I Posed As A Pregnant Teen To Test Abortion Pill Sites. What I Discovered Horrified Me.

Also imagine that you have an intrauterine device (IUD) in your uterus that was supposed to prevent you from getting pregnant, but now that it failed, it puts you at higher risk that this pregnancy is an ectopic pregnancy (where the embryo implants outside of the uterine cavity)—a life-threatening condition.  

Anyone with even a modicum of medical training would immediately flag your case as needing in-depth follow-up. They would want an ultrasound to confirm how far along you are and that you do not have an ectopic pregnancy (both of which impact the risks of abortion pills). A girl who is 13 and pregnant also needs to be screened for sexual abuse. Necessary evaluations like these are exactly why Michigan urgent care doctor Viktoria Koskenoja claims that “all” abortion patients she sees “want to talk to someone in person.”  

Dr. Koskenoja’s patients clearly realize what many Americans are realizing: the lack of guardrails on mail-order abortion drugs, as well as ongoing medical care for women, is incredibly dangerous.  

As a board-certified OB/GYN who is well-versed on this issue, even I was shocked to see how poorly abortion drugs, now available online with no prescription, are monitored and regulated and how any medical supervision or support for women and girls is truly nonexistent.  

Just recently, I posed as a pregnant 13-year-old with an IUD to test the guardrails of a “Plan C” abortion drug site. The site should have immediately referred me to the nearest medical professional for an in-person appointment and ultrasound. Such an appointment would have protected me from potentially taking the drugs with a life-threatening ectopic pregnancy, would have been critical for ensuring I wasn’t a victim of domestic or sexual abuse, and would have confirmed my baby’s gestational age.  

Instead, the site allowed me to proceed after answering a few questions indicating that I had a host of potentially life-threatening contraindications to the abortion drugs. All I had to do was acknowledge (as a young, scared teenager) that I was willing to accept the risk (which was not even accurately described).  

The experience revealed that the current situation in this country with abortion drugs, which now account for nearly two-thirds of all abortions, is far more dire than even I had imagined. Thanks to the FDA’s reckless actions, which it seems to want to continue, frank medical malpractice is occurring under the guise of “telehealth.”  Make no mistake: this online shopping experience doesn’t even come within a mile of being telehealth.  

The site allowed me to proceed after answering a few questions indicating that I had a host of potentially life-threatening contraindications to the abortion drugs.

The website took no steps to verify that I was ordering the pills for myself. At no point was I required to produce identification proving that I was who I said I was, a legal guardian of the minor allegedly purchasing the drugs, or even a female at all.  

I imagined several disturbing scenarios that this lack of guardrails or in-person medical evaluation enabled—forced or coerced abortions, enabling sexual abusers or traffickers. In situations like these, a medical visit is often a woman or girl’s first and best chance to get help. And that chance at help has now been ripped away in the pursuit of abortion access above women’s safety.  

The stories of women like Catherine Herring and Rosalie Markezich, along with so many others, confirm that this is not a theoretical risk. No-visit dispensing of abortion drugs does not empower women. It empowers their abusers, with no accountability. 

Throughout the “screening” process, the website failed to warn me about serious potential risks or side effects commonly associated with the abortion drug mifepristone other than bleeding. It didn't even clarify until the final acknowledgements that mifepristone can cause life-threatening infections (which led to a black box warning on the drug that is still in place). I know from my own practice and research that almost one out of every ten women suffers a severe complication due to mifepristone—including heavy bleeding, infections that can lead to sepsis, incomplete abortions, and the need for surgery.  

Much of the information on potential risks on the website was either incomplete or inaccurate. It wrongfully claims the pills work 96-99 percent of the time. The lower end of this range is only accurate very early in pregnancy (at less than eight weeks gestation). For every week beyond that, the risk of an incomplete abortion increases. For example, at 13-14 weeks gestation, women face a 33 percent chance—one in three—they will need a surgical completion of their abortion or even emergency surgery. 

Fully informed consent for women to be able to make a decision based on information tailored to their specific situation is impossible under the current dispensing regime, and does not even seem to be a goal of those pushing these drugs. Though the website encouraged women with irregular periods to seek an ultrasound to confirm their gestational age, and warned women that getting pregnant despite an IUD means they might have a life-threatening ectopic pregnancy, it did not require proof that women had done either. Neither did it adequately describe the risks when these things are not known, especially in language that a 13-year-old would be able to understand. 

Almost one out of every ten women suffers a severe complication due to mifepristone

At the very least, the website could easily require women to upload their ultrasound results to screen for potential red flags that an abortion provider would catch in person. This would not replace in-person medical evaluation, but without at least this requirement, there is zero proof that a woman is even pregnant, no confirmation of her gestational age or whether she has an ectopic pregnancy, or even if she is the one ordering the pills herself. Without these things, informed consent is impossible.  

This is medical malpractice that is actively endangering the health and lives of women, not to mention that it has drastically expanded the number of preborn children’s lives that are being ended in every state in the country (including those who have passed laws restricting abortion). Any medical professional who saw a pregnant woman with the risk factors I entered would perform an ultrasound before giving her mifepristone. The website just let me move on and pay them $150 to get the pills. They got their money, had no liability for any harm they caused, and I would have been left abandoned to my local emergency room when I experienced complications.  

While I knew that mail-order abortion had flimsy guardrails, I was unprepared for the fact that these abortion drug websites have zero medical oversight, even for women or girls with multiple reasons why these drugs could be life-threatening. The website only warned me once of the risks of the drug and let me continue after merely acknowledging I’d read the associated warnings. It's easy to see how desperate young women or abusive men would ignore these warnings with potentially deadly consequences. The few warnings I was given were woefully insufficient, especially because they just allowed me to move on every time (or go back and change my answers to falsely lower my risk) and ultimately receive the drugs, even in a state where abortion is illegal.  

Informed consent is impossible.  

The entire process took less than 30 minutes. Despite being told that my information would be reviewed by a healthcare professional once I submitted it and I would only receive payment information if I was approved by said professional, less than two minutes after submitting the form, I received an email requesting payment and my address. 

My heart broke imagining the countless dangerous scenarios where desperate young women, including girls as young as 13, might be tempted or coerced into purchasing drugs online in a moment of panic. Girls like the one I posed as have been repeatedly fed the lie that mail-order abortion is “healthcare” and are left to discover the truth in isolation.  

This is not “telehealth”—it’s an online shopping experience that empowers only those selling the drugs and abusers. Women and girls deserve better than this. Just because a woman might be contemplating abortion doesn’t mean she deserves a lower level of medical care or a complete lack of follow-up. Michigan urgent care doctor Koskenoja (an abortion supporter) seems to agree. “It annoys me,” Koskenoja told NPR in a recent interview, “That telehealth is considered an acceptable thing in rural areas.”  

Dr. Koskenoja is right to be annoyed, and women are right to want better guidance and stronger guardrails on such critical decisions. In a time when our country is deeply divided on many issues, including abortion, we should all be united in this. Women deserve better than what the current abortion drug scheme offers them.