Jim Harden got the phone call at 2:30 in the morning.
“The smoke detectors are going off in the Buffalo office,” he was told. Right away, Harden knew it wasn’t a false alarm.
Harden is the president of CompassCare Pregnancy Services in New York state, and he was right about the smoke detectors. In the dead of night on June 7, a group called Jane’s Revenge broke into the pro-life medical pregnancy center, smashing glass, lighting Molotov cocktails, and spray-painting graffiti (“Jane was here”).
CompassCare was one of nearly 50 pregnancy centers attacked across the United States since the overturning of Roe was first leaked in May. So far, there have been “no arrests that we’re aware of,” Harden said.
In a state that spent the summer earmarking $35 million for abortion providers (including $10 million for security) and starting investigations into pro-life pregnancy centers, the lack of response to Jane’s Revenge in New York was hardly surprising.
But it doesn’t bother CompassCare as much as you’d think.
“We became a nationally recognized organization overnight,” said Kathy Mauer, CompassCare vice president of patient services. Harden “has done more than 200 interviews so far. It put us out there. And pro-life, believing Christians started helping us.”
The Christians prayed. They sent money. They offered their expertise in areas like construction, law, marketing, and telehealth.
“I am so encouraged by the church in the United States,” Mauer said. “Those who have a passion for the gospel and for people—they’re there. They’re coming out in droves. They are standing for righteousness—they really are. It’s very encouraging and very emboldening.”
The timing couldn’t have been better. Last month, CompassCare launched an initiative they’ve been working on since 2018—to reach and serve every woman who is considering abortion in a post-Roe world.
Mauer, who has been involved in pro-life ministry since the 1980s, calls it “possibly the single most innovative thing in the pro-life movement since it began.”
From Death to Life
Harden was born at the hospital his father ran.
“My mother was a Planned Parenthood volunteer,” he said. “I was born with an abortion-causing contraceptive wrapped around my wrist, at the hands of famed abortionist Neville Sender.”
Harden’s parents weren’t believers, and they didn’t think the time was right for a child. A few years later, they divorced. Then, separately, they each came to Christ—his mom at a Billy Graham crusade, his dad through a friend at a racquetball club.
“After seven years apart, my dad asked my mom to remarry him, and she did,” Harden said. “I came to Christ when I was 15 because I was watching my parents. They had both really changed.”
Harden chose ministry over medicine, then married a girl who worked at a pro-life pregnancy center. “People are the crown of creation,” said Harden, who has 10 kids of his own. “The opposite of love is partiality—deciding who deserves life and who doesn’t. We need to protect the mother and the child and demonstrate to them the love of Christ.”
He was just out of Trinity Evangelical Divinity School and pastoring in Florida when someone in New York asked if he would help them develop a brand-new medical model for pro-life pregnancy centers. He told them he’d help them out for a couple of years.
“That was 21 years ago,” he said.
The pro-life landscape looked a lot different then.
Then and Now
Even before Roe v. Wade nationally legalized abortion in 1973, pregnancy centers were already popping up in abortion-friendly states such as Hawaii and California. By the time Harden moved to New York, there were already more than 2,000 crisis pregnancy centers, compared with around 830 abortion clinics.
Back then, all abortions were surgical, which means an abortion provider physically cuts or suctions the developing baby out of the mother’s womb. But a brand-new pill named mifepristone (also known as RU-486) had just been approved by the Food and Drug Administration (FDA). Meant for abortions, it stops the progesterone a woman naturally produces to nurture her child. The patient then takes misoprostol, which causes her uterus to contract and expel the baby.
This is called the “abortion pill,” even though women are given two different chemicals in five different pills (and sometimes more if the first round doesn’t work). It’s different from the “morning-after pill,” which attempts to stop conception by suppressing ovulation and building up mucus in the cervix. If that doesn’t work, it also irritates the uterine lining to keep the embryo from implanting.
