WE ORGANIZE TO CHANGE EVERYTHING

We Organize to Change Everything

Fighting for Abortion Access and Reproductive Justice

Verso Reports and Lux Magazine
June 2022

Edited by
Natalie Adler
Marian Jones
Jessie Kindig
Elizabeth Navarro
Anne Rumberger

The collection © Verso Books, 2022

All contributions © The contributors, 2022

Revolutionary Letter #1 © Diane di Prima, 1971. Initially published by City Lights, and reprinted in the Verso Book of Feminism with permission from the author.

Cover design: Sharanya Durvasula

Cover drawing: Robert Frederick Blum, “Figure,” 1876, courtesy Cooper Hewitt, Smithsonian Design Museum Collection

Interior posters designed and distributed by Shout Your Abortion:
shoutyourabortion.com/take-action/#fuck-the-supreme-court

The “Stop Forced Sterilization / ¡Alto a Esterilización Forzada!” poster is copyright © 2020 Committee for Abortion Rights and Against Sterilization Abuse (CARASA) News, vol 3, no 9, 1979, New York, NY, USA, which is held in the Joseph A Labadie Collection, University of Michigan.

All rights reserved.

The moral rights of the authors have been asserted.

Lux

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Verso is the imprint of New Left Books.

ISBN-13, US and Canada: 978-1-80429-105-4

ISBN-13, UK and Republic of Wales: 978-1-80429-105-4

I have just realized that the stakes are myself
I have no other
ransom money, nothing to break or barter but my life
my spirit measured out, in bits, spread over
the roulette table, I recoup what I can
nothing else to shove under the nose of the maître de jeu
nothing to thrust out the window, no white flag
this flesh all I have to offer, to make the play with
this immediate head, what it comes up with, my move
as we slither over this go board, stepping always
(we hope) between the lines

– Diane di Prima, Revolutionary Letter #1

Acknowledgments

The editors wish to acknowledge the workers of Lux magazine and Verso Books for supporting this project, most especially Sarah Leonard and Sharanya Durvasula at Lux and Mark Martin and Phan Nguyen at Verso Books. Marian Jones would like to especially thank Natalie Adler, Yuri Kavalerchik, and Bryan McTiernan. Cheryl Rivera would like to thank Kennan McClung for his thoughts and assistance. We would also like to thank Mallory Adamski at the National Indigenous Women’s Resource Center and Naomi Braine at Brooklyn College for their enthusiasm and assistance.

In addition, we are indebted to the following publications and authors for allowing us to reprint their work:

Jenny Brown’s essay is adapted from her own book, Without Apology: The Abortion Struggle Now (Verso, 2019).

The introductory text to “The Attacks on Native People’s Autonomy” is excerpted from an article printed in the National Indigenous Women’s Resource Center’s Restoration Magazine in the June 2022 edition, and can be found in full at niwrc.org/restoration. It is reprinted and excerpted with permission.

Pregnancy and Abortion is translated by Arlen Austin from Mariarosa Dalla Costa and Selma James’s 1972 book Potere femminile e sovversione sociale. This excerpt originally appeared in Lux, Issue 1, January 2021.

Raquel Reichard’s essay was originally published on Refinery29 on October, 20, 2020, as “In Puerto Rico, a History of Colonization Led to an Atrocious Lack of Freedom,” and is reprinted here with permission.

Victoria Law’s piece was originally published by Rewire News Group as “Alabama Case Illustrates Difficultues Women behind Bars Face When Seeking Abortion,” on August 5, 2015, and has been revised and updated for this publication by the author. Reprinted with permission from Rewire.

An earlier version of Marie Solis’s essay appeared in Jezebel as “Pregnant, Addicted, and Prosecuted,” on September 30, 2021, and has been revised by the author for publication here.

“How to Give Yourself an Abortion” by Arielle Swernoff, illustrated by Mattie Lubchansky, initially appeared in Jewish Currents in the Fall 2019 issue. A revised version appeared in June 2022, and the later version is reprinted here, with permission from the author and publisher.

Lizzie Presser’s article was originally published as “Whatever’s Your Darkest Question, You Can Ask Me,” appearing in the California Sunday Magazine on March 28, 2018, and is reprinted here with permission.

Introduction

by Jessie Kindig

“I have realized,” the revolutionary poet Diane di Prima wrote in 1971, “that the stakes are myself / I have no other.” All we have “to break or barter” is our own flesh. This is scraping things down to the bone: there is nothing more fundamental to politics than the body.

What we are watching in the United States, as this book quickly came together in the spring of 2022, is the victory of a decades-long campaign to turn the bodies of everyone who can become pregnant into weapons used against us.

It’s worth recounting the misogyny at work here, in all its cruel precision. For example, the passage of Oklahoma’s House Bill 4327, the most restrictive in the country, bans abortion from fertilization onward and allows private citizens to sue providers and anyone who “aids or abets” a person seeking abortion care. Abortion will be legal for survivors of rape and incest, but only if they file an official police report first.

Jen Deerinwater, who is from the same Oklahoma town now represented by the bill’s author, Rep. Wendi Stearman, quotes in hir essay this reported exchange between Stearman and Rep. Cyndi Munson (D–Oklahoma City) as the state legislature debated the bill:

“Are you aware that girls, ages 11, 12 and 13, have the ability to become pregnant?” Rep. Cyndi Munson, D–Oklahoma City, asked Stearman. “Are you aware that children 11, 12 and 13 have been raped and assaulted, usually by a close family member or somebody close to them? Are you not interested in saving that child’s life?”

“There is nothing in this bill about taking that child’s life,” Stearman replied.

“No, it is in the bill,” Munson said. “Because if a young girl is raped by her uncle, she’s likely not going to go report to law enforcement … She’s not allowed seek an abortion under your bill, as I understand it. And you’re OK with that?”

“I am OK with that,” said Stearman.¹

•••

We made this book because we are furious with the state of things, and because we have long been furious with the state of things.

One of the sad ironies of this moment is that should Roe fall, many things won’t change. We live in a country where nearly 11 million women live more than an hour’s drive from an abortion clinic (likely more than that now, given the recent bans in Oklahoma and Texas), where roughly 1,200 women have been arrested since 2005 for having miscarriages or pregnancy-related problems, and where the eugenic practice of forcibly sterilizing nonwhite and criminalized women continued, in California’s prison system, until 2011.

The strategy the mainstream abortion rights movement has followed since winning Roe has been timid and moderate, focused on lobbying and fundraising and legal cases—a strategy directly counter to the loud, visible, angry, community organizing of the women’s liberation movement that won the federal right in the first place—a vivid example of which is given here by Barbara Winslow. This is a strategy, Jenny Brown and Marian Jones argue, that tamed the movement, narrowed it to the question of choice rather than freedom, privacy rather than justice. In seeking to make abortion “safe, legal, and rare” (as the Clinton Democrats apologetically put it) mainstream feminism has gentrified the abortion rights movement—making it not just white and elite but also taking what had been won by a massive political community and turning it into the preserve of professionals.²

This is by no means a new argument: Lux’s editorial board and generations of feminists and socialists before us have said as much. When we did, it usually resulted in us getting kicked out of events, laughed off or hushed by mainstream leaders, redbaited, or hassled by liberal women in “prochoice” coalitions. It is cold comfort, though, to now be proven right. Calling in from the last abortion clinic in Mississippi, Derenda Hancock and Kim Gibson talk with Anne Rumberger about what giving up on loud, vibrant, clinic defense has cost us.

It seems quite clear: with the fall of Roe imminent and talk of an outright federal ban on abortion (and maybe contraception, and maybe LGBTQ rights): this strategy has cost us everything.

•••

It has cost us everything because abortion is about everything: to control reproduction is to determine who is a criminal and who is not, who should parent and who should not, whose body is their own and whose is not. Another way to say this is: an attack on abortion is never just about abortion.

As Erin Matson and Shireen Rose Shakouri describe in detail, behind the antiabortion movement is an ideology of white supremacy and the right’s terror of the so-called “Great Replacement,” the time when white people will be outnumbered by nonwhite people. This is not a fringe belief but an influential fascist ideology fueled by a well-funded, instutionalized network of think tanks, far-right politicians, extremist activists, and violent vigilantes in the US and around the world.

The flipside of protecting white babies is preventing the birth of nonwhite babies, and so the forced pregnancies of white women go hand in hand, ideologically speaking, with the long history of state-sanctioned forced sterilizations of Indigenous women, Puerto Rican women, and Black and brown women, as Raquel Reichard, Marian Jones, and a coalition of Native community groups describe here in detail. It is also about solidifying a strict regime of binary, immutable gender, and Dr. Mary K. Bowman reports on how the bans against abortion providers have been paralleled by attacks on gender-affirming health care for transgender people.

The abortion crisis is, Amy Littlefield writes, “a labor crisis too,” one in which reproductive clinic workers and providers—such as Crystal and Luna, interviewed here—face ever-diminishing resources, greater restrictions, and mass unemployment.

The loss of abortion is also a potential loss of sovereignty for Indigenous communities: the abortion bans not only impact Native people at disproportionately higher rates but also threaten the legal basis for tribal sovereignty. As Cecilia Fire Thunder, the National Indigenous Women’s Resource Center, and the Native American Community Board argue in their amicus brief for the Dobbs case, this is part of a centuries-long campaign of diminishing Indigenous people’s autonomy, taking away their right to parent, and breaking treaty after treaty promising Native people the right to their own land and to self-government. What this ongoing crisis of reproductive and colonial violence has meant personally for Indigenous people is given intimate voice in Jen Deerinwater’s essay.

The criminalization of abortion also expands the purview of the carceral state. All women are now added to what Cheryl Rivera here calls “the criminal class,” the population of mostly poor, mostly Black and brown people whose labor has been ruthlessly exploited and whose bodies have long been subject to violent forms of control. The laboring body is also, of course, the body in labor—the birthing body, the pregnant body, the breast-feeding and child-rearing body—and this laboring body is now criminalized too. As Marie Solis describes at length, attacks on abortion have granted the fetus more rights than the person carrying it. In a survey of incarcerated women’s attempts to access reproductive care, Victoria Law finds an eerie mirroring between the carceral state and abortion bans. United States policies have long attempted to make one’s identity and perhaps even one’s own body—Blackness, queerness, and non-whiteness—into a criminal liability; now the possession of a womb is added, again, to that list.

•••

Luckily, there are many more places in the world than the United States, and the movement for reproductive freedom is a global one.

In 2017, a grassroots campaign against gender violence spread throughout Argentina, then South America, then the world, coalescing and massing with the feminist street protests in Poland after the 2016 abortion ban, and erupting into the global women’s strike in March 2018. Ni Una Menos, the movement was called—not one more person will we lose to gender violence! As the strike call argued,

The strength of our movement lies in the links we make with each other …
We organize to change everything.³

Their cry is our cry. If abortion is everything, then we organize to change everything.

South America is, today, home to one of the most dynamic feminist movements in the world, one where activists are immediately recognizable, as Naomi Braine describes, by their trademark pañuelos verdes, their green bandanas. As the United States spent the past few decades instituting abortion restrictions and bans, our neighbors to the south have been adamantly doing the opposite. Mexico, Colombia, and Argentina have legalized abortion—and Chile may soon—while networks of feminist activists have made self-managed abortions more accessible and created new forms of solidarity in the process. Verónica Cruz Sanchez describes to Elizabeth Navarro what this looks like in her home state of Guanajuato, Mexico—and shows in practice what global solidarity looks like, as Mexican feminists in her organization, Las Libres, have begun to accompany American women through abortion procedures after Texas passed a near-total abortion ban in 2021.

As Braine notes, we in the United States have much to learn from the rest of the world, and can draw both strategy and inspiration from their example. “Feminists across the Global South,” she argues,

have developed strategies for supporting people with abortions in places where it is highly restricted or outright banned, have done so for years on the basis of solidarity rather than service, and have managed the potential legal risks involved.

As Lizzie Presser writes, an “abortion underground” has existed in the United States throughout the twentieth century, one that is now composed of midwives, nurses, and activists performing illegal or non-medical abortions themselves. With the rise of the abortifacient drugs mifepristone and misoprostol—colloquially known as abortion pills—the ease of performing a safe, economical, and self-managed abortion, legal or not, has increased. As the example of Las Libres in Mexico shows, an entire movement can be built from the distribution of abortion pills, for it means not just emergency care but the possibility for direct action and political defiance, the building blocks of a movement fighting for what a truly supportive, legal, abortion provision could look like. Or as Amelia Bonow writes,

The ruling in Dobbs will be opposed by the vast majority of Americans, and the existence of abortion pills mean that a mass defiance of abortion bans is inevitable. This is the closest the judiciary has come to a legitimacy crisis in almost a century, and it is time for us to push.

So get yourself some pills and let’s push! Arielle Swernoff and Mattie Lubchansky offer an illustrated guide to how to give yourself an abortion at home, and our editors have put together a resource guide for how to access abortion funds in different regions and for different communities, how to order abortion pills and where to go for support and advice as you take them, how to help defend existing clinic and support providers, and how to share your story.

•••

It is our hope that this book will be one starting point for a revitalized, and socialist, feminist movement, and the beginning of much-needed discussions both political and strategic: Does the urgent need for underground abortion care supersede fighting for decriminalization or defending existing clinics? Do we focus on mutual aid in our communities or national and international battles? How do we build a true movement for reproductive justice not limited to personal choice but opposed to incarceration and forced sterilization, one that fights against the destruction of Indigenous sovereignty and the criminalization of trans people? How do we take care of all of us and fight for all of us too?

One answer is to be found in the words of Movimento di Lotta Femminile di Padova, part of the group of Italian socialist feminists in the 1970s. In their 1971 pamphlet on pregnancy and abortion, they called for an expansive goal—one similar to that of the Black feminists in the United States in the 1990s who coined the term “reproductive justice.” “We are changing,” the women of Movimento wrote, “the sign of this struggle.”

The problem is not abortion.
The problem is having the possibility to become mothers as often as we want to become mothers. Only when we want to, but whenever we want to.

Abortion is not just about abortion. It is about autonomy, justice, and democracy for us all. Abortion is the tolling bell that warns us, women and men, people of any and no gender, all of us of any race and ethnicity, poor and not-poor alike, of the state of our rights and the prospects for our future. As the women of Movimento put it, “only by measuring how much we enjoy this right can we measure the social wealth we enjoy.”

We want it all.

Okanogan County, Washington
June 2022

I. It’s Time to Fight

1

The Fight Is On

Why We’re Going Backwards on Abortion Rights—and How We Can Rebuild a Fighting Feminist Movement

by Jenny Brown

For decades we’ve been told that abortion is merely a wedge issue used by Republicans to split working-class Catholics from the Democratic Party, and to excite a Protestant evangelical base. The main goal of antiabortion politics, we’ve been instructed by such writers as Thomas Frank, is not to curtail abortion. Rather it is to appeal to conservative voters who will elect politicians whose real interests lie with the 1 percent.¹ “Starting in the 1970s, Republicans have offered support for working-class antiabortion views in exchange for working-class support for pro-business positions,” explains feminist law professor Joan C. Williams.² In this version, the push to ban abortion comes from the grassroots, not the top.

Faced with the imminent banning of abortion across half the country, this argument should be forced into retirement. Abortion is not simply the manipulation of a political symbol, it’s a real and consequential fight over our reproductive labor. Employers and the rich don’t want to contribute anything toward the essential work of having and raising kids, but they want us to do it anyway. The attack on abortion is part of the broad assault on working-class living and working conditions, and it is aimed at extracting our reproductive labor without compensation.

People in the US support Roe by a healthy majority. A higher number support abortion with no restrictions that ever before, around 32 percent.³ Abortion has much more public support than when it was largely made legal in 1973, but through the decades, the bulk of organizing has focused on legal cases and lobbying, with the apologetic, timid, respectable approach you would expect when your main audience is funders, judges, and legislators rather than ordinary people. Those tactics have run their course, so it’s time to return to the tactics that won us abortion rights fifty years ago—as part of the broad, revolutionary demands of the Women’s Liberation Movement and the general freedom struggle.

Why Is the Court Abolishing Legal Abortion?

In 2017 House Speaker Paul Ryan made headlines for saying, “We need to have higher birth rates in this country” as he prepared to attack Social Security.⁴ But he was just saying what establishment think tanks and policy analysts have been saying for a decade in response to a 30 percent drop in the birth rate since 2007. The US birth rate is now 1.64, the lowest it has ever been. In 2012, conservative columnist Ross Douthat pleaded for “more babies please,” in the New York Times, while the Wall Street Journal regularly warns that our birth rate will lead to economic stagnation and national decline.⁵ Think tanks like the Center for Strategic and International Studies warn that “the rapid aging of developed countries will pose a major challenge for global prosperity and stability during the first half of the twenty-first century.”⁶

“Too few people” is the world’s new “population time bomb,” the Wall Street Journal warned in 2015. The “developed world’s working-age population [will] start declining next year, threatening global growth.” Stagnant economies will be the result, they claim. “Simply put, companies are running out of workers, customers or both. In either case, economic growth suffers.”⁷

Racist versions have been bursting through, too. Iowa congressperson Steve King, a vigorous opponent of both abortion and immigration, tweeted in 2017: “Culture and demographics are our destiny. We can’t rebuild our civilization with somebody else’s babies.”⁸

Birth rate figures released in May 2018 led to a new round of hand-wringing. A Tampa Bay Times editorial was typical: “The fertility rate in the United States declined again last year, raising long-term concerns about population growth and the nation’s ability to maintain a stable economy and support aging generations.”⁹ The New York Times fretted,

The country has been living through one of the longest declines in fertility in decades and demographers are trying to figure out what is driving it. Rates tend to drop during difficult economic times as people put off having babies, and then rise once the economy rebounds. But the rate has not recovered since the Great Recession.¹⁰

The Times noted that the United States used to be able to rely on teen and unintended pregnancies but that now

the United States seems to have almost caught up with most of the rest of the industrialized world’s low fertility rates. It used to have higher fertility for reasons like more teenage pregnancies, more unintended pregnancies and high fertility among Hispanic immigrants. But those trends have recently reversed, in part because of increased use of long-acting birth control methods like IUDs.¹¹

From the standpoint of the 99 percent, lower birth rates are a phony crisis, but from the standpoint of the establishment, the problem is real. Their profits, and capitalist economic growth in general, rely on a continually growing workforce replenished with ever larger cohorts of young people to work and consume and pay taxes and serve in the military, and to provide for older workers when they retire, either individually through family ties or collectively through Social Security. Immigration has compensated somewhat as US birth rates have slumped below the 2.1 births per woman required for a stable population. But immigration carries its own political liabilities for the employing class, which cannot entirely be overcome by marginalizing and terrorizing immigrant communities to prevent them from acting politically.

These factors may explain why, while other “cultural issues” such as same-sex marriage and marijuana legalization have been making progress, we have gone backward significantly on abortion. This is because abortion is being misclassified as a cultural issue. In fact, the production of children—and who will pay for it—is a key economic battlefront.

If the birth rate is the underlying issue, it’s no wonder establishment Democrats are “wimpy” on abortion, and even birth control, from upholding Hyde Amendment restrictions on abortion funding to attempting to block access to the morning-after pill. Establishment Democrats have the same views as the rest of the establishment on encouraging a higher birth rate without additional public or corporate expenditure.

The US system increasingly relies on reproductive coercion, but this isn’t the only possible response to lower birth rates. In Europe, politicians openly discuss declining birth rates and respond with programs that make it easier to combine work and family, providing substantial paid parental leave (480 days in the case of Sweden); subsidized childcare; child allowances (monthly payments to parents); shortened work hours; and other blandishments parents in the United States can only dream of, along with national health systems that take the worry out of obtaining health care.¹² In contrast, in the United States the rich are on a tax strike and private health insurance companies have a profitable stranglehold on our medical system. Employers don’t even want us to take unpaid parental leave, never mind the six months or more of paid leave provided in over fifty other countries. On top of this, our work hours are longer than in Europe—we work ten weeks a year more than German workers.

It’s hardly surprising that under these circumstances, even with limited access to birth control and abortion, we are having fewer children than ever. The birth rate in the United States is now considerably below the 2.1 children per woman required to replace the current population.

“People say they’re not having kids because it’s insanely expensive,” explains a report on a 2018 survey that shows that the decision to start a family has been weighed down by childcare costs, lack of affordable housing, and overwork.¹³

But rather than encourage childbearing with incentives, as they have in Europe, in the United States we have a regime of coercion. Abortion and birth control are expensive and set about with restrictions, resulting in a higher unintended birth rate than in comparable countries.

This explains why we’re experiencing such vigorous attacks on abortion and birth control now. In 1973, when Roe v. Wade was decided, the ruling class was split on the question. Now they really want more births. And it would indicate why the rhetoric we’re responding with, like privacy and choice, are inadequate to the task. The tools we’re responding with, legal arguments, lobbying, support for establishment Democrats, and the occasional large march are not going to get the goods either.

Why Has the Feminist Movement Failed to Safeguard Abortion Rights?

The late 1960s women’s liberation struggle to win abortion was wildly successful. After four years of a radical uprising demanding the repeal of all abortion laws, the court decided Roe. But by the 1990s, without the constant fuel of women’s experiences being analyzed in consciousness-raising, and cut off from its radical leadership, the reproductive freedom movement had become defensive, using slogans like “Save Roe” and “We won’t go back.” It is largely due to the arguments and organizing under the banner of reproductive justice that our agenda has become broader, deeper, and potentially more radical again.

By 1994, the movement’s ineffectiveness had become clear when the Clinton administration proposed expanding health care coverage. The proposal fell short of guaranteed health care, like every other rich country, every socialist country, and many developing countries have. On top of that, in an attempt to appeal to congressional Republicans, the proposal avoided any mention of abortion coverage.

At a conference on reproductive rights and health care in Chicago, twelve Black women caucused to discuss the proposal. They thought the Clinton strategy would fail on its own terms—that sacrificing abortion wouldn’t gain the proposal any Republican support. This turned out to be true. But more important, “We didn’t trust the administration would feint to the right and then move left,” recalled Loretta Ross. “If health care reform did not explicitly prioritize women’s needs, how could we support it? We felt we were being thrown under the bus by our purported allies.”¹⁴

The women criticized how the proposal “isolated reproductive rights issues from other social justice issues.” They started to develop a new framework for looking at these questions:

We questioned the primacy of abortion, but not its necessity. We placed ourselves in the center of our analysis and made the case that while abortion was a crucial resource for us, we also needed health care, education, jobs, day care, and the right to motherhood.

From this discussion, they launched the concept of reproductive justice “by splicing together the equation of reproductive rights + social justice = reproductive justice.”¹⁵

“Reproductive justice is not difficult to define or remember,” Ross explains in her primer on the subject:

It has three primary values: (1) the right not to have a child, (2) the right to have a child, and (3) the right to parent children in safe and healthy environments … The problem is not defining reproductive justice but achieving it.¹⁶

By examining their own experience and what they wanted in their lives, these women came to a conclusion that allowing the feminist movement to be whittled down to one issue—legal abortion—had been a terrible mistake. Abortion was important, but it needed to be just one part of a movement for women’s full emancipation. The women who met in Chicago called their group Women of African Descent for Reproductive Justice, and their first public intervention was to place a signature ad in the Washington Post demanding that Black women’s needs be covered in the health care reform then being debated. The ad argued for a comprehensive universal health care system with equal access regardless of income, health or employment status, age or location, and stated in all caps, “we will not endorse a health care reform system that does not cover the full range of reproductive services for all women including abortion.”¹⁷ The ad was signed by 836 Black women.

In subsequent meetings, writing, and conferences, these women and others, coordinated by the group SisterSong, developed the concept of reproductive justice based on their own experiences. In 2003, they launched it at a national conference and fought for its application in organizing the next big reproductive rights march, which drew over one million people to Washington in 2004.¹⁸

The reproductive justice framework, and the arguments made for it by Black women, have slowly infused the whole movement, sparking what Ross calls “a radical provocation and an interruption of narrow, repetitive, and unproductive debates about abortion.”¹⁹

Reproductive justice is the answer to a neoliberal feminism that preserves technical rights that require money to exercise. One example is the Hyde Amendment’s ban on Medicaid and other federal funding for abortions, leaving millions of women with the “right” to abortion but no real access. Since 1976, no Democratic Congress, never mind any Republican one, has been willing to defend the reproductive rights of low-waged and unemployed women by repealing Hyde. The Democratic Party finally came out against the amendment during the 2016 presidential election, when Hillary Clinton was trying to prove that she was a better feminist than Bernie Sanders, who had opposed Hyde publicly for his entire political career. Faced with a Sanders-led floor fight at the convention, the party erased its own history of silence on the matter, stating: “We will continue to oppose—and seek to overturn—federal and state laws and policies that impede a woman’s access to abortion, including by repealing the Hyde Amendment.”²⁰

Repealing Hyde would be helpful, but as the originators of reproductive justice point out, what we really need is a national health care system that covers everyone for everything, the kind that Bernie Sanders promoted and that Hillary Clinton dismissed.

When women first gained legal abortion rights, starting in the socialist world, and later throughout Europe, the procedures were provided free, like all other medical care. But in the United States, with its for-profit health insurance system, the expansion of the legal right to abortion did not automatically mean access to abortion. In 1989, the pioneering women’s liberation group Redstockings updated the movement’s 1969 “Free abortion on demand” slogan. The feminist phrase “on demand” meant abortion at the woman’s discretion and not subject to approval by doctors, hospital boards, police, or psychiatrists. Now it’s “Free abortion on demand through national health care for all.”²¹

Why Is Framing Abortion around “Choice” So Ineffective?

Abortion since Hyde, without real access unless you can pay, is the sort of choice we’ve been experiencing in many areas of our lives, thanks to the Democratic Party’s procorporate agenda. We have to individually purchase services, like health care, childcare, and college, that in other countries are provided to everyone free.

Childcare is available on the private market—with private market prices—but it costs more than college tuition. College is available, but if you can’t pay up front, you have to go into debt, marking your next decades as a modern indenture. You have a choice to take family and medical leave (finally passed under Bill Clinton, a leader of the neoliberal Democratic tendency), but it’s unpaid, so you can only take leave if you can forgo a paycheck.²² Under the Affordable Care Act, health insurance is available, but limited to those who can afford to pay the premiums, copays, coinsurance, deductibles, and out-of-pocket maximums. Choose your plan wisely!

Framing abortion and birth control as a personal choice feeds right into this framework. “Choice” makes it seem that parents are indulging a personal whim by having children rather than making a valuable contribution to the ongoing existence of society.²³

You have a choice to have a child, but unless you have enough money and time you may be seen as irresponsible for doing so. If your living situation is regarded as unhealthful by the authorities, the state may take your children from you rather than requiring the landlord to provide decent housing. People of color get extra scrutiny and are punished more severely when they’ve made the “wrong choice.”²⁴ “Responsibility”—as in the welfare-shredding Personal Responsibility and Work Opportunity Reconciliation Act passed under the Clinton administration—is only applied to those who don’t have money. Those with the most have little responsibility to contribute through taxes to the society and workforce that has been so generous to them. The richest avoid taxes entirely. Instead, states go after “deadbeat dads” (or moms)— mostly wage workers who are making so little that there is nothing to take.²⁵ They can be thrown in jail in many states and lose their occupational and driver’s’ licenses. And, in true neoliberal style, the money taken from the noncustodial spouse is often not provided to the person taking care of the children; it’s seized to fund the welfare that the family is already receiving because of their low wages, lack of childcare, or unemployment.²⁶ Market freedom requires imposing the most draconian and miserable constraints upon actual human beings.

This is not how other countries approach child rearing, and as a result child (and parent) poverty in the United States is quadruple that of other rich countries. Many provide a monthly child allowance and guaranteed health care; nearly all provide paid leave; most have subsidized or free childcare.

Our attenuated right to abortion has become the only answer from the Democratic political establishment to the crises families face when they have kids: If you can’t afford children, just don’t have them. You had a “choice,” after all. This bankrupt doctrine is reaching a breaking point. Many potential parents have decided it’s just too hard to have kids, or they have stopped at one, plunging the US birth rate below replacement levels and motivating the power structure to further crack down on reproductive rights.

This is why reproductive justice argues that abortion and birth control can’t be understood separately from housing, jobs, wages, health care, policing, racial and sexual hierarchies, immigration, and environmental health.

How Do We Fight Back Now—and Win?

The young radicals who started the women’s liberation movement in 1968 didn’t expect women could be free with capitalism intact. Many had already risked their livelihoods and lives in the civil rights and antiwar movements and the New Left. While men were sexist in those movements, that was not the only thing that made them decide to start an independent feminist movement. After all, men were sexist outside those movements, too. Most saw organizing for women’s liberation as recruiting a new constituency to the general freedom movement while creating an independent female power base to make sure rhetoric about “Equality and freedom for all” included women.²⁷

These feminists were right that women’s freedom cannot be won without confronting the power of employers and the rich. As it turned out, the movement made important strides, but in areas that didn’t cut too deeply into the prerogatives of capital and employers. In that category (call it “column A”), we have made progress on appearance and dress codes; integration of all-male spaces and workplaces; men doing childcare and housework; better sex; and educational equality. The areas where we are stuck or going backward (call it “column B”) are those that require capitalists to cede control or cough up resources: equal pay; public childcare; paid family leave; and conditions from universal health care to living-wage jobs that allow women economic independence from men. Indeed, half our progress toward equal pay has been a result of men’s wages dropping to meet ours.

Due to the fall in the birth rate starting in the 1970s, abortion and birth control have moved from column A, things that don’t greatly impinge on the prerogatives of capital, to column B, things that do. This means that feminist advance now requires a confrontation with the power of capitalists. This should tell us exactly what a fighting women’s liberation movement needs to do.

1. Expose the High Birth Rate Agenda

The power structure could accommodate our demands on abortion when birth rates were already quite high, but as birth rates have dropped below replacement, they’ve started coming for our reproductive rights. They want our reproductive labor—and they want it cheap.

So far, they’ve been getting it cheap, while we face a crisis. Even in the best conditions, raising children can be complicated, stressful, and full of heartache at the same time that it can be delightful, rewarding, and full of love. Add money and time woes, and partners who don’t fully participate, and many women are deciding against having kids, or stopping at just one, resulting in an informal “birth strike.”²⁸

Making you have a child even though it will require too large a sacrifice in every other part of your life—time, energy, money, health, education, housing, professional or creative aspirations, relationships—is not an unfortunate unintended consequence of abortion restrictions but their primary goal. This is why there’s such a fight over who will control the process. If women had complete liberty on reproduction, we’d be free to demand better conditions or refuse the labor.

Is it enough to say abortion is an economic issue? Katha Pollitt writes that reproductive rights “are not a distraction from the important, economic issues. They are an economic issue: Without the ability to limit and time their pregnancies, women will always be disadvantaged at work and subordinate to men.”²⁹ Abortion allows women “only [to] have children they want and can raise well.”³⁰ But there is a problem with defending abortion this way. It suggests that the solution to our economic struggles is to not have kids. But this is just one more way we are expected to accommodate ourselves to an economy that pipelines the good things in life to the top and leaves us with ashes. “Depriving people of the opportunity to have kids is like depriving them of the opportunity to fall in love,” writes Maureen Tkacik.³¹

Yet this is the only solution the Democratic wing of our political elite is willing to contemplate in response to the disaster their policies have made of family life. Certainly the redistribution of wealth required to create universal childcare and health care is off the table, and the Republican program looks to be forced pregnancy.

So is more socialism the answer? It is often implied that socialists and communists are as bad or worse than capitalists on reproductive rights, with Romanian orphanages and Chinese forced abortions occupying headlines in the corporate media. But countries with socialist revolutions in fact led the capitalist world in freeing women from forced childbearing. As capitalism has returned to formerly socialist countries, coercive pronatalism has come back with it, suggesting that capitalism’s requirement for endless growth is in conflict with reproductive freedom.

The first country to overthrow its reactionary abortion laws was Soviet Russia in 1920, shortly after the Bolshevik revolution. Eastern European governments followed after World War II, along with the revolutionary governments in Korea, China, Cuba, and Vietnam.

By contrast, it wasn’t until the mid-1970s that Western European countries allowed abortion at a woman’s discretion. Why were the reds better? Certainly, communists and socialists were willing to challenge the power of the church. But also, these governments valued women as comrades, production workers, and even soldiers, roles they couldn’t take on if burdened by the uncontrolled childbearing characteristic of the old feudal and capitalist regimes. The revolutionaries understood the old systems of individualized housework and childcare to be inefficient and harmful to women’s self-development. Lenin described housework as “a daily sacrifice of self to a thousand insignificant trifles,” and railed against men who didn’t contribute.³² The Soviet government made it a priority to relieve women of childcare and housework with daycare centers, cafeterias, and laundries.³³

In 1970, the government of Vietnam stated,

Creches, infant classes, canteens, restaurants and service groups have helped lighten household chores for Ha Noi women who are thus in a better position to take part in productive work and to increase their productivity. In addition, our sisters have more time for cultural, political and professional studies, and for rest.³⁴

And that was in the middle of a war of extermination conducted by the United States.

Additionally, constant growth of the population has been less important to socialist governments than to capitalist ones. There was the ill-fated and outrageous Romanian attempt to raise the birth rate by banning abortions and surveilling women’s reproductive systems (1967 to 1990). But that seems to have been the exception that proves the rule. We now have a hundred years of various socialist countries to compare, including ones that have gone back to capitalism, and a pattern has emerged: as capitalism returns, so do demands for higher birth rates.

For example, communist Poland made abortion widely available in 1956. While the postwar birth rate declined steadily, from 3.6 in 1956 to 2.2 in 1986, the government didn’t restrict abortion. But in 1990, immediately after the return of capitalism, abortion was limited and then in 1993 it was outlawed with exceptions only for rape and health. Recently, the Polish government instituted more draconian punishments, arguing that the birth rate is too low.³⁵

China shows the same pattern. With the return of capitalism, China’s famous one-child policy has become a two-child policy. Now, in the face of capitalist pressures for growth and a demand for young workers, “Officials are … scrambling to devise ways to stimulate a baby boom, worried that a looming demographic crisis could imperil economic growth,” the New York Times reported in 2018.³⁶

Anthropologist Kristen Ghodsee writes that socialist and communist bloc countries had a pretty good feminist track record, much better than the capitalist countries, not just on abortion but also on incorporating women in science, medicine, engineering, and leadership roles. Thanks to universal programs and full employment, women were able to be economically independent of men, which enabled them to demand that men treat them better, leading to more equal relationships and even to better sex.³⁷ These gains were rolled back after 1989.

