October 15, 2025

Karla Van Keulen, M.D.

         The cell phone goes off at 2:34 AM—an Emergency Room patient needs my assistance. She is a 22-year-old who is orthostatic, minimally responsive, and has heavy vaginal bleeding. I then find out that she had found an abortion pill online and taken it to terminate her pregnancy, which was her first, without having a medical evaluation. When I see the patient at 3:04 AM the operating team is enroute and blood products have been ordered. Then she is rushed to the operating room. She has an emergency dilation and curettage at 3:45 AM, loses approximately another liter of blood, and receives a blood transfusion. The emergency operation was successful, but during the patient’s follow-up appointment she shares that she regrets taking the abortion pill and wishes she knew the risks involved beforehand. She also would like to be pregnant again but sadly may never be able to. With the abortion pill more readily available online, emergencies like this one are the tragic reality for many women and OBGYNs.

Medicine has changed significantly in the thirty-two years of my medical career. We have seen some incredible successes and achievements that truly make medicine more effective and that have saved many lives. The age of viability for unborn infants is now about twenty-two weeks; we now have better treatment for chronic illnesses; and we are now able to perform more minimally invasive surgeries. These are just a few medical advancements that have impacted the world of obstetrics and gynecology.

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