For women whose pregnancies are too far along for a chemical abortion, surgery is the more effective option (98 percent vs. 94 percent success rate). But the abortion pills can be taken at home, the whole experience is easier to pass off as a miscarriage, and there’s no anesthesia, knife, or vacuum involved.
And if you’re quick, you can change your mind. “We can give her progesterone and shut down the effects of the first pill,” Mauer said. “We’ve seen huge success with that.”
You might expect the abortion pill to immediately skyrocket in popularity, but it didn’t—perhaps partly because the FDA tied it down. It was placed on a limited list of drugs—just 60 of the FDA’s 20,000 prescription products—that need Risk Evaluations and Mitigation Strategies due to “serious safety concerns.”
Doctors were originally required to determine the length of the pregnancy and whether or not it was ectopic (which would require surgery), inform patients that the medicine might not work (which would lead to either possible birth defects or a surgical abortion), and ensure the patient took not only her first pill but also the next series of pills two days later in the provider’s office. Two weeks later, she had to return again to make sure the pregnancy was ended.
Abortion-rights groups called it “medically unwarranted,” but even if you don’t believe life begins at conception, it seems prudent to be careful with the abortion pill. A small but growing number of pregnancies are ectopic, which means the baby is developing outside of the uterus, generally in the fallopian tube. Not only will the abortion pill not end the pregnancy, but it can mask the cramping symptoms caused by the pregnancy and delay medical care. Research also shows that women who abort by misoprostol pills struggle more afterward—with heavier and longer bleeding, pain, vomiting, and diarrhea—than women who abort by surgery. The FDA has released multiple warnings about infections, severe blood loss, hospitalizations, and deaths.
“Online abortion marketers are calling the abortion pill safer than Tylenol,” Mauer said. “It is not.”
Telabortion
By the time the pandemic hit in 2020, the FDA had loosened some of its restrictions, and the majority of abortions were done by medication prescribed in person by FDA-preapproved doctors and shipped directly to their offices. (You can’t buy the abortion pill at CVS or Walgreens.) At the same time, the number of abortions—which had dropped for decades—began to climb a little.
“When COVID hit, the FDA was pressured by the abortion industry to get them to change the regulations,” Harden said.
Eventually, it worked. In April 2021—more than a year after the COVID-19 pandemic closed much of American life—the Biden administration announced that the abortion pill could be prescribed via telehealth and shipped by mail. In December 2021, the FDA made the change permanent.
By the end of 2021, “there were over 100 abortion provider websites that would give you this medicine,” Mauer said. You didn’t need an appointment, insurance, or Medicaid. “All you needed was a credit card and an ID.”
That means no one is confirming the pregnancy or checking to see how far along it is, or if it’s ectopic, or if the pills work, or if there are side effects. Since the pills come in the mail, they can come from anywhere—even another country (though technically, that’s illegal). If a patient has problems, some pill providers advise her to go to the emergency room and tell them she’s having a miscarriage, assuring her that “medical providers in hospital emergency departments can’t tell the difference between complications due to chemical abortion and miscarriage,” according to one letter obtained by CompassCare.
The shift to telehealth was a huge win for the abortion rights industry—far bigger and more strategic than it appeared. Harden knew, because he’d been watching the abortion industry for years.
“We had started to see the abortion industry in New York building infrastructure despite declining abortion numbers,” he said. “That was strange. But then we started to see the judiciary pushing abortion cases up through the circuits. We saw Trump changing the balance of power in the judiciary for the first time since the 60s. And we thought the Supreme Court might have an appetite to take this one up again—and if we thought that, the abortion industry was thinking that too.”
Harden watched abortion lobby shift, strategizing more around the states than the federal government. They think Roe is going to be overturned, he realized. That’s why New York and other abortion-friendly states needed more infrastructure—to handle patients coming from other states. And that’s why access to pills over the phone was such a crucial decision.
Sure enough, after the Dobbs decision, demand for telehealth abortions jumped. American companies began expanding in states that allow abortion, while women in states with restricted abortion are either traveling to nearby states to receive their pills or ordering them from out of the country.
