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. 2025 Mar;49(1):127-153.
doi: 10.1007/s11013-022-09810-4. Epub 2022 Nov 28.

Intimacy, Anonymity, and "Care with Nothing in the Way" on an Abortion Hotline

Jennifer Karlin  1 , Caroline C Hodge  2
Affiliations

Intimacy, Anonymity, and "Care with Nothing in the Way" on an Abortion Hotline

Jennifer Karlin et al. Cult Med Psychiatry. 2025 Mar.

Abstract

This essay is an ethnographic account of a volunteer, anonymous hotline of physicians and advanced practice providers who offer medical advice and guidance to those who are taking medications on their own to end their pregnancies. Attending to the phenomenology of caring on the Hotline reveals a new form of medical expertise at play, which we call "care with nothing in the way." By operating outside the State's scrutiny of abortion provision, the Hotline offers its volunteers a way to practice abortion care that aligns with their professional and political commitments and that distances them from the direct harm they see caused by the political, financial, and bureaucratic constraints of their clinical work. By delineating the structure of this new regime of care, these providers call into question the notion of the "good doctor." They radically re-frame widely shared assumptions about the tenets of the ideal patient-doctor relationship and engender a new form of intimacy-one based, ironically, out of anonymity and not the familiarity that is often idealized in the caregiving relationship. We suggest the implications of "care with nothing in the way" are urgent, not only in the context of increasing hostility to abortion rights, but also for a culture of medicine plagued by physician burnout.

Keywords: Medical expertise; Medication abortion; Patient-centered care; Patient-doctor relationship; Self-managed abortion.

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Conflict of interest statement

Declarations. Conflict of interest: Authors declare that we have no conflict of interests. Ethical Approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed Consent: Informed consent was obtained from all individual participants included in this study.

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