Still, we can see some of these effects on relationships in Scandinavian countries today, where government programs allow women much more independence than we have here.³⁸ While feminists are often told we have to slowly change sexist culture, in fact universal public programs could advance equality between men and women right away.

We have immediate opportunities in the United States to move feminism toward bolder, more universal demands that would give us this kind of independence here. For example, for four decades feminists have been trying to defeat Hyde Amendment restrictions on federal abortion funding as a way to expand abortion rights. But with the growing demand for Medicare for All, we have a chance to win health care for everyone, making sure full reproductive rights are included. That’s a lot more inspiring than once again trying to get Congress to include abortion in Medicaid, a means-tested program that leaves many out. And a universal health care system would mean that no woman would be compelled to stay in a job or a marriage to have access to health care.

2. Win People Over, Break Down Fear

In US polls, a consistent 20 percent think abortion should be illegal in all cases, with another 30 percent expressing moral disapproval and various levels of thinking that abortion should be legally restricted. But rather than giving up on half the population, we can study how abortion organizers changed minds in the 1960s. And with a fresh feminist angle showing how restrictions on abortion and birth control are about keeping our reproductive labor cheap, we have a chance to reach additional women. By connecting our right to refuse reproductive labor to our demands for improved reproductive working conditions—including the provision of childcare, health care, paid leave, and shorter hours for all—we can move people on this issue. Many women have only been exposed to an elitist and antipeople feminism of the 1 percent, whose answer to our economic struggles is that any problems you have supporting and raising kids are your personal responsibility. After all, you had a “choice.” Lean in. But people aren’t dumb or brainwashed for having kids—it’s important, difficult work needed by the whole society.

Organizing is based on breaking down fear, and with abortion there is fear everywhere: fear you will be rejected by your family or other loved ones; fear of being known as “the one who had the abortion” and the rejection by employers, partners, friends, or coworkers that might cause; fear of being attacked publicly or threatened privately; fear your children will be affected by stigma. The role of the organizer is to dissipate fear through organization, support, sisterhood, telling the truth, and making public what was once private, more and more, until so many people have talked about their abortions that any remaining stigma becomes untenable. “We cannot meet fear with rhetoric or statistics,” wrote Judith Brown in 1968. “We must be ready to organize, support, and act.”³⁹ Shout Your Abortion has again shown that women are willing to say their names and speak about their abortions— and not just “good girl” abortions where a wanted pregnancy went wrong.

Because the power structure never admits that positive changes come from public protests, many people are responding to the crackdown by forming underground networks to provide abortions to the handful of people they’ll be able to help. But in the 1960s, it was public protest and lawbreaking that changed the law, not underground efforts which were, by definition, unknown until later. Today civil disobedience is taking on new forms. On December 1, 2021, members of Shout Your Abortion publicly took abortion pills in front of the Supreme Court, defying the prescription-only restrictions on this medicine and aiming to make the safety and effectiveness of these pills universally known.⁴⁰ Plan C Pills (plancpills.org) trains “‘ambassadors of information,”‘ while Aid Access (aidaccess.org) provides pills from overseas in all fifty states and is battling the FDA for their right to do so. These public efforts increase the pressure to remove the prescription requirement on abortion pills. National Women’s Liberation (womensliberation.org) is collecting signatures pledging publicly to “Aid and Abet Abortion.” In the illegal days, Parents’ Aid made women march in public demonstrations to receive (illegal) abortion referrals. The Society for Humane Abortion required that in order to get an abortion referral, women had to do two hours of office work, donate $5, and write two letters to legislators about the abortion laws.⁴¹

Many people are looking for a way to move against the outrages and injustices they’re experiencing. Often they just don’t see how they can have an effective role. This is why it is not an imposition to ask someone to take political action—speak out, march, join an organization, contribute money, meet, plan, petition, canvass, picket, sit in, occupy, violate laws, strike, vote.

More important than speaking truth to power is speaking truth to each other in order to build our unity and power. This is how we’re going to protect and advance abortion rights, and it’s also how we’re going to win the other things we need for our freedom and happiness.

2

Pañuelos Verdes, Acompañamiento, Solidaridad

The Global South Has Much to Teach the North in This Moment

by Naomi Braine

The green bandana, el pañuelo verde, has crossed the southern border to enter the US feminist lexicon as a symbol for abortion rights and bodily autonomy. In the wake of the leaked draft of the Supreme Court decision on Dobbs, the color green has been appearing in signs and banners at demonstrations in support of abortion and opposition to the rollback of Roe, as can be seen in this string of photos from a demonstration in New York City that includes a woman holding the iconic Argentinian pañuelo with “Aborto Legal, Seguro y Gratuito” (Abortion legal, safe and free).

The green bandana is indeed an international symbol of abortion rights, one that emerges from the longstanding, militant, and increasingly successful struggles for abortion rights in Latin America. Over the last thirty years, the spread of self-managed medication abortion and the feminist movement to support women through the process led to decreasing maternal mortality from illegal abortion, despite extremely restrictive laws across the region. In the past five years, building on the work of the preceding decades, feminists throughout the region have won significant legal victories, including the legalization of abortion through fourteen weeks in Argentina, major court decisions decriminalizing abortion in Mexico and Colombia, and the ongoing transformation of Chile from a place where abortion was completely banned to one where access may be written into the new constitution.

The green bandana is not the only thing that feminists in the US can learn—and are learning—from the struggles for abortion rights in the Global South, especially Latin America. Self-managed medication abortion (SMA), which is increasingly popular in the US both through telemedicine and more autonomously by obtaining pills and instructions online, began in Brazil in the 1980s and ’90s, although many US activists may not realize that. Here in the US, we can learn faster, adapt strategies from other places more effectively, and in the process build solidarity-based alliances across borders, if we intentionally recognize and draw on the experiences of feminists in the Global South. They have much to teach us, and we can learn from a place of respect and genuine collaboration, a dynamic already apparent within regional abortion networks across Latin America and sub-Saharan Africa, where activists engage in ongoing processes of sharing knowledge, skills, and strategies

Starting in the early 2000s, activists across Latin America and sub-Saharan Africa developed grassroots, community-based strategies to share information about how to safely use medication for abortion and support people with unwanted pregnancies through the abortion process. The abortion hotline is the most basic and probably the most widely used way to provide information about SMA: there’s a telephone number that people can call to talk with someone about their situation, get information about SMA, and call back whenever they have questions. In Latin America, hotlines focus on primarily on abortion while in Africa they are often broader, nesting information about medication abortion within a larger array of sexual and reproductive health information. Accompaniment, or acompañamiento in Spanish, involves ongoing communication to accompany a pregnant person through the abortion process, from an initial conversation through sharing information about SMA to remaining in contact with the person through the abortion itself, usually with some follow-up afterwards. “Accompaniment” has gradually become a generalized description of the process of supporting someone through a self-managed medication abortion, whether in person or by phone, text, or email. Activist collectives around the world have developed the knowledge and experience needed to routinely accompany people through second-trimester abortions, although this requires more time and engagement for everyone involved than a first-trimester abortion.

Activists engage with this work from a place of solidarity and care, a commitment to accompany people through a process that for many elicits anxiety and uncertainty. Abortion outside the medical system has a dangerous reputation, especially in a place like the US where the 1960s experience of back-alley quasi-surgical procedures lingers as the dark shadow of the near half-century of legal abortion within the medical system. Activists across the Global South work in collectives and NGOs to support and enable a very different experience, based on solidarity among people who may not know each other but commit to travel through a process together.

The work of these collectives and community-based NGOs has similarities to the work of doulas, who support people through pregnancies and sometimes through abortions as well. However, the activists who engage in this work are generally not reproductive health professionals, a fact central to both the power and the success of this movement globally. The requirements for becoming an acompañante involve the acceptance of feminist values and commitments, and attendance at many workshops, but the training is done within the collective and accompaniment is understood as a form of feminist direct action. That is, it is solidarity work that benefits all of us, rather than a service or a form of charity.

The phrase “direct action” may call up images of people blocking roads and doorways, nonviolently disrupting work on pipelines, occupying the offices of politicians, or perhaps super-gluing themselves to the corporate offices of an oil company or bank. The most common forms of direct action draw their power from a combination of visibility and disruption, often starting with a press release and ending in arrests, but the essence of direct action involves shared action to directly target injustice. Some direct actions are forms of civil disobedience, also commonly associated with media-oriented arrests, and it’s useful to remember that the core definition of ‘civil disobedience’ is the refusal to obey an unjust law. Breaking a law publicly can be an important form of protest, as with the Freedom Riders who refused to obey segregation laws on interstate transport, but the civil disobedience aspect lies in the refusal to follow the law, not in doing so publicly or in getting arrested. The Underground Railroad was an example of direct action and civil disobedience that was built on the ability to remain invisible to authority. Driving a woman from Texas to New Mexico to get an abortion became a vital form of civil disobedience in September of 2021, after the passage of SB8, and is much more effective as direct action when no one gets arrested or charged. Answering an abortion hotline is a form of feminist direct action, and accompanying an abortion combines direct action with solidarity-based support for someone else’s act of involuntary civil disobedience in having an abortion despite legal restrictions.

The US has a long-standing reproductive health and justice crisis of limited access plus escalating criminalization that requires the broadest possible range of responses. We need doulas, midwives, telemedicine, online pharmacies, abortion funds—and, learning from our sisters in the South, we may need solidarity-based feminist collectives that offer information and support on medication abortion in a variety of different legal and social contexts, with swiftly changing laws. The internet and digital technologies open up possibilities for sharing support as well as information across distance, without the need for expensive travel. Aid Access will provide abortion medication through advance provision (meaning to have in case you need it in the future), and both Plan C and Ms. magazine offer ideas for how to get pills by mail in places where abortion telemedicine is banned. There are websites in Latin America that offer a wide range of tools, including step-by-step instructions for medication abortion, and a Kenya-based network has produced a practical guide to medication abortion.

A key starting point may be for those of us in the United States to realize that feminists across the Global South have developed strategies for supporting people with abortions in places where it is highly restricted or outright banned, have done so for years on the basis of solidarity rather than service, and have managed the potential legal risks involved. There is already a network of lawyers that stretches from Canada through the Southern Cone to share experience and strategies for supporting both activists and people who need abortions, including If/When/How in the US.

Perhaps it’s time for (more) US feminists to join the regional networks of SMA activists who have been doing this work for a long time; there’s a lot to learn, experiences to share on all sides, and new possibilities for moving forward together from this place we now find ourselves.

3

Women Themselves Are the Solution

Las Libres Has Been Helping Women Access Abortion and Human Rights in Mexico, and Now the United States, for Over Two Decades

by Verónica Cruz Sanchez
interviewed and translated by Elizabeth Navarro

In the year 2000, Guanajuato, Mexico, passed a bill to outlaw abortion even in the case of rape, issuing one of the harshest restrictions the country had ever seen. In response, feminist activists, including Verónica Cruz Sanchez, coordinated an unprecedented wave of protests, creating enough political pressure to overturn the bill. This victory marked the beginning of the feminist collective Las Libres—the free ones—in the most conservative region of the country, no less. From its inception, Las Libres has organized by and for women, in service of women’s rights and liberation.

Las Libres has been part of the struggle for reproductive rights in Mexico over the last two decades. Contraception was initially outlawed in 1931, but the 1974 General Population Law required the government to offer family planning services, including contraception, and amended the constitution to uphold the right of all Mexican citizens to decide on the “number and spacing of their children.”¹ After conservative political gains in 2000 with the election of right-wing populist president Vicente Fox, right-wing political and religious interests of the country again tightened restrictions on abortion. For the next decade, as in the United States, access to abortion in Mexico varied state to state, and fluctuated with public outcry and government pushback. After 2007, when Mexico City (both the capital city and an autonomous federal entity, like Washington, DC) defied the Catholic Church and legalized abortion, twenty-eight other states refused to decriminalize the practice.

Until 2018, twenty out of Mexico’s thirty-two states had enacted laws declaring that life begins at the moment of conception. Abortion-related crimes carried prison sentences of up to six years, though reports circulated that women remained in prison for decades at a time. Since the year 2000, coalitions of fervent Christian groups, populist politicians that embolden the most conservative corners of the country, and the intimate entangled coalition of big money, big lobbies, and pro-life organizations shaped the landscape in which Verónica Cruz Sanchez and Las Libres developed their organizing strategies. In 2021, the unrelenting fight of feminist resistance to abortion bans achieved the impossible. Mexico joined a handful of Latin American countries, including Argentina, Uruguay, Cuba, and Guyana, guaranteeing legal abortion when the Supreme Court, with a unanimous 10-0 ruling declared the criminalization of abortion to be unconstitutional.

Despite this victory, today there are many outstanding questions for the country: Will local and district judges obey the newly established precedent? Will the medical community align their practice with the decision? Was the court too imprecise about pregnancy stages? What role will abortion assume now in the country’s political and social life? The factions that divided the country have not disappeared—but what is certain is that the organizers who fought will not leave the streets until every woman is free to decide her own life on her own terms.

For twenty-two years, Las Libres has fought in the streets, courts, hospitals, state congresses, universities, rural communities, and homes, in-person and virtually, for women’s rights and self-determination. Today, their organizing has a global reach: their materials are translated into at least six languages, and collective members accompany women through their abortions all over the world, working most recently with women in the United States. As a collective, they have developed a legal defense strategy for the criminalization of abortion-related charges; created educational models for rural, Indigenous, and impoverished peoples on issues of sexual violence, birth control, and abortion; mobilized for legislation against gender-based violence and femicide; conducted media campaigns and done substantial research on abortion access; and coordinated protests and public demonstrations in nearly every state of the country. Their struggle is a reminder of what is possible, as Verónica Cruz Sanchez says below, through relying on the relentless spirit and collective power of ordinary women.

– Elizabeth Navarro

Elizabeth Navarro: Who are Las Libres and what is their origin story?

Verónica Cruz Sanchez: Las Libres is an organization that was born in the year 2000—we’ll turn twenty-two this year. From the beginning, we at Las Libres decided to focus on two issues: the development of women’s right to live a life free of violence, and building what is necessary so that women and teenagers and girls can live out their sexual and reproductive rights.

When we first started, we dealt much more with preventing teen pregnancy, with sex education in rural communities, and one thing led to another.

As far as abortion goes, the context surrounding it unfolded before us. Our first struggle and victory came during the year 2000, when the local state congress of Guanajuato eliminated from the penal code the exception clause for abortion [which was illegal in Mexico at the time], which had allowed for abortion in the instance of rape. But when we tried to explain to the public why the issue was so grave, what we found is that the majority of girls and women that were survivors of rape had never had access to that right and that the majority were forced into motherhood as a result of rape. And when we began to look case by case, we discovered that of the majority of girls who had been raped and needed an abortion, their rapist was their biological father.

That discovery to us was akin to insanity.

When we exposed this fact publicly, there was such indignation that we managed to reinstate the exception clause into the penal code.

However, we realized that that right was not actually real if in actuality women could rarely access it. It was then that we said to ourselves, “Hey”—and it was really like this!–“we don’t know what we’re going to do, but we are going to guarantee that right to them.” And we set out on a search, at first for doctors, psychologists, private attorneys, and men and women that were willing to help us with this problem. We persuaded them to provide help for free, and directed women to them when they needed an abortion, especially women most in need of health services and information.

One thing that Las Libres has always tried to do is involve the public. That has been very important, achieving broad social support to resolve our own problems, since they are not solely women’s issues or women’s problems. Rather, they are produced and reproduced by all of society, and are pertinent to all. It’s been interesting that because of all of the support that Las Libres has had, even around abortion, even in this region known for being more conservative––Guanajuato has been one of the states where the public perception has shifted most rapidly.

So we dedicated ourselves to accompanying women and girls, initially rape victims, for abortions. Logically, however, that work expanded. We advertised publicly and so soon, women came to us and told us, “I was not a victim of rape, but I also want to have an abortion.” So we said why not? And we began to guarantee safe abortions at home to all women who wanted them. Along the way we learned about the protocol of the World Health Organization for medication abortion at home. When we found out that medical supervision was not needed, it was like well this is it, that’s the solution, right?

We have since also worked in decriminalization. We found women in jails who had been jailed for abortion and related crimes. When we found them, we said, “We don’t know what else we are going to do, but we are going to take them out of prison because there’s no reason why they should be there.” And we also began to build solidarity networks to build a defense strategy [for incarcerated women], which was also very extraordinary and very, very educational for the population. We wanted to show people the consequences of inaction. We have exposed the reality for women who were imprisoned because somebody believed they did something wrong, because someone didn’t apply the law correctly.

So that’s how we came to find ourselves. And that led to us specializing in everything relevant to abortion, in legal terms, medical terms, social terms. We started all of this in Guanajuato, but our labor has led us to work practically across the entire country. We have developed successful networks of accompaniment for safe abortions, we have built and honed an entire defense strategy for women facing criminalization for abortions across the country. And on the issue of violence against women, we do accompaniment work with women and girl survivors, particularly of sexual violence and feminicide.

EN: How did these these networks of accompaniment develop?

VCS: It’s actually very clear: it’s the women themselves that are the solution. What was always clear for us was that we wanted any woman who came to us to access her human rights, that even though the world claimed abortion was wrong, that it was a crime, that the woman belonged in jail or in hell for it, that her family would kick her out—that in spite of all that, each woman could know that there was a segment of society willing to support her with the necessary resources to ensure that she could live out her human rights within her lifetime.

It’s this idea of creating the space to live out rights, in spite of anything external.

So then women would often come back and say, “If I was able to live it out like this …” It was as if a veil of cobwebs had lifted, and it was like, this [what I am being told about the evils of abortion] is actually not my lived experience, it wasn’t like this! And that’s when the cobwebs would lift.

As women we are always tempted to explain ourselves. And so they would say, “Look, I actually should abort” or “I have to abort” or “I must because I’m studying, because my parents don’t know, because if they find out they’ll throw me out.” And we offer her information: that she can do the abortion at her house, that if she doesn’t tell anyone then no one has to find out, that it was super safe. And especially, when we tell her we can guarantee her health and freedom—it is then that she is convinced. Almost always they came back after they had experienced that abortion was a right they could access, and asked, “If I was able to live it, we should all be able to live like this. What can I do so that another lives it?” So that was the lightbulb moment. This was the answer, women would pass on their experience. And that was vital.

When we were first taking off, the pills were very expensive and there was only one brand. And in fact, the majority of women always relayed to us a specific financial worry. They often didn’t even know if it was a crime, that wasn’t the concern [about abortion]. They weren’t worried about whether or not it was a sin either, in spite of the majority of them being Catholic. They were worried about the possibility of death and whether they’d be able to have children. And the third thing that worried them was: What will it cost? And our answer was always: “Nothing, it’s free.” And that was completely unbelievable to them.

We were able to see how instantly that removed every single negative connotation that abortion could have: They’re going to give me the pills and they’re going to be there to support me! It was completely unfathomable.

Back then, you could buy the pills and they cost around 2,000, almost 3,000 pesos, there were twenty-eight pills per box. That’s when we adopted a a protocol around the experience. For a single dose, four pills were administered intravaginally so that they could go a long way, and we saved money that way. Seven doses per box. And then the woman would come back and say, “What can I do to help?”

So we would tell her, keep the pills and when the next woman comes, you’ll give her the pills. And along the way the first woman would give the next woman information, but most of all she would pass along her own experience. Imagine a woman who is terrified of what will happen to her, and she hears that someone who has just gone through this is going to accompany her and support her through it, it was like “Well, if she was okay, then I will be okay too.”

That is really what started generating these networks of solidarity, what was in reality the first set of networks of accompaniment that would eventually spread widely.

I always have to talk about that because it was so important.

EN: Can you describe your practice of accompaniment?

VCS: The first networks of support and accompaniment were not made up of feminists, they weren’t collectives, and they were not formed by organized groups the way we know them now. The first networks were made up of women, the same women who lived through an accompanied abortion. They came back and said, “I want to give back to society, for what I received.”

It was there that it became obvious, with much more organizing, that this was a political movement. That momentum is what will decriminalize abortion. Because while we’re waiting around and fighting this struggle so that hopefully one day the lawmakers decide to do us the favor of legalizing abortion, women are here, they’re alive now, they’re facing many problems for which there are concrete solutions to be found through women’s solidarity.

I’ve always said, in our Mexican context, we’re not the government, or armed forces, or attorneys—instead we’re going to solve the problem for each woman, case by case. The way to resolve a social problem is through social means, through women. Women’s organizing and solidarity, the network building among women—they generate women that can say, “I have an answer, I have a solution, and I can carry it out myself.”

This is how the networks of accompaniment took place until about 2009. That was when we began to create networks in specific states and with organized groups. That’s when things really take off in Mexico. We had gathered the necessary experience so that the networks could take root across the country and grow into their current form. Today these networks exist all over the country, and in nearly every territory in the expanse of Latin America.

It was in that initial phase of organic growth that we found the way.

EN: What were some of the initial hopes or indications that this was a movement with potential, that it could in fact grow organically?

VCS: From the beginning we had a clear idea that this effort had to reach women. This was our collective goal. This was for women, and it had to be developed by us women. What was also certain from the beginning was our effort to destigmatize abortion. This was our other path, an alternative to waiting around for legislators to legislate. From the beginning [all] this was clear about Las Libres.

But it wasn’t that we woke up one day and said, “Why don’t we do all this?” Rather it was through our intention to resolve a problem. And it was women who actually put the solutions in front of us. It was the first woman that came back and said, “What can I do? If I lived it like this how can I ensure others do too?” That’s when it becomes obvious: of course we have to do something to offer this to everyone who asks.

When women say, “I can accompany another person and can gift them the pills,” then even the economic issue begins to disappear. When you remove some of the negative charge, you discover that that’s the path to having a conversation for the first time in the public sphere about a topic that was silenced and made invisible and used to hold power over women.

Because this isn’t only about biological reproduction, it’s also about social reproduction and how women have been relegated to the domestic sphere so that they can’t dispute political and economic power in the public sphere. When we started to see the first women we ever accompanied at our protests and marches about abortion rights, we said, “Well of course! That’s what it is.” In other words, we as women can fight for our own rights by dismantling all of these myths, and we can do it ourselves.

From there we moved in the direction of destigmatizing the issue. This meant removing abortion from its negative place in our social understanding and placing it where it belongs. Because it will always be a necessity: women have always aborted, they have always needed it.

It’s not true that birth control or sex education—though obviously they’re important—will prevent abortion. We need to actually talk with people about what these issues really are, that abortion is unavoidable because women will seek and receive abortions regardless of whether they’re legal. But it’s a really complex task to make people see reality, so sometimes you have to put reality right in front of them so that they can face it and engage with it.

Part of what I do is tied up in the history of labor struggle. For example, in this case, it takes one woman to know her rights, to raise her consciousness of the issue, and then there’s no possibility of stopping it—the issue now calls for social mobilization and movement, to rearrange what is in disarray.

That’s what a social movement is, and that’s exactly what women are creating today, a social movement that’s powerful, alive, and global. It’s about women saying: “First we will take our rights, then we will live them, then we will support and accompany others in their experience, and then there’s no way to stop that momentum because those rights belong to us because we’re humans.”

EN: Is part of the work you do in collaboration with legislators and government policies, or is the idea much more of working in spite of them?

VCS: All of the above. All of it together. We have to work with legislators because they have to understand that they have a responsibility and an obligation to guarantee rights. And we work to ensure human rights for women. The reality is we still have a state and laws and institutions. But above all, public funds have to be deployed in ways that guarantee human rights. So our collaboration is in terms of demands, of reminding them that this is their obligation and they must do it.

Obviously however, our resources, our money, our labor, and our time is directed primarily—and this was a decision we made consciously—toward the very women and girls we are trying to help. We’ve decided that we want to donate our labor to the women and girls who need it most. From our perspective, that’s women in rural areas, Indigenous regions, and innercity urban populations. However, we accompany any woman who comes to us. We don’t turn anybody away, but we do prioritize those women in greatest need.

So we work with women to teach them their rights and how to demand them. At the same time, we have to work with legislators, politicians, and decision makers. For example, when it comes to violence against women, when a woman decides to come forward and report, we have to acompany her through the legal system so that she can find justice. But as it turns out, that system does a poor job and often has no idea how to handle the issue. The result is that we then have to accompany the institutions themselves as well, so that they can learn how to resolve the issues—or at the very least, so that that a particular woman can have her case resolved in the right manner, because after all, that’s the whole point.

So while our focus is on women and girls, we also work with the law and policymakers and we especially work a lot with the media because that’s a source for both sides. It’s a source for influencing a favorable public opinion. Lining up journalists and reporters means that they can deliver a message to the public, which will place social pressure on the politicians and decision makers. So we do have to work with everybody in this struggle .

EN: After twenty-two years, what do you think are the key policies and protocols of accompaniment? If we are to create and develop networks of accompaniment elsewhere, what is needed?

VCS: We need three things. The first is public willingness: We don’t generally approach people who don’t want to accompany another person. Instead, people ask for it, have asked to do it, that’s always the case. If people ask for it, it means the desire and the source for organizing is already present.

The first networks that called us from other states [in Mexico]—and typically it was a young woman—would call to say, “I want to form a network here in Tijuana!” And she would say, “But I only have two friends. Can I do it with just the three of us?” Of course! And I went to Tijuana to join the group of three to build a network in their house, and now that network is one of the strongest supports to [the work in] the United States.

But I am saying this because people often make the mistake of thinking they have to gather a hundred people or twenty people and they say, “How can I make this happen with only three people?” But that’s exactly it—that’s how these things get started. Then you organize and shape and build or not, because not everything has to be massive. Sometimes three or four of us do the work that in another place a hundred might do. That’s it.

Social commitment is really the key, social responsibility.

The second thing is that we as the public become aware of who has more resources, and I don’t mean financial resources, I mean life resources. We have the responsibility to accompany those with less in terms of life resources. I believe that is fundamental to networks of support. If you’re against abortion, if you don’t like abortion, if you’re prejudiced against abortion, if you don’t like engaging with women and you’re afraid, then don’t do it. Better you don’t. We need people that have a special fortitude, not only a desire to help but also the willingness to challenge a social system.

Because what we’re doing is confronting a system that doesn’t believe it needs to guarantee these rights and we’re saying, “No, the fact that you don’t guarantee them means you’re not doing your job. That the laws are not in harmony is not our problem, it’s yours, so you resolve it. And while you do that, we’ll resolve it through the everyday lives of women, through their everyday needs.”

The third thing is cultivating solidarity among women. Across human history women have practiced solidarity, support, and accompaniment. The question then becomes, how do you organize and leverage this organic solidarity toward a political objective in the public sphere? You take the power that solidarity and collective organizing produces and you deploy it.

EN: What I am gathering is that Las Libres is actually entirely constituted through a network of support, comprised of all the women the work has touched and who want to help another.

VCS: Yes. The majority of women who we support come out of a violent situation. When each woman can successfully say, “I am free from the weight of the issue of abortion, it was a social burden I was carrying!” They almost always say, “I am free now,” that’s the language they use. And we understand it symbolically: she must be saying it in part out of gratitude for our support, but also in large part on account of herself, like she affirms her own freedom. Now I am free. And that’s our fight at Las Libres, until every woman is free in every aspect of her life.

EN: And you accompany people all over the world?

VCS: Yes, we work at a global scale. In fact, I think that was always the case. I think we understood ourselves as being Guanajuato-based because we have been so loud here, our work has caused an uproar and we’re always doing a million things. But much of that work has been all across Mexico as well.

Prior to the pandemic, we had received requests from all over the world. Initially, we did not understand why that was happening. What we did know is that there are global networks, global organizations that we’re tapped into, that put out content about us, or shared our articles and materials. We were already sort of prepared for it, because the landing page on our website (which is how people most commonly contact us) was already available in six languages. We had volunteer staff that spoke each of the languages so we said, why not translate it?

But then a specific event happened at the same time as the pandemic. When the event happened, we began to get a large influx of cases from all over the world and wondered what global event was taking place, since cases were coming in daily. We were very confused, and that’s when we came across a Facebook post published by someone we think is a man. The post is a picture, very typical of Mexico, a picture of a large semi-truck used to transport produce. The truck is covered with a tarp, and on the tarp is printed “Mifegymiso.”

In the post, this man does something absolutely fantastic, because he begins by writing: “It’s too bad that women’s rights exist, too bad that sexual and reproductive rights exist, too bad that abortion is available to woomen, it’s too bad that women can make decisions about their own bodies. It’s a shame.” Obviously that draws attention, but he goes on: “It’s a shame that medical abortion exists, that it can be self-administered … it can be carried out the following way … four pills …” He continues until the entire protocol is in the post, and finally he concludes, “It’s a shame that Las Libres exists if you have any further questions or concerns.”

When we came across it, it had already been shared over 10 million times. So that was the reason, no wonder! But we don’t know who the poster is or where it came from. Strange things like that are always happening to us as a result of all our work.

During the pandemic everybody and everything was closed. But we never closed. We simply decided not to. Because this post went viral right at the beginning of the pandemic, and now everything anyone was doing across the world was via the internet, we too were suddenly viral. And many networks and groups in other countries started to direct anybody who needed an abortion to Las Libres.

We were making the rounds on Twitter and Facebook, but we had not actually published anything there! Everyone was saying, “If you need support or guidance or information, call Las Libres!” So that’s a bit of the background to why we began to accompany any person in any part of the world.

EN: How did you begin to accompany women in the United States in particular?

VCS: SB 8, the greatest [abortion] restriction in Texas, was enacted on the 1st of September 2021. And then a week later, on September 7, 2021, Mexico’s Supreme Court voted to decriminalize abortion, citing its unconsitutionality. So then the United States media reached out to us and interviewed me frequently, because Las Libres was now a referent for what this struggle looked like when abortion was criminalized, and how to successfully accompany women in these cases and in legal actions.

In speaking with us about the issue, there was one journalist who said, “Hold on, hold on, hold on, so you’ve accompanied women through their abortions as far back as twenty-one years ago in a state like Guanajuato, the most restrictive of all? How were you able to do this?”

So I would tell them the story. And what I got back was, “so … in theory we could do this in Texas?”

And of course you can. Technically speaking, Guanajuato was a more restrictive state than Texas, and had already imprisoned women for aborting. That’s when a lightbulb came on for me. Because of course, we can’t be implicated [in US abortion bans] because we’re outside of the jurisdiction and in Mexican territory. And the women who abort in Texas, in their homes, just like here—so long as they don’t say anything, nobody will find out, and nobody has to know they aborted. So then, to us it was like, of course we can do it!

Then the question was, how are we going to do it? Because we have to get to those women somehow. So I spoke with as many of our organized networks of accompaniment along the Texas–Mexico border as I could. I proposed it to them and everybody was in. And there was also an article in the New York Times about our strategy.

All of this combined led to a ton of cases of women from the United States coming in to Las Libres, and all of it has snowballed. I think that women found out primarily through the commentary from media published about us. They learn our name, and go to our website or our Facebook. We’ve even been contacted at our office landline by people in Texas!

EN: How is this accompaniment work carried out now, virtually or in person,? Do you travel?

VCS: In diverse ways. One of the methods is with women who have the ability to travel and move between the two countries. They can come to Mexico, to cities along the border, and connect with our networks of accompaniment. They can actually get it done while physically in Mexican territory.

The other way is through the international networks that we have already developed for people to take and distribute the medicine. Many people who come to Guanajuato or San Miguel from the United States come from states without restrictions, the two most common being California and New York. They take the medicine and travel with it and they have it ready. When a woman from Texas comes to us, we contact the people we know have the medicine in the United States and they send it to the person in need. And then our job, from Mexico, is to support them through the abortion virtually, and to guide them and provide them with all the necessary information.

EN: We’ve arrived at that famous question you’re asked. I might frame it as advice rather than critique. What do you identify as the places for growth within the feminist movement—and especially the reproductive rights movement—in the United States?

VCS: When I give talks or workshops at various universities outside of Mexico about women’s rights, I was always asked this question. My answer then and now is still that I think feminism in the United States has been institutionalized. That’s understandable, though, right? Because you had won the rights, at least on paper. I remember in 2006, when I received an award from Human Rights Watch and went on a multicity tour to the US and Canada, I would often speak about abortion. Back then, I would speak about the accompaniment in Mexico of women and girls who were survivors of rape, and North American audiences were shocked to learn that access to abortion was not guaranteed to them: how could someone be forced to give birth after their rape? And the audiences would say, “It’s a good thing that’s an issue we’ve already overcome here.” And I thought to myself, well not exactly.

Instead the conversation would shift, and they asked me what they could do to help us. Here was another problem. They were accustomed to saying, “OK, well, I’ll donate money. It’s through money that I can find the solutions.” But that’s not right at all.

I remember, because I was particularly confrontational, that I would respond, “Well, if you stop generating problems for our countries we wouldn’t need your money. Because many of the problems in our countries, especially Mexico, come as a result of you, right? Instead you could help if you could better organize yourselves as human beings.” That would upset them. But I think these are some of the problems.

I loved that universities had feminist spaces, because it wasn’t even women’s studies or gender studies—it was feminist studies, and classes about rights and feminism. And that was great, but I think people grew comfortable there, in this space where rights had already been won. They were producing research, producing within the academy, producing. But the streets were abandoned, the everyday lives of people, the question of their daily needs. Because of the belief that the issues had already been overcome. And now when we see [these abortion bans today], they weren’t overcome, right?