“Everyone went telehealth,” Mauer said. “So, we did, too.”
TeleCare
“When I found out I was pregnant, I was very shocked,” said Jabra, a young mother who tells her story with energy and lots of hand motions. “I had people telling me, ‘Oh, . . . no, don’t do that—have an abortion.’ So I was very highly influenced to go to Planned Parenthood.”
She did, still feeling uncertain. The nurse reasoned with her that since she’d come to Planned Parenthood, she must’ve wanted an abortion, and she might as well follow through on that. Jabra swallowed the first abortion pill and took the second set of pills home.
“I started shaking, and I was like, ‘Jabra, what did you do?’” she remembered. “What can you do to get medicine or anything out of your system? And I instantly thought—induced vomiting. So I ran outside and I stuck my fingers down my throat. . . . I was sobbing. It was a cry, a prayer for God, ‘I’m so sorry. Please!’”
She jumped online, searching for ways to stop an abortion after taking the first pill. She spotted “abortion pill reversal” and kept praying, “Please, God, let this be real.” Through a website and scheduling team, she got in touch with a CompassCare nurse.
“We’re gonna open up the office,” the nurse said. “I’m running down there now. . . . We’re getting your medicine ready.”
Jabra met her there and was able to reverse the effects of the first pill. Eight months later, her son was born.
Like Jabra, many women who are considering abortion head online, Mauer said. Some are looking for a way to reverse the pills. Others are doing initial research.
“They’re typing in ‘abortion risks’ or ‘abortion side effects’ because they want to make sure they know what they’re doing,” Mauer said. Along with dozens of websites offering the abortion pill, CompassCare is now there to meet them—not with a quick pill prescription, but with an invitation to in-person medical care and a supportive community through a system called TeleCare.
“We’re marketing—online, in radio, and on television—in that direction,” she said. “They can click on a button that says, ‘I need to talk to a nurse now.’”
A staff of on-call nurses will respond immediately, helping the woman to understand the value in a clinic visit—to assess if the pregnancy is ectopic, to check for STDs that might complicate things, and to weigh all her options. Then they can connect her, as quickly as possible, to an appointment with medical staff in a local pregnancy clinic.
Speed is crucial, Harden said. “A woman typically makes up her mind about the outcome of her pregnancy within 24 hours after the first positive home pregnancy test. Pro-life telehealth reduces the time it takes a woman to interact with a nurse from 24 hours to 24 seconds, giving pro-life pregnancy centers an edge over the abortion industry.”
Right now, this service is only available in New York, where CompassCare has offices in Buffalo, Rochester, and Albany. But over the next few years, CompassCare plans to give its telehealth tools to pro-life medical centers in all 50 states.
“That would give us the ability to serve every woman in America who wants an abortion,” Harden said. “That’s nearly 1 million women each year.”
Pro-life telehealth reduces the time it takes a woman to interact with a nurse from 24 hours to 24 seconds, giving pro-life pregnancy centers an edge over the abortion industry.
It’s ambitious, but it’s not out of reach for CompassCare’s technical abilities. Since they’re located in New York, they’ve been careful to know what every nurse is doing in case they needed to defend themselves, Harden said. A few years ago, that led to the creation of Optimize, a medical management system that helps pregnancy centers track patient health, move them along a linear process, and measure results. Nearly 650 pregnancy centers use that system right now—a ready-made network for this next step.
“We’ve identified our first cohort of 10 strategically located centers to work out the kinks, then we’ll deliver to 70 more by the end of the year,” Harden said. Within three years, all 650 should be connected to the telehealth system.
Online Patients
The woman who is Googling abortion side effects and statistics isn’t the same woman who was looking for an abortion 40 years ago.
“Shame was the more obvious driver back then,” which meant a patient was more likely to lie about her intentions, Mauer said. So pregnancy center staff used demographic information to assess the likely outcome. “Back then, a woman was more likely to get an abortion if she was between 17 and 26, if the father wanted an abortion, or if she was unemployed.”
