Last Friday, there were none

By: John Madigan, originally published July 28, 2025, Crisis Magazine

A recent wave of Planned Parenthood clinic closures may not be from a decline in abortions, but a move to self-managed home abortions.

Most weeks, I spend an hour or so standing on a public right-of-way facing a nearby Planned Parenthood clinic. I pray the Rosary and hope that the image of Our Lady of Guadalupe that I hold might touch the heart of a client or worker entering that office a few parking spots away.

It’s a small storefront. They don’t do surgical abortions there.  But they have done a brisk business selling abortion pills to young women, to middle-aged women, to black women, to white women, to Hispanic women. 

Burdened mothers walk in, then they walk out an hour or so later empowered to kill the children in their wombs. Most hold a single sheet of paper.

Last Friday, for the first time, there were none.

I live near a small to midsize city, a mile or so from a large university. Soon after beginning this weekly vigil, I noted the consistency and volume of Planned Parenthood’s business—usually seven to nine women, occasionally 10 to 12, sometimes even more customers during my midday hour.

But over the last 12 -18 months, there’s been a slow and steady decline. It’s gotten to the point that I hardly remember the last time more than five women entered during an hour. Could it be that more women are choosing their children over abortion?  

Likely not.

Recent figures indicate that the number of abortions in the United States has actually increased over the past several years and that more and more of these abortions—now well over 60 percent—are accomplished through chemicals alone. Many of these “medication abortions” now occur following an online video appointment. Planned Parenthood refers to these as “self-managed abortions” and “at-home abortions.”

It used to be that “medication abortion”—use of the abortion pill(s)—followed on-site appointments, pregnancy tests, and personal counsel. Today, more and more Michigan women bypass the pleasant smiles and passing support of Planned Parenthood’s staff members for an online appointment and a chemically-induced abortion, all in the privacy of one’s bedroom and bathroom. 

This is abortion by “telehealth”: no visit necessary; only a video chat followed by the abortion pill confidentially and plainly mailed to one’s home. 

This status quo is a direct result of President Biden’s aggressive promotion of abortion. During 2021, using the Covid pandemic as leverage, the Biden Administration proposed and promulgated rules by regulatory decree which obviated prior standards and practice in order to allow abortion pills to be mailed without need for a physical exam or appointment.  

Those regulations were finalized in January 2023. Not long thereafter, our local Planned Parenthood’s traffic began to decline. 

Just a few months ago, Planned Parenthood announced the closure/consolidation of four of its 14 clinics in Michigan and the dispatch of 10 percent of their 200+ Michigan staff. One wonders how 90 percent of their staff members remain employed after nearly 30 percent of their locations were shuttered.  

The answer is all too clear. According to the Guttmacher Institute: “Medication abortion has proven to be a game changer in expanding abortion care in the United States.” “Self-managed,” “at-home” abortions following online “telehealth visits” is a growth business for Planned Parenthood.

This is the present and the future of abortion in Michigan and across the country.

And what of these at-home, self-managed abortions?

Planned Parenthood of Michigan states that these medication abortions are a safe, convenient, and private way to end a pregnancy. “The only difference is the virtual visit and pills coming by mail.” The Guttmacher Institute agrees: “Medication abortion provided via telemedicine is as safe and effective as provision in a health care facility.” 

Others are not so sanguine about the move from personal medical care to self-inflicted and self-managed abortions. Insurance generated data analyzed and published recently by the Ethics and Public Policy Center tells a very different story: that “over one in ten patients experience at least one serious adverse event.”

Well, which is it?  

We deserve to know the answer to that question.

This much we do know: Planned Parenthood is facilitating a growing number of abortions in America through “telehealth.” At the same time, they are distancing themselves from direct and personal participation in these abortions. In so doing, they may also be placing a distance between themselves and ethical obligations and legal liabilities which old-fashioned, direct, and personal participation in the act of the abortion implies. 

A neat trick, that.

Call it whatever you wish—“medication abortion,” or “self-managed” abortion, or “at-home” abortion—Planned Parenthood’s near-total, values-free abortion advocacy has succeeded more than its founders could have ever imagined.

Abortion is being completely mainstreamed.  

In their time of desperate need, our women are being isolated and then abandoned. 

They stand alone.  

Our Lady of Guadalupe, pray for us.

John Madigan has worked for more than 20 years as a consultant and in executive roles with non-profit organizations. His charitable and educational interests in support of pregnant women and promoting the dignity of life led to his representation of dozens of individual defendants charged for acts of civil disobedience at or near abortion clinics.