With regards to abortion, I think the law has already had its effect, beyond criminalization and the lawsuits. When we talk about Texas specifically, it has paralyzed people, which is the effect of, “Don’t do this, don’t help women, you’ll get in trouble.” If any person can sue you or press charges, you become afraid and you won’t speak up. Instead of saying, “No, this isn’t right, this can’t be sustained!” Instead of asking “How will we bring this all down?”

Everything [about Las Libres’s approach] sprouted from Guanajuato: we were in this super-restrictive environment and in the face of that restriction, in the face of the impossible and with zero response from the state, we had to find the solution. In an environment like that you have to come up with different ideas. You’re forced to imagine alternatives, and as a consequence you think of more possibilities than if you’ve already won.

I think the great threat to the United States movement is finances, that they take away all your funding [for providing abortion access] and then sue you or [force you to] post a heavy bail for accompanying someone. This paralyzes rather than mobilizes. This issue intersects with fear and money.

These are the big issues that abortion has there, and that has women very, very, very tied up when organizing for these issues.

EN: You described how once a law or policy or idea has arrived at an institution, be it the academy or the courts, it becomes fixed in stone. And that limits what one can imagine as an alternative or as a winning strategy. An example is the law: we knew and recognized a path to obtaining legal abortion, but now that’s gone. We can critique these institutions, but in a way, even most of the critique lives within the institution and takes place there. Abortion rights groups in the United States spend so much time debating how to work within and be recognized by these institutions that their solutions no longer go beyond them. This seems to me to limit what we think we can accomplish. How do you keep a movement alive—not just active, but with the life and vitality to endure for over two decades and to mobilize mass numbers of people? To endure?

VCS: Reality will impose itself in everyday life. I’m talking about the lived reality that women face. We interact daily with women and girls with diverse problems who force us to think of creative, material solutions to what they face every day. If you’re trying to solve problems from a desk, and with it everything that this analogy might symbolize, you simply won’t know what the problems are or what solutions might be, not really.

You can see it in these essays and articles, these published papers. They’re often outdated [in terms of today’s] reality. They’re speaking about the landscape women faced ten years ago. But the question should be, how do we solve the problem that is emerging right now? When you start at the desk, you can’t live in reality. You have to go back to the streets.

Here on the streets there are new challenges every day, and every day you have to ask, how are we going to do this today? Who do we call? Who do we collaborate with? And then you have no choice but to activate on all fronts. I think that’s what it is. That’s the big difference.

I always provide the example of a 2006 study of Guanajuato conducted by a very prestigious university with the most prestigious investigators from Mexico, analyzing sexual violence and the governmental units created by the state to address the issue. People still talk about and quote this study, they’re stuck in it. But these specialized units aren’t even called that anymore, they have a different name.

I offer this as an example because it has often fallen on us, Las Libres, to change the justice system in Guanajuato through our case work, and that’s not often understood. When we read these articles with outdated references we realize that there’s no awareness of how irresponsible it is to cite outdated materials! This study was conducted in 2006, but this thing doesn’t even exist anymore, so what are you even talking to women about? What are you doing critiquing this nonexistent thing and inviting misinformation when you reference it? What information are you actually disseminating?

Another example: when young people go out to march on the streets, without attending to the history or the legacy of this work, and they’re chanting that an abortion in the instance of rape should be legal. But it’s been legal for twenty years! If you go out onto the streets as an activist to march, you carry a high burden of responsibility to know what you are marching about. What you say out there has to be based on up-to-date knowledge about what has been won and what continues to be fought for, because you’re informing women. Women will look to you and think that abortion is not legal in Guanajuato, so they won’t seek it out, because they’re going to trust the knowledge on the issue from the feminists on the streets.

Those are some of the problems that these outdated critiques can have. If you critique something that no longer exists, then you bring it into the public imaginary as if it does exist. That’s where the great divorce from reality comes in, from real life, from the everyday life at the frontlines of discourse. Feminism has a lot of very outdated discourse in relation to lived reality. Some of the discourse on the internet is repeated like an echo chamber, but it doesn’t actually happen like this. It’s not lived like this.

EN: What advice do you have for organizers and women in the United States, should the Roe v. Wade decision be overturned, as we expect it will?

VCS: More than advice, it’s a bit of hope. Anything can be reversed through community organizing. We are more powerful, in numbers, than those in power, even as they might wield more power. But social organizing, community organizing, the collective, fighting for collective rights, will always bring gains for everyone, for a majority. It’s possible.

Above all, Mexico is a perfect example of this, of taking back these rights through solidarity. The good news today about Mexican women is that they are demanding, demanding, demanding, reporting, reporting, reporting, and cornering the decision-makers into doing things a different way. Never stop demanding different conditions, that would be my advice.

4

The Attacks on Native People’s Reproductive Autonomy

Amicus Brief Filed in the Dobbs v. Jackson Women’s Health Organization Supreme Court Case

Shared on behalf of Cecilia Fire Thunder (Oglala Lakota), the National Indigenous Women’s Resource Center, the Native American Community Board, and Team: Counsel of Record Lael Echo-Hawk; Legal Team Lauren van Schilifgaarde and Sarah Deer; Epidemiology Team Abigail Echo-Hawk and Kaeli Flannery; and Research Assistant Elise Higgins

In May, women and reproductive justice advocates across the nation were shocked when a leaked draft US Supreme Court decision hinted at a decision striking down the Roe v. Wade decision, which held that the constitutional right to privacy includes a woman’s right to terminate a pregnancy by abortion. Last winter, advocates and organizations first sounded the alarm on Dobbs v. Jackson Women’s Health Organization after the state of Mississippi filed a brief that called for the complete overturn of Roe, as a rollback on the case would open the door for abortion bans at the state level.

In response to the case, Cecilia Fire Thunder, Lael Echo-Hawk, Sarah Deer, Lauren van Schilifgaarde, Abigail Echo-Hawk, Kaeli Flannery, Elise Higgins, the Native American Community Board, and the National Indigenous Women’s Resource Center, along with 32 organizations and 225 individual signatories, filed an amicus brief in Dobbs. The amicus brief outlined the threat to reproductive justice and body sovereignty and its potential harm to Native women, girls, and birthing people. Oral arguments were heard in Dobbs before the US Supreme Court on December 1, 2021.

Below is an excerpt from the amicus brief, submitted on September 17, 2021; the full text can be found at: n8ve.net/4QbLp.

—NIWRC’s Restoration Magazine, June 2022

The federal government has a historic trust relationship with its NativePeoples that is now embedded in the Constitution of the United States, treaties between the United States and tribes,¹ and in numerous federal statutes. The Trust Relationship manifests in a number of obligations, including the obligation to provide meaningful access to all aspects of reproductive health care, which includes abortion services. This positive obligation uniquely positions Native women vis-à-vis the federal government. Unfortunately, the dereliction of this federal obligation has resulted in a de facto delegation to private abortion providers subject to state laws. The proposed Mississippi 15-week abortion ban, and any subsequent state abortions bans, will deny Native women the right to federally mandated health care despite this federal obligation. Just as state governments lack authority over the decisions made by a federally recognized tribe, no state should have the authority to determine the reproductive decisions of individual Native people.

The federal provision of health care has accompanied explicit federal policies to assimilate Native people out of existence. Traditional family planning and birthing practices were historically suppressed, while the clinics and hospitals intended to replace those traditional supports were either never built, were poorly outfitted, or have subsequently closed. Many Native parents suffered the pain of the boarding school era, wherein Native children were taken away from their home communities to be raised by strangers. Reaching its peak in the mid 20th century, the Indian Health Service (IHS) has been found to have sterilized at least 3,406 Native women, many without clear, documented consent. The cumulative result is that far from meaningful, self-determined reproductive health care, federal health care has instead largely eroded Native reproductive autonomy.

Petitioners raise a peculiar argument—namely, that American women and girls have succeeded in every avenue of life in the United States and that access to birth control is quick, easy, and free, suggesting that abortions are no longer necessary. Brief for Petitioner at 29-30, Dobbs, et al., v. Jackson Women’s Health Organization, et al. (July 22, 2021) (No. 19 1392). This could not be further from the truth for most Native women in the United States regardless of whether they live in rural or urban areas. In fact, Native people are less likely to receive any kind of sexual health service compared to white women. More troubling still, this gap in care impacts a population exposed to disproportionate rates of sexual violence. Native people likely suffer the highest per capita rates of unwanted pregnancies as a result of assault or coercion. Yet Native people have the least access to emergency contraception and abortion services.

Even in urban settings with IHS facilities, restrictions on the use of federal funding make abortion inaccessible for many Native women. The Hyde Amendment presently restricts all federal dollars, including all funds intended to fulfill the trust obligation to provide health care to Native people, from funding abortion services except in extremely rare circumstances. For Native people, this has resulted in a total prevention on access to abortion care since 1976, despite the constitutional guarantee of access enshrined in Roe v. Wade, 410 U.S. 113 (1973), and a further shortcoming of federal reproductive health care. Policies restricting access to abortion places Native women at greater risk of violence and fatal outcomes, illustrated by current disproportionate rates of maternal and infant mortality.

The federal government’s meager steps to address the epidemic of sexual violence in Indian Country coupled with the restrictions enshrined in the Hyde Amendment and the chronic under-funding of IHS, constitute a policy of obstructing Native American women’s access to comprehensive reproductive health care. The right of Native women to be free from sexual assault and have meaningful access to abortion must be viewed through the lens of the federal government’s trust relationship with Native people. The federal government’s failures are a re-victimization and a reviolation of Native American women’s bodies.

In addition to being a human rights violation, a state’s categorical prohibition of all abortions within their jurisdiction is also the death knell of the lone Native reproductive health care option relied upon by the federal government to fill the gap left by the Hyde Amendment. Because of the federal government’s systematic failure to provide their treaty-mandated health care to Native people, this proposed extension of state despotism is not just a constitutional violation, it is also a breach of federal trust obligations.

•••

Despite the obligations embedded in the Trust Responsibility, Native people are the heirs of a legacy of forced assimilation, child removal, forced sterilization, and substandard care that includes an effective ban on abortion due to the Hyde Amendment. They experience alarming rates of sexual violence, infant and maternal morbidity and mortality, and attendant mental, physical, and socioeconomic trauma. And instead of stepping forward, the federal government has stepped back, delegating its fiduciary duty to provide reproductive health care to private healthcare providers who are subject to state abortion laws.

States, including Mississippi, have no authority to determine the reproductive decisions of Native people. Upholding the proposed Mississippi pre-viability abortion ban will open yet another dark chapter of depriving Native people the right and dignity to choose if, when, and how to have a family. The decision of the Fifth Circuit should be affirmed.

5

Clinic Defense Is Advocating for Our Patients

Defending the Last Abortion Clinic in Mississippi

by Derenda Hancock and Kim Gibson, interviewed by Anne Rumberger

We Engage is a 501(c)(3) organization born on the sidewalk outside of the Jackson Women’s Health Organization in Jackson, Mississippi, also known as “the Pink House.” The Pink House has long been the only abortion clinic in Mississippi, and it has also been unique in that it is one of the few abortion clinics in America where patient escorts engage with the antiabortion protesters on the sidewalks. We Engage supports the group of patient escorts/clinic defenders known as the Pink House Defenders, while working to end abortion stigma and raise public awareness about what is happening outside abortion clinics. Derenda Hancock and Kim Gibson founded We Engage in 2019.

The tactic of clinic defense has long been controversial in the reproductive rights movement, though hundreds of clinic defenders were mobilized to protect clinics from the antiabortion group Operation Rescue in the early 1990s. But since the late ’90s, many mainstream reproductive rights organizations and abortion providers, including Planned Parenthood, have adamantly opposed clinic defense on the grounds that it causes more chaos outside of clinics and negatively impacts patients, who are unable to tell the difference between antiabortion protestors and proabortion clinic defenders. As We Engage describes here, this resistance to clinic defense has had devastating consequences, for patients, clinic staff, and the broader reproductive rights movement.

Anne Rumberger: How did you first get involved in reproductive rights activism?

Derenda Hancock: While I’ve always supported repro rights, I wasn’t involved on the ground until 2013. I managed restaurants for thirty-two years, which meant seventy-hour work weeks, so activism wasn’t in the picture. After the “crash” of 2008 and its aftermath I joined the Occupy Movement. Occupy opened my eyes to all the social injustices in this world. As occupiers began to go their separate ways, my focus turned to women’s inequality and repro rights in particular. My partner James and I attended a Roe v. Wade celebration at Jackson Women’s Health Organization, the Pink House, and learned that they wanted to form an escort group to assist patients. James went to the training and started immediately, and I joined a week later. When the original organizer left four months later, I took over coordinating the Pink House Defenders. That was over nine years ago now.

Kim Gibson: Upon my return to Mississippi in 2014, I had the opportunity to participate in counter-protests against antiabortion protesters at Jackson Women’s Health Organization, the Pink House. When I came back, I also helped put together the Mississippi Humanist Association, a chapter of the American Humanist Association and served as president. In January 2017, the escort/defender team at the Pink House put out a call for defenders and my husband and I attended the meeting. I started escorting at the Pink House on February 1, 2017. I soon saw that this is where “the rubber hits the road” as far as the fight for religious freedom in this country, and decided to work toward reproductive justice, and fight for freedom FROM religion via legislation.

AR: In the past few years, have you seen an increase in the number of antiabortion protestors outside of the Jackson Women’s Health Organization? Have the antiabortionists’ tactics changed?

DH: The numbers of antiabortion protestors have varied over the years, and even daily. But after Trump was elected in 2016 the number of protesters on a consistent basis increased significantly. A larger concern than the numbers has been the escalation. We’ve seen many protestors go from “mild-mannered” and simply handing out pamphlets and offering help to ridiculous extremes: bullhorns, giant speakers, fetal porn signs, ladders … their props are endless. They have become more and more aggressive and constantly violate the FACE Act. [The Freedom of Access to Clinic Entrances Act was passed in 1994 and makes it a federal crime to use force, the threat of force, or physical obstruction to prevent individuals from obtaining or providing reproductive health care services.]

KG: I haven’t seen much of an increase in numbers of antiabortion protesters at the clinic; their numbers have held pretty stable since I started escorting/defending. However, I have been outside the clinic only since Trump was elected, when there was an influx of antiabortion protesters who are more aggressive. I have DEFINITELY seen their influence increase. This current environment is all I know, except for the events prior to 2017, when it was usually a traveling group coming through town, because for a while Mississippi was the only state with one clinic left, and antis thought it would be the first to go. And here we are, with Mississippi about to take the right to abortion away from so many.

AR: What is clinic defense? Why do you believe it’s necessary to engage with antis outside of abortion clinics?

DH: Clinic defense is advocating for our patients. I believe that when defenders engage with the antis it not only gives patients a sense of security but the motivation to stand a little taller and encourages them to advocate for themselves. We do believe in RESPONSIBLE engagement, and patients ALWAYS come first.

Because NOT engaging has worked out SO well for us (sarcasm intended). My understanding is that nonengagement policies were spearheaded by the big prochoice organizations in an attempt to lessen confrontations on the sidewalk. By forbidding clinic escorts to advocate for themselves, or patients, we literally rolled out the red carpet for antis to take control of our sidewalks. With no pushback from our side, the antis have grown bolder and been allowed to control the narrative. The only way to change that is to turn the tables—you get what you give. They must be confronted and called out, and we need to make it clear that we are taking back our damn sidewalks. In the process we also have to engage the general public to gain their support. By sharing the interactions we have with antis outside the clinic on social media, we hope to show more people what it’s like for our patients. Both our clinic owner and clinic director support engagement.

KG: Clinic defense is doing more than walking someone to the clinic door; it is advocacy, and engagement is a tactic. Clinic defense is “rolling up the welcome mat” and letting antiabortion protesters know they are unwelcome. What defense and engagement is NOT is screaming at antis as you walk with patients. Engagement is necessary and normal for a variety of reasons. The tactic of engagement serves many purposes—for example, distraction of antis’ vitriol and attention away from patients, and intel gathering on antis’ activities. Engagement also makes it difficult for antis to do what they came to do—harass and intimidate patients—when they also have to navigate interference. When you stand there and ignore them, many times they will just escalate their behavior themselves, but if you interact in a responsible manner, that escalation can be modified or diminished. There are so many reasons [to do clinic defense]—to push back on their false narrative, to let people know they are not the only voice on the sidewalk. It gives patients confidence knowing you know who the antis are, that you are there between them and the protestors. And escorts/defenders should be able to speak, to tell antis to back up or stay off the property, because we have free speech rights as well.

AR: Why is clinic defense a controversial tactic? Why has there been so much reluctance among many reproductive rights supporters to confront the antiabortion movement?

DH: I don’t know! Their theory is that it causes more chaos, to which I call BS. No matter what, there will be chaos on the sidewalk. And who are these reluctant people? How much time have they actually spent in the parking lot of a clinic? I believe that their reluctance is based on ignorance of the actual situation. I invite them to come spend thirty+ hours a week with me on the ground. If they don’t SEE what’s really happening at clinics and how using different tactics with different antis allows us to control, even calm, the space, then their reluctance is just a shield for their cowardice.

KG: Clinic defense is controversial because of the engagement tactic. I am of the belief that many in repro circles have no idea what actual responsible engagement with antis is like or the purpose it serves. People just “drank the Kool-Aid” on engagement. It makes me so angry to hear from OUR SIDE, “We don’t talk to them, it will just escalate their behavior,” as if the responsibility for the antis’ behavior is on the escort/defender. It is not. Even if there is NO escort interaction, often antis are just left to do whatever with no boundaries because no one is checking their behavior. De-escalation has its place of course, but confrontation does as well.

The reluctance to confront comes from the known behaviors of the antis as well as the widespread training from large organizations—Planned Parenthood, NARAL, Feminist Majority—[who have argued] that since 1994’s FACE Act, we don’t need to engage because it causes more chaos. Well, here we are. Antis have escalated chaos and we are about to lose our rights. Confrontation of antis takes back our power of “NO – this is NOT OK” and done in a smart public way reminds people that antis are NOT the only voice on this matter, this frontline. We were outside of a clinic this year [not in Jackson], countering antis with signs supporting patients and abortion, and the clinic let us know that patients were glad we were there.

AR: What are the main challenges abortion rights activists in the South currently face? What will change if/when Roe v. Wade falls?

DH: I can only speak for us (Pink House Defenders/We Engage), but our current challenge is having enough volunteer defenders. That’s always been a challenge. Clinics in the South can’t handle the volume of patients seeking care. A first appointment at the Pink House is currently three weeks out, when in the past it was never more than a week. We currently help control patient flow into the building, so what two of us could do prior to Covid, it takes four of us to handle now. Though abortion funding isn’t what we do, we’ve been made aware that smaller funds can’t keep up with the demand and often can’t support all of the patients who need financial assistance. In the meantime, there are big orgs out there sucking up funds that grassroots organizations, such as ourselves, need to just function.

Of course, everything depends on how the decision is worded, but it won’t be a win. Best case scenario here in Mississippi is we MIGHT be able to hang on to the ONE clinic we have and be able to continue offering this limited abortion care up to fifteen weeks for another six months to possibly a year (I’m a dreamer) before they pass more laws further cutting access. We have a six-week ban already that was blocked, so there’s that. Worst case scenario: by July there will be NO abortions in Mississippi and in at least twelve other states due to their trigger laws [which will ban abortions in those states as soon as Roe is overruled].

KG: The South faces so many challenges. Theocratic governments that support and are supported by antis. The stigma that keeps it all going is strong here. Lack of funding and lack of concern from the rest of the country.

What will change if/when Roe falls? Around here, so many people already live in a post-Roe environment. The barriers to abortion are so great that there are people already there. The poor will not have access to abortion, because the travel required will put it out of reach. States that have access will be destinations. For the South, that looks like New Mexico, Illinois, Colorado, maybe North Carolina as the closest providers.

If like so many in the repro community you believe RU-486 [mifepristone, a medication typically used in combination with misoprostol to bring about a medical abortion] will save us, it won’t. Yes, medication abortion will help make it better than pre-Roe days for some, but there will still be people that pills cannot help, as their usage only goes to 10–12 weeks [of pregnancy]. The pills necessary for medication abortion will be inaccessible in states without abortion. Tennessee has made it illegal to mail abortion pills in the state and there is no reason to think other states won’t follow suit. And we shouldn’t have to source what we need from feed stores, friends, online, etc. To have to rely on RU-486 is capitulation. Pregnancy outcomes will be further criminalized, and pregnant people will suffer and die. We see this already. People have no idea what this ruling will bring down.

AR: What strategies will help build a mass movement for abortion access? What obstacles stand in the way?

DH: There will be NO mass movement for abortion access until AT LEAST the twelve states that have trigger laws have fallen. (See Texas, for example). And even then, that may be wishful thinking. If it doesn’t affect people directly, they don’t care. The biggest obstacle, as in so many things, is apathy. The other obstacle is capitalism. To build a mass movement, for anything actually, I think we have to get people to see that the system, which in this case is the US Supreme Court, has failed them. This capitalist system has placed blinders on the general public (work, eat, sleep, repeat), so I fear a lot more rights than just abortion will be stripped from us before people will revolt. The antis have a plan in place. Once they have won the abortion battle, they will simply move on to birth control and LGBTQ rights: they have literally told us so.

KG: Engagement of the public is necessary for a mass movement, and to date the public has not been engaged in a way that is meaningful enough to get them out to support reproductive rights in real, tangible ways. Over the years the public has been conditioned by certain organizations to donate instead of agitate, and now we have complacency. We can coordinate with the public in a better way to get people energized, but only once our messaging is resonant.

As far as obstacles, number one is pushing back on the stigma that has been internalized in this nation for years; we have bought into the shame spread by antis, to the point that some people who support the right to abortion won’t even SAY the word abortion. Countering the false narratives of the antiabortion movement is necessary but curtails our ability to be more pro-active, because then we are constantly on the defensive. We stand in our own way with respectability politics, and doing the same things—messaging type, tactics, etc.—over and over and expecting something different to happen.

AR: What does a world with reproductive freedom look like?

DH: Alas, I have no idea since I have never seen such a world, and I fear I never will. Maybe it would look like a feminist’s version of the anti’s Heaven? I’m trying to be funny so as to laugh rather than cry. When you’re standing on the sidewalk of the last clinic in the state knowing that the odds of the Pink House doors being open two months from now are incredibly slim, just picturing a world with reproductive freedom is an impossibility.

KG: Those who need reproductive healthcare should be able to access it easily without shame, fear, stigma, harassment. People should be able to take care of themselves with dignity. Reproductive healthcare should not be politicized or impacted by religion. Without reproductive freedom, we are second-class citizens. Reproductive freedom = equality.

6

They Were Wrong to Bet on Our Silence

Shout Your Abortion’s Rapid Response to the Dobbs Decision

by Amelia Bonow

Shout Your Abortion is mobilizing a nationwide rapid response to the Dobbs decision. A briefer version of the following document was created in early May 2022 and shared with organizers all over the country.

The leak of the Supreme Court’s draft decision in Dobbs v. Jackson Women’s Health Organization was shocking; the document itself was not. But within the expected range of outcomes, this draft decision—written by Alito, overturning Roe and Casey outright—is a cataclysm. The announcement of the court’s final decision in Dobbs must be met with a transformational level of fury and a resounding commitment to collective defiance. We must push activist outrage into mainstream public consciousness like never before and galvanize supporters who have previously been quiet or conflicted. We must show the political actors who enabled this crisis that they were wrong to bet on our silence and leverage this moment to redefine the expectations of engagement from abortion supporters, elected or not.

When Roe falls, we will have a unique opportunity to sweep much of the public into expressing outright rejection of the decision, and to engage previously passive supporters in efforts to neutralize its impact. In the immediate aftermath of the decision, this means consistent mass mobilizations and blanket messaging that doesn’t center on rights but rather on our commitment to ensuring safe abortion access, no matter what any court decides.

In the longer-term project of reshaping the movement to exist in a post-Roe America, this means creating and bolstering systems of access which function outside of the law and reframing the issue altogether: abortion is not a private issue but a matter of justice which concerns and impacts every member of society. Abortion access is not guaranteed by the courts and cannot be broadly eliminated by legal decisions; it is a community responsibility and requires wide participation. Aiding and abetting abortion—in the form of funding abortions, sharing information about pills, and saving independent clinics in blue states—is a moral imperative and a project which cannot be left to activists alone.

In recent years, movements in Latin America have won fights which were thought to be unwinnable, while here in the United States, we’ve failed to build a vocal base of support for abortion access even though the numbers are in our favor. The usual attitude among supporters of abortion rights is meek and convoluted, due in part to decades of sidestepping and capitulation from Democrats, who allowed Republicans to define the terms of the conversation and claim the moral high ground without any meaningful contest. Dobbs represents the successful conclusion of a decades-long project of the Right; it also must be recognized as a catastrophic failure on the part of the Democrats, who have allowed the obliteration of abortion rights to occur while they control both houses of Congress as well as the White House, without so much as a whisper. We must demand that Democrats make a case for their own existence, even if we do not believe they deserve to exist. Obviously, they need to abolish the filibuster and pack the court, but in order to stop the harm that is coming most immediately, we must demand bold, aggressive, creative protections for abortion rights at the state level, such as Connecticut’s Public Act 22-19, which protects abortion providers and patients who have traveled from out of state to provide or receive care.

The ruling in Dobbs will be opposed by the vast majority of Americans, and the existence of abortion pills means that a mass defiance of abortion bans is inevitable. This is the closest the judiciary has come to a legitimacy crisis in almost a century, and it is time for us to push.

In the immediate aftermath of the decision, Shout Your Abortion will be mobilizing in all fifty states. The specific actions in each state will be determined by local organizers. Messaging will be broadly unified around our promise to defy abortion bans and call on all supporters to contribute to efforts to provide access to abortion in their communities.

AidAndAbetAbortion.com

Ways to get involved post Dobbs

ShareSafeAbortion.info

Current, comprehensive resources related to accessing abortion

ShareAbortionPill.info

Information about finding abortion pills and using them safely

ShoutYourAbortion.com

Stories, art, community

7

What We Need Now Is More of What We Did

The Militant Multiracial Grassroots Campaign That Won Abortion by Popular Referendum in Washington State—in 1969

by Barbara Winslow

In 1970, a feminist organizing campaign in Washington State successfully organized to liberalize abortion laws through a popular vote—the first, and still only, state to do so. Perhaps our history can show us what it is possible to win and how we might organize a renewed, fighting movement in this moment when it seems that Roe will be overthrown.

Our successful campaign was probably the single greatest achievement in the early years of Seattle’s feminism.¹ We demonstrated the truth of Laurel Thatcher Ulrich’s popular slogan that “well-behaved women rarely make history”: we were outrageous, provocative, innovative, and fearless. Ours was a real grassroots mobilization of women, one that relied on creative and confrontational nonviolent civil (and sometimes uncivil) disobedience; day-to-day organizing in the streets, the schools, and the stores; and outright defiance of the unjust abortion laws. We brought together a wide range of women’s liberation activists who fought not only to change Washington State’s abortion laws, but also to extend reproductive health services and to create multiracial feminist health networks. By bringing in our own personal experiences, we changed the popular understanding of abortion as a healthcare problem to be solved by professionals to an understanding that abortion is a woman’s right, inextricably connected to issues of bodily integrity, gender, sexuality, class, and race.

Our grassroots feminist movement continued to campaign to keep abortion legal, funded, and accessible to all women regardless of age, geography, or marital status. We challenged the racist, eugenicist, and population control approaches to contraception and abortion, agitated for an end to coercive sterilization, and placed abortion rights in the context of a holistic feminist healthcare perspective. Radical women’s liberation activists navigated the challenges of coalition work; we faced the perennial conundrums of reform or revolution, conviction or compromise. Finally, we learned how to traverse these complicated waters and gained invaluable experience in grassroots organizing and institution building.

We Relied on Ourselves—Not the Courts, the State, or the Democratic Party

We began by winning over the Washington Citizens for Abortion Reform (WCAR) to introducing a bill in the state legislature to liberalize Washington State’s restrictive abortion laws. WCAR’s strategy had been to pass legislation quietly and with a little publicity as possible.

What they didn’t count on was active support from women’s liberation activists. As opposed to WCAR, which relied on mainly White professionals working within “the system,” we believed in mobilizing popular support, bringing in more women into the struggle. Yet at the same time, we knew that we could and should work within WCAR; after all, we convinced them we could win enough votes to pass the bill. And when we disagreed, we learned how to make our disagreements public, without hurting the referendum strategy.

In that year there were two left feminist women’s liberation organizations, Seattle Radical Women (RW) and Women’s Liberation-Seattle (WL–S). We had done our homework, researching the prevalence of abortion in Washington State and producing a pamphlet explaining why abortion reform was necessary, “One out of Every Four of Us Has Had or Will Have an Abortion.” The first edition was mimeographed, but the second edition was printed on an offset press with a run of 5,000 and sold for 25 cents, with a discount for bulk orders. The pamphlet proved to be effective propaganda: both editions sold out.

We Weren’t Ladylike

Clara Fraser, a Trotskyist and leader of Seattle Radical Women, worked at an antipoverty program called Seattle Opportunities Industrial Center (SOIC). She convinced her supervisor that they should bring their clients to the first reading of House Bill 312 (HB312). What Fraser really had in mind was to mobilize working-class and mainly Black women to demonstrate their support for abortion rights.²

Fraser’s idea worked: members of Seattle Radical Women and Women’s Liberation-Seattle joined with over fifteen hundred women, mainly African American, and converged on the state capital in Olympia. Fraser believed that the legislators and guards in the capitol were frightened by the presence of African American women—as she later wrote, “Hordes of dark-skinned people with placards came to the doors of the rotunda … The guards were terrified. There was hand-to-hand combat between some of the demonstrators and the guards. Our folks had overrun the guards and occupied the Rotunda.” WCAR officials begged Fraser to remove the sticks from the banners and urge the SOIC contingent to stop trying to speak with legislators. We did not comply.

Jill Severn, a member of Radical Women, reported on this demonstration:

The SOIC delegation was divided into several smaller groups, each intending to speak to one or two of the Rules Committee members. Within a few minutes, Capitol guards were frantically rounding them up, claiming that it wasn’t in keeping with legislative decorum for bands of women to be roaming the halls like that. Apparently, what they meant was that the visitors’ color did not match the decor, and besides, the women were scaring the legislators, who were still a little shaky from a recent visit by the Black Panthers.

I was a member of Women’s Liberation-Seattle, and this was my first demonstration for abortion rights. I also wrote the women’s liberation column for the Peace and Freedom newspaper, The Western Front:

None of [the senators] had any intention of listening to what the women had to say; they all walked in and immediately started defending their various positions on the abortion bill as if they were experts on this question. One particularly brilliant speech about pregnancy and the development of the fetus in the woman’s stomach [sic] was delivered by a Rules Committee member who is now a candidate for mayor of Seattle.

The demonstrators, furious, jeered and booed the legislators, challenging their power to determine who should have an abortion and why. Committee members admitted that they opposed abortion for religious and personal reasons. When Jill Severn told state Senator Day that women were tired of being lectured by men and that they sought control of their own bodies, Day objected that women should not have the right to make such a decision. “Women are of varying intelligence,” he said. “So are legislators!” heckled a demonstrator. The terrified senators hastily announced that the committee room was scheduled for immediate use and the women would have to leave.

This public demonstration in support of abortion reform dramatically transformed the campaign. The issue of abortion was now on the front pages of Seattle’s newspapers. Our slogan, “Abortion Action NOW!” became a reality. In one day, radical women had learned invaluable lessons about politics. It was clear that abortion reform would not be won through quiet legislative lobbying and deal-making. Infuriated at the elitist, White, and male-dominated character of conventional politics, radical women were determined to be loud and involve as many people as possible in fighting to change the law. Outraged and appalled that the official voices for reform refused to speak of abortion as a woman’s right, radical women began discussing abortion in feminist terms.

The confrontation in Olympia was Nina Harding’s first foray into women’s liberation activism, which she had come to through her own experiences of an unhappy marriage, unreliable contraception, and illegal abortion. She would become a leading figure in the Seattle women’s liberation movement and a major figure in the development of Black feminism—she may also have been the first to use the coat hanger as a protest symbol for abortion rights.

At a Radical Women meeting where they were discussing articles about illegal abortions and planning slogans and posters, Harding remembered the poster that she made:

I discovered in those readings that women had used any number of instruments in order to abort. And many of those instruments were things I had around my house, like crochet hooks, like knitting needles. I couldn’t believe it! I said, “Well I have those things, well, yes, I’ll use a coat hanger.” I still had the coat hanger and catheter tube hanging from it, and I got an older knitting needle, and old crochet hook and an old rusty nail and I scotch taped it to the sign that said “Tools of the Trade.”

At the demonstration, this poster caused quite a furor among Radical Women and with the press. Some people thought it was too horrifically graphic, and others thought it was in bad taste, but most of us believed it represented reality. Whether or not this was the first time the coat hanger was used in an abortion protest, it became a symbol for the demand to decriminalize abortion, and we are seeing the coat hanger again as we organize for reproductive justice.

We Made Ourselves Visible Everywhere

For over a year, we went door to door in Seattle and the neighboring city of Tacoma, trying to convince voters; we were everywhere at the University of Washington and Seattle Central Community College, leafletting and arguing for support of Referendum 20. Some of our gutsier members leafletted University of Washington Husky football games, while others spoke at Veterans of Foreign Wars and American Legion headquarters, or at PTA and other community meetings; we were invited in to speak in churches and synagogues. I was even invited to make a presentation at the Ladies Auxiliary of the Seattle Symphony (yes, such groups existed at the time)! Radical Women organized a high school meeting on the topic of Black women and the abortion struggle, featuring high school students, and more of our members were invited to speak at Seattle’s public high schools. We wrote countless letters to the Seattle Post-Intelligencer, the Seattle Times and the UW Daily, and could see how public opinion was slowly moving in our favor. Activists were regularly on KRAB, the alternative radio station, and as often as possible spoke on radio and television stations.

Today, if we are going to win back our bodies and our rights, we have to be mobilized, vocal and visible—everywhere.

