    When equipped with truth, and given time, why don’t we trust women to make good, informed choices about their bodies and their future?   

In 2000, chemical abortion was approved for use with stringent safeguards in place to protect women.   Of the more than 20,000 approved prescription drugs, only 57 drugs are dangerous enough to have the Risk Evaluation and Mitigation Strategy (REMS) in place for certain precautions to be taken.  Some of the safeguards for the abortion pill (RU486) include a visit with a physician, documentation of gestational age under 63 days, informed consent about the risks with 24 hours to weigh the warnings and dangers, an opportunity to rule out an ectopic pregnancy (19.7 out of 1,000 pregnancies that grow outside the uterus and can be life-threatening), and access to a hospital in case of emergency.  

Although the rate of complications increases exponentially as gestational age increases, and over 5000 complications have been reported, in 2016 the FDA (Food and Drug Administration) extended use of the abortion pill up to 70 days (about 2 and a half months) gestational age.   It no longer requires providers to report a complication unless it results in death.  

On April 12, 2021, the FDA decided to waive enforcement of these precautions, paving the way for more telemedicine or abortion pill by mail.  The American Association of Pro-Life OB/GYNs challenged this decision to remove the safety protocols, exposing women to increase potential to be harmed by complications or incomplete abortions.  

A woman deserves to have her health and safety protected, but by easing access to “at-home” abortions, she is more at risk of complications.  International research studies suggest that failures and complications after medical abortion are common.  In fact, complications occur four times more frequently from medical as compared to surgical abortions. 6-7% of women require an additional surgical procedure for prolonged bleeding, infection, and incomplete abortion.  

The first pill in a chemical abortion, mifepristone, binds to receptor sites and blocks the hormone progesterone which is needed to sustain a pregnancy.   The second pills of the process, misoprostol, induce contractions so that the baby and contents of the uterus are expelled. Women have a right to know the truth about the process, the rate of complications, the failure rate and how it could affect their reproductive future and mental health.   They need to know about the Black Box warnings for mifeprex and misoprostol when used without close medical supervision. 

The recommendation for women to take the pill at the first sign of a missed period is reckless and dangerous.  An incorrect guess about the baby’s gestational age, an undetected ectopic pregnancy that could rupture causing life-threatening hemorrhages, and a RH negative woman not receiving prophylactic Rhogam could lead to complications with future pregnancies.  

A woman also needs to know that she always has choice to change her mind and that 68% of abortion pill reversals are successful if she decides to continue the pregnancy after the first pill. 

At Anchor of Hope we want to be her anchor, to steady her as she processes the changes in her body and future. We do this by giving her accurate information, encouraging her to take time to think about how this could affect her future.  We want to show her the age, placement, and viability of her unborn child before she makes a life-altering decision.  We believe women deserve to hear that they can be successful regardless of an unexpected pregnancy. We offer care and time to mourn the vision she may have had for her life, to help her dream new dreams in a safe supportive environment.  



 FINAL-PB-8-Medical-Management-of-Elective-Induced-Abortion.pdf (

Progesterone use to reverse the effects of mifepristone – PubMed ( 

Quality women’s healthcare exists and is here to provide you hope. You can choose. Contact a nurse today by texting or calling 920-452-4673.


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