Those markers continued up into the 2000s. Then things changed.
“There’s no shame today in telling us she’s going to have an abortion,” Mauer said. “We lean less on the demographic information and much more on what she says. She’s much more forthright about what she’s going to do.”
These days, teens are more likely to carry their pregnancies, while women in their 30s are more determined to abort, she said. “They’re tough as nails and convinced they know better. They already have the two children they wanted, and they don’t want a third. More than ever, we hear, ‘This is not how I planned it.’”
That’s the position of about 60 percent of CompassCare patients, Mauer said. “They have in mind the commercial, the ideal, the Instagram look, and this doesn’t fit. Maybe they want to go to college, or they have the two kids, or they gave the baby clothes away already. . . . Our culture is overdosing on the idea that we own our own lives.”
We’re upside down, taking away from women the joy of sacrificing their lives for someone else, she said.
To be right side up, “we have to be tethered to the gospel,” Mauer said. And if her patients are going to make a counter cultural choice, they, too, need the gospel.
Gospel Connection
CompassCare is determined to share Jesus with everyone, whether through an online chat or an in-person office visit.
“In the office we have an empathetic, understanding professionalism, but also a relational dynamic with her,” Mauer said. There are no tricks or manipulations to get her to keep the baby.
“God hasn’t given me decision-making power in her life, nor should I take it from her,” Mauer said. “He didn’t put a barbed-wire fence around the tree in the garden. He said, ‘Don’t do it,’ and then he let Adam and Eve do it. The God-given will to make a choice is dignifying.”
That said, “we don’t believe women want to kill their children,” Mauer said. She doesn’t lecture her patients but asks them questions.
“I’m so glad there’s not a heartbeat yet,” one patient said.
“Oh yeah? Why is that?” Mauer said.
“Because it makes it seem more real.”
“Is it more real?” Mauer asked.
“Well, no,” she said. “I guess it is real. . . . When is it a baby?”
“That’s the question everyone is asking,” Mauer told her. “It seems like it would be standard, doesn’t it?” And that’s when she can share the gospel, that God is the One who creates and ordains. She tells each girl that she is valuable, loved by a Father, an image-bearer of God.
“I’m talking about her life, not her baby’s,” Mauer said. “But she can connect the dots.”
It’s a powerful message, especially since most of Mauer’s patients come from broken or fatherless homes and are unsure of their own worth.
And that’s Mauer’s favorite part of the job. “There is nothing like it—looking into her eyes and communicating the love of Christ,” she said. “So far this year we’ve had over 150 women—about a third of our patients—say yes when we asked if they were willing to surrender control of their lives to Jesus.”
Spiritual Battle
Two weeks after the Dobbs decision, President Biden called the Supreme Court “out of control” and signed an executive order asking the Health and Human Services Department to protect and promote access to abortion, including the abortion pill. The day before, the American Board of Obstetrics and Gynecology warned that it might remove board certification from doctors it believes are sharing disinformation about abortion that “create[s] false narratives about essential safe practices in that specialty.”
“The abortion industry is facing an existential threat,” Harden said. “They’ve now been limited, while pregnancy centers can still operate everywhere.”
The battle is spiritual, he said. “The thief comes to steal, kill, and destroy, specifically the crown of creation—humanity. Abortion represents the destruction of humanity at its inception. There is so much power to glorify God in a single human being. Satan hates that.”
Being in the middle of the fight can be scary. The morning after the firebombing, some CompassCare staff were anxious.
“But nobody failed to show up for their shift,” Harden said. “The very next day, we received three offers to relocate, so we were up and running at an alternative location in Buffalo the next day. All the nurses continued serving. There was a little trepidation there, but everybody realized we serve a great God who is our protector and provider.”
Sure enough, he’s providing. “We couldn’t have launched our telehealth program without the help of the church [received after the publicity],” Mauer said. “I love that I get to do this, and the Lord gives me grace to keep going.”