We Learned We Had to Organize against Forced Sterilization Too

The issue of abortion was inextricably tied to forced sterilization, commonly practiced on women of color and poor White women. Two events changed the Seattle struggle from one of abortion rights to a larger understanding of reproductive rights. In February 1969, the local Peace and Freedom Party brought Fannie Lou Hamer, the legendary activist of the Black Freedom struggle, to Seattle. I was asked to speak with Mrs. Hamer about our Referendum 20 campaign. She spoke movingly about the Black Freedom struggle. I then spoke about our campaign. Mrs. Hamer commented that my presentation was very interesting, but that she did not support a woman’s right to abortion. She then related a story about beaten by the police so severely that she had to be hospitalized. After her release and much later, she found out that she had been sterilized—against her wishes. The entire audience gasped.

The predominantly White audience did not know about the history of the coercive sterilization of African American women, so prevalent that it was referred to as the “Mississippi appendectomy.” Years later, I presented a paper about this incident, with my after-the-fact remarks about how I should have, perhaps, ceded the entire speaking platform to Mrs. Hamer. Several students pointed out that had I not spoken, none of us at that well-attended event would have learned so dramatically about racist sterilizations.

The second incident involved a member of Women’s Liberation–Seattle. In 1969, Theresa Williams, a White working-class woman with a multiracial child, heterosexually active, on welfare, a student at Seattle Central Community College, and a founding member of the first Seattle Central Community College women’s liberation group, had an illegal abortion. In early 1970, she again found herself pregnant. She went to the Group Health Cooperative of Puget Sound, an HMO-type provider which paid for “therapeutic” abortions. Group Health agreed that Williams was a candidate for a “therapeutic abortion” because she had proven that she could not, in their words, handle her own life. Now, think about that statement. Group Health did not critique the availability and efficacy of contraception, but rather demeaned and punished women who were heterosexually active. An abortion was recommended, but only if she agreed to be sterilized. Utterly desperate, Williams agreed.

She told her story at a WL–S rap group meeting. In order to help Williams, three WL–S members went to see the executive director at Group Health Hospital and asked him about its procedures regarding abortions and sterilizations. He proceeded to justify the policy, citing another case involving an African American woman. Aghast, the three women realized that there had been other victims. Williams was infuriated; in her mind, her sterilization was akin to being raped.

Women’s Liberation–Seattle publicized this case. We wrote it up in our newsletter Ain’t I a Woman and in the abortion primer “One out of Every Four” as an example of one of the many costs women were forced to pay to access a legal abortion. For members of WL–S, the personal was very political, and this particular outrage taught the women more about issues of race, class, gender, and sexuality than any study group ever did. Many of us learned from this experience. Our later publications, organization of feminist health clinics and reproductive justice organizations emphasized the interconnection of opposition to forcible sterilizations to legal, safe, and funded abortions; we included support for lesbian (later LGBTQ) liberation and childcare as part of this work as well.

Yes! We Broke the Law and Supported Lawbreakers

A few months into the campaign, Dr. Frans Koome wrote a bombshell letter to Governor Dan Evans and sent copies to the press. Koome informed Evans that he had been performing between fifty and seventy illegal abortions per week and would continue to do so, no matter what legislators decided. He announced that he would open a Reproductive Crisis Clinic in Renton, next to the Seattle-Tacoma International Airport, which would be accessible to residents of both cities. Koome explained that illegal abortions led to the “vicious chain reaction of early forced marriages and divorce with everybody suffering including the children, adoption is no solution, unwed mothers we have enough already on our welfare rolls, overpopulation is a serious threat.”

In the first week after the publication of his letter, Koome performed twenty-two abortions and scheduled twenty-nine for the next week. Although Koome flagrantly defied state law, he was not prosecuted. He continued performing illegal operations with impunity, although he was continually harassed and sued for malpractice. While medical professionals did little to defend Koome everyone, including WCAR, demonstrated support. We invited him to speak at the UW, Seattle Community College, churches, synagogues, and other venues. We wrote letters to the press, spoke to the print and television media, donated money, and organized support rallies for him. His public stance, combined with the enormous support from the feminist community, demonstrated the futility of Washington’s restrictive abortion law. Today, we need to convince more medical professionals to follow the bravery of Frans Koome; they should publicly announce they will defy antiabortion laws, and we will find ways to protect and defend them.

We Didn’t Always Do It Right

Despite the centrality of race to the abortion and reproductive rights movement, building a truly interracial movement around abortion rights was always problematic. First, this was because both the leadership and rank-and-file membership of mainstream and radical women’s groups were overwhelmingly White. And second, it was because of the tense issues swirling around race, gender, Black nationalism, and feminism. As Nina Harding explained:

I had many Panther women friends, and we agreed on the issues, but it came to a screeching halt when it came to the issue of abortion. Because the party line is that abortion was white folks’ genocide of black people. And in order to perpetuate the race we had to continue to produce babies. And of course it played to their whole notion of sexuality because to produce babies obviously means that you have to have sex [so] the only viable sex for a black woman was with a black male.

Many African American women who had been leaders in the civil rights movement supported Referendum 20 but admitted that the younger militants of the Black Power movement would not listen to their arguments. According to Geri Ware, Nina Harding, and Clara Fraser, some of the women in the Black Panther Party had abortions and supported abortion rights but remained silent about the referendum campaign. Ware, a longtime community activist, later spoke about how she tried to convince younger militant women to support abortion reform, but to no avail. Another African American trade union activist who was a member of the Communist Party (CP) at the time remembered that while the CP supported Referendum 20, it did not mobilize its Black members and supporters around this issue, which it regarded more as a matter of democratic rights than women’s rights. Johnetta Cole, then an assistant professor at Washington State University in Pullman who was active in the militant Black freedom struggle, did not remember doing anything about Referendum 20.

For the most part, women from the women’s liberation movement tried to answer the charges of racism and genocide and to find ways to integrate race and gender in their approach to the struggle for abortion reform. Radical Women, which was at that time the most racially diverse of all the women’s liberation organizations, made a point to speak about the interrelated issues of class, race, contraception, abortion, gender, and genocide. In March 1969, Radical Women participated in an “Afro-American Abortion Assembly” at Franklin High School, situated in what was then one of Seattle’s majority Black neighborhoods. African American students spoke on both sides of the issue. RW member Jill Severn had a radio talk show on a popular quasi-underground station, KRAB, in which she addressed Black nationalism, genocide, and a woman’s right to abortion, answering the calls predominantly from African American men who charged that abortion and birth control amounted to genocide against the Black community. The spokeswoman on the issue for RW was Nina Harding, who was herself African American.

Despite all this outreach and discussion, though, at the time of the abortion referendum, none of the groups involved in the campaign, from the reformist WCAR to the radical groups, formally approached Black organizations and newspapers as coalition partners. One WCAR leader admitted that she was more worried about alienating White conservatives than attracting African American allies. Our failure to build institutional ties with Black organizations showed: not one Black organization supported the referendum, and there was not one single article in either the two Black community newspapers, Fact and the Medium, nor did WCAR place ads in them (though the antiabortion group Voice for the Unborn did).

Both newspapers were influenced by the Black Nationalist position that Black women should not use contraception or have abortions, but should instead have babies for the revolution. There were no references in either newspaper, or for that matter in the WCAR publications, to the Black feminists, such as Shirley Chisholm, Flo Kennedy, the Mount Vernon Women’s Group, or the Third World Women’s Alliance, who had challenged the argument that abortion and birth control were genocidal and that Black women should be able to decide whether or not to have a child and receive appropriate medical care.

Dr. Julius Butler, an African American physician who was on the board of WCAR, wrote a personal reply to the Voice for the Unborn ad that was printed in Fact. He countered the antiabortionists’ argument:

How is it that they are concerned about Black children and Black family life? Where was their moral outrage in our attempt to get rat control legislation, better housing, better health care, and better jobs? The Voice for the Unborn further asks, “Should being unwanted be punished by death in our society?” The answer to that question is that this racist society does punish the unwanted member, and often by death. The murders at Jackson State was an example of this. Where is the moral outrage for the daily killings of Blacks that take place in this society and has taken place historically for three hundred years?³

Yet this eloquent statement seemed to fall on deaf ears.

The predominantly African American Central District precincts of Seattle’s King County gave the referendum half-hearted support or rejected it outright. Further, neither the Black press, the major city newspapers, or the feminist and left media media reflected after the vote on the salience of race in the referendum campaign and on the movement’s missed opportunity. The failure on the part of reproductive rights activists to engage with communities of color about the multifaceted meanings of abortion, contraception, and coercive sterilization was yet another example of racist indifference. We should never let that happen again.

We Were Outrageous and We Had Fun

We also successfully confronted the antiabortionists. In Seattle, the newly formed Voice of the Unborn (VfU) did not have the media savvy they have now, and one particular billboard campaign of theirs had disastrous (read: excellent) results. One VfU billboard depicted a male fetus with a gestational age of four months, curled up in a large hand. The first time the ad was shown in the papers, it was deemed “offensive” and “obscene” by the courts because the fetus’s male genitalia were visible. Another billboard showed the same fetus with a message reading: “Let Him LIVE: Be a VOICE for the Unborn, Vote No Ref 20.” Early one morning at the height of the campaign, three women who belonged to the Anna Louise Strong Brigade, a radical women’s liberation collective, took a can of red paint, crossed out the “HIM” and wrote in “HER.” Another group of radical feminists graffitied a second billboard with “Happy Mother’s Day.” We won that battle of the propaganda war.

In October, the Voice for the Unborn called a rally to oppose Referendum 20. WCAR decided to ignore it, but Women’s Liberation–Seattle called upon all women’s liberation groups to stage a counterdemonstration in order “to expose and oppose the nature of this campaign and use this opportunity to reach as many people as possible with our leaflets.” We were going to leaflet before the march, concentrating on areas where large numbers of women worked, such as the telephone company and the two major department stores.

The VfU march was inauspiciously called for October 31—Halloween!—and a large contingent of women from the number of women’s liberation organizations came appropriately dressed as witches. Lee Mayfield described the VfU march. “It was very scary. Suddenly, marching down the hill from the Westlake Mall came hundreds of rosy-cheeked parochial school students, mainly young boys, carrying signs that said KILL KILL KILL.” The VfU’s signs had “KILL” in huge letters and in smaller letters, “the bill.” The impact was dramatic—young people marching to KILL.

The VfU’s contingent was no match for the five hundred or so exuberant women’s liberation activists. When the young boys tried to sing “He’s Got the Whole World in His Hands,” we chanted back defiantly, “That’s the problem!” The antiabortion forces were outyelled, outdanced, outmarched, and outnumbered. After a while the scene got a bit ugly, and a group of demonstrators started yelling at and hitting women protesters. Clara Fraser and I were chased down a street and hit over the head with picket signs. One young man kept asking us if we believed in God. He was so dumbstruck when we told him we were atheists that he dropped his picket sign and ran away. The voices of the “unborns” were muted when the antiabortion demonstrators met a contingent of witches marching down Fifth Avenue, beating their drums and chanting.

By all counts, the counterdemonstration was tremendously successful. Voices for abortion reform and for women’s liberation made the front pages of both Sunday papers and were the lead stories on all three major news shows. Women’s liberation had won this battle of the streets and the media. Lee Mayfield believed that the success of this demonstration “was the only point in the campaign where we got some inkling of the potential strength of our movement, as a militant and forthright connection between abortion reform and women’s liberation.”⁴

The next Tuesday, November 3,1970, Washington State voters went to the polls and ratified Referendum 20 with a majority of 56.5 percent. Many factors contributed to the referendum’s success, including a supportive political climate, but women’s liberation activists should also be credited with the victory. We had been more than energetic foot soldiers; in Seattle, we changed the political dimension of the abortion struggle. Abortion was now “A Woman’s Right,” not just a solution to a problem worked out by a woman with her doctor’s or minister’s approval.

Furthermore, the women’s liberation movement had vowed to expand access to abortion, to fight to reduce abortion costs, and to oppose restrictions even if that meant violating the law. It later made good on these pledges, including setting up a modern day “underground railroad” called the Abortion Referral Service. The movement raised the issue of coercive sterilization and continued its fight for expanded access to birth control for economically disadvantaged, unmarried women and teenagers. It laid the basis for the network of feminist reproductive health centers in Seattle that was established after the success of Referendum 20. Finally, the abortion campaign galvanized the women’s liberation movement and drew thousands more women into the struggle.

What Do We Do in 2022?

Although 2022 is not 1969, there are lessons to be learned from our experience, especially from grassroots radical activism. What we need now is more of what we did in Seattle. We need tens of thousands of people like Dr. Frans Koome, the courageous doctor who openly flouted Washington State’s antiabortion laws. Medical practitioners should not just sign petitions and speak out in the media; they should publicly defy the restrictions and challenge the laws. Dr. Koome was supported and protected by thousands of women who supported his work. We will protect those who stand up for women’s rights.

We also will need thousands of medical practitioners who will break the law in antiabortion states by providing reproductive health care, as did the sisters in the Jane collective in Chicago. In Seattle, women like Elaine Schroeder learned how to perform abortions as well. At self-help groups dubbed “pelvic parties,” women examined their own and others’ cervixes, which helped them to overcome shyness about their “private parts,” and learned how to treat minor gynecological problems, such as vaginal infections. They also taught other health care professionals. Elaine Schroeder remembered: “We were right on the cutting edge. We went into the medical school with the medical students and showed them how to do pelvic exams. They didn’t show us how to do them, we showed them how to do them.” Schroeder and other paramedics witnessed autopsies at local hospitals, “so we could see the reproductive organs as part of our medical training.”

Tens of thousands of us should be like Lee Mayfield, who drove women to Vancouver, Canada, as part of the “underground railroad” where a trusted nurse performed abortions. We must organize people to take women to states where safe, legal abortions remain available, as well as to Mexico and Canada. We need to shout our support for reproductive justice from as many rooftops as possible: social and print media, talk radio, podcasts, places of worship, schools, unions, workplaces, and community meetings. We need to demand that elected representatives at the local, state, and national arenas make reproductive health a priority. More people should follow the example of the activists who graffitied antiabortion billboards and made the pro-abortion feminist movement as visible as possible. We have much to do again.

II. Reproductive Justice
Is Justice for All

8

Empty Choices

Women of Color and the Fight for Reproductive Justice

by Marian Jones

In 1994, prochoice organizations gathered at a conference in Chicago to hear then President Bill Clinton’s healthcare reform plan, which excluded reproductive healthcare in a bid to appease Republicans.¹ As noted in the 2004 book Undivided Rights: Women of Color Organizing for Reproductive Justice, the proposed bill also avoided reproductive health care and “isolated reproductive rights issues from other social justice issues.” None of the proposed solutions considered how factors such as race or class affect “the decision to become a mother.” So, twelve Black women activists in attendance at the conference organized an informal caucus to address these omissions. They argued that, in addition to abortion, women of color “need health care, education, jobs, childcare, and the right to motherhood.”²

These women were Loretta Ross, Toni M. Bond Leonard, Reverend Alma Crawford, Evelyn S. Field, Terri James, Bisola Marignay, Cassandra McConnell, Cynthia Newbille, Elizabeth Terry, “Able” Mable Thomas, Winnette P. Willis, and Kim Youngblood.³ To describe their politics, new organizing framework, and movement, they created the term “reproductive justice.”⁴

According to Toni M. Bond Leonard, the caucus eventually evolved into an activist group known as Women of African Descent for Reproductive Justice (WADRJ).⁵ WADRJ placed a full-page ad in the Washington Post and Roll Call “in support of providing all women access” to reproductive care, and held a press conference on Capitol Hill; they reissued the “We Remember” pamphlet (a 1989 booklet that linked reproductive rights to other oppressions);⁶ gathered signatures from Black women in support of their new movement; and sent a letter to former President Clinton in support of Dr. Jocelyn Elders, who was fired as surgeon general in December 1994 for advocating for the decriminalization of drugs and the dissemination of contraceptives in educational institutions.⁷

These activists established the SisterSong Women of Color Reproductive Justice Collective (SisterSong) in 1997. SisterSong is comprised of sixteen organizations that are led by women of color and from a variety of racial backgrounds.⁸ As stated by SisterSong, the three pillars of reproductive justice are: the right to an abortion; the right to carry children; and the right to raise children in a safe and healthy environment.⁹ Together, these three pillars comprise an ambitious framework around which to mobilize women of color for both social justice and reproductive health.

Struggles for affordable housing, the abolition of prisons, anti-imperialism, and the end of environmental racism are all part of a reproductive justice agenda. So are any other intersectional fights for bodily autonomy.

This chapter looks at the reproductive justice (RJ) movement and how it relates to abortion rights in communities of color. Reproductive justice is a broad political paradigm that encompasses a wide range of social justice issues while remaining narrow enough to prevent us from losing sight of our ultimate goal of achieving true justice in society, of which abortion is only a small part. As an example, SisterSong member and Women’s Studies professor Kimala Price cites Asian Communities for Reproductive Justice (ACRJ) in Oakland, California. This organization’s efforts to defeat ballot measures that would have made it more difficult for women in the state to obtain reproductive health care reforms were successful due to its collaboration with other “social justice movements, such as immigrants’ rights and traditional African American civil rights groups.”¹⁰

In June 2019, SisterSong joined the ACLU and Planned Parenthood in suing Georgia over its six-week abortion ban. This was SisterSong’s first high-profile lawsuit, catapulting the group into the national spotlight.¹¹ However, the case has been postponed until the Supreme Court rules in Dobbs v. Jackson Women’s Health Organization, a challenge to Mississippi’s fifteen-week ban.¹² In that case, the Supreme Court will rule on the constitutionality of abortion restrictions based on pre-viability, with an official verdict expected in June.¹³ Politico reported on May 2 that the Supreme Court’s conservative majority intends to rule in Mississippi’s favor, overturning the constitutional right to abortion.¹⁴

More than just the right to become or not become a parent without interference, the fight for reproductive justice is about providing parents and caregivers with the resources, opportunities, and access they need to live the lives they choose. The use of a justice framework rather than one based on rights is important here: rights are based on the premise that all people are equal, whereas justice emphasizes the importance of achieving equity while recognizing that different communities have different histories and redistributive needs. A nominal right means nothing to someone who lacks the money or time required to make use of it, and can be taken away as easily as it was granted. The movement’s goal is for women to regain power over their reproductive fate, which is now decided by their race, gender, and class, and by the various institutions that facilitate oppression.¹⁵

It is “ill-conceived,” writes Maureen Tkacik in “Abortion and the Politics of Failure,” to connect the concept of “feminism” to such a specific issue as abortion because an abortion is a singular moment in one’s life. “Kids, on the other hand, are with you forever,” she says.¹⁶ To build a militant movement for reproductive rights, the feminist left needs reproductive justice more than ever.

Reproductive Injustices

People of color have seen their reproductive rights repeatedly violated and have been the targets of population control measures throughout history. Notable examples include the rape of Black women by white slave owners, the removal of one-third of Native children from their families and tribes under the US family separation policy,¹⁷ the unethical testing of oral contraceptive pills on Puerto Rican women in the 1950s,¹⁸ and the practice of offering sterilization in exchange for lower sentences in the criminal court system today.¹⁹ Women of color continue to be harmed by eugenics policies such as sterilization abuse, nonconsensual testing, and the promotion of dangerous long-acting hormonal contraceptives.

The right-wing crusade to control the reproduction and autonomy of white and black women is based on two contradictions. First, there is white supremacy, which Lorretta Ross describes as “an interlocking system of racism, patriarchy, homophobia, ultra-nationalism, xenophobia, anti-Semitism, and religious fundamentalism that creates a complex matrix of oppressions faced by people of color in the United States.” According to Ross, mass incarceration and immigration restrictions are motivated by “fears of being numerically and politically overwhelmed by people of color.”²⁰

Simultaneously, the elite seek to outlaw abortion, which is one example of such a contradictory population control policy. The employing class must keep a ready supply of surplus workers on hand to diminish worker power, but since regular population booms and busts are inadequate, they tilt the scales. Jenny Brown, author of Birth Strike and Without Apology, relates Marx’s “reserve army” labor theory to reproductive control. “The presence of the ‘unemployed’ weakens all workers,” she says. “The more unemployed people there are, the less power employed workers have and the lower wages can be driven.”²¹

In addition to white supremacy and capitalism in general, progress toward reproductive justice was stymied by the lack of participation by women of color in the early birth control movement and the notion of race science that emerged in the early twentieth century. The movement’s ideological underpinnings were rooted in eugenics, according to Angela Davis’s chapter “Racism and Birth Control and Reproductive Rights” in Women, Race, and Class, which explains why the movement has a poor track record of combating racism and class exploitation.

Proponents of birth control in the early twentieth century saw abortion as a viable solution to poverty. They believed that “having fewer children” would alleviate poverty, but Davis points out that poverty can be alleviated by more good jobs, higher wages, or better educational opportunities, none of which have anything to do with birth control.

As Dorothy Roberts explains, a common argument used by eugenicists to oppose poverty alleviation efforts was that “adequate medical care, better working conditions, and minimum wages” were all harmful because they made it easier for people with lesser genes to enjoy better health and procreate.²² Instead, eugenicists advocated the forced sterilization of anyone deemed “unfit” to bear children, notably people of color, people in prison, and those with disabilities.²³

Margaret Sanger, a nurse who advocated birth control, founded the American Birth Control League (now Planned Parenthood) in 1921 and is regarded as the pioneer of the birth control movement. Sanger was not only a member of the Socialist Party but, according to Angela Davis, actually invented the term “birth control.”²⁴ Sanger’s supporters included labor activist Elizabeth Gurley Flynn, anarchist Emma Goldman, and Socialist leader Eugene V. Debs.²⁵ Sanger became more susceptible to eugenics arguments after leaving the Socialist Party to launch an independent birth control movement, partly because the party did not prioritize birth control.²⁶ In an editorial for the American Birth Control League’s magazine, Sanger defined birth control as “more children from the fit, less from the unfit.”²⁷ Sanger’s connection with eugenics has inextricably tied her cause to racial hierarchy and genocidal discourse.

For Black women in particular, the eugenics movement was a continuation of slavery. Eugenists sought control of Black reproduction, but this time through racial cleansing in order to create a better society. Roberts argues that slavery “marked Black women from the beginning as objects whose decisions about reproduction should be subject to social regulation rather than to their own will.”²⁸ Fannie Lou Hamer spoke out about her forced sterilization experience. Hamer was sterilized unknowingly during a cyst removal in 1961. She underwent a “Mississippi appendectomy,” a term she coined to describe the nonconsensual sterilization of women deemed “unfit.”²⁹

Thirty states allowed sterilization in public institutions following the Supreme Court decision in Buck v. Bell in 1927.³⁰ Federally funded eugenics boards were established in thirty-two states by 1935 to determine whether eugenic sterilization was permitted for individuals deemed undesirable or unfit. Women were sterilized for “feeblemindedness, promiscuity, insanity, criminality, disability, and poverty.” Women of color, particularly in the South, and poor women, were more likely to be sterilized.³¹

The Southern Poverty Law Center filed a lawsuit against the federal government on behalf of Minnie Lee and Mary Alice Relf, who had been subjected to nonconsensual sterilization in 1973. The District Court determined in Relf v. Weinberger that federally funded programs had sterilized between 100,000 and 150,000 impoverished people each year. In other cases, doctors threatened to withhold aid funds if a patient refused sterilization.³²

Over 20,000 people with disabilities and/or mental illness in California were forcibly sterilized between 1909 and 1979. Latinx people in California were 59 percent more likely to be sterilized during this period. Nor is this practice a thing of the past. Between 2006 and 2010, at least 150 women in California prisons were sterilized by California Department of Corrections and Rehabilitation doctors. According to the women, they were coerced into doing so by prison guards.³³

African American women were sterilized at three times the rate of white women between 1950 and 1966. By the 1970s, up to 25 percent of Native American and Indigenous women of reproductive age had been sterilized by the US Public Health Service. Over one-third of sterilized women did not understand (or were misled so as not to believe) that the tubal ligation sterilization method was permanent.³⁴ According to various estimates, between 60,000³⁵ and 70,000 individuals were sterilized in the twentieth century.³⁶

In an effort to reduce population growth and unemployment in the mid-1930s, the US and Puerto Rican Commonwealth governments supported involuntary sterilization and contraceptive testing.³⁷ A third of Puerto Rican women between the ages of twenty and forty-nine were sterilized by 1965, often without their consent or knowledge and under coercion. An estimated one-third of the women polled in one study from 1968 had no idea that tubal ligation was permanent after it was performed.³⁸ In the 1970s, Puerto Rican women were more likely than any other women in the world to be sterilized.³⁹

Dr. Helen Rodríguez Trías, a public health specialist and women’s rights activist, was a key figure in the anti-sterilization movement. She founded the Committee to End Sterilization Abuse in 1974 and its successor, the Committee for Abortion Rights and Against Sterilization Abuse (CARASA). In 1979, both of these committees were instrumental in developing federal sterilization guidelines.⁴⁰

Beginning in the 1990s, two harmful long-acting hormonal contraceptive shots, Norplant and Depo-Provera, were marketed to young Black, Latinx, and Native women,⁴¹ without first addressing the adverse effects on their communities’ health that these medications might have.⁴² Norplant can cause eyesight loss, heart disease, and stroke, and more than 50,000 women have sued Norplant’s manufacturer, Wyeth-Ayerst, over the treatment’s negative health impact. Similarly, Depo-Provera may cause irregular periods, birth defects, breast cancer, and infertility, among other things.⁴³ As soon as these devices were given approval by the FDA, judges all across the country began deploying them in the sentencing process. Women of reproductive age convicted of possession or other felonies were commonly offered Norplant and Depo-Provera as an alternative to jail. Many states introduced legislation that would make the shot a condition of further welfare payments. In Kansas, Louisiana, and North Carolina, legislatures subsidized Norplant purchases.⁴⁴

Racist and colonialist policies have been the driving force behind the infringement of Native American civil rights and reproductive rights. The major objective of the Indian Health Service (IHS), which started providing family planning services to Native Americans in 1965, was to lower the birth rate.⁴⁵ Studies have found that the Indian Health Service sterilized 3,406 people from 1973 to 1976. Native women said that they did not want to agree to these surgeries but were forced to do so.⁴⁶ Kimala Price argues that reproductive justice is critical for Indigenous women who are concerned with abortion access but also with their community’s survival and self-determination.⁴⁷

Eugenics and sterilization abuse are thus significant aspects of American history that should not be ignored. This is critical for feminists to comprehend because the eugenics movement had a long-lasting impact on reproductive policies and the lives of women of color.

The Problem with “Choice”

A further facet of RJ is its critique of “choice,” which is the preferred term of liberal feminists in arguing for abortion rights. Dorothy Roberts argues that a right based on individual choice is constrained and unachievable, particularly in the absence of the means and access to assert that right.⁴⁸ Dorothy Roberts, in In Killing the Black Body: Race, Reproduction, and the Meaning of Liberty, refers to concepts like choice or freedom as “negative rights,” which mask the “presumption that the right to choose is contained entirely within the individual and not circumscribed by the material conditions of the individual’s life.”

Roberts argues that defining privacy as keeping the government out of “personal decisions” isn’t enough “to protect the dignity and autonomy of the poor and oppressed.”⁴⁹ These personal decisions conceal coercion and inequality, obscuring the racist roots of population control policies that restrict the reproductive freedom of women of color. Instead, to “ensure the equal distribution of procreative resources in society,” she calls for “positive rights,” that is, true equity over false notions of freedom or liberty.⁵⁰ As Roberts points out, the “privacy doctrine” leads to “government nonintervention in the private sphere,” which makes it easier for women to be oppressed rather than giving them more autonomy.⁵¹ Meanwhile, positive rights are those “that combine the values captured by both liberty and equality.”⁵²

The case against “choice” as a framework for reproductive rights has been made most eloquently by Roberts in Dissent magazine, and it is worth quoting in full:

The language of choice has proved useless for claiming public resources that most women need to maintain control over their bodies and their lives. Indeed, giving women “choices” has eroded the argument for state support, because women without sufficient resources are simply held responsible for making “bad” choices. The reproductive rights movement was set on this losing trajectory immediately after Roe v. Wade when mainstream organizations failed to make funding for abortion and opposition to coercive birth control policies central aspects of their agenda. There was no sustained major effort to block the Hyde Amendment, which has been attached to annual appropriations bills since 1976 and excludes most abortions from Medicaid funding. Mainstream reproductive rights organizations practically ignored the explosion of government policies in the 1990s, such as welfare “family caps” and prosecution for using drugs while pregnant, principally aimed at punishing childbearing by Black women who received public assistance.⁵³

Women of color recognized early on the danger in the wording of the Roe decision. For instance, the National Council of Negro Women warned in a 1973 editorial supporting Roe v. Wade that we must exercise caution:

The keywords are “if she chooses.” Bitter experience has taught this Black woman that the administration of justice in this country is not colorblind. Black women on welfare have been forced to accept sterilization in exchange for the continuation of relief benefits, and others have been sterilized without their knowledge or consent. A young pregnant woman recently arrested for civil rights activities in North Carolina was convicted and told that her punishment would be to have a forced abortion. We must be ever vigilant that what appears on the surface to be a step forward does not in fact become yet another fetter or method of enslavement.⁵⁴

Among other things, reproductive justice is a critique of the legal foundation of 1973’s landmark Supreme Court decision in Roe v. Wade, which argued that choosing an abortion was part of a woman’s Fourteenth Amendment–protected right to “privacy” and so made abortion legal (again) in the United States. Following this victory, most abortion rights advocates recast their politics in terms of choice and privacy, as opposed to arguments for gender equality or universal access to reproductive healthcare. According to the editors of Undivided Rights, one of the first books to lay out a RJ framework, the term “abortion” was dropped in favor of protecting a woman’s “legal right to choose,” which sounds less political. ⁵⁵

The goal of this new prochoice movement was not to ensure that women had access to abortions, but to develop an electoral strategy to protect the negative right to abortion. Kimala Price also claims that Roe demobilized the militant second-wave feminist movement because many thought the fight for abortion was over. That is why prochoice organizations did not object when Congress passed the Hyde Amendment in 1977, which prohibited the use of federal funds, including Medicaid, for abortions.⁵⁶ Until Hyde, Medicaid covered one-third of all abortions, or nearly 300,000 per year.⁵⁷

The concept of choice is even less meaningful in today’s nearly post-Roe world, where abortion access is limited state by state and will be wholly moot if Roe v. Wade is overturned. While larger social and economic structures have always limited reproductive choices like when, whether, and how to have children, middle-class white feminists may soon face similar experiences to those of poor women and women of color (although wealthy women will always have easier access to safe abortions).

Democrats and the Supreme Court

Instead of adopting a strategy more in line with women of color, such as being “pro-access” rather than “prochoice,” the movement began on shaky ground. By relying on the already precarious right to privacy legal precedent, prochoice organizations such as NARAL and Planned Parenthood have put themselves permanently on the defensive since their strategy is entirely reliant on defeating judicial challenges.

Moreover, mainstream prochoice advocates have serious problems with their electoral strategy, particularly their blind loyalty to the Democratic Party, their alignment with middle-class donors, and their inability to win elections at a critical mass.

According to journalist William Saletan, following Roe v. Wade major abortion rights organizations redefined themselves as “prochoice” organizations in an attempt to broaden their coalition beyond the feminist movement. They characterized abortion as a question of big government intervention into women’s private lives, as the Roe decision had; easily recognizable as part of a right-wing or libertarian framework opposed to “big government.” As Silliman et al. point out, starting in 1984 NARAL, Planned Parenthood, and other major prochoice groups conducted national polling to “determine what messages would be effective with conservative voters and could drive a wedge into the conservative opposition.” In other words, the opposition that prochoice groups sought to address and win over was, and still is, composed of anti-tax, anti-welfare, and anti-Black constituencies. “They could declare war on all of these constituencies in the name of a broad liberal agenda,” says Saletan of prochoice groups. “Or they could divide the coalition and isolate pro-lifers by seducing the other constituencies.” And, unfortunately for the left, “they chose the latter and put a libertarian spin on it.”⁵⁸

According to Sam Rosenfeld and Daniel Schlozman in N+1, to win on abortion the Democratic Party needs to win elections more often and in more states. However, the party’s donors’ desires shape the party’s agenda and whom that party represents. Rosenfeld and Schlozman point to the “culturally liberal donors” whose preferences have culminated in the party’s failure to form cross-class majorities, thus making it extremely difficult to fulfill any aspect of the party’s agenda. Campaigns that focus on abortion are able to get more funding from these donors than campaigns that would aid working-class women. This means that measures that impact class-based oppression or poverty are low on the party’s agenda. To overcome this impasse, Rosenfeld and Schlozman believe the party must construct “a class-oriented feminism that folds reproductive rights into a robust maternalist and pro-worker agenda.”⁵⁹

Much more importantly, the movement’s failure at the national level makes state legislatures even more powerful. Roe v. Wade legalized abortion, but it also allowed states the ability to restrict access to abortion in the interests of the “unborn child.”⁶⁰ New York Congresswoman Bella Abzug sought to codify Roe in 1973. She introduced the Abortion Rights Act, H.R. 254, to prohibit states from enacting additional abortion restrictions. The bill did not make it through the legislative process, and states went on to enact a significant number of additional restrictions. “And it speaks to a simple human reality that it’s much easier to try to knock something down than to defend it,” says Joshua Prager, author of The Family Roe.⁶¹

In 2010, the National Right to Life Committee (NLRC) produced three draft bills for Republicans in state legislatures, one of which included a twenty-week abortion ban. Only Nebraska had a twenty-week abortion ban when the NRLC began lobbying for it in 2010, but as of May 3, 2022, more than a third of states now have such a policy.⁶²

As a result, abortion access in the United States has deteriorated dramatically. Between 2011 and 2017, state TRAP (Targeted Regulation of Abortion Providers) legislation closed fifty clinics in the South and thirty-three in the Midwest, according to the Guttmacher Institute.⁶³ In the last two years, pandemic conditions and insufficient funding have forced the closure of forty-one clinics.⁶⁴

Democrats will almost certainly use Dobbs v. Jackson Women’s Health Organization to persuade people to vote for them in the next midterm elections, but the Democratic Party is unlikely to build the supermajority it needs to override the filibuster and codify abortion rights.⁶⁵

What’s Lacking in the Prochoice Movement

The lobbying and electoral strategies used by liberal prochoice groups have not been effective enough. Only so much can be accomplished by concentrating on the rulings of the Supreme Court and expanding constitutional rights. One example is the case of United States v. Texas, in which the Supreme Court of the United States upheld the Texas abortion ban, also known as Texas SB 8. This statute bans abortion after six weeks and relies on citizen militias for enforcement.⁶⁶ It is the most draconian abortion restriction in the country (at least at the time of writing).

