---
layout: post
title: "Inside the Miscarriage Hotline Fielding America's Abortion Questions"
description: "How volunteer doctors are answering panicked calls about abortion access, legal fears, and pregnancy loss in post-Roe America."
date: 2026-02-22 16:00:25 +0530
author: adam
image: 'https://images.unsplash.com/photo-1768405942773-87e8d4fb782b?q=80&w=2070'
video_embed:
tags: [news, health]
tags_color: '#e91e63'
---
April Lockley sits in her New York apartment, phone in hand, fielding calls from strangers across the country who are terrified. Not about the medical procedure ahead of them. But about what happens after. "If I go to the emergency room, will they call the police?" This question, repeated dozens of times daily, tells you everything you need to know about what reproductive health looks like in America right now.
Lockley is a family medicine doctor and medical director of the Miscarriage and Abortion (M+A) hotline. She's been doing this since 2020, but the nature of the calls changed dramatically after the Supreme Court gutted Roe v. Wade in 2022. Before that ruling, callers wanted to know about pain management. Now they want to know if they'll be arrested.
## The Fear Underneath
The shift wasn't subtle. Lockley described it plainly: "The anxiety around a medical provider knowing they're pregnant at all, the concern about legal safety – that anxiety is much more prevalent." People aren't just worried about their health anymore. They're worried about their freedom.
Think about what that means. Someone is going through one of the most vulnerable moments of their life, and instead of focusing on medical care, they're running threat assessments in their head. They're calculating whether trusting a doctor will result in a police officer at their door. That's not healthcare. That's something else entirely.
The M+A hotline, created by a group of foresighted physicians back in 2019, anticipated this nightmare scenario. They saw what was coming under the first Trump administration and decided to build infrastructure before the floor fell out from under reproductive rights in America.
## Forty Calls, Forty Texts, Seven Days a Week
Last year, the hotline received just over 14,000 phone calls. That's roughly 40 calls a day, plus another 40 text messages. All handled by over 100 volunteers, nearly all of them healthcare professionals themselves. They're doing this unpaid, from their homes, while grocery shopping, getting their hair done, or sitting in the back of an Uber.
The calls cover the entire spectrum. Some callers have simple medical questions: Can I take ibuprofen with abortion pills? Others need real-time support while managing an abortion at home: Am I bleeding too much? Am I bleeding too little? Some calls are heartbreaking, from people who thought they were pregnant but are now bleeding and don't know if they're experiencing a miscarriage.
And then there are the calls from teenagers who have never received any actual sex education. Lockley starts from scratch with these callers, asking basic questions about their menstrual cycle, about whether they have a safe place to receive mail, about whether they have a trusted adult in their lives. These conversations are rewarding but emotionally heavy.
## Where the Crisis Is Concentrated
Most callers come from the Southeast. It makes sense. That's where the worst restrictions landed first, where several states implemented near-total abortion bans almost immediately after Roe fell. Nearly four years later, 21 states have enacted abortion restrictions, with 14 of them imposing near-total bans.
But here's the thing that catches people off guard: the number of people actually getting abortions in the U.S. has increased since Roe fell. How? Telehealth. When a physician prescribes abortion pills virtually and sends them by mail, it bypasses state restrictions. Telehealth now accounts for roughly one-quarter of all abortions in the country. Self-managed abortions using pills have also skyrocketed. Both methods are safe and effective, and they've become lifelines for people in states where care is banned.
But Republicans aren't backing down. They're actually ramping up their efforts to restrict these options too. It's a game of legal whack-a-mole, except the mole is people's bodily autonomy and the stakes are real consequences: criminalization, legal fees, lost freedom.
## The Criminalization Risk Is Real
While state shield laws protect telehealth providers who prescribe pills across state lines, that protection is fragile. A handful of red states have sued abortion providers from blue states anyway. The legal landscape is becoming increasingly hostile, and it's not just providers who face risk. People who self-manage their abortions have actually been criminalized for their pregnancy outcomes, even though self-managed abortion is technically legal in nearly every state.
Lockley emphasizes this point carefully. The hotline isn't prescribing abortion pills. They're educating callers so people can make informed decisions about their own bodies. "When people feel like they don't have any options," she said, "they are more likely to do something dangerous or get in legal trouble."
That's the core of it. Access to information isn't just about healthcare. It's about safety. It's about preventing people from panicking and making desperate choices because they're working with incomplete or terrifying information.
Many former abortion clinics in states like Texas, Oklahoma, and Tennessee are still operating, offering pregnancy tests and ultrasounds to confirm that telehealth abortions were successful. They exist in this strange legal gray zone, providing support to people who accessed care through other means.
## The Human Cost
The stories Lockley tells reveal the human cost of these restrictions. People without health insurance who can only afford to conclude a miscarriage through mail delivery of pills. People managing abortions later in pregnancy because they couldn't get a clinic appointment in time. Support calls from parents and friends who don't know how to help the person they love.
The fact that a doctor has to answer these calls from her apartment while taking care of her toddler, juggling shifts of four to six hours where she might field dozens of questions, says something brutal about where we are as a country. We've outsourced reproductive healthcare to volunteers working from home.
That's not a sustainable system. It's a stopgap. But it's what we have, and as long as abortion bans keep multiplying, calls to the M+A hotline will keep coming. The question is whether we'll ever actually address the crisis itself, or just keep building more hotlines to patch the damage.
If you or anyone you need support, the Miscarriage and Abortion Hotline is available at (833) 246-2632, and the Repro Legal Helpline can be reached at (844) 868-2812.
