When the Centers for Disease Control and Prevention (CDC) released its latest abortion surveillance report, headlines across the country celebrated a supposed victory: abortion rates appeared to decline by about 3% in the year following the 2022 Dobbs v. Jackson decision that overturned Roe v. Wade. Many attributed this dip to stricter state laws and shifting cultural attitudes.

At first glance, it sounds like good news for those who believe every human life is worth protecting. But beneath those numbers is a troubling truth few are talking about: this isn’t a true decline, it’s a disguise. Abortions aren’t disappearing. They’re simply moving from clinics to mailboxes.

And that shift comes with risks and consequences most women are never told about.

The Numbers Don’t Tell the Full Story

The CDC’s abortion data only includes procedures reported by clinics, hospitals, and doctors’ offices that are legally required to document them. What it doesn’t count is the growing number of abortions happening privately, often secretly, through pills sent by mail.

Independent research paints a much different picture. According to the Society of Family Planning’s WeCount project and the Guttmacher Institute, the average number of abortions rose from around 80,000 per month in 2022 to over 90,000 by 2024, despite more than a dozen states enacting bans or severe restrictions.

Medication abortions using mifepristone and misoprostol now make up over 60% of all abortions in the U.S., up from about 53% before Dobbs. And about one in four of those are prescribed via telehealth and delivered directly to women’s homes, often without a single in-person medical visit.

What looks like a “decline” on paper is actually a shift in how abortions are carried out.

From Clinics to Clicks: How Abortion Moved Online

After Roe fell, telehealth services like Aid Access and Plan C quickly filled the gap. Their model is simple: fill out an online questionnaire, sometimes speak briefly with a clinician, or not at all, and receive abortion pills by mail.

For women in states with abortion bans, this can feel like a solution. But what’s being sold as “empowerment” often leaves women completely alone during one of the most physically and emotionally intense medical experiences they will ever face.

Because make no mistake: abortion pills are not harmless.

What Happens When There’s No Doctor

Here’s how these pills work:

• Mifepristone blocks progesterone, detaching the developing embryo from the uterine wall.

• Misoprostol induces contractions to expel it.

In a medical setting, doctors perform ultrasounds to confirm the pregnancy is under 10 weeks, rule out ectopic pregnancy, and screen for conditions like anemia or bleeding disorders.

At home, with only a laptop and a packet of pills, none of that happens.

Without a proper medical evaluation, women risk taking the pills too late in pregnancy, misdiagnosing an ectopic pregnancy (which can be fatal if ruptured), or facing life-threatening bleeding and infections. A 2021 British Medical Journal study found that 6% of women who used abortion pills without in-person care required follow-up medical treatment. Emergency room data suggests thousands of complications go unreported because they’re coded as “miscarriages.”

That distinction matters. When a miscarriage is treated with misoprostol, it’s done under a doctor’s care. But with mail-order abortions, women are often left to call 911 or rush to the ER — alone and terrified.

Many describe soaking through pads every hour, passing large clots, fainting, and fearing they’re bleeding to death, all without knowing if what’s happening is normal. And when they arrive at the ER, there’s no doctor waiting for them, only the fear of judgment or even legal consequences.

The Vanishing Line of Accountability

Until recently, the FDA required mifepristone to be dispensed in person under a safety program called REMS (Risk Evaluation and Mitigation Strategy). That safeguard was suspended during the pandemic and permanently removed in 2021.

Now, women can receive abortion pills from a provider they’ve never met, in a state they don’t live in, with no guarantee of medical follow-up. Shield laws in states like California and New York protect prescribers from prosecution, but not the women who take the pills in states where abortion is restricted.

So if something goes wrong, who is responsible...the provider, the patient, the overseas pharmacy? The answer is often no one.

Medicine is built on trust, accountability, and the principle of “do no harm.” Mail-order abortions replace that relationship with a transaction, expecting women to self-diagnose, self-administer, and self-manage complications. That isn’t empowerment. It’s abandonment dressed up as progress.

The Emotional Fallout of Mail-Order Abortions

The physical dangers are serious, but the emotional toll can be just as devastating.

Studies show that self-managed abortions carry higher risks of psychological distress, especially when there’s no counseling, no support, and no aftercare. Many women report lingering feelings of shock, grief, or regret — feelings that are intensified by the graphic nature of what they witness during the process.

For a society that claims to care deeply about women’s mental health, this silent suffering should concern us all.

What’s Really at Stake

The narrative that abortion pills equal empowerment is powerful. It promises privacy, convenience, and control. But in reality, it asks women to act as their own doctors, removes critical safety measures, and normalizes a healthcare model where human connection is optional.

It’s also shifting the abortion debate itself. Once a visible act tied to clinics, laws, and public discourse, abortion is becoming invisible, a private crisis unfolding behind closed doors, uncounted, unspoken, and unseen.

That’s not liberation. That’s loneliness.

The Path Forward: Real Empowerment Means Real Care

If we truly care about women’s health and dignity, we cannot celebrate a “decline” that’s merely a statistical illusion. We must ask deeper questions:

• Why are women turning to pills in isolation?

• What support systems are failing them?

• And what would true empowerment look like?

The answer begins with compassion, not commerce. It looks like doctors who listen, communities that support women through pregnancy without shame, and policies that value both women and the lives within them.

At Seven Weeks Coffee, we believe women deserve more than a pill in the mailbox. Through every bag sold, we support free medical and social services that provide real, holistic care during pregnancy, so no woman is forced to face unprecedented medical risks and negligence alone.

Because no woman should have to confront her deepest fears armed with nothing but a shipping confirmation email. She deserves to be surrounded by faces, hands, and hearts, by people who will stand beside her.

That’s the kind of care that quietly changes the world, one mother and one baby at a time.