In the wake of this decision, reproductive justice organizations rallied to make abortion as accessible as possible. ACCESS REPRODUCTIVE JUSTICE Executive Director Jessica Pinckney outlined her organization’s efforts to improve abortion access after the ruling. In a press release, the organization, which funds abortions and provides support and assistance with transportation, lodging, and child care to people seeking abortions in California, stated that “we are committed to doing everything in our power to ensure people have full access to abortions and the other reproductive healthcare they need because restrictive laws do not get to determine the futures” of our people.⁶⁷

In the days that followed Texas’s ban on abortions after six weeks, NARAL sent out a fundraising email proclaiming an intention to “donate a portion of the proceeds to an abortion fund in the state,” with the remainder of the proceeds remaining with the organization. However, the email did not specify which abortion fund would get the donation. Many complained that NARAL exploited the situation to fundraise with the intention of keeping part of the funds. NARAL then tweeted a petition to support the Women’s Health Protection Act (WHPA), which made no reference to the local abortion funds of smaller grassroots groups.⁶⁸

This incident reflects a long-standing tension within the movement, argues Marie Solis for Jezebel. These institutions, typically run by white women, have boards of directors and depend on millions of dollars in government grants, significant donations, and membership dues. Large national organizations like Planned Parenthood and NARAL lobby the White House and Congress to change abortion laws; they craft policies and sway public perception. While Planned Parenthood and NARAL may coordinate state campaigns or support for new legislation, grassroots groups perform the really necessary work.⁶⁹

Many of the country’s abortion funds are led by women of color, as are all of the country’s reproductive justice organizations. Abortion funds and RJ organizations advocate more directly; they generally pay for travel, accommodation, and childcare, as well as the abortion itself. The volunteers who arrange this care view their role as bridging the gap between the legal right to abortion and actual access to care.⁷⁰

In the guise of maintaining a moderate political stance, several organizations, such as Planned Parenthood, have gone so far as to oppose women’s access to birth control. For example, over-the-counter emergency contraception was a major battleground for the reproductive rights movement in the early 2000s, writer and National Women’s Liberation (NWLM) member Jenny Brown told Jezebel. NWLM lobbied the Food and Drug Administration (FDA) to approve OTC emergency contraceptive access without any restrictions, while the National Association for Reproductive Rights (NARAL) and Planned Parenthood warned against it. According to Brown, the leaders of those organizations were concerned about the optics of fighting for adolescent access to the pill. They proposed aiming for a less lofty goal, such as making this contraceptive available in the emergency rooms of rape victims. Instead, Brown and the NWLM pursued tactics that were deemed too radical and aggressive by other large organizations. They sent the FDA a letter signed by thousands of supporters threatening to break the law and give out emergency contraception. Brown and her co-organizers found physicians willing to write prescriptions for the medications and illegally distribute them. Nine women, including Brown, were arrested at a sit-in outside the FDA’s Maryland offices. In 2013, the FDA approved OTC emergency contraception for all ages. It was only possible, Brown argues, because of the demands of radical reproductive rights activists.⁷¹

Conclusion

For many poor and minority women, procuring an abortion is already quite difficult. Simpson says that more than 100 antiabortion bills that limit or ban abortion have been passed in nineteen states in just the past year.⁷² The loss of the constitutional right to abortion is one hurdle, but it is not the only one.

A minor can only obtain an abortion with parental consent, a court order, or an appeal. Women who are pregnant and want to have an abortion but must travel to another state must find a way to pay for their travel, lodging, and any other associated costs. It’s challenging to find an abortion doctor online due to constant abuse and harassment. Abortion is no longer taught in medical schools as part of the core curriculum. In order to comply with strict privacy regulations and avoid exposing themselves to violence, doctors who perform abortions and those who work for them try to withhold information, including treatment and pricing information, while on the phone. Many places require patients to make two appointments: one for counseling and one for surgery. According to Pamela Bridgewater Toure, no other medical procedure subjects patients to this level of difficulty, bureaucracy, opacity, violence, or intimidation.⁷³

The principles underlying reproductive justice can serve as our compass while we fight for a more equitable society. If we make protecting “choice” a higher priority than the pursuit of justice, or if we focus our attention on abortion rather than on other aspects of reproductive health care, we may find ourselves left with no choices at all.

9

Sovereignty Lost

Not Only Has Native People’s Right to Parent Our Children Been Stolen from Us, but So Has Our Right to Abortion—Even with Roe v. Wade in Effect

by Jen Deerinwater

I’ve supported abortion since I was ten years old. I noticed the adults that mistreated girls and womxn were overwhelmingly antiabortion, and I didn’t want to be like them. That’s no surprise, given that my youngest years were spent in a small town in Tulsa County on the now reestablished reservation of the Cherokee Nation of Oklahoma. Collinsville was a small, two-stoplight kind of town with a Main Street similar to many others I’ve seen across the so-called United States.¹ It’s an ultra-conservative, Trump-loving part of the country with many evangelical Christians and a long history of attempting to legislate the bodies and lives of those with wombs.

My first personal encounter with this came at fourteen years old after my boyfriend raped me. When my period was late, I was terrified that I could be pregnant. I didn’t know what I would do, but having a baby wasn’t an option. A friend’s mom bought a pregnancy test for me because I was worried, given how small my town was, that everyone would know if I bought one myself.

I had recently been hospitalized for attempting suicide and I came from a divorced family, which meant some people in this small town looked down on me. I also saw the way rape survivors were treated in the media: William Kennedy Smith, member of the famous Kennedy family, had been on trial for rape only a few years earlier and been rapidly acquitted of all charges, despite the testimony of multiple women and a rape kit. The survivor was first painted as a liar and then as a slut who got what she deserved. Given that I was a mixed Native child from a “broken home,” and had just been in a mental hospital, I didn’t think anyone would believe me, nor care. Thankfully my period returned and I didn’t have to worry about how I would access an abortion as a minor in rural Oklahoma—but that moment in time solidified my commitment to reproductive rights.

At fifteen, my step-dad accepted a new job in the dusty, cactus-spotted lands of Abilene, Texas. With a population of around 125,000, Abilene is the major urban area of this region of West Texas. Dallas is the nearest large city, roughly 180 miles away.

Abilene began as a stopping point for cattle drives and later became home to three private, ultra-conservative Christian colleges and Dyess Air Force Base. Sexual education, birth control, condoms, and abortion were not easily available, if at all. My high school sex ed consisted of our health teacher, a football coach as I recall, hanging a “True Love Waits” t-shirt on the chalk board. “True Love Waits” is the Baptist Church’s deeply misogynistic, anti-queer, and rape culture–oozing abstinence-only program that is fixated on female purity and virginity.

At my high school, I heard stories of unwanted pregnancies and secret trips to Planned Parenthood in Dallas or cases of or fears of contracting STIs. Thankfully, when I wanted hormonal birth control my mom made sure I had it, and being the research nerd that I am, I learned as much as I could about STIs, pregnancy, and prevention. Even if I had to steal them due to financial or privacy concerns, I always made sure I had condoms once I chose to become sexually active on my own terms.

I eventually escaped home and moved to the coasts. I grew, changed, and found a home of sorts in political movements, including the prochoice movement. I think this made it easier for me at twenty-six when my birth control failed and I became pregnant. I knew with unwavering certainty that I had a right to control my body and ultimately my life. Having that knowledge, though, didn’t make it easy.

I discussed the situation with my (by then) ex-boyfriend, and we were both in agreement with my decision to have an abortion. I would become part of the 25 percent of womxn in the United States who’ve had an abortion since Roe v. Wade became law in 1973. While my ex may have been prochoice and supported my decision to have an abortion, he only did so out of convenience for himself. He threw some cash my way and left me to deal with our problem on my own. He complained that I didn’t schedule the abortion at a time that was convenient for him. As if abortion was available on demand and it wasn’t my body going through it.

A friend went with me to Planned Parenthood, where we waited all day to receive the pills for the medical abortion, which I thought would be a less invasive and more private way to have an abortion. However, I didn’t fully understand that I was about to go through something akin to the process of giving birth. I was repeatedly instructed by medical staff to have someone with me, but no one explained why. I lied and said I wouldn’t be alone when I took the pills, because I was afraid I’d be denied an abortion. I couldn’t tell them that the father didn’t care enough to be with me. I was also struggling with the PTSD symptoms from what occurred when I was fourteen. I needed an abortion immediately and I would have said anything to get one.

Hours later, in the throes of extreme nausea and cramping, I wished he were with me. I didn’t want my ex back—he wasn’t a good person, nor someone that I would want to raise a child with—but I would have given anything to have him with me to get the glass of water I was too sick to get for myself. When I came to on my bathroom floor after passing out from the pain, I was utterly alone. He never called to see how I was after the abortion.

About a month later, I attended the annual protest that the Massachusetts-area affiliates of the National Organization for Women held to counter the Boston antiabortion protest. I thought I was prepared for the onslaught of demeaning, derogatory words that the antiabortion zealots use about people like me, but I wasn’t: a sign claiming abortion was manslaughter brought tears to my eyes. I dedicated my life to fighting for justice and a better world. Did these people not realize that I didn’t take having an abortion lightly and that I took every means necessary to prevent a pregnancy? Didn’t they realize that there was a (cis)man involved, and that the responsibility didn’t lie solely on my shoulders?

I was overcome by rage. Rage over the injustice of being called a murderer while my ex got off scot-free. He didn’t have to beg for a day off work, or go through hours of excruciating pain or weeks of bleeding. He would never be called a murderer, a slut, or have to fight for his right to control his body and destiny. He would never have to write an essay like this, and he would never feel enraged and frustrated over having to explain why he had an abortion. In a just world I wouldn’t owe anyone an explanation at all.

•••

Despite my commitment to abortion rights, I didn’t see myself reflected in prochoice spaces. The people I was surrounded by were overwhelmingly white, hetero, able-bodied, ciswomen from middle-to-upper socioeconomic backgrounds. As I’m a multiply-disabled, bisexual, Native, Two-Spirit womxn these spaces often felt dismissive. Many of those people would feign concern over the privileged make-up of the prochoice movement, but wouldn’t do much to change it. I didn’t see the prochoice activists I met work in solidarity with oppressed people who were without abortion access, nor did I see their concern for those who lost their rights to parent entirely. Very few seemed to care that in the 1970s it is estimated that up to 50 percent of Native womb carriers were sterilized against their will by the Indian Health Service (IHS).

Created under the 1921 Snyder Act, IHS is a federally funded trust and treaty responsibility to provide healthcare for citizens and members of federally recognized tribal nations, which means our ancestors paid for this healthcare through the loss of their lives and lands. However, IHS has been used by the US government as a tool of genocide. The Claremore Indian Hospital in Oklahoma, where I went as a child, was notorious for forced sterilization. Stripping our womb-carriers of their ability to have children is the continuation of over five hundred years of misogynistic violence against Indigenous peoples, and an attack on tribal sovereignty and self-determination that uses our womxn as fodder. There are so very few of us left that it would take little to entirely eliminate us from the Earth.

Compounding the dire genocidal conditions that IHS’s sterilization caused is the reality that our children are continuing to be stolen from us and Native people are being denied the right to parent, which was exacerbated by Indian boarding schools. The boarding schools were created as part of a series of genocidal and white, Christian assimilationist policies known as “Kill the Indian, Save the Man.” Atrocious acts of torture, sexual and physical assault, and murder occurred at these schools. A recent report by the US Department of the Interior on the federally funded Indian boarding schools found there were 408 schools in thirty-seven states or the then-territories of Alaska and Hawai’i. Unmarked Native children’s gravesites have been found at fifty-three schools. The investigation is ongoing, and as has occurred in similar investigations in so-called Canada, more gravesites will surely be uncovered.

Native children have been singled out for adoption into white, Christian homes in the foster system as well, effectively taking them out of Indigenous communities. The theft of our children was so extreme that the Indian Child Welfare Act (ICWA) became federal law in 1978. ICWA helps protect our Native children who are eligible for or enrolled in a federally recognized tribal nation from being adopted to overwhelmingly white, Christian homes. Before ICWA, 25 to 35 percent of all Native children were removed from their homes and 85 percent of them were placed outside their families and tribal nations even when safe homes with relatives were available.

Even with ICWA in place, many of our children are still stolen today, and our womb carriers’ rights to parent are still in question. Native people are up to four times more likely to have our children placed in foster care than non-Native people. Oklahoma, which has one of the largest Native populations in the US, reported in 2020 that Native children represented more than 35 percent of those in foster care, yet Native people only comprised 9 percent of the state’s population. It’s quite telling that many of those who want to overturn ICWA also want to overturn Roe, including Supreme Court justices Thomas, Alito, and Roberts (and most likely Kavanaugh and Coney Barret)—the idea, here, is a full-scale bid to control reproduction across the board. The Supreme Court will rule on ICWA in the 2022–23 session in Brackeen v. Haaland.

Not only has our right to have and parent our children been stolen from us, but so has our right to abortion. Roe didn’t grant abortions for all. Native people have a right to full healthcare at IHS, including reproductive healthcare, but under the Hyde Amendment abortions can’t be performed using federal funds except to save the life of the pregnant person or in cases of rape or incest. Despite this clause, though, abortion services are close to unavailable at IHS regardless of the circumstances: one study by Native American Women’s Health Education Resource Center reported that between 1981–2001 IHS performed only twenty-five abortions, and that 85 percent of IHS facilities were noncompliant with IHS and Hyde Amendment regulations. Only 5 percent of IHS facilities provided abortion services onsite, and none of the IHS pharmacies kept Mifeprex (RU-486) for medical abortions. The study also found that IHS didn’t make referrals to outside abortion providers.

Because Native people are disproportionally more likely to live in poverty and to be disabled, many of us access our health care through Medicare or Medicaid, also subject to the Hyde Amendment. However, states can opt, and some do, to use some of their funds to pay for abortion for Medicaid recipients. And yet, even with three forms of federally funded health care supposedly available to me I have struggled to access even the most basic of reproductive health care. Most recently, I was a year late in replacing my IUD and suffered unnecessary pain as a result, because there weren’t enough providers that would accept Medicare and Medicaid to perform the simple procedure. There are also no IHS facilities in Washington, DC, where I now live, despite the agency being headquartered only seventeen miles away.

Compounding this reality is that thirty states, as well as the District of Columbia, have laws allowing the forced sterilization of disabled people. The 1927 Supreme Court case Buck v. Bell allows these eugenicist policies, but outside of the disability community this issue is rarely discussed in prochoice or even many reproductive justice spaces. This isn’t merely outdated legislation still on the books: in 2019 Iowa and Nevada codified the forced sterilization of disabled people.

All it would take is the stroke of a judge’s pen and I could legally be sterilized against my will. With the exception of North Carolina and Alaska, which have made forced sterilization of disabled people illegal, the law is unclear in the other seventeen states, so sterilizations might occur under guardianships. Guardianships, which garnered media attention when Britney Spears spoke of being forced to use long-acting birth control, is another way the system controls disabled people’s reproductive rights, and there are currently only three states that have banned the forced sterilization of disabled children.

To add insult to injury, as a resident of Washington, DC, I can’t use my Medicaid to pay for abortion outside of the Hyde Amendment exceptions. Many DC residents and elected officials support Medicaid-funded abortions, but Congress overrules this with a yearly appropriations rider in the Financial Services and General Government subcommittee. DC isn’t a state, so Congress has ultimate say over most facets of local government, and we have no voting representation in Congress. In far too many ways, my rights to reproductive justice have been stripped from me.

•••

Today I awoke to a message from my mom reading, “Welcome to Gilead. Under his eye.” She’s never been particularly politically active, but she was enraged over the latest Oklahoma abortion ban. As I write this, Oklahoma Governor Kevin Stitt has just signed the most restrictive abortion ban in the country into law. HB4327 was co-written and sponsored by Oklahoma Rep. Wendi Stearman of Collinsville, the town where I grew up. Under this violent law, abortion is banned once fertilization has occurred except to save a pregnant person’s life during a “medical emergency” based on a life-endangering physical condition that could require specific medical tests to authenticate; or in case of a rape or incest that’s reported to the police. This law takes effect even while Roe still stands. It also allows individuals to sue abortion providers, clinics, and anyone else who has taken part in providing or helping someone to obtain an abortion.

The violence of this law is undeniable: when Stearman was asked if Oklahoma should be forced to financially provide for people forced to have children under this law, she said no. As reported in the Tulsa World, when Oklahoma Rep. Cindi Munson, a Democrat representing Oklahoma City, asked Stearman “If a young girl is raped by her uncle, she’s likely not going to go report to law enforcement … She’s not allowed seek an abortion under your bill, as I understand it. And you’re OK with that?” Stearman replied: “I am OK with that.”

Given an earlier law that banned abortion at six weeks, two of the four abortion clinics in Oklahoma had recently stopped offering the procedure; when HB4327 went into effect, they all stopped. There are also concerns that this bill could lead to IUDs being outlawed, especially as other states, like Missouri and Idaho, are actively working to ban IUDs, which the antiabortion zealots falsely claim is an “abortifacient” (IUDs prevent fertilization of an egg, but they also stop the implantation of a fertilized egg).

Tribal nations as a whole are also needlessly under attack by the antiabortion forces. Governor Stitt recently commented that he’s monitoring our tribal nations to ensure that we don’t offer legal abortions on our reservations. Simultaneously, Stitt is waging a war against Oklahoma tribes and our treaty rights, and a ruling by the Supreme Court has yet to be made on Oklahoma v. Castro-Huerta, a case that could undermine sovereignty on our lands.

The point of Governor Stitt’s comment wasn’t based on any actual evidence from tribal nations, some of which have large conservative Christian populations, but was rather an attack on tribal sovereignty—just as the Goldwater and Cato Institutes have no interest or business in Native children’s affairs but support the overturn of ICWA in order to further weaken tribal sovereignty. It’s a similar approach that the antiabortion movement has taken that brought us here: they slowly chipped away at Roe at the local level and through the accretion of lawsuit after lawsuit, with the support of nonprofit organizations and for-profits.

The crushing weight of colonialism and the various forms of institutional oppression it brought to these lands has often left me feeling alone and overwhelmed. After all, my personal history is intricately intertwined with violent attacks on womxn and on Indigenous and disabled people, and a continued effort to control and eradicate us. But just as our ancestors rose against our oppressors, we resist now. Organizations like Indigenous Women Rising, an Indigenous health education and advocacy organization, has an abortion fund for Indigenous and undocumented people. Disabled womxn and people were quick to organize to ensure that disability justice is prioritized in our calls for abortion access. Many 2LBTQIA+ people have repeatedly stated that the end of Roe isn’t simply a ciswomen’s issue, but it touches everyone who is assigned female at birth. The resistance to the overturn of Roe has been vast, and I’m hardly alone in this struggle. But until tribal sovereignty is the law of the land, I will never have full reproductive justice. The colonizer’s court will never bring sovereignty.

10

Aborto Libre, Seguro y Accesible

In Puerto Rico, a History of Colonization Led to an Atrocious Lack of Reproductive Freedom

by Raquel Reichard

When birth control pills hit the US market in 1960, it heralded a new age of sexual autonomy for women. “Freedom in a tablet,” as it’s been called, liberated women from becoming pregnant when they didn’t want to and gave them more control over their reproductive choices. But in Puerto Rico, where women were used as subjects for birth control trials and impelled to undergo sterilization, the emancipating drug also carries a history of coercion and is emblematic of Puerto Rican women’s enduring struggle for reproductive freedom.

In Puerto Rico, fertility control developed under colonialism in the early twentieth century, after the Caribbean archipelago had been seized by the United States in the Spanish-American War of 1898. During this time, neo-Malthusianism—the belief that poverty stems from the proliferation of the poor—was a popularly held view throughout the West, notably by prominent US officials and intellectuals, who also endorsed pseudo-scientific eugenics theories as a means to guarantee that only able-bodied, rich, white people should be encouraged to reproduce. The colonial governments in Puerto Rico and the contiguous US were filled with people who believed these philosophies, and the archipelago was deemed overpopulated, specifically by a citizenry of impoverished and thus “inferior” Black and brown people. To solve the alleged problem, government officials instituted policies that, among other things, reduced births through sterilization. “These programs developed within a colonial, eugenic social context, where the belief was that some people are more fit to reproduce than others and that poor brown people in a so-called underdeveloped nation were not fit to reproduce,” said Iris López, the director of the Latin American and Latin@ Studies program at City College of New York.

Starting in 1937, when Law 116, allowing eugenics-based sterilization, passed in Puerto Rico, the US federal government began subsidizing and promoting the irreversible procedure on the archipelago. With additional encouragement from local industrial employers, who favored sterilized laborers, and health workers, who went door-to-door imploring mothers who had two children to undergo hysterectomies or tubal ligations, sterilization became so common and normalized that it was simply referred to as “la operación.” By 1953, nearly one-fifth of Puerto Rican women had received the free procedure. Many of them were unaware that the surgery was irreversible. Over the course of three decades, the colonial government, under the Puerto Rican Eugenics Board, also ordered the sterilization of 97 people, including many who were disabled. The surgery was urged at birth control clinics throughout the archipelago, including several that were established by US eugenicist Clarence Gamble, an heir to the Procter & Gamble company. Throughout the 1930s, he used his facilities to test contraceptives that had not yet been approved by the FDA—like the diaphragm, foam powder, sponge, and spermicidal jelly—on 1,500 women on the archipelago. In the 1950s, Gamble also supported and encouraged biologist Gregory Pincus and obstetrician John Rock to test a hormonal birth control pill they were developing on Puerto Rican women. In the US, the men—who were championed by Planned Parenthood founder Margaret Sanger and philanthropist Katharine Dexter McCormick—were also secretly testing the drug on a small group of women. However, they knew that the medication would never receive the FDA approval needed to bring it to market without large-scale experimenting.

Starting in 1955, the pair conducted several trials in impoverished neighborhoods throughout the archipelago, most notoriously at a housing project in Río Piedras. The hundreds of women who participated knew the drug prevented pregnancy, but they were unaware that they were part of a clinical trial. They also didn’t know that the medication, which contained much higher doses of hormones than modern-day birth control pills, was in an experimental stage or that it carried negative side effects. About 17 percent of the women in the study complained of nausea, dizziness, headaches, stomach pain, and vomiting, while three participants died. The deaths of the women were not investigated, and Pincus and Rock dismissed the complaints as psychosomatic.

Bianca I. Laureano, an Oakland, California–based sexual educator who has centered birth control’s troubling history in her academic research and writing, calls the trials “dehumanizing.” She also notes that while the tests were part of a project to expand contraceptive options for women in the US, the eugenicists behind the pill disvalued Puerto Rican life and openly discussed their desire to have the population wiped out. “The idea of [Puerto Ricans] being unfit to form families as we choose is rooted in white supremacist culture and beliefs. No matter how Puerto Ricans may identify their racial background, the fact that they are Puerto Rican was enough to erase an entire community and attempt to abolish a culture,” Laureano notes.

Nevertheless, by 1960, Enovid, though tested on women without their informed consent, was approved by the FDA and available across the US. Back in Puerto Rico, however, the medication, which was priced at 50 cents a pill or $11 a month, was inaccessible to the destitute women who played a key role in the tablet’s creation. As a result, sterilization continued to be the main form of birth control on the archipelago. By the 1970s, one-third of the women were sterilized—the highest sterilization rate in the world.

In Matters of Choice: Puerto Rican Women’s Struggle for Reproductive Freedom, López notes that some women were victims of sterilization abuse, particularly in the early twentieth century, while later generations predominantly had the procedure deliberately. Those who chose the irreversible surgeries, she says, did so through so-called “agency within constraints.” In other words, the women who opted for sterilization practiced agency because they understood the weight of their decision. However, their choices were limited to their economic reality, like their inability to purchase other forms of birth control. “When we look at the question of what constitutes reproductive freedom, then we have to say that they are not exercising full reproductive freedom, not even the women who are making these decisions, because of the conditions under which they are making them,” López says.

The US’s legacy of coercive sterilizations and fertility control isn’t relegated to the distant past, and extends beyond Puerto Rico. This past September, a nurse at a private immigration detention center in Georgia came forward to report a US Immigrations and Customs Enforcement (ICE) facility that was actively performing mass hysterectomies on detained people. In California’s prisons between 2006 and 2010, nearly 150 women were sterilized. Similarly to what was done in Puerto Rico in the mid-twentieth century, these women had “agency within constraints,” but nothing close to true reproductive freedom.

More than half a century after the birth control trials and mass sterilizations in Puerto Rico, there is still a lack of reproductive freedom there, according to Mayra I. Díaz Torres, the program director of Clínica IELLA, a San Juan–based clinic offering affordable gynecological and abortion services. While abortion is legal on the archipelago and there are more birth control options available today, Torres argues that these services aren’t accessible or even broadly known to Puerto Ricans. “For a long time, sterilization felt like the only option for poor women. Fast-forward to 2020—they still don’t have options,” Torres said. “When the prices of these products are extremely and obscenely high, you are limiting the options of these women and they are at a disadvantage.”

In Puerto Rico, nearly half of the population lives below the poverty line, making the hefty price tags on birth control unaffordable to many. For instance, IUDs can cost more than $1,000, while monthly fees for contraceptives like the pill, the patch, or the ring can range from $10 to $150 a month. Even more, abortion care, which is barred from federal funding due to the Hyde Amendment, ranges between $275 to $2,400, depending on the term of the pregnancy. “Reproductive freedom means reproductive justice; that everyone, regardless of gender, race, or class, can choose what they want to choose and that the menu of choices is the same for everyone. Here, the menu for the rich has a lot more pages than the menu for the poor,” Torres says.

Further complicating things is the fact that reproductive rights are currently under siege in Puerto Rico, and Torres fears that people’s available options could soon be even slimmer. In 2019, lawmakers passed PS950, a bill that would have required women under the age of eighteen to obtain their parents’ consent to get an abortion, among other restrictions. Then Governor Ricardo Rosselló vetoed it; however, the author of the bill, Sen. Nayda Venegas Brown, vowed to introduce many more antichoice measures. Her threat became ever-more frightening in June, when Governor Wanda Vázquez signed a new civil code, the archipelago’s second-most important legal document, that included perplexing language that could offer protections to fetuses.

In addition to these political struggles, Puerto Rico only has four abortion clinics servicing the entire archipelago, and most are in the San Juan metropolitan area, with one in Ponce; they also serve neighboring countries with limited abortion access, like the Dominican Republic. Moreover, some of the already small number of the providers are more than seventy and will be retiring soon, leaving those in need of abortion care with even fewer options.

Soon, Torres fears, Puerto Rico, once an abortion haven for well-off white American women in the 1970s and a testing ground for birth control research, could again leave the reproductive needs of its most marginalized—its natives—behind.

Through the campaign Aborto Libre, Seguro y Accesible en Puerto Rico, Torres, alongside other reproductive rights activists, is fighting back against the political and social moves against abortion through educational efforts that aim to improve the archipelago’s substandard sexual education program and inform people of their reproductive rights.

“There needs to be comprehensive sexual health education in schools. There needs to be a cultural change in the way we see sex and sexuality as taboos. There need to be multiple birth control methods available for free as well as more clinics that offer quality and accessible abortions, and all of these services need to take place in facilities that are trans-inclusive and treat everyone with dignity,” Torres says. “That’s when we’ll have reproductive freedom in Puerto Rico.”

11

Labor Crisis in the Clinics

When You’re Not Focused on the Workers, Who Is Going to Provide the Care?

by Crystal and Luna, in conversation with Amy Littlefield

The crisis facing abortion access is a labor crisis, too. As many as twenty-six states are expected to ban abortion in the aftermath of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. When that happens, abortion clinics across the country could close, leaving thousands of workers out of a job. Facing the prospect of massive unemployment in their sector, these workers have been organizing their workplaces and supporting each other.

Journalist Amy Littlefield spoke with Crystal—a Planned Parenthood worker in a state that is unlikely to ban abortion for the time being, but likely to see an influx of out-of-state patients who will add to an already heavy patient load—and with Luna, an anonymous activist who helps run ReproJobs, an online worker support community for the reproductive health, rights, and justice movement.

Even as workers in this sector have helped drive a surge in unionizing spurred by the Covid pandemic and soaring inequality, Luna and Crystal say that workers are facing pressure to defer their own needs to prioritize the crisis in abortion access facing patients. In recent years, workers at several nonprofits—including Planned Parenthood affiliates like the one Lux reported on in Texas—have accused their bosses of trying to stymie union drives.

“We’re in a system that’s really, really complicated, and our entire movement is funded off of the exploitation of labor by billionaires,” Luna says. Organizing in this space “is not an easy fix, but I do think we can do it without minimizing the racism and transphobia and worker exploitation that people are experiencing, and without telling them not to talk about it, and that this isn’t the right moment to fight for your rights,” Luna adds. “We’re in a renaissance of labor organizing right now. Why do repro workers not get to be part of that?”

Amy: Crystal, why did you decide to start unionizing?

Crystal: We started talking about a union in summer 2019. I feel like the reasons are super relatable for most workers. We wanted to have more control and more say in what was happening in the workplace, and we recognized that a union was a way for us to have a collective voice. Things really began to kick off when Covid-19 hit. Everything was new and it felt really scary. It just sped up the conversation and lit a fire under the whole thing.

Amy: How are your contract negotiations going?

Crystal: Planned Parenthood is dragging their feet at every single opportunity. It’s exhausting, and that’s the point. They want to exhaust the workers and wear down our spirits and break us. Every single thing is a whole conversation that takes months. They’re scheduling really few sessions. We have to beg them for more sessions. We’ll spend weeks and weeks coming up with proposals or counters, and they’ll come to the meeting with nothing. They’re saying no to everything and saying that the reason is because they don’t know what’s going to happen, and they can’t commit to anything, which is like, OK, it’s really nice that you’re using the fall of Roe and the loss of abortion access to sabotage your workers.

Amy: I saw you tweet, “Big repro employers think Roe falling gives them carte blanche to violate workers’ rights. We do not consent to martyrdom.”

Crystal: We know what’s coming down the road. We know how awful it is. And we know that we have to be ready. And we know that it’s a little bit unpredictable. But to give us absolutely nothing? It [feels like they have] no real care for their workers with regards to the crisis that we’re about to experience and are currently experiencing.

Amy: This summer, clinics could shut down in about half of states. Clinics in the remaining half of states will see a huge influx of patients—even more than what’s already underway because of the ripple effect from the six-week ban in Texas. How are you thinking about shaping demands and bargaining a union contract, knowing that this precipice is coming?

Crystal: We definitely have been trying to just get reasonable workload and staff-to-patient ratios in the contract. Because we have completely unrealistic workloads that break us and drive people out. I feel like if it was any other workplace any other time, we might be able to actually get some movement. But because it’s Planned Parenthood, because it’s right now, they’re just not willing to work with the bare minimum of giving us the workload that is sustainable and doesn’t break your workers and drive your workers out.

One of the things that we’ve been trying to get as a union is nondiscrimination language in our contract. It’s a problem across the board with Planned Parenthood. Because of the issues our coworkers have had, we really are not budging on having nondiscrimination language in our contract. And at the same time, despite publicly saying they’re doing better, Planned Parenthood does not want to put nondiscrimination language in our contract, and they say that it’s because that language already exists in the law, and we are already legally protected. And it’s like, Planned Parenthood should know better than anyone that what is law does not mean that you’re going to get those protections.

Amy: What is your workload like? Are you already seeing an influx of patients?

Crystal: We’re booked out incredibly far. I feel like that’s the biggest evidence of how many patients we’re dealing with. We’re booking out like three to four weeks right now, which is just completely unacceptable for pregnancy care where it’s so time-sensitive. How can you take somebody who’s six weeks and by the time they come in they’re ten weeks?

Amy: Why is that backlog happening?

Crystal: I just think inadequate staffing. We don’t have the staff. We don’t have the doctors. It’s something that’s really difficult on an individual level, because there’s a part of you that’s like, oh my god, we need more clinic days, we need more appointments, so that people aren’t booking four weeks out, but at the same time knowing that we don’t have the staff for that.

Amy: Why are you so short-staffed?

Crystal: We always have a high turnover rate because we have a ridiculous workload. We don’t get treated well. We don’t get paid enough. I’ve been here for like four or five years. And I’ve seen so many people come and go. I’m also a trainer in the abortion clinic. So I watch it happen where I see people come in, hopeful, excited to be doing abortion work, and then just have them completely emotionally crushed over the course of months.

Amy: Luna, how does Crystal’s experience reflect the overall experiences of workers in the reproductive health, rights, and justice movement?

Luna: I think people come into this movement wanting to be of service to this work. And then when they see behind the curtain, they’re disheartened, because it is hard to go to work every day seeing an organization—your workplace, your employer—espousing a certain type of views online and fighting for other people to have certain rights, knowing you are sitting there trying to ask for the same thing, and they will not give it to you.

I get really disheartened in this movement when I see that the plight of the workers just gets completely ignored. I’m in so many meetings about post-Roe, and we’re about to have massive unemployment in our movement, and that is not part of the conversation at all. And of course, making sure people seeking abortions get their care and are not criminalized is super, super important. I’m not saying that that shouldn’t be the focus of the conversation, but also the people who are providing that care should also be a critical focus and making sure that they have the care that they need, because they are already being served with subpoenas and criminalized for doing this work. Also, newsflash, they are also people who need abortions, too.

Crystal: Yeah. And that was really central to our unionizing—that the workers are patients. The majority of us are people who needed care from these clinics at one point.

