brand logo

This is an updated version of the article that appeared in print.

Am Fam Physician. 2023;108(5):519-522

Author disclosures: Dr. Wetterer is in the Physicians for Reproductive Health Leadership Training Academy; Dr. Shenko is a volunteer physician with the Miscarriage and Abortion Hotline; and Dr. Prine is on the leadership team of the Miscarriage and Abortion Hotline and is the executive director of the Abortion Coalition for Telemedicine Access.

Case Scenario

M.A. is a 24-year-old patient who presents to my office two weeks after using abortion pills that she ordered online because abortion is now illegal in this state. M.A. reports that she took 200 mg of mifepristone orally 10 weeks after her last menstrual period. Twenty-four hours later, she took four misoprostol (Cytotec) pills buccally. When nothing happened, she stated that she took another misoprostol dose, after which she experienced heavy bleeding and cramping. Ten days later, she is still bleeding irregularly. She is wondering whether this is normal or whether she is still pregnant. How should I answer her questions? What are my legal risks in this situation?


The American politicolegal landscape surrounding abortion and routine pregnancy care has been changing rapidly since the 2022 Supreme Court of the United States issued its decision on Dobbs v. Jackson Women's Health Organization.1

Patients and physicians face uncertainty about how abortion and miscarriage care may be accessed and what legal liability they may face. One grassroots response has included a dramatic increase in accessing medication abortion pills outside established health care systems, such as online pharmacies, telehealth visits with physicians from other countries, or even informal networks.2,3 Patients commonly access resources such as Plan C, Mayday Health, and the Miscarriage + Abortion Hotline (833-246-2632). The hotline is staffed by more than 60 volunteer clinicians—mostly family physicians—and offers medical information via phone and text.2

Already a member/subscriber?  Log In


From $165
  • Immediate, unlimited access to all AFP content
  • More than 130 CME credits/year
  • AAFP app access
  • Print delivery available

Issue Access

  • Immediate, unlimited access to this issue's content
  • CME credits
  • AAFP app access
  • Print delivery available
Purchase Access:  Learn More

Case scenarios are written to express typical situations that family physicians may encounter; authors remain anonymous. Send scenarios to Materials are edited to retain confidentiality.

This series is coordinated by Caroline Wellbery, MD, associate deputy editor.

A collection of Curbside Consultation published in AFP is available at

Continue Reading

More in AFP

More in PubMed

Copyright © 2023 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.