Amy: Luna, how is the movement talking about this impending crisis for workers?

Luna: There’s the larger conversation of what happens to clinics, but not necessarily the workers in the clinics. When people say clinics, they mean the care that clinics provide, like the work of the workers, but not the workers themselves. And that is disappointing. And we’ve definitely tried to nudge the conversation a little.

There’s a scramble for some clinics and organizations to try to unionize, to at least have a guarantee of some sort of severance should the clinics shut down, and to just know that there’s some protections because we already know how hard it is to get a job after working in abortion, particularly in a really hostile climate. So [workers are trying] to make sure that people have at least three months of pay to be able to live on while they try to figure out what’s next. And I know that people are just trying to figure out how to scrimp and save as much as possible.

What is concerning is that Crystal mentioned that Planned Parenthood affiliates and other organizations are kind of drawing out the union process. That worries me, because when you’re not focusing on the workers and making sure that they’re protected, who is going to provide the care?

Amy: I wanted to ask about salary because when I was looking through the ReproJobs salary database, some of the salaries that people in clinics are making are $30,000 or less. That doesn’t provide much of a buffer if clinic workers lose their jobs because of the Supreme Court.

Crystal: I have like four titles at my job. The amount of work that we’re doing, and what we make, is insulting. I’ve driven by Taco Bells where their shift managers are making the same amount—or at least according to the signs—they’re offering the same amount for what an entry-level position in the clinic is. And when you’re doing as much as you’re doing, when you’re doing lab work, when you’re assisting the doctors, and you’re paid like $16 or $17 an hour, it’s completely unacceptable. But again, it’s not something they’re really willing to budge on. If you ask for more money, they’re like, well, we don’t know what’s going to happen and we have to be prepared for anything.

What I know for a fact is that Planned Parenthood sits on so much money. Part of unionizing is you get to delve into that. You can just see a lot more transparently what the finances look like. It’s insulting that they won’t budge on it when you see how much other people make in other fields that are doing less work. And that’s why there’s so much turnover. Because why would you stay? If you’re emotionally distraught from your work, you’re working long shifts, and it’s physically harming you? I mean, that’s another thing that comes up too is so many of my co-workers and friends in other clinics, it takes a toll on your body, physically. I’ve seen people quit because of the health effects from working these shifts, and then you’re not even making that much money? It’s just not sustainable.

Luna: For years, we’ve heard that we need to save up the money in the movement for when Roe falls—and here we are. And yet, coffers have not opened to protect the workers, to protect abortion patients. I would say as much as our movement’s mantra is “trust women,” at what point are we actually going to do that in our workplaces?

Amy: What trends are each of you seeing when it comes to organizing in this space?

Luna: Organizations like the Jane Collective, and a lot of the abortion liberation work of the 1960s and ’70s came out of socialist liberation work and organizing. So, in a way we’re sort of getting back to our roots. I don’t know that [any] repro organizations in our history have ever been as unionized as we are right now. And we’re continuing, which I think is really essential and beautiful. I don’t think it’s [just] because of the current political situation. I think we were getting to that point [already], with the racism that people were tired of dealing with. And then it was exacerbated by the tiered systems of how workers were treated during the pandemic, and how our workplaces were not practicing the public health information that we usually preach.

I’m also glad that we finally see ourselves as part of the labor movement. Because I think we bought into this idea that the labor movement is for those other people over there who work in coal mines or factories and that we’re not that type, we work in the nonprofit sector and we’re just not those type of workers. We finally recognize ourselves as workers and that we can advocate for ourselves. And by advocating for ourselves, we are advocating for the patients that we take care of every day.

Crystal: One thing I can say, I feel like repro workers are really coming together for each other. I don’t think our employers are there for us whatsoever. I don’t think that they’re planning ahead or thinking about how this is going to impact all of us. But what I do know is that there are spaces forming where we’re all talking and—specifically abortion clinic workers, and other people who are doing abortion provision and abortion funding work—we’re all talking and we’re being compassionate toward each other, and we’re creating those spaces where we can just kind of like sit with how traumatic this all is and know that we’re not alone. And that is really heartening to me. We’ve talked to a lot of new repro union campaigns. There’s a lot, a lot, a lot, a lot of new union campaigns, of workers who want to unionize, and they are getting advice from the unions that already exist. We are all talking.

Luna: That’s the number one thing we hear at ReproJobs—that even if people recognize that we can’t do anything to fix it, people feel so relieved to know that they’re not alone, and that what they’re experiencing is real. And I liken it to, you know, hearing an abortion story or abortion stigma, right? Because you recognize that this thing that you went through that you felt so alone about and you didn’t think you could talk to anybody about—there are so many other people who went through that as well. And that’s the beautiful piece. That’s the organizing piece. And I think that’s part of what helps get people through the day.

Amy: What’s the number one piece of advice you give those fellow workers, Crystal?

Crystal: Talk to your co-workers. I don’t know what it is, but I feel like every single time I meet with them, it’s the thing we spend the most time on, because there is a lot of distance between a lot of the clinics. And they’re always like, well, how can we talk to the other staff about unions if we never see them? And it’s like, you gotta get to know them.

Luna: It’s funny that you say talk to your co-workers, because we used to say that a lot when people would complain to ReproJobs about their workplace. We were like, you know your entire staff is in our fucking DMs? You guys should just talk to each other. Like, stop talking to us. What can we do about it? Talk to your co-workers.

Amy: Crystal, your dad was a tollbooth worker and union steward, and we’ve talked about how he acknowledged your work at an abortion clinic for the first time when you first won a union election. He liked the Instagram post about your union victory and that felt like a big deal.

Crystal: I grew up watching my dad take care of grievances and he would always talk to me about how workers need a union. But my dad does not approve of any of the work I do. He won’t acknowledge what I do. The most I’ve ever talked about my work with my dad is like, twice, we’ve talked about the union. And that’s it. But honestly, that’s like better than nothing. In my opinion, it’s the most I’ve ever gotten. And, you know, I’ll take what I can get. And it gives me hope, too, because, you know, if we can talk about the union, maybe one day, we can talk about more than that. Because I believe in moving people a little bit at a time.

Luna: Labor organizing impacts us all, whether or not someone understands the work that we do, or if they buy into the abortion stigma, they do understand what it’s like to not have a workplace that values your work. And I think that’s a great equalizer.

Amy: We need the whole country to get there, right? And that’s what I find so moving about your story about bonding with your dad and having him like your Instagram post, Crystal, is that that’s the cultural change work that we need. We need that kind of slow, steady engagement among workers in order to gain ground on labor rights and abortion rights as well. Thanks so much to you both.

12

White Supremacy and the Antiabortion Movement

Abortion Bans and Regressive Gender Roles Increase the Number of White Babies Born While Criminalizing Women of Color

by Erin Matson and Shireen Rose Shakouri

The antiabortion movement is not just patriarchy, or the domination of men over women. It is a white supremacy movement. Successfully fighting and ending the antiabortion movement requires fully reckoning with its opposition to racial equality and employing an intersectional approach to justice for all people.

Though the modern antiabortion movement was indeed constructed to replace segregationism as a right-wing organizing tool, the roots of contemporary white supremacy go much deeper. The antiabortion viewpoint is itself white supremacy in action. Its goals, outcomes, and theories move in tandem with racist white supremacy theories.

It is important to consider three interlocking concepts:

• White supremacy is the belief that white people are superior and should dominate society, at the expense of other racial and ethnic groups.

• Gender roles are the social and cultural roles associated with masculinity and femininity. They are completely separate from biological sex, though they are often conflated (and doing so can cause grave harm to transgender and gender nonconforming people).

• Reproductive oppression is “the regulation of individuals’ bodies, sexuality, labor, and procreative strategies as a strategy to control individuals and entire communities.”¹

Simply put, white supremacy requires gender roles and reproductive oppression to succeed.

White supremacy requires an ongoing supply of white babies, and subservient (albeit privileged) white women to birth them. While publicly proclaiming their support for “life” and even trying to co-opt antiracist language on occasion, the antiabortion movement cares nothing for people of color, LGBTQ people, and people experiencing poverty—those who are most often criminalized and harmed by abortion bans as well as laws restricting pregnancy and sexuality.

White supremacy in action necessarily includes:

• Enforcing strict gender roles, such as separating people on the basis of biological sex and giving them unequal rights under the law, as abortion bans do.

• Controlling sexuality, such as separating who is able to access abortions based on whether they had “bad” sex or were victimized by rape and incest, as many abortion bans do.

• Seizing control of the means of reproduction, not only through abortion bans but also through bans on fertility treatment in the name of fetal rights, and much more.

It is clear from the many bans that exist at the state-level today, and the right-wing efforts in Florida and elsewhere to ban discussion of LGBTQ issues in schools, that these white supremacist goals are already in place.

Initially in the United States, antiabortion sentiments were mostly held by Catholics, and there was little energy around political activism for these causes. Many Protestants found antiabortion zealotry unpalatable for its association with “papists,” a moniker for Catholics who were historically derided for their supposed fealty to the Pope in Rome instead of patriotic allegiance to the United States. The issue remained fairly fringe and politically disengaged as a result.²

Approaching the 1900s, fears of white Anglo-Saxon Protestants being demographically overtaken by Catholic Irish and Italian immigrants fueled an interest in increasing Protestant birth rates, as well as the targeting of Catholics by the Ku Klux Klan and other white supremacist groups.³ Violence as a tool for controlling reproduction was not new, but the KKK helped institutionalize it in American life.

As immigrants increasingly came not just from Western Europe, but from other parts of the world like Latin America and Asia over the 1900s, the goalposts of whiteness have shifted to welcome white Catholics, who were increasingly accepted into the definition of “whiteness,” helping reassert demographic control based on a white, rather than WASP, identity. We see these shifts play out today as well, with the “model minority myth” employed as a cudgel both against Black, Native American, and Latinx people for their perceived lack of ability to assimilate and achieve economic success,⁴ and against Asian-American and Pacific Islanders when they make demands to improve racial equity but are told they should be satisfied with their station above other people of color.

Throughout the mid to late 1900s, white Jewish people began to replace Catholics as the new white targets of the KKK and other white supremacist groups, while major white Evangelical and Baptist organizations still largely supported abortion rights or were ambivalent at the institutional level. Some Evangelical leaders affirmed that there were no explicit Biblical instructions against abortion, and as late as 1971 the Southern Baptist Convention voted to legalize abortion rights.⁵

The Roe v. Wade decision came and went in January 1973, and while there was opposition, the antiabortion movement as we know it today did not exist. Driven largely by white conservatives, it was created as a response to desegregating schools, rather than to Roe. Randall Balmer, a scholar of Evangelicalism, writes,

[Paul] Weyrich insisted, what got the movement going as a political movement was the attempt on the part of the Internal Revenue Service (IRS) to rescind the tax-exempt status of Bob Jones University because of its racially discriminatory policies, including a ban on interracial dating that the university maintained until 2000.

Weyrich was a co-founder of the Heritage Foundation and a key early strategist who helped birth the ‘religious’ right, joined by Jerry Falwell, Ed Dobson, and others. Falwell, for his part, though claiming to have been politically galvanized by opposition to abortion, did not preach against abortion until 1978.⁶

After years of trying to court white Evangelicals and coax them into conservative political activism, the promise of upholding segregation (in their own private and tax-exempt Christian segregated schools) and maintaining their coffers while doing so, was the organizing force needed to build a grassroots conservative movement. This goal was shrouded in the trappings of a new, “moral” movement which was against abortion, rights for women, and LGBTQ rights.⁷

The logic the people who would come to frame themselves as abortion opponents asserted was that they needed to maintain their own, separate Christian schools in order to uphold the teachings of their religious values, weaponizing the concepts of freedom of religion and free speech to enshrine racial segregation while also creating a petri dish for growing the next generation of bigoted ideologues.

Simultaneously, the unabashedly violent wing of the antiabortion movement led a reign of terror—including clinic bombings, the murder of abortion providers, clinic blockades, and widespread harassment of abortion patients—through the 1980s into the early 2000s that is unfortunately experiencing a resurgence today. In some cases this has led to overt cooperation with white nationalist groups, such as Patriot Front joining the 2022 March for Life, or use of symbols from the KKK, such as an antiabortion demonstrator in a Klan robe standing outside an abortion provider in Milwaukee.

This period is remarkable for antiabortion figures’ frequent invocation of Holocaust rhetoric, imagery, and neo-Nazi talking points to simultaneously cast doubt on the impact of the Holocaust against Jewish people, to demonize abortion providers and incite assassinations, and to advance the cause of “racial purity.”⁸ A militant antiabortion extremist in the late ’90s created a website called The Nuremberg Files, where he listed names, photos, addresses, and other personal information of abortion providers and clinic staff and also kept gleeful count of the murders, injuries, and other violence perpetrated against people and clinics. His website was not shut down until 2022, by court order after Dr. Barnett Slepian’s murderer used the website to stalk and kill him in 1998. Dr. David Gunn and Dr. John Britton were also killed by antiabortion extremists with ties to organized white supremacist groups.⁹ As scholar of the far-right Alex DiBranco describes,

In 1985, the KKK began creating “wanted” posters listing personal information for abortion providers … Randall Terry, founder of the anti-choice group Operation Rescue, and John Burt, regional director of the anti-abortion group Rescue America in the 1990s … targeted Dr. David Gunn, who was murdered in 1993 in Pensacola, Florida. Gunn’s successor, Dr. John Britton, targeted by a Rescue America “wanted” poster, was killed in 1994.¹⁰

Terry is now serving as the spokesperson for a group pretending to serve “progressive” antiabortion interests,¹¹ which frequently uses “Holocaust” and invokes its imagery and rhetoric in their abortion opposition.¹²

A throughline of the antiabortion movement’s organizing rhetoric is about combatting what they perceive as demographic shifts that oppose their hold on power. From early Catholics to later nonwhite immigrants, the primary concern has been maintaining racialized control. DiBranco continues,

The Florida-based KKK organized a rally in support of Dr. Britton’s killer, [and the] founder of the racist group White Aryan Resistance (WAR), condoned the killing if it “protected Aryan women and children.” Burt himself was a Florida Klansman prior to becoming Christian and an associate of both killers. “Fundamentalist Christians and those people [the Klan] are pretty close, scary close, fighting for God and country,” Burt told The New York Times in 1994. “Some day we may all be in the trenches together in the fight against the slaughter of unborn children.” Members of the Portland-based skinhead group American Front regularly joined Operation Rescue to protest abortion clinics. Tim Bishop, a representative of the white nationalist Aryan Nations, said, “Lots of our people join [the anti-abortion movement] … It’s part of our Holy War for the pure Aryan race.”¹³

This means forcing white Christian women, through violence, societal pressure, direct coercion, and dwindling options, to bear more children in order to prop up white supremacists’ desired white ethno-state. It also means punishing people of color for their birth rates through criminalization, enforced poverty and limited economic mobility, and inhumane immigration restrictions.¹⁴

It’s no wonder that modern white nationalist figures and groups have found a home in the “pro-life” movement: from antiabortion group New Wave Feminist’s former vice president being outed as a white nationalist,¹⁵ to the white supremacist neo-fascist hate group Patriot Front marching alongside the March for Life in multiple cities this year,¹⁶ to “pro-life” priest Frank Pavone defending said marchers by proclaiming that there is “nothing wrong with being white and nothing wrong with being a nationalist.”¹⁷

The connections between white supremacy and antiabortion are plain. Abortion bans and regressive gender roles serve to increase the number of white babies born, while criminalizing and harming women of color especially. Abortion justice and gender justice and racial justice—together they rise, and together they fall.

13

Your Body Is Not Your Own

What If We Understand the Criminalization of Abortion as Part of Creating a Larger Criminalized Class?

by Cheryl Rivera

In the wake of the leaked memo signalling the end of Roe v. Wade, feminists of all stripes mobilized within forty-eight hours to organize rallies, marches, pamphlets, and fundraising campaigns. These efforts varied as much in their tactical approaches as in the substance of their politics—Democrats did just as much fundraising off the back of the leaked memo as abortion access funds. Liberals and left activists came together but just as quickly found themselves at odds. At a large rally held in New York’s Foley Square, a speaker from former cop Mayor Adams’s office attempted to give a rousing speech, but was shouted down by radical elements in the audience screaming “Fuck Mayor Adams!” until the speaker finally retreated from the stage.

As the fallout from the memo mounted, reproductive justice organizers had to make quick decisions about how to intervene into a public discourse dominated by liberal activists and talking heads. The liberal feminist has correctly pegged abortion bans as an effort to control and criminalize women. However, the last several weeks have made it clear that the liberal feminist does not have an understanding of how the attacks on abortion access fit into a larger political project of state criminalization. If abolitionists don’t add our voice to the fight around abortion, we risk liberal feminists dominating the narrative. And while attacks on abortion are about misogyny, they are also about much, much more: realizing this means realizing how much is at stake, for all of us, and is the first step to building the broader class solidarity across the left that can create a mass movement.

•••

Who is criminalized, how they are criminalized, and why they are criminalized is part of how class is constructed. Abortion restrictions criminalize women, not just to oppress them on the basis of misogyny, but also as part of an effort to define women as a precarious class whose bodies, labor and wealth can be appropriated by capitalists.

The United States has always used criminalization as a way to construct class, going back to its founding as a genocidal slaver nation. Early interactions between European colonizers and Indigenous peoples were marked by constant white violence in response to Indigenous efforts to protect their homes and people. Constables in the northeast were established to stand as bulwarks against white fears of Indigenous violence. As white colonizers expanded into the West, they built police departments that could demarcate who was to be protected under the nascent state and who was to be pursued by it. St. Louis’s police department was founded, for example, in 1808, only five years after the Louisiana Purchase, and with the explicit purpose of “protecting” white people from the Indigenous people who had long used the area as a hub for trade. From the beginning, a key element in the formation of the United States was determining who can legally do violence and whom can violence can legally be done to. In the South, slave patrols were organized to ensure that Black people could not escape the brutality of their enslavement, and also to impress unlucky free Blacks into it. In many Southern counties, white men were required to serve in the slave patrol, thus ensuring that the criminalized population was demarcated along explicitly racial lines. The sanction of violence against those resisting enslavement and settler-colonialism is the first form of criminalization in this nation.

The criminalization of resistance continues today. Policing stands as a venerated institution that is supported by both major political parties; the United States spends upwards of $200 billion a year on policing and incarceration. It is true that some people are criminalized for interpersonal violence—violence that police, prisons, and the legal system have done nothing to actually stop, and which pales in comparison to the magnitude of structured state violence. But importantly, many people are criminalized by the state every day for “crimes” including stealing food and supplies to survive, refusing to comply with state orders, sleeping in public, jumping turnstiles in subways, fighting back against violence done to them, and using drugs for fun or to cope with the oppressive conditions of the life this state allows us to have. All of these actions are forms of resistance to a state that has, since its inception, intended for you to be useful in securing its power and profit, or die.

The body has always been a crucial source of profit for the state and its ruling class—the US relied, for example, on turning bodies into capital through slavery. The question is always: Whose bodies? The state criminalizes particular classes of people: the working class and the underclass—and particularly, the Black and Indigeous people of these classes. But the criminalized class is flexible. Although racialized bodies—Black, Indigeous, migrant, etc. - are understood as first and foremost criminalized bodies, they are not the only ones who can belong to the criminal class. The flexibility of criminality is that it may expand and contract, allowing more people to be sorted into the category when necessary.

It’s no coincidence that as the average American’s quality of life—access to affordable housing and health care, jobs with good wages, quality education, and basic necessities—has declined since the economic crash that abortion access, but not the rate at which people seek abortions, has also declined. The panic of the 2008 recession made it possible for the Affordable Healthcare Act (ACA) to pass, and while the act did not go far enough to secure health care for all, it did make it possible for more people to receive health care, including abortions, than ever before. The antiabortion movement was already in full swing, having been invigorated by the murder of Dr. George Tillman in 2009. To combat the possibility of the ACA leading to more abortion freedom, politicans like former Wisconsin Govenor Scott Walker moved to defund Planned Parenthood affiliates and enact targeted restrictions on abortion providers (called TRAP laws) in most states across the US. The last decade has seen dozens of abortion restriction laws passed in states every year.

The recession of 2008 never quite receded for most Americans. Millennials, now in their thirties, are far less likely to own their own home compared to any previous generation. The federal minimum wage has not increased since 2009. The ongoing Covid-19 pandemic has only worsened conditions. Under such economically dire conditions, many young people feel they cannot afford to have children. The future of capitalism requires, however, the continued supply of not only bodies into the labor pool, but also social reproduction of the current structures of our capitalist society for the next generation. To do so, the worker must be coerced. As the economic conditions have gotten worse, the number of TRAP laws enacted in states has only increased; Planned Parenthood notes that there have been forty-one additional abortion restrictions enacted in 2022 alone.

While it is true that conservatives have been laying the groundwork to destroy Roe v. Wade for much longer, we can see how quickly it has unfolded over the last decade as part of an expansion of the prison-industrial complex that exists in part to manage the disorder produced by austerity and state neglect, and in part to expand the white supremacist state’s categorization of which bodies can be sites of labor from which wealth can be extracted, and which bodies are disposable entirely. Abortion criminalization allows the state to force some bodies into labor to produce future labor and punish those who do not.

You can see this same social-control-as-capital-accumulation at play when low wages provoke worker efforts to strike and unionize, and police are called in to intimidate and arrest them. You can see it as well when people are arrested for stealing from a store like Target, but Target is never punished by law for wage theft. Some bodies have a one-way extractive relationship with the state.

Abortion criminalization is not just about controlling women’s bodies; it is also about destroying the recently rejuvenated labor and Black liberation movements. Capitalists wish to control all aspects of the body; the body that labors, in all senses. To do so, it slowly expands the category of who can be controlled, because autonomy is a treasured luxury for a handful of elites.

•••

Where are we led if we understand the criminalization of abortion as part of creating a larger criminalized class? While the deeply rooted and ever-present white supremacist logic of the United States means that Black and brown people will continue to be the primary victims of abortion criminalization, a Supreme Court decision striking down Roe will open more people than ever to the possibility of entering the criminal class. And yet, hand in hand with this great expansion of criminalization comes a corresponding expansion of the number of people with a material stake in fighting back.

Shock waves are reverberating across the nation from women who still cling to the promise of bourgeois politics, the promise of a state that can ensure rights, not just take them away. For those women—many of whom are white, educated, monied—it may be a jolt to feel the confines of class close in around them. Perhaps this is why the abortion rights movement is so white; Black and brown people’s bodies are routinely criminalized and have been for centuries, and abortion rights are not the only way our bodies are criminalized—our attentions may be drawn to one of the other numerous fights for control over our lives. With the potential fall of Roe v. Wade, white, monied women have to come to terms with precarity as a potential part of the criminal class, the possibility of being targeted alongside the Black and brown women who have felt the sting of criminalization for generations. And all those who will be criminalized for asserting autonomy over their reproductive lives will become part of a larger criminalized population that includes all who face persecution from police, prisons, and the legal system.

This criminalized body, of which many of us are a part, does not yet recognize itself as one body. We must recognize that criminalization creates a class solidarity that we can exploit. The state wishes to criminalize us for insisting on bodily autonomy, but it can only do this through leveraging the violence of police and prisons. This is why abolition must be one of the core values of any abortion access movement.

We are seeing this work being done already through the efforts of mutual aid abortion funds that can not only help women in places with legal abortion get one, but also help women who live in places where abortion is illegal circumvent a criminalized status by traveling out of state. However, simply outwitting the state that criminalizes us cannot be the end goal. We must destroy the apparatus wholly: dismantle the police who enforce the laws that bind, destroy the prisons that hold those of us who are bound, and delegitimize the legal system, including the Supreme Court, that sanction both.

In the coming months, as people are paying attention to the Supreme Court decision and perhaps even despairing, organizers must focus on connecting the threads that reveal most of us to be perpetually on the verge of criminalization—whether by virtue of having a uterus or otherwise. Any body can become part of the criminal class in this country—your body is not your own, and neither is what your body produces. We find evidence of this not only in the fight for abortion access, but also in the fights for labor rights, for housing, and for abolition, as the state severs people from the fruits of their labor and coerces them into the unforgiving precarity of the free market—often alongside the slow violence of austerity, and sometimes with hot flashes of authoritarianism. We can also find solidarity by looking at these same fights.

Our work must reveal that the project of criminalization stems from the state’s fundamental drive to control our bodies and our labor; and that this control is both foundational to this state and necessary for its survival. To protect the bodily autonomy of each of us, we must move as one body against state control of any of us.

14

Abortion Behind Bars

The Carceral State Already Removes Bodily Autonomy and Any Illusion of Reproductive Choice

by Victoria Law

The upcoming Supreme Court decision in Dobbs v. Jackson Women’s Health Organization will decide not only on Mississippi’s ban on abortion after fifteen weeks of pregnancy but the right of states to enact similar bans on reproductive choice. But even if the Supreme Court doesn’t rule in Mississippi’s favor, one very large group will continue to face obstacles to abortion access—incarcerated people.

Each year more than 1 million people are sent to women’s jails and prisons. An estimated 58,000 are already pregnant when incarcerated.¹ Behind bars, reproductive choice is frequently nonexistent—and pregnant people seeking abortions are often stymied by sheriffs, prison wardens, and other nonmedical staff. (I use the term “pregnant people” to acknowledge that not every person in a women’s jail or prison identifies as a woman.)

A 2021 study found that only nineteen state prisons and four jails allow abortion in both the first and second trimester.² Two-thirds of those nineteen state prisons and at least one jail required the incarcerated woman to pay for the procedure, which can be an obstacle in and of itself.

In states with restrictive abortion laws—or that might soon outlaw abortion altogether—people seeking abortions can access abortion funds and cobble together travel for a procedure in a different state. It’s arduous and time-consuming and many may not be able to take the time off work, or away from family and other responsibilities to do so, but that option is there (at least for now).

Pregnant people in jails and prisons do not have that option. They rarely, if ever, know about, let alone can access, outside abortion funds. (One exception is the Richmond Reproductive Freedom Project, which has a specific fund for reproductive health care behind bars.) They cannot travel to a different state for the procedure.

In essence, says Carolyn Sufrin, director of Advocacy and Research on Reproductive Wellness of Incarcerated People (ARRWIP), “pregnant people in states where abortion is outlawed will be literally punished by carrying a pregnancy to term.”³

Even now, when Roe v. Wade still stands and abortion has not been outlawed, jail and prison administrators have thrown up additional roadblocks to abortion access. Take the 2015 case of twenty-nine-year-old “Jane Doe,” who entered the Lauderdale County Jail in Florence, Alabama. She already knew that she was pregnant. So did the authorities who accused her of exposing her embryo to drugs and arrested her under Alabama’s chemical endangerment law.⁴

Shortly after her arrest, on July 10, she requested a medical furlough, which is a temporary release from jail for medical reasons, to obtain an abortion. The nearest abortion provider is approximately seventy-five miles away in Huntsville, Alabama, which provides abortions up to 21.6 weeks. According to the suit she filed, Jane Doe was not requesting that the jail pay for the procedure; she would pay for both the abortion and transportation to the clinic on her own.⁵

Nonetheless, three days later, the sheriff denied her request. According to court documents, his response read, “It is the policy of this office that all non-emergency services are provided through our medical staff at the jail. Your request cannot be handled by our staff and on its face, it does not constitute a medical emergency.” If she wanted an abortion, he concluded, “a Court Order will be required directing the Lauderdale County Sheriff’s Department to transport you to Huntsville, Alabama, for the stated purpose.” So, Jane Doe, whose release date was unknown at that point, requested just that. With the assistance of the ACLU in Alabama, she filed a lawsuit in federal court.⁶ On Monday, July 27, Jane Doe had a hearing as to whether being in jail should restrict her right to an abortion. Then she had to wait even longer—the judge stated that he would issue his ruling on Friday, July 31.

But Singleton wasn’t the only official creating legal obstacles. Chris Connolly, the county’s district attorney, filed a motion to terminate Doe’s parental rights over the embryo, which would strip her legal right to an abortion.⁷ A guardian ad litem was assigned to the embryo. Maurice McCaney, a different attorney than her ACLU counsel, was appointed to represent Doe. That case was also scheduled for Friday, July 31, but in juvenile court, which is closed to the public; its records are kept confidential. If Connolly’s motion were successful, it could set the stage for other officials to prevent others from obtaining abortions.

On Wednesday, July 29, Doe’s attorney in the parental rights case filed an affidavit from Doe stating that she had changed her mind and would now carry her pregnancy to term.⁸ “After much consideration and counsel, I … have decided that I no longer desire to pursue an abortion procedure and intend to carry the unborn child to full term and birth,” she wrote in the affidavit that McCaney submitted to the court on her behalf. “I have arrived at this decision of my own volition and choosing … without any undue influence, duress or threat of harm.” Had she changed her mind after obtaining the court order necessary for an abortion, it could very well be argued that she made her own decision. And of course, it is impossible to know for sure. But it seems evident from an outside perspective that the delays around the court order, coupled with the threat of terminating her rights over her own body, most likely influenced Doe’s decision to pull out of the legal circus. On Friday, July 31, after speaking with her in closed court, the federal court judge dismissed her abortion lawsuit.⁹

Under the Eighth Amendment, people in jails and prisons have a constitutional right to adequate health care.¹⁰ While many stories have examined that right when it comes to pregnancy behind bars, less is known about women’s access to abortion care.¹¹ As Jane Doe’s case illustrates, the little that we do know suggests that sheriffs and other administrators around the country have often thrown up barriers to abortion access. In other words, jails and prisons are sites where bodily autonomy, and reproductive justice in general, must be fought for.

Alabama’s Jane Doe is not the first woman in jail who has had to file suit to access her constitutional right to terminate her pregnancy before twenty weeks.

In 1987, a woman seeking an abortion was forced to bring suit against New Jersey’s Monmouth County Correctional Institute.¹² The jail’s policy required women to not only pay for the procedure, but also to obtain court orders to be released to have it.¹³ She ultimately prevailed, with the court holding that the jail’s policies unconstitutionally interfered with incarcerated women’s abortion rights. Although the county argued that abortion was an “elective” procedure, the Third Circuit Court of Appeals ruled that abortions, like all other pregnancy-related care, are a serious medical need.¹⁴ The court also ruled that, because incarcerated people are totally dependent upon the jail or prison to provide medical care and other basic needs, the facility must subsidize the cost of an abortion if a woman has no money and is unable to raise it.

In 2004, Sheriff Joe Arpaio of the Maricopa County Jail in Phoenix, Arizona, infamous for its tent city and chain gangs, also rejected a woman’s request for an abortion, stating, “I don’t run a taxi service from jail to an abortion clinic and back.”¹⁵ She, too, was forced to file a lawsuit in superior court. She prevailed and was able to obtain an abortion. (At that time, according to the Union-Tribune of San Diego, approximately 45 of the 1,000 women at the jail were pregnant.)¹⁶ The court also ruled that the sheriff and the county could no longer require women to obtain a court order before jail staff would transport them for an abortion.

The following year, in October 2005, the Supreme Court weighed in on the issue in Crawford v. Roe.¹⁷ Until September of that year, the Missouri Department of Corrections, which operates the state’s prisons, had a policy of providing transportation for women seeking abortions, so long as they could pay for the procedure. On September 5, however, the policy changed. The new prison policy stated that an abortion would only be approved if it was deemed necessary for saving a woman’s life and health—and if it was approved by the medical director and regional medical director. Transportation for what were deemed “elective abortions” would no longer be considered.¹⁸

Soon after the policy changed, a woman known in court documents as Jane Roe, who was in her sixteenth or seventeenth week of pregnancy and facing a four-year prison term for a parole violation, sought an abortion. Although the woman was willing to pay for the procedure, state officials initially denied it, telling her that they would not arrange for an abortion that was not medically necessary. A federal judge disagreed, issuing an order requiring that she be taken to a clinic in St. Louis, but Supreme Court Justice Clarence Thomas temporarily blocked the order. Three days later, the Supreme Court vacated the stay, allowing the woman to obtain the abortion.¹⁹

But legal precedent doesn’t mean that jails, even those that have already been ordered to stop hindering the right to abortion, will always allow access. In 2008, despite the ruling three years earlier prohibiting him from doing so, Maricopa County Sheriff Joe Arpaio demanded a court order from “Mary Roe” in response to her request to be transported from the jail to obtain an abortion.²⁰ By the time Roe prevailed, four weeks had passed and her pregnancy had progressed to the point of requiring a two-day hospital stay instead of a one-day procedure.

If the Supreme Court overturns Roe and states are free to set their own rules, even these lawsuits may no longer be an option, says Sufrin. “These roadblocks used to be illegal,” she said. “But if people found legal representation, they could sue for abortion access.” But should the Supreme Court overturn Roe, she says, “There will no longer be any legal recourse.”²¹

Even when a court order is not explicitly necessary, as reproductive justice scholar and advocate Rachel Roth has noted, policies like Monmouth County’s that require incarcerated women to pay for their abortion, as well as for transportation and staff time, can prohibit women from attempting to make arrangements.²² A 2015 report by the Prison Policy Initiative confirmed that people in jails and prisons are poorer than those who are not. Nationally, the median income of an incarcerated woman before her incarceration is $13,890, compared to $23,745 for a nonincarcerated one. For Black women, who are disproportionately policed, prosecuted, and imprisoned, the median income drops to $11,820, compared to $24,255.²³ Given these low incomes, the requirement that women pay for their own abortions has probably forced more than one woman to carry her pregnancy to term instead.

In April 2022, Oklahoma governor Kevin Stitt signed a bill making abortion illegal except in medical emergencies.²⁴ For years, Oklahoma has had the highest female incarceration rate per capita, and, before the 2022 law, state prison policy required that a woman submit her request for an abortion, in writing, to the medical provider. The woman was responsible for paying for the procedure; all financial arrangements needed to be completed before the abortion would be scheduled. In addition, the policy stated that “No Department of Corrections (DOC) employee will be compelled to participate in the offering of these options if to do so would be in conflict with his or her personal/religious beliefs.” Thus, even if a woman were able to raise the necessary funds from prison and reach a provider, she would face further obstacles in finding staff willing to transport her to the clinic. On any given day, 14 of the nearly 3,000 women in Oklahoma’s state prison system are pregnant, but women who have spent more than ten years in Oklahoma’s women’s prisons have told me that they have never met anyone who has ever had an abortion while locked up.

People in jails and prisons have a constitutional right to medical care. Requiring pregnant people to obtain court orders or navigate institutional bureaucracies violates that right. And, as seen in the case of former Maricopa County Sheriff Joe Arpaio, court injunctions do not necessarily stop administrators from creating such obstacles. Furthermore, in each of these cases, the woman was able to pay the costs of the procedure and, when her request was denied, able to make contact with organizations such as the ACLU to file a lawsuit. But policies requiring women to pay for their abortions can—and probably do—stop other women from even being able to file that first request, meaning that their stories never reach the courthouse or the outside world.

We have to remember that not every person behind bars knows what resources are available to help her fight for her reproductive rights (including her right not to reproduce). “Many incarcerated people don’t know they have rights to abortion because all of their [other] rights have been taken,” notes Sufrin. The Supreme Court decision, allowing states to decide whether to outlaw or severely restrict abortion, “will just add to the confusion.”²⁵

We also don’t know how many other people have been denied abortions but have not had access to legal counsel willing to help them file suit. Several months before the Alabama lawsuit, I received a postcard from a woman who learned that she was pregnant while in the Maricopa County Jail. She stated that she had been unsuccessful at obtaining an abortion and so was forced to carry the pregnancy to term. That was the only communication I heard from her.

And even with financial and legal resources, incarcerated people can still face lengthy delays when they need abortion care. In Alabama, Jane Doe originally requested a medical furlough so that she could obtain an abortion on July 10. Even if the district attorney had not complicated the process by filing to terminate her parental rights and prevent an abortion, she had to wait three weeks for the judge’s decision. If she had pursued seeking an abortion, the three-week delay might mean a longer and more costly procedure.

Ultimately, Doe’s suit became a battleground for whether women in jail or prison—and people in general—have the right to make their own decisions about their bodies.²⁶ The day after Doe withdrew her suit, ACLU legal director Randall Marshall said, “This lawsuit is about Jane Doe’s constitutional right to make her own determination regarding her own pregnancy rather than having the state court judge, the district attorney or the sheriff make that decision for her. If this is truly her own decision [to move forward with the pregnancy], it must be respected.”²⁷

The continuous denial of abortion access cannot be challenged without also addressing the ways in which incarceration—in jails or prisons—strips people of all bodily autonomy, including their reproductive rights. Since 2000, women in jails and prisons have been the fastest-growing population behind bars.²⁸ The most systematic way for reproductive rights and reproductive justice advocates to challenge this lack of access is to change policies that send so many women to jails and prisons altogether. Otherwise, advocates face the daunting—and never-ending—task of trying to reach and get resources to the hundreds of pregnant women cycling through jails each year and hoping for speedy and sympathetic court rulings.

15

Pregnant and Prosecuted

In a Post-Roe World, the Rights of the Fetus Would Supersede Those of the Person Carrying It—But for Many Pregnant People, This Is Already True

by Marie Solis

Jennifer Johnson wasn’t sure she wanted to talk to another reporter. When she last spoke to the media, more than two decades ago, she felt exploited and misunderstood. “Pregnant, Addicted—and Guilty?,” a 1990 New York Times headline about Johnson asked. The previous year, Johnson’s local paper, the Orlando Sentinel, described her legal proceedings as the “cocaine baby case.” It seemed that not even Oprah Winfrey, the empath of daytime television, could get Johnson’s story right. Winfrey, who interviewed Johnson in 1995 alongside three other mothers who were recovering drug users, revealed during the episode that she had smoked cocaine in her early twenties. Johnson, whose appearance on the show had been arranged by her attorney, balked at the suggestion that Winfrey understood what she was going through.

“There was this public image of me that was created,” Johnson said. “People would see me and say, ‘Oh, that’s the girl who smoked crack with her baby?’”

Johnson was arrested in 1989 for using crack cocaine while she was pregnant and later convicted of “delivering drugs to a minor,” a charge that had never before been used to prosecute a pregnant person using drugs. Hers was one of the first instances of a person being prosecuted for a crime they were believed to have committed against a fetus.

Johnson became a mother in the 1980s, just as the so-called war on drugs was swinging into full effect and the collective moral panic about a crack “epidemic“ was peaking. Earlier in the decade, a young doctor named Ira Chasnoff published the research—later to be debunked—that spurred the “crack baby” myth, creating the specter of a drug-addicted Black mother who cared little for her infants and doomed them to poor health and negative life outcomes. The findings led one television anchor to report a factually incorrect statistic about a “500 percent increase in damaged babies.”

To some, Johnson, a low-income Black woman who had admitted to using the drug while pregnant, fit this emerging narrative, which portrayed people in her position as villains rather than as parents battling addiction. That image became central to her court case. But in order to justify sentencing a young Black mother to more than a decade of probation, prosecutors and policymakers insisted that they were helping Johnson and that her punishment was for her own good as well as a move toward establishing a necessary precedent. “Arresting a mother for delivering cocaine to her unborn child may be considered drastic and extreme,” Governor Bob Martinez of Florida said at the time, “but it is only a matter of time before every state in the nation feels the need to take drastic steps such as those we’ve taken.” That Johnson’s life might be destroyed in the process was irrelevant.

Johnson’s story isn’t anomalous. She’s one of hundreds of women who have been criminalized for using drugs while pregnant, many as recently as this year. Others have been criminalized for self-inducing abortions, attempting suicide, giving birth to a stillborn, and being shot in the stomach and charged with crimes like murder, manslaughter, and child endangerment. Advocates say low-income women of color are the typical targets for prosecution in these cases.

As six-week abortion bans and other restrictions have chipped away at Roe v. Wade, more women like Johnson found themselves standing before judges and juries for such offenses: in April, about seven months after Texas passed the strictest ban in the nation, a woman named Lizelle Herrera was arrested in the state, charged with murder, and held in jail on $500,000 bond for self-inducing an abortion. The district attorney later moved to dismiss the case and Herrera was released from police custody after mobilization efforts helmed by abortion rights groups led by women of color.

The impending Supreme Court decision on a fifteen-week Mississippi ban, which appears poised to further dismantle the landmark Roe ruling, will almost certainly lead to more arrests like these, abortion supporters say. When abortion is heavily restricted or outright banned, any negative pregnancy outcome, even premature birth or a birth defect, may be criminalized. A miscarriage, for example, could be interpreted as an attempted abortion and prosecuted under the existing abortion statutes, like those in several states targeting self-managed abortion. This was the case last year in Oklahoma, where Brittney Poolaw was sentenced to four years in prison after losing a pregnancy. But often any pregnancy outcome is beside the point. Johnson gave birth to two healthy infants, but she was still accused of harming them. Prosecutors may build cases based on their own objections to a pregnant person’s habits and behaviors so long as they raise the possibility of risk to a fetus, advocates fighting criminalization say. Those behaviors can include drinking and using drugs, but they may also include more innocuous-seeming activities, like forgetting to put on a seatbelt or waiting too long to see a doctor. Such cases have been documented.

Lawyers have largely succeeded in getting these cases thrown out, but entering the legal system is life-altering for their clients. Johnson said she was only now, more than two decades later, beginning to feel that she had gotten her life back. On a Zoom call last July, she greeted me with laughter as her camera turned on, explaining that she was wearing a patterned scarf on her head because she was having a bad hair day. (“Don’t put a picture of this in your article!” she joked.) She said she finally had the words to make sense of what she went through in the ’80s and ’90s. Before, she said, other people defined her experience for her.

“White people had this language and would theorize the situation, but nobody asked, ‘What happened to you?’” Johnson told me. “They weren’t talking to me; they were talking about an idea.”

•••

In 1987, Johnson, then twenty-one years old, told her son’s pediatrician that she had used cocaine the night before his birth. The pediatrician tested both Johnson and her son for the drug, and the results came back positive. Johnson had confessed with the hope of receiving guidance and care: she thought someone would help her if she told the truth. But hospital staff neither reported her to authorities nor connected her to resources that might help with her recovery, her lawyer said. She had just begun using drugs regularly, and she told me she could have stopped if someone had referred her to a counselor or rehabilitation center. Instead, she and her newborn were sent home, where her husband, whom she described as an abusive drug dealer, was waiting.

Two years later, Johnson gave birth to her daughter Jessica. After delivering the baby, a similar scenario unfolded: Johnson told her obstetrician she had used crack cocaine just as she went into labor. When she was pregnant with Jessica, she made multiple attempts to find a treatment center that would admit her, but at the time, there were no facilities in Florida that accepted pregnant women; only a few took women at all. She was turned away by an outpatient drug program after being told she presented too great a liability to the organization. In December 1988, just one month before she delivered Jessica, Johnson called the paramedics on herself for a drug overdose. She was taken to the emergency room, where she told doctors that she was using crack and feared for the fetus she was carrying. She was admitted to the hospital for observation, according to court documents, but quickly released.

Both times she delivered healthy babies with no complications, and both times she thought that doctors would be more responsive to her disclosure, that they would take her “to a drug place or something,” she later said at her trial.

It was Johnson’s persistence in seeking help that provided Jeff Deen, an aggressive Florida state prosecutor, with more fodder for his case against her, Johnson’s lawyer said. In 1989, Deen decided to make an example out of mothers who used drugs while pregnant and went looking for cases to prosecute. At the time, the Los Angeles Times reported that Deen had been “researching state laws’ for months, looking for “an avenue to prosecute a growing number of drug-addicted mothers.” In his search, he found documents that detailed Johnson’s positive drug tests and many admissions to smoking cocaine and decided to press charges.

“She created a paper trail that the prosecution used against her,” Johnson’s attorney, James Sweeting, later told the Los Angeles Times. “She made a lot of statements about her addiction that came back to haunt us.”

In January 1989, still in the hospital with her newborn daughter, Johnson was investigated by Florida’s Department of Health and Rehabilitative Services, whose officials were responding to a report filed by hospital staff. Jessica was taken from her, and Johnson left the hospital alone. About two months later, Johnson was arrested by authorities from the county sheriff’s office and charged with child abuse as well as two counts of “delivery of a controlled substance to a person under the age of eighteen.”

In a state court, prosecutors argued that Johnson had “delivered” the cocaine to her infant children in the thirty to ninety seconds immediately following their births via blood circulation before the umbilical cords had been severed. There was no hard evidence for this claim: prosecutors put together a case based largely on testimony from doctors who discussed the way an umbilical cord circulates blood between the placenta and child during delivery and after birth, and with experts who explained details about how the body metabolizes cocaine.

“When Dr. [Sashi] Gore was asked whether a woman who had smoked cocaine at 10:00 p.m. and again between 6:00 and 7:00 a.m. the following morning and delivered a child at 1:00 p.m. that afternoon would still have cocaine or benzoylecgonine present in her bloodstream at the time of delivery, the response was yes,” Florida Supreme Court justices wrote when they ruled on Johnson’s appeal.

That argument had never been made in court prior to Johnson’s case, and it relied on a law that wasn’t intended to apply to pregnant women. The statute originally aimed to prosecute adults who dealt drugs to minors; the legislation outlines violations related to selling drugs within 1,000 feet of schools and parks, for example. Nonetheless, in July 1989, Johnson became the first woman in the country to be convicted on the charge, where “delivery of drugs” was said to have occurred via umbilical cord.

When lawyers from the American Civil Liberties Union began advising Johnson’s lawyer, the judge who presided over the trial, O. H. Eaton, told reporters, “I cannot imagine why the ACLU feels sympathetic for mothers who transfer cocaine to their babies.” This was the common attitude at the time, reinforced by misinformation about the birth defects and developmental problems that researchers connected to pregnant women’s crack use. In reality, children are more likely to be impacted by prenatal exposure to tobacco and alcohol, studies show, but these substances aren’t illegal (neither are they layered with racial biases to the extent that crack cocaine is).

Johnson was sentenced to one year of house arrest and fourteen years of probation, which required her to, among other things, attend treatment, find a full-time job, and notify her probation officer of future pregnancies. Johnson received treatment while she went through the appeals process for her case. Doors to treatment centers, she said, miraculously opened to her once she was criminalized and legally required to be admitted.

•••

In late June of last year, Johnson was visiting her daughter Jessica in Tampa, Florida. While making hotdogs for her granddaughter, she held up the phone to let the five-year-old say “Hi!” to me. Now in her fifties, Johnson lives alone in Rochester, New York. She’s an ordained minister, and when we first spoke she was about to finish her master’s degree in criminal justice. She spends her days caring for her youngest son’s three children. Because he was the last of her five children, he was too small to remember her struggles with substance abuse or her battles with the legal system. It had been much harder building a relationship with Jessica, Johnson said, and they had only recently grown close. Her June 2021 trip to Tampa was the first time they spent time together in thirty-two years.

Johnson has had to establish more of a friendship with many of her children, rather than the traditional parent-child bond, because she was separated from them for more than a decade. Though she never officially lost custody of them, the two of Johnson’s children who were implicated in the state’s case, Jessica and her brother, went through the foster care system and spent some time with an aunt in New York along with two of their other siblings.

“When I used to see a mother with a baby I’d have a level of guilt,” Johnson said. “I’d think, ‘Why couldn’t I get seen in the light of being a good mom?’”

Johnson said she felt her reproductive rights had been violated when she was arrested. Like many Black women, Johnson said, she had to fight to raise her children. According to a 2012 UCLA Law Review article, most of the Black women who were incarcerated were the primary caretakers of their children. Meanwhile, one-third of children in foster care are Black, and “most have been removed from black mothers who are their primary caretakers.” The criminal justice system and the foster care system serve to “penalize the most marginalized women in our society while blaming them for their own disadvantaged positions,” writes Dorothy E. Roberts, a professor at the University of Pennsylvania in her book on the child welfare system.

Johnson’s criminal trial can be seen as a case study in the prejudices of these overlapping systems. According to Eaton, the judge who convicted her, Johnson’s crime was that she “made a choice to become pregnant and to allow those pregnancies to come to term.” The prosecutor charging Johnson put it even more plainly: “When she delivered that baby [Jessica] she broke the law.” In the eyes of the legal system, an abortion might have been the preferred outcome for a Black mother battling addiction.

But if Johnson’s case is a salient example of how Black mothers may be criminalized, then it’s also a reminder of how little support they have, even among groups that should be sympathetic. Reproductive rights organizations had only marginal involvement with Johnson or her case. Though the National Abortion Rights Action League and two chapters of the National Organization for Women signed onto an amicus brief in support of Johnson, big names like Planned Parenthood and NARAL were conspicuously silent. Spokespeople from the two national organizations were unable to provide me with any examples of advocacy work they had done around pregnancy criminalization in the past.

“I can say that mainstream prochoice and reproductive rights groups were interested in these cases to the extent that they might have implications down the road for the right to choose abortion,” said Lynn Paltrow, founder of the National Advocates for Pregnant Women and a lawyer who worked on Johnson’s case when she worked at ACLU. But there was little interest at the time in expanding the movement to acknowledge its intersections with racism and the war on drugs, or to further “the rights of people to have children without fearing arrest,” she said.

Reproductive rights organizations may now be more aware of the different forms pregnancy criminalization can take, but the advocacy specific to women who find themselves in a situation like Johnson’s is marginal. Organizations like If/When/How, a legal advocacy group for reproductive rights, and civil rights nonprofit Color of Change have both launched new initiatives dedicated to helping people who have been criminalized for pregnancy outcomes. But If/When/How’s legal defense fund would not cover women in Johnson’s position—the funds are only meant for those who “did something with the intent of ending the pregnancy,” senior counsel from the organization explained.

When I asked Planned Parenthood about its plans to focus on the issue, a spokesperson suggested that I talk to Paltrow instead. A NARAL spokesperson told me that it was “critical to ask questions about what a [post-Roe] world will look like” before also suggesting that I speak to Paltrow.

But pregnant people are being prosecuted while Roe is still in effect. Johnson’s 1989 conviction led to a number of copycat prosecutors who attempted to use the same legal strategies to criminalize young Black women. (Paltrow said it was no coincidence that cases concerned with “fetal harm” were on the rise that year. In 1989, the Supreme Court ruled in Webster v. Reproductive Health Services that states could have an “interest” in protecting fetuses before viability.) Between 2006 and 2020, the National Advocates for Pregnant Women identified 1,200 cases that involved some form of criminalization for a person’s pregnancy outcome. Some of these involved drug use, while others involved miscarriages, the mistaken belief that someone had attempted an abortion, or actual abortions.

Prosecutors typically make their case by willfully misinterpreting existing criminal statutes, Paltro said, using pre-Roe abortion bans that remain on the books, or arcane fetal homicide laws, which were originally passed to protect pregnant women from domestic abuse and other targeted violence. In 2014, Tennessee became the first state to pass “fetal assault” legislation, which expressly criminalized women for using drugs while pregnant; it’s estimated that several dozen women were prosecuted under it before the law lapsed two years later. A more oblique law, passed in Alabama in 2016—ostensibly meant to protect children from at-home methamphetamine labs—has been used to prosecute more than 400 women for the same thing. Without Roe, states will have more license to criminalize pregnant people, and the lawyers defending them will have a harder time making their cases.

•••

We are “wired to believe in a just society,” Paltrow said, which makes it hard for people to believe that people in the United States can face criminal punishment for being pregnant, but a new case comes across her desk at NAPW two to three times a week.

If the Supreme Court guts Roe, that number is expected to skyrocket, since any negative pregnancy outcome could be misconstrued as an attempted abortion. And in fact any perception of harm or attempted harm could provide the basis of a legal argument for prosecuting a pregnant person: in a post-Roe world, the rights of the fetus would in effect supersede those of the person carrying it, abortion supporters say, which Paltrow and others argue is already true.

Paltrow said that criminalizing pregnant people was one of the more covert ways the antiabortion camp has succeeded in chipping away at the protections of Roe, since it promoted the idea that a fetus is a person—something conservative politicians have long worked to codify in law. In this sense, the criminalization is both the cause and effect of eroding abortion rights in the United States. “If you can put someone in jail because they gave birth to a healthy baby after using a drug that causes no harm while pregnant, what do you think is going to happen when Roe is overturned?” Paltrow said.

Because many of the cases where a pregnant person has been charged with a crime involve some form of prosecutorial overreach, according to Paltrow, the charges are often dropped, dismissed, or overturned. But even when charges and convictions are successfully challenged, it’s often after people have already paid steep legal fees or served jail time. Years of reputational harm, stigma, and emotional distress can also follow.

In one of NAPW’s most well-known cases, Purvi Patel spent three years in prison for feticide—a charge stemming from the suspicion that she had self-induced an abortion—until her conviction was overturned in 2016. Patel’s legal battle became a major cause célèbre for the feminist internet at the time, and news stories warned that her case could be “just the beginning“ of prosecutors targeting pregnant women. But while stories like Patel’s are alarming enough to grab the public’s attention, it has been a challenge to make people see the connection between one pregnant woman’s case and another. When Patel was arrested and sentenced, few would remember that Patel was not “just the beginning”—Johnson was.

As in Patel’s case, Johnson’s conviction was unanimously overturned in 1992, but the legal system had already changed the course of her life. She was a virtual stranger to her oldest children. “You never get over that trauma,” she said. “You don’t recover from experiences like these—you just live with the injustices.”

Johnson’s conviction still appears on her record; the narrow confines of Florida law make it nearly impossible to get expunged. Johnson said she usually did great in job interviews up until the point at which her potential employer ran a background check and saw the words “delivery of drugs to a minor” beside her name.

Despite experiences like these, Johnson said she didn’t have any aspirations to reform the criminal justice system. She described herself as “politically neutral,” and in an email she explained that her aim was to mitigate harm for the people and help them resolve their legal battles as quickly as possible.

Johnson is still searching for a job in her field, but her main preoccupation has been mending her relationships with her children. “My daughter was angry for a long time,” she said. “Then she had her baby and she’s a mom and she’s more loving and accepting. My son tells me, ‘Thank you for fighting your addiction.’ I’m a super good mom.”

16

One Struggle, One Fight

Abortion and Transgender Health Care Are Under Attack by the Same Forces Using the Same Playbook

by Dr. Mary K. Bowman

The criminalization of abortion in over half the United States has occurred alongside attempts in state after state to ban health care for trans youth. This is not a coincidence. Both are attempts by the Right to reaffirm binary gender and enshrine gender-based oppression into the law. The focal point of the Right’s attacks has been health care provision—the most basic thing we need for bodily autonomy and political freedom. It is critical for our movements to enter into this political moment with an understanding of the shared roots of these attacks in gender-based oppression, and to build a broad-based movement that can protect our health care and our health care providers—and by doing so, abolish gender-based oppression altogether.

Binary Gender Is Over (If We Want It)

Gender was differentiated from sex as a concept by feminist scholars in the 1970s. Gender refers to characteristics usually presumed to be associated with masculinity or femininity, which an individual has within them and expresses through their personality and behaviors. Gender is both socially constructed and a fundamental way that people understand themselves, move through the world, and structure their relationships.

Core to the Western colonial definition of “gender” is the gender binary, the concept that there are only two genders—man and woman—and only two gender expressions—masculine and feminine. Within the gender binary, people may feel themselves to have some combination of masculine and feminine, might be more or less one or the other, or strictly male or female. But the binary limits the total number of possible gender/identities to two. In truth of course, gender identities are beautifully infinite, to paraphrase the writer ALOK.

The art project “GENDER IS OVER (if you want it)” was inspired by John Lennon and Yoko Ono’s iconic billboard “WAR IS OVER (if you want it).” It places a fine point on the social construction and inherent harms of gender norms. However, it is important to complicate that assertion by specifying that binary gender is over (if we want it). Gender as a self-concept and complex relationship to body, self, and others is truly infinite. To achieve liberation, we don’t necessarily need gender to be over—we need the way that gender oppression functions in society to be over. We need the gender binary to be over.

Gender is, above all, a method of categorization and social control—not a “natural” part of being human. As feminists and Marxists have long argued, gender roles are extremely valuable to class society; value and profit are better extracted when a gender binary organizes work in and outside of the home. Social reproduction theory asserts that while waged labor outside the home is what produces profit and wealth for the ruling class, its existence is dependent on unwaged labor inside the home. Unpaid domestic labor has historically been feminized. All the things upon which the maintenance and reproduction of waged labor depend—cooking, cleaning, clothing, and “producing” (that is, growing and birthing) actual human babies—fell to femmes. Without unwaged domestic work, wage labor is nearly impossible, as food, sleep, housing, and clothing are all required to continue to live and function in a waged work environment. US capitalism relies heavily on trillions of dollars of unpaid work to keep workers showing up to jobs for pay.

The profits of the ruling class depend on half the planet not expecting or demanding wages for social reproductive labor. Keeping women and feminine individuals in unpaid domestic work has been accomplished through the maintenance of binary gender roles within the nuclear family. The structure of the nuclear family and its dumping of domestic labor responsibilities on the back of one or more feminine individuals within the home is a highly effective way for those in power to increase their wealth, as well as to keep the working class exhausted and less capable of participating in uprisings and their overthrow. Femmes are compelled to continue in this way for a variety of reasons—care and love for their families, social expectation, deeply internalized misogynist/homophobic/transphobic rhetoric, abuse, and explicit violence. Those who depend on binary gender roles have attempted to find biological, historical, evolutionary, and moral justifications for them. Yet they have everything to do with power, patriarchy and capitalism, and those sure as hell can be over (if we want it).

“Family Values” Attacks on Abortion and Trans Care

The Right launches similar attacks on abortion rights and queer and trans existence using the concept of “family values.” The nuclear family is a construction of colonized Western society. Western colonization enforces binary gender because it serves the imperial, white supremacist project, similar in utility to the social functions of race and class. These supposed divisions and “opposing” identities divide society to help the ruling class maintain power.

Forced monogamy and individualized units of blood relatives ensured that property was inherited patrilineally, thus protecting generational wealth and the supremacy of the genocidal white men in power. Perhaps this is why many queer, trans, and pro-abortion feminists are more than happy to be accused of degrading “traditional family values” and “destroying America” as these ideas (and the country that peddles them) are repellent and oppressive.

Abortion threatens the status quo not only because it upends “family values” and gets the Religious Right in a tizzy. If people who can get pregnant are in charge of their reproductive futures, then they can refuse participation in forced birth and unpaid labor which largely functions in the service of cisgender men and their bosses (usually more cis men). Trans existence similarly threatens the status quo because not conforming to binary gender complicates this supposedly “natural” labor divide. Challenging these dominant norms may lead to questioning the entire order.

The Criminalization of Trans Existence

Parallel to the criminalization of abortion, the Right has been trying a variety of methods to criminalize trans existence through legislation. Restricting access to bathrooms and participation in youth sports has been common across the country. Approximately twenty-one states have introduced legislation in the last five years policing what restroom an individual can use on the basis of their gender presentation. Newly introduced legislation to ban trans kids from playing on gendered sports teams is pending in a number of states currently, while fifteen states already have those laws in place at the time of this writing.

The Right’s current crusade against health care for trans young people clearly shows how abortion rights and trans liberation are inextricably linked. In 2021, twenty-two states introduced legislation prohibiting access to care for trans youth, thirteen of which also included criminal penalties for prescribing providers.

Arkansas passed the Save Adolescents from Experimentation (SAFE) Act, the first law in the country banning gender-affirming care for trans youth. On May 8, 2022, the Vulnerable Child Compassion and Protection Act was passed in Alabama, making the prescription of gender-affirming hormone therapy to minors a Class C felony—the first law in the country to criminalize gender-affirming care provision for youth.

Several bills are being considered in other states for the 2022 session. Idaho House Bill 675 used the term “genital mutilation” to mischaracterize gender-affirming care, and attempted to criminalize leaving the state to obtain gender-affirming care for a young person. HB675 passed the house but died in the Senate on the grounds of “undermining parental rights,” though the Republican Caucus made sure to make their strong condemnation of gender-affirming care known. “Parental rights” being inviolable by the state is a curious argument from the party seeking to end bodily autonomy for pregnant people whom the party considers to be parents since conception.

Texas Governor Greg Abbott’s February 2022 executive order quite prominently moved to criminalize parents supporting and facilitating their children’s health care. On May 13, 2022, the Texas Supreme Court upheld that gender-affirming healthcare for trans youth is worthy of child abuse investigations. This has expanded the possible state punishment from patients and providers—the abortion template—to now include parents. Again, this strategy is clearly patterned after the Texas abortion ban, where civilians are unofficially deputized to report parents of trans kids who may be guilty of providing loving support and gender affirmation.

While some politicians in other states have publicly condemned these bans, no state has gone so far as to explicitly codify a right to gender-affirming care for all persons, including youth. In this way, the trans liberation movement has more ground to gain, and can pattern our demands after gains made by the abortion rights movement. The Right is not the only side where strategies can be shared.

The Criminalization of Care

One shared strategy of the Right is punting the responsibility and legality of health care rights from federal court to individual states. Allowing states to regulate this life-saving care instead of blanket federal protections creates more opportunities to challenge, restrict, and ban access. Another strategy is introducing extremist bills that they expect not to pass, with the intention of pushing the limits of what’s possible forward and inflaming public discourse. They share templates to introduce copycat bills in every state where the political climate might be favorable. In the case of abortion, many of these bills have been introduced in the hope of a legal fight that advances to the Supreme Court to pose a direct challenge to Roe. This is where we now find ourselves with Dobbs v. Jackson.

Missouri House Bill 2810 is a salient example of extremist tactics. HB2810 would make the possession of abortion medications and equipment a felony in the state of Missouri. The original language of the bill included the treatment of ectopic pregnancy—nonviable pregnancies which are life-threatening medical emergencies. After harsh media and political criticism, mention of “ectopic pregnancy” was removed from the bill, but legislators reinforced that dispensing abortion medications to end an ectopic pregnancy would still be considered a felony under the law. The most absurd aspect of this extremism is the abortion medications mifepristone and misoprostol are not used to treat ectopic pregnancy.

Yet the criminalization of ectopic pregnancy treatment was never the goal. Including it in the bill made felony charges for providers seem reasonable by comparison. Their willingness to remove extremist propositions helps them look cooperative and willing to compromise. Even when their bills are not passed or they lose court cases, the Right will often reframe the same arguments in new bills and get them back into the courts, retreading the same ground over and over again, hoping for an eventual win in the right political moment.

Extreme attacks on the most fundamental aspects of public life—using a restroom or a water fountain—have also been right-wing strategies to create a hostile and dangerous environment for targeted communities. Many saw connections with the Jim Crow laws of the South during the first wave of bathroom bills, recognizing that it’s never been about bathrooms, just like Jim Crow was never about water fountains.

Because attacks on trans people and attacks on reproductive rights are both rooted in gender oppression, the language in abortion bans can easily be transformed into language used in trans health care bans. As always, Texas provides a prime example. Senate Bill 8 emboldens civilians to take on law enforcement themselves and turn in anyone they suspect of aiding and abetting people seeking abortion care for criminal prosecution. Governor Abbott’s executive order on trans youth, upheld by the state Supreme Court, is essentially the same: rat out your neighbors for trying to take care of their kids and the state will arrest them. Of a piece, Arizona’s 2010 racist anti-immigrant law, HB1070, gave citizens license to call the cops on people who “looked like” they were undocumented. The Right clearly takes inspiration from every type of bigoted precedent they can find.

Gender-Affirming Care

There are approximately 1 million trans adults in the United States, though it’s likely this is an underestimation. More recent research shows that 2 percent of US high school students identify as trans or nonbinary. Indisputable professional medical consensus that gender-affirming care is strongly supported by scientific research, and profoundly beneficial for transgender and nonbinary people.

The rate of suicidality, self-harm, and attempted suicide among trans and nonbinary youth is disproportionately higher than that of their cisgender counterparts. Several research studies have supported that access to gender-affirming care, including hormone therapy initiated during adolescence, has been associated with lower incidence of suicidal ideation and attempted suicide. If the Right wants a lot of babies to stay alive, supporting trans youth’s access to life-saving care would be an excellent place to start.

Conservatives assert that gender-affirming care is a form of child abuse, which involves experimentation, involuntary surgeries, and the infliction of forcible permanent changes to young people’s bodies. Gender-affirming care for all ages typically begins with a variety of nonpermanent, reversible, or changeable voluntary decisions: social transition—how you present yourself to the world with clothes, your name, pronouns, hairstyles, makeup, etc., and legal transition—changing your name legally, changing your gender marker legally, updating your legal documents. Social and legal transitioning can start as early in childhood as a person would like, and a child might change those things multiple times, change them back to what they used to be, or keep them forever. There is potential for limitless fluidity and self-exploration without permanence or harm.

The earliest medical intervention for trans youth is pubertal suppression, which is possible prior to the onset of puberty (usually between eight and twelve years old) through age seventeen. Pubertal suppression means using medications that temporarily delay puberty to buy young people time to sort through how they’d like to develop physically, whether they want certain secondary sex characteristics, which ones they want, and when.

The introduction of hormone therapy is not typically initiated until a person is at least age sixteen, though in some cases this may happen a year or two earlier with parental support. Anyone under age eighteen will only be able to access pubertal suppression or gender-affirming medications with parental consent from all legal guardians, typically both biological parents regardless of their marital or relationship status. Gender-affirming surgeries generally don’t happen until someone is eighteen and can consent to those treatments independently.

Accessing gender-affirming care as a young person is already incredibly difficult, beyond parental consent and medical clearance. There are few providers who manage medical transition for anyone, let alone minors, especially in the Southeast and Midwest. Gender-affirming care, medications, and surgeries are prohibitively expensive even for most adults, and rarely covered by private or public insurance (though coverage has improved in some states and through some insurance carriers). Some of the attempted bans seek to make coverage of gender-affirming care through insurance illegal as well, copying similiar state restrictions of abortion care coverage through private insurance.

It doesn’t take hormones or pubertal suppression to positively impact the mental and emotional health of trans young people. A 2021 survey from The Trevor Project showed trans and nonbinary youth who reported having their pronouns respected by all the people they lived with attempted suicide at half the rate of those who did not. The ability to change their name or gender marker on legal documents and access to gender-affirming spaces also lowered rates of suicide attempts. While gender-affirming medical interventions like pubertal suppression and hormone therapy improve trans patient outcomes remarkably, nonpermanent, noninvasive, nonmedical behavioral and social practices have just as much impact on the quality of life and health of trans young people.

Trying to win the race to the bottom, in April 2022 Florida’s surgeon general, Joseph Ladapo, issued new guidelines from the Florida Department of Health against not only medical transition for youth but social transition as well. The guidelines state, “social gender transition should not be a treatment option for children or adolescents,” and suggest alternative “treatment” options of “counseling” and “social support.” This is an extension of Rick DeSantis’s “Don’t Say Gay” crusade to remove discussion of queer and trans identity from public schools.

As the state attempts to restrict all care providers from affirming trans identities for young people, one can assume that the only remaining “counseling” alternative would be a form of conversion therapy. A 2018 study showed that LGBT individuals who had been subjected to conversion therapies had double the risk of attempted suicide compared to LGBT individuals who had not. If the Right truly cared about the health and well-being of transgender youth, they would vociferously champion access to gender-affirming care—because the alternatives are deadly.

The Impact of Health Care Bans on Providers

These waves of criminalization for both abortion and gender-affirming care primarily target providers for state punishment, rather than patients. This has long been a part of the Right’s political strategy. Since providing care, rather than receiving care, is easier to prove, it is much easier to bring charges against a provider than a patient (though there are many horrifying examples of states detaining people, usually at the point of care, who were suspected of having abortions). Attempts to criminalize providers also discourage new providers, students, and existing providers from training and providing care for fear of state and community retribution. Thus there is a critical shortage of care providers for both abortion and trans health care, and fewer and fewer providers are learning how to do it.

The assassination of Dr. George Tiller by an antiabortion extremist in 2009 left only four physicians in the United States trained to provide third-trimester abortions. The providers of third-trimester abortions offer the most compassionate and supportive care to their patients and patients’ families, worlds apart from the medically inaccurate and vulgar language used by the Right to frame the procedure. These procedures are akin to fetal hospice, facilitating the end of a pregnancy as gently and thoughtfully as possible. (For more on the complexity and care of third-trimester abortion, watch the 2013 documentary, After Tiller, which intimately follows and interviews the remaining providers after Tiller’s assassination.)

Since 1977 in the United States and Canada, antiabortion terrorists have murdered eleven people and attempted to murder seventeen. They are responsible for 383 death threats, 153 physical assaults, 373 clinic invasions, 41 bombings, 655 anthrax threats, and 3 kidnappings. National Abortion Provider Appreciation Day commemorates the assassination of Dr. David Gunn, the first abortion provider to be assassinated in the United States. Routine harassment of clinic staff and providers by antiabortion protestors is now considered an expected hazard of the job. Abortion providers are targeted for online doxxing and are stalked by violent extremists—who target and terrorize their families and children as well.

In addition to explicit violence toward providers, the antiabortion movement opens fake clinics which confuse and endanger patients while interfering with safe care provision at real ones. Crisis pregnancy centers (CPCs) lure pregnant people in with free pregnancy tests and free ultrasounds, but their purpose is to coerce and shame people into continuing their pregnancies. They are not staffed by medical professionals and do not provide any medical services. In some states, legislation has been passed mandating that CPCs post visible notices stating that they do not provide medical care or abortions and that they do not have medical care providers.

CPCs are the recipients of federal and state funds that would otherwise go to sex education and actual reproductive health services. Nationally, CPCs outnumber abortion clinics by an average of 3 to 1 and an estimated $60 million in federal abstinence and marriage-promotion funds have been directed to CPCs. As a particularly insidious tactic, antiabortion organizations attempt to build or open CPCs as close to real abortion providers as possible to trick patients.

When Roe is overturned, Illinois specifically is facing a catastrophe of unspeakable magnitude. Already Illinois is considered an oasis state for abortion access in the Midwestern US. Abortion bans and restrictions in surrounding states are so severe that their residents find it necessary to cross state borders to access abortion in Illinois. Assuming the Dobbs decision negates federal protection of previability abortions, the number of people at risk for pregnancy whose nearest abortion provider is in the state of Illinois will go from 100,000 currently to almost 9 million–an 8,651 percent increase. The exponential increase in the need for care predicted to hit Illinois is very concerning to providers here. We are scrambling to put infrastructure in place to help accommodate such a massive influx of patients, but it is clear that without a fighting movement or a proabortion administration, this is an impossible task.

One must also wonder what new layers of police and military presence at internal domestic borders may develop as different states seek to criminalize neighboring practitioners who provide care to their residents. What will enforcement of abortion criminalization look like in the age of tank-driving county cops with military-grade weaponry and budgets flush with “extra” COVID funding? It is not uncommon for clinics, especially in populous liberal cities, to establish friendly relationships with local law enforcement for “protection” from antiabortion harassment and clinic protests. However, the abortion rights movement must concern itself with the realities of violent law enforcement and routine police suppression of activist struggles for justice, as we enter into this next horrific chapter of our decades-long fight. The police do not and will not protect us. We need alternative ways of keeping patients and providers safe from antiabortion harassment without relying on the violence of policing.

A queer correlary to CPCs is conversion therapy, the abusive programs targeting LGBTQ youth to shame and traumatize them based on their sexuality or gender presentation. Unfortunately, the field of medicine also has a history of destructive medical and surgical interventions to try to “cure” homosexuality and gender diversity. The fear-mongering and false claims from the Right about gender-affirming care for young people—genital mutilation, permanent physical changes, abusive medical practice—actually happen to babies and young people with intersex traits in an attempt to uphold the biological defense for binary gender. It is a heinous practice and there is a vibrant movement to end it. How upset the Right must be to learn that not only are there more than two genders, there are more than two sexes!

There are fewer direct comparisons between attacks on abortion providers and attacks on queer and trans care providers. The latter have experienced profound discrimination and harassment due to the identities of their patients and the perceived risk of care provision, especially regarding HIV/AIDS. Much more common though are acts of violence aimed at queer and trans people themselves, sometimes in the context of care environments. This is alongside an ongoing epidcemic of fatal violence against trans people, especially transgender women of color: 2021 was the deadliest year on record for trans people in the United States. On average, transgender people are over four times more likely to experience violence than cisgender people, including rape and sexual assault.

The criminalization of healthcare provision results in overwhelmed, targeted, and unsafe providers as well as patients. If this country continues to criminalize gender-affirming hormone therapy and care, the impact on trans care providers will be profound. If trans care continues to follow the political trajectory of abortion, there will be even higher risks for similar types of harassment, discrimination, and violence.

Fighting for Our Collective Liberation

The reality of the current political landscape is that the Right is trying to kill people—people who can get pregnant, Black and brown people, Indigenous people, transgender and nonbinary people—and it is up to us to fight back. If anyone can turn this boat around, it will be the formidable, brilliant, radical young people who have grown up in the midst of escalating climate catastrophe, endless wars, commonplace mass shootings, and a deadly global pandemic. We also have historical examples from our movement ancestors who fought worse things and won.

Roe was not the result of an objective interpretation of the Constitution on the part of the Supreme Court. The protections offered by Roe were a product of sustained and arduous struggle. We won that decision under President Nixon, an antiabortion Republican, with a conservative majority in the Supreme Court. We won because there was a militant, multiracial feminist movement in the streets, forcing the public to address the realities of criminalization and forcing politicians and pundits to acknowledge that a majority of the population supported abortion rights.

Currently, both the abortion rights movement and the queer and trans liberation movements have been commandeered by nonprofits and prominent national service providers. These corporate institutions dominate the public discourse with weak liberal axioms and blind obedience to the Democratic Party, funneling rage and momentum to the polls rather than the streets. The Supreme Court leak indicating the end of Roe more than adequately illustrates that movement leaders have chained themselves to a losing strategy. The nonprofit and national care organizations raking in donations as Roe is poised to fall have never met a fight they couldn’t limply lose. LGBT nonprofits have put very little of their money or energy into protecting trans kids—but are now starting to fret about marriage equality as the Supreme Court makes its agenda clear.

We must take back leadership of our own movements, movements we started with brave rebellions and collective care, movements which will only win if our communities are controlling them from below. Organizing reproductive and trans healthcare workers into labor unions could shift movement strategy and leadership directly into our own hands. Not only would unions better protect workers from violence and legal attacks, collective organization and worker power could bring teeth to our movements currently lacking due to their corporate leadership.

Critical to our survival in these treacherous times are organizations which offer material support—organizations which assist abortion travelers with housing, transportation, and emotional support; abortion funds; community groups and care providers protecting and welcoming trans youth and their families. Yet the political moment also demands incisive and visionary political strategy to forge ahead. In this we are fortunate to have robust, inspiring historical examples.

The Combahee River Collective was founded by a group of radical Black feminists in 1974. They were, in their own words, “actively committed to struggling against racial, sexual, heterosexual, and class oppression, and see as our particular task the development of integrated analysis and practice based upon the fact that the major systems of oppression are interlocking.” SisterSong is an organization which moves in that same tradition and developed the Reproductive Justice framework in 1994 on which the abortion movement depends. From Chicago, there is the vital legacy of the Jane underground abortion collective, a group of volunteers who provided over 11,000 safe but illegal abortions pre-Roe. Multiple online care organizations have taken up their mantle—Plan C, Aid Access, Women on Web—providing mail-order abortion medications in states or countries where abortion is illegal or heavily restricted.

Ancestors of queer and trans liberation are numerous and brilliant. ACT-UP, the AIDS Coalition to Unleash Power, is a direct action organization dedicated to increasing access to HIV and AIDS care, especially for queer and trans people. There is none more lovely than the STAR Collective—Street Transvestite Action Revolutionaries—founded by our beautiful foremothers Marsha P. Johnson and Sylvia Rivera, best known for starting the Stonewall rebellion. Carrying on that radical tradition is the Brave Space Alliance in Chicago, which provides material support and advocacy for Black, Indigenous, and people of color who identify as trans. Out of Atlanta, Southerners On New Ground describes itself as “a home for LGBTQ liberation across all lines of race, class, abilities, age, culture, gender, and sexuality in the South.”

Additionally, there are historical examples of how queer and trans liberation activists have shown up in solidarity with other movements which they’ve recognized as intrinsically linked to their freedom. Church Ladies for Choice, founded by ACT-UP members in 1991, was a drag troupe that came out fighting with the feminist movement for abortion rights. Lesbians and Gays Support the Miners was a UK-based group started by young communist queers who fought to support striking miners under violent state repression unleashed by Margaret Thatcher.

The goal of the abortion rights and trans liberation movements must be abolition, nothing less. There is no autonomy or safety for us under capitalism, colonialism, white supremacy, gender oppression, and ableism. So we must demand abolition. Police abolition to end the violent presence of cops at our clinics, in our communities, and against our movements. Prison abolition to end incarceration not only of care providers, patients, and parents, but of all humankind—migrant children caged at borders and survivors of domestic violence to those whose offenses require compassionate restorative justice not torture and isolation. Billionaire abolition. Military abolition. White supremacy abolition. Global warming abolition. Gender violence abolition. Poverty abolition, which is, of course, the abolition of capitalism.

The next phase of this movement must rapidly evolve if we want to win. We must embrace intersectional, trans-inclusive feminism as the only way forward. We must build solidarity with the movement for Black lives, the labor movement, the antiwar movement, the immigrant rights movement, the climate justice movement, the disability justice movement, and the Indigenous liberation movement. Our next steps require diverse and synthesized tactics, just as the Right is coordinated and strategic in their many attacks. We need masses in the streets, masses providing mutual aid, masses doing grassroots organizing, voting, and facilitating access to care. None of these things on their own leads to collective liberation. It has to be everything we’ve learned from our activist ancestors, and new things that have no historical precedent.

17

Pregnancy and Abortion

Only by Measuring How Much We Enjoy This Right Can We Measure the Social Wealth We Enjoy

by Movimento di Lotta Femminile di Padova
translated by Arlen Austin

In 1971, the Italian group Movimento di Lotta Femminile di Padova—the Women’s Struggle Movement of Padua—produced “Maternità e Aborto,” or “Pregnancy and Abortion,” a manifesto condemning a society that “has forbidden abortion while at the same time forcing abortions,” when the conditions of life and work “destroy the prospects of even wanted pregnancies.” The Italian feminist movement of the 1970s is best remembered for launching an international movement demanding wages for housework. Their call for remuneration for the invisible household labor that sustains capitalism still resonates when so much care work goes unseen and underpaid (if paid at all).

The language of “Pregnancy and Abortion” here likewise feels all too contemporary for US readers, because a child has become a luxury item today, given the cost of birth, childcare, and housing, and the total lack of state support. Lotta Feminista calls out the state that forces people to be mothers then “shakes off all responsibility” and offers little to help them raise their children. This is the world conservatives in the US now envision, where women are forced to carry pregnancies to term without health care or childcare, where safe haven laws and adoption are supposed to have negated the ordeal of an unwanted pregnancy, or where Amy Coney Barrett’s example is supposed to show that women “don’t have to choose” between career and children. Instead of this world, Lotta Feminista envisions a world in which the right to have children or not is intertwined with the right to have good sex—in “comfortable, warm, and beautiful surroundings.” It’s a vision of abundance and freedom that goes far beyond abortion.

This and other documents from the archive of pioneering Italian feminist Mariarosa Dalla Costa are made available online by Brown University and the Biblioteca Civica di Padova. Translated by Arlen Austin from Mariarosa Dalla Costa and Selma James’s 1972 book Potere femminile e sovversione sociale.

Like all women today, we too find ourselves with a need—urgent for everyone—to organize the fight for abortion, given that the level of medical research does not allow us to simply demand the free mass circulation of contraception. We are certainly not satisfied with the pill, the injection, or the other chemical and mechanical systems, as we are perfectly aware of all the dangers they still pose, nor are we satisfied with the development of gynecology, which has been, unsurprisingly, extremely slow compared to other branches of medicine, and which has done little to resolve the dangers associated with contraception. And so we are forced, as an immediate minimum objective, to organize ourselves for abortion, meaning that we organize not for “therapeutic” abortion, which would only reinscribe and aggravate existing class hierarchies, but for legal and free abortion (with anesthesia) accessible to all.

At the same time, we denounce the fact that until now the very illegality of abortion has worked as a major pillar of an enterprise built on human flesh—to the extent that it has been a method of delaying or even discouraging the search for contraceptives that do not ruin the biological and psychological health of women. The illegality of abortion has been the basis on which this enterprise has been built and articulated, through the decisions made as to where to concentrate forced abortions and how to organize the division of illegality/legality to the benefit of the novice doctor or the university baron who procures clients for private clinics.

Because we have fully understood all this, our struggle is first of all a struggle against all the social and power structures that have allowed this violence and which want our bodies subject to it. And so let’s say straight from the start that we are changing the sign of this struggle:

The problem is not abortion.

The problem is having the possibility to become mothers as often as we want to become mothers. Only when we want to, but whenever we want to.

The proletarian women of the south now have fifteen children and middle-class women somehow manage to have only two or three. But it is not the miserable privilege of not having children that is our ultimate goal.

After all, they have already begun to give us these poorly made pills, these injections that do not work, and they will eventually give us something better, and even allow us abortions.

The fact is that all this means (and cannot mean anything other than): “Regulate yourself a little. If you earn 100,000 lire, you can have a child; if you earn 150,000, you can even have two.” Our prompt response is that we are not party to this program.

We refuse this logic right now, immediately. This accounting, which takes for granted that our earnings or those of a husband should be the basis for planning how many children we have, is badly flawed and must be entirely redone.

Certain literature has begun to circulate inviting mothers, European mothers in particular, to participate in family planning as a matter of “social responsibility.” We reply that the type of “social responsibility” we feel is not at all that of adapting to our wage level, but of destroying every wage level, every wage mechanism, so we can have all the children we want and only when we want them. We measure our “social responsibility” by our capacity to fight to fully implement and propagate the right of each and every person to place a child on the face of the Earth as often as they want.

This is a right that still often has to pass through the conquest of a room for two, because if the precapitalist communities where parents made love in front of their children are now a “paradise lost,” then now, after the original sin separating Adam, Eve, and their children, a room for two is a minimal achievement—in Turin as in Reggio Calabria. Crowded promiscuity is not the utopian community we want to achieve.

Making love as often as one wants, having children as often as one wants, in comfortable, warm, and beautiful surroundings.

That means not paying for motherhood either at the price of wages or at the price of social exclusion.

Only by measuring how much we enjoy this right can we measure the social wealth we enjoy.

III. Get Yourself Some Pills

18

Maybe Abortion Isn’t as Complicated
as We’ve Been Led to Believe

The Underground Network of Midwives, Herbalists, Nurses, and Activists Providing Home Abortions across America

by Lizzie Presser

On a winter morning, Anna walked the aisles of an herbal medicine store, picked up a bottle each of blue cohosh and black cohosh, along with a plastic bag of pennyroyal tea, and drove to the topless bar on the edge of town where she worked.¹ There she met Jules, another dancer. They performed on a small stage with crystal curtains, the green light of an ATM flashing on their left, until 9 p.m. The women, both in their twenties, then drove to the Motel 6 where Jules lived and entered her dim room on the second floor, which smelled of grape cigars. Anna pulled out the tinctures and tea and explained the plan. She was going to help Jules try to have an abortion.

Anna had found the herbal recipe online. She’d read other tips as well: frequent hot baths, vigorous exercise, lots of gin. Women have relied on herbal abortion for thousands of years, and though specific regimens were hard to come by, anecdotal accounts littered the internet. Anna didn’t know how long it would take, so she moved in with Jules at the motel, dancing at the club each night. She set an alarm every four hours, keeping Jules to a schedule of 20 tincture droplets under the tongue and a cup of brewed tea. She drew baths for Jules, listened as she ran the stairs, and watched as she gulped Tanqueray. Anna kept taking her temperature and handing her glasses of water too.

Nine days in, Anna was lying across from the tiny TV when Jules screamed from the tub. She ran into the bathroom, where drying lingerie hung from the rods, and saw a pinkish swirl marbling the bathwater. Jules stepped out of the tub, and a gush of blood fell onto the floor. Holy shit, Anna thought to herself. This works.

Anna, who was a young mom, often doled out health advice to other girls at the club, trying to get them to eat better or use natural cures when they didn’t have money for antibiotics—garlic for yeast infections, cranberry juice, not cranberry cocktail, for urinary tract infections. She had grown interested in health work after she had become pregnant. Doctors had drug-tested her repeatedly even though she told them she was sober. They insisted on induced labor. For delivery, they gave her an episiotomy, which resulted in a fourth-degree tear from her vaginal opening to her anal sphincter.

The experience left her angry, and it got her thinking about birth and how to do it better. Within a few months, she’d enrolled in a midwifery school and trained as a doula, a support person and patient advocate during pregnancy. When she wasn’t dancing at the strip club or taking classes, she attended births in homes and hospitals. She gravitated to clients like herself, often low-income women in tougher circumstances, who didn’t seem to get the same treatment in hospitals as wealthy women. In homes, Anna found the care could be slower and gentler, the patients more in control.

About four years after her child was born, Anna became pregnant again, and she couldn’t afford another kid. She had quit college and midwifery school because of the cost, and she was supporting her unemployed boyfriend along with her preschooler. She’d read that vitamin C could bring on a miscarriage, but after she took 10,000 mg, she started vomiting and ran a fever. Anna didn’t know what else to do, so she took herself to a clinic, where she paid in cash. The doctor entered the room in acid-washed jeans, performed the procedure in thirty minutes, and left, hardly saying a word. She was ushered into a dark observational area, where women sat in a circle of pleather lounge chairs, some crying, others staring blankly as they came to from the sedation. Anna felt conflicted. It was clear she had needed to do this, but she also asked herself why it was she could carry one baby to term but not another. And then came the guilt that she had decided so easily to end the pregnancy.

In the dressing room above the stage at work, where the girls sat on benches, ironed their hair, and smoked between sets, Anna started speaking about her abortion. It wasn’t that she regretted it; she just wanted to talk about it, and she was sick of everyone else’s silence. She’d been raised by a mom who had told her not to discuss politics, religion, or money, and she enjoyed breaking all three rules at once. Soon enough, other dancers began sharing their stories, and many complained about clinics—the cost, the lectures on birth control, a dread that someone might recognize them, a vague sense of reproach. When Jules found out she was pregnant, it seemed natural that she came to Anna. She didn’t have much money, and she wanted to keep the whole thing private.

After Jules bled at the Motel 6, Anna wanted to know more about abortion. She asked midwives she had worked with for guidance on holistic care, and one suggested the herbalist Susun Weed’s website. The design looked straight out of the 1960s—a silver-haired woman wearing a bandanna beamed in front of a waterfall—but Anna read the site top to bottom, noting different plants that women used, some of which have been shown to block progesterone or cause contractions. She felt she would never speak the language of feminist activists or academics, but she tore through books, from Margaret Nofziger’s A Cooperative Method of Natural Birth Control to Dr. Christiane Northrup’s Women’s Bodies, Women’s Wisdom. She read about clinical abortion, too, and fantasized about learning the necessary skills in medical school, which she knew would be too expensive. That year, three more friends asked for her help when they got pregnant. She tried herbs with all of them, modifying the regimens, but it worked only once.

Anna started posting on Facebook about abortion, looking for direction. Eventually, a friend reached out to her, offering to introduce her to a woman named Natalie. The two talked on the phone. Anna admired how Natalie spoke with such authority and openness. Natalie liked how casually smart Anna was, how she connected reproductive health care to social justice. After several calls, Natalie told Anna about a side of her life she hadn’t yet shared: She was helping with a workshop on how to provide home abortions. Anna was welcome to attend. She just had to keep it a secret.

In March 2015, Anna drove to a suburban, brown-shingled home with a small garden. When she walked inside, she hit her head on a chain hanging from the ceiling. Where the fuck are we? she thought as she looked around. The home belonged to a set designer, and the roughly twenty students practiced in themed rooms, giving one another vaginal exams and checking blood pressure. Partway through the workshop, a pregnant woman arrived who had agreed to let them witness her abortion by a Del-Em, a homemade suction device invented by female activists in 1971, when abortion was still outlawed. It was built from a Mason jar, a one-way valve, and two lines of plastic tubing—one that leads to a cannula, a medical straw that removes fluids, and another that leads to a syringe without a needle, which can be pumped to create suction. A student threw a floral blanket on the leather bed, and Anna hid the masks that lined the room. The woman entered and laid on her back before a midwife, who set a speculum around her cervix, peered inside her vagina with a headlamp, and inserted the cannula into the uterus. The students watched as the client pumped the syringe, blood slugging down the see-through tube.

In that three-day training, Anna learned about different categories of herbs and how to combine them. The Del-Em, which had seemed too complicated when she read about it online, now wasn’t quite as intimidating, and she was willing to try it. It was the conversation on misoprostol, though, a pill for medical abortion, that most excited her. Anna was surprised to hear that a licensed practitioner would covertly mail them to her. The World Health Organization laid out dosages with clear instructions and recommended midwives, even those with just a few months of training, to perform first-trimester medical abortions. Instead of two weeks with herbs, which were hardly reliable, the abortion would take just twenty-four hours, with an 80 to 85 percent success rate and few risks.

Through the workshop, Anna was joining a loose underground network of 45 women who had learned how to provide home abortions. It has since grown to around 200 women across the United States. (At last count, the number of licensed abortion facilities was 1,671.) Because the network is decentralized, there’s no complete record of how many pregnancies they’ve ended. According to interviews with providers in the network, the conservative estimate is more than 2,000 in the past three years. Some of the women have studied as midwives or doulas or nurses. Others are mothers and activists and herbalists who had needed an abortion, or whose friends had, and they decided to learn how to provide them. Like Anna, most are low-income women who have felt frustrated by their experiences. Clients seek them out because they can’t afford an abortion by a physician, or they want privacy, or they prefer home remedies to conventional medicine, or they want attentive care, or a clinic is just too far away.

The providers are building on a history of female home practitioners in the United States that existed until the early twentieth century. They are also part of a global trend to expand access to abortion by training midwives and community health workers. Across the United States, though, the work is restricted by dozens of laws. These women and their clients risk imprisonment and fines if caught. Since 2000, at least fifteen women have been arrested or criminally investigated for ending their own pregnancies and six people for aiding someone who did. Home providers face opposition from regulators and lawmakers and antichoice groups, but they also have not found much support from the major prochoice groups, which have fought for decades to protect clinical abortion. With few political allies, these providers have been doing this work quietly and on their own.

By the end of the training, everything clicked for Anna. She didn’t have to search blindly for the answers anymore. Now she could get the materials she needed, and she had a mentor who was on call to field questions when they came up. For the first time, Anna didn’t feel so alone. “Other people out there were interested in this,” she says. “It wasn’t just me being some weird freak.”

•••

The first abortion Natalie assisted was her mother’s. During her freshman year in college, she wrote a report on the history of herbal contraception and abortion for a holistic medicine class. She sent it to her mother, Jean, to proofread, and she flew home for the holidays. When she got there, her mom kept asking questions about the paper. Eventually, she admitted why. “I’m pregnant,” she said. She had asked a midwife for advice but hadn’t heard a word. She had been to the abortion clinic in town some years earlier, and they had treated her like cattle. “Maybe we can try the things you know about?” she asked her daughter.

Natalie bought herbs and started her mom on a recipe she’d read—the same one Anna used. A week into the regimen, when Jean still hadn’t bled, they went to Planned Parenthood. A group of clinicians crowded into Jean’s examination room. “This is really weird,” Jean remembers one of them saying, looking at the ultrasound. “The pregnancy test said you’re pregnant, but we don’t see an embryo.” The herbs, it turned out, had started to terminate the pregnancy, and a nurse gave her misoprostol to expel the contents of her uterus. That wasn’t that hard, Natalie thought. Maybe abortion isn’t as complicated as we’ve always been led to believe. When another friend asked for help a few months later, Natalie and her mom oversaw a variation on the recipe together. After two weeks, the friend bled. Jean kept talking with Natalie about how many other women needed to know they could have abortions on their own. “You need to get this information out there,” Jean told Natalie. “Maybe you should be a midwife or an herbalist but focus on abortion.”

Back in college, Natalie began researching the history of midwifery and herbalism in the United States. Midwives and homeopaths once provided a range of services, and abortion was one of them. In the mid-nineteenth century, if a woman chose to miscarry in the first trimester, before the fetus had “quickened” or moved, she was thought to be restoring her period, and it was legal. “Abortion” referred only to a termination after the fourth month. In the early weeks of a pregnancy, midwives helped women restore their periods with plants like pennyroyal, savin, tansy, and ergot, and doctors, among others, sold drugs made from herbs.

Then, after the American Medical Association was formed in the 1840s, it launched a campaign to make abortion illegal at all stages of pregnancy. The AMA’s campaign painted abortion as immoral, and by 1880, it had secured criminal abortion laws in nearly every state, granting only doctors the authority to decide when the procedure was acceptable. The effort grew, in part, out of physicians’ interest in limiting competition from midwives and homeopaths. Pregnant women, especially the poor, continued to seek the care of midwives, many of whom were immigrants and women of color; medical journals began referring to midwives as abortionists, describing them as dangerous and ignorant. Although studies established that midwives had better maternal mortality outcomes than physicians in the early twentieth century, the overwhelmingly male AMA almost succeeded in driving them out. States began writing new laws restricting midwifery, and the share of births that midwives attended dropped from half in 1900 to 15 percent by 1930.

Midwifery, though, persisted in parts of the country, particularly where Black women couldn’t access medical care because of segregation laws, and two different types later re-emerged in white communities, focusing on birth. The first, nurse-midwifery, now operates primarily within medical institutions. In the early 1970s, another branch of midwives, who practice in homes, grew in reaction to the mostly male medical establishment and the over-medicalization of hospital birth. Even though midwives have developed national standards, they still can’t get licenses in eighteen states. Neither branch advocates for the right to provide home abortions.

As part of Natalie’s studies, she also learned about health workers in developing countries who had been trained with the skills to provide an abortion. From Vietnam to Bangladesh to South Africa, it had become accepted practice. Some midwives used a manual vacuum aspirator, known as MVA, a 60 cc plastic syringe attached to a cannula that empties the contents of the uterus by suction—the same tool that many doctors in the United States use for first-trimester surgical abortions. Health workers with less training administered misoprostol; though the drug was originally developed to treat ulcers, Brazilian women later discovered it could safely end pregnancies. In Europe, a nonprofit was sending abortion pills to thousands of patients, with trained counselors, not medical professionals, coaching them by email.

Natalie found it strange, if not disconcerting, that women in the United States risked jail time for ending their own pregnancies, and they didn’t have guidance if they bought pills from online pharmacies. Most frontline health workers weren’t trained on abortion, even though one in four women have one. Natalie knew that the science didn’t back up these restrictions: patients are far more likely to die from childbirth than abortion.

As Natalie experimented more with herbs, she learned clinical skills and secured misoprostol through a practitioner at wholesale prices, under a dollar a pill. She built her own Del-Em (the homemade version of MVA) and practiced using it on friends who had their periods. What could be five days of menstruation would release in an hour. A fertilized egg, up to about six weeks in gestational age, could be extracted as well. Over time, friends and colleagues asked if she could give a class on what she knew.

About a dozen women showed up to a private home and studied four methods for home abortion: herbs, misoprostol, the Del-Em, and, for more advanced practitioners, MVA. Natalie brought speculums for cervical exams and papayas as practice wombs. They covered pre- and post-abortion care, the kind of attention midwives and doulas offer during birth. Natalie discussed how she counseled clients, took a health history, sat with them while they bled, and established herself as a confidante. Fear, she said, was the emotion that usually accompanied abortion. “Whatever’s your darkest question that you can’t ask your husband and you can barely ask yourself, you can ask me,” Natalie told clients. The women reviewed the tradition of this care and the latest studies on safety. Some people, Natalie told them, consider this work an act of civil disobedience. The laws they might be breaking came to around forty—for practicing medicine without a license, mailing pills, burying fetuses. The training took three days and cost $250 to attend.

Soon, requests for more workshops started to circulate among the group. The first students had told friends, and they wanted to learn, too. The women who wrote came from rural towns as well as major cities; most were white, many queer. They didn’t just live in states with tough abortion restrictions—like forty-eight-hour wait times and clinics with mandated doorway sizes—but also in states where abortion was accessible or covered by Medicaid. It wasn’t only access they wanted to provide, but better care.

After a while, the workshops began to look like a network. There was no formal structure, no bylaws, no office. The women exchanged numbers, and some with more clinical experience agreed to coach those with less. The training manual grew to 800 pages. Licensed practitioners offered to help out, putting in orders for MVA kits and cannulas. After a year and a half, though, some women wondered if the network had reached its peak—the demand for workshops had started to dwindle. Then Donald Trump was elected president. He had promised to defund Planned Parenthood and appoint justices who would overturn Roe v. Wade. In the following days, a dozen requests for training were made—women said they would fly thousands of miles to join. Within months, the network had extended into every region of the country.

•••

Anna left the workshop with a World Health Organization protocol booklet, the training manual, and an order for a bottle of misoprostol. At home and in the dressing room at the club, she read through the materials and scribbled notes. She decided that if she was going to give misoprostol, she should try it on herself first. Without a pregnancy, she barely felt the effects—just a stomachache and diarrhea. Through a pet store and a science supply catalog, she bought the parts to build a Del-Em. She splayed her legs in front of a mirror and propped up a flashlight to watch as she searched her own vagina for the opening in her cervix. In those first months, she practiced on friends on their periods, holding the blunt-tipped cannula between her gloved fingers, learning to recognize the sensation when it passed through the cervical canal, the tunnel that leads to the uterus, and gently turning the straw-like tube, clockwise, counterclockwise, up and down, to find the blood.

Dancers traded stories between sets, and when they mentioned unwanted pregnancies, Anna told them they didn’t have to shell out hundreds of dollars—she could help. She knew that a few split money with pimps, and many were paying for childcare. She explained that abortion was now extremely safe. Major complications occur in one-quarter of 1 percent of cases. She told them that misoprostol, which she called “miso,” was her method of choice. In US clinics, it was prescribed with mifepristone, a more effective combination. Around the world, though, misoprostol is taken outside clinics and by itself—it’s easier to get and usually cheaper. The highest risk was an ectopic pregnancy, a rare condition where an embryo attaches outside the womb. In that case, the miso would do nothing.

Anna began to see one or two clients each month, all women she knew. Like others in the network, she met with them ahead of the procedure and always on their own. She wanted her clients to feel free to talk, separate from their partners, about the care they wanted, both physical and psychological. She let them know that if anything were to go wrong, she would escort them to the hospital. Doctors can’t test for misoprostol, so she coached clients to say they were miscarrying; the treatment for a complicated abortion is identical. She let them know that this was new to her, but she would be present throughout. She would be with them as they took the miso, and she would smell their pads for a foul stench, checking for an infection. If they had any questions about bleeding, dizziness, vomiting, cramping, and pain, doubt or grief or fear or shame or joy, she was there.

The training had felt like a revelation, but doing the work confirmed it. Twelve hours with a client was tiring and daunting. Anna, though, had support: After every few clients, she would call her mentor and review how she had done. From birth work, she knew that touch therapy and counterpressure techniques helped with pain, and as the women rested, she got them food or swept their kitchens. Early on, Anna noticed that most of her clients approached her believing it would be impossible to get an abortion. Once they bled, they laughed with relief, they stood up taller or spoke freer, breathed more deeply. Sometimes they talked about feeling powerful; they had control over their own bodies. If they thanked her afterward, she brushed it away. “You just needed someone to remind you that you could do it,” she told them. Then, she came home and cried. “I started to realize this was a calling, which is weird because most people wouldn’t be like: You know what I want to do when I grow up? Be an abortionist.”

Six months after she started, the referrals picked up, and Anna began providing for people she didn’t know. She had explained her training to a neighbor who worked at a reproductive health center, a social worker, and trans men around town. When they met people who wanted to bypass a clinic, they passed on her number. Anna had initially thought she would serve only women at the strip clubs, but she started to recognize that the need was vast; on average, she was seeing one client a week. “It was really a combination of everybody,” she says, “sex workers, bartenders, stay-at-home parents, accountants, students, preschool teachers, car salespeople, chefs, waiters, nurses.” Her clients were Black and brown and white and gay and trans and straight. When they were homeless, Anna met them at motels or let them stay in the trailer where she lived; at other times, she marveled at their big homes in gated communities.

Some came to her to keep it private—from partners or parents or religious relatives. They didn’t want to walk by protesters who flanked the clinic’s doors. Some had births or miscarriages or abortions that had gone badly, and they didn’t want to go through that experience again. Some clients were used to managing their health on their own, a few were hippies, and others knew the research on misoprostol but wanted some guidance. Most came to her because they struggled to afford clinical care as well. Many insurance plans don’t cover abortion, and rates can run above $600. That first year, Anna would ask for just $50, but she often provided her services for free.

Anna thought her job was about 10 percent abortion care and 90 percent emotional care. Sometimes her clients talked about trauma or abuse or how their decisions to end their pregnancies signaled their relationships were failing. They asked Anna for help finding shelters or counseling if they left their partners. They talked about addiction, their kids, how they wanted to have kids but how now wasn’t the right time, or how their partners wouldn’t make good fathers. Anna could relate to a lot of what they said—she wasn’t a stranger to these circumstances. Sometimes, they talked for hours, every day, over many weeks.

Anna came to learn that the clients who needed the most extensive aftercare were often those who had struggled to reach their decision. Although most felt they hadn’t taken a life, many were still grieving. Clients occasionally asked her to search through the blood so they could see the products of conception. Anna placed fish netting beneath them as they bled, catching the maroon clots and the yellowed, stringy tissue. “This is the clump of cells that would have grown into a fetus, and the group that would have grown into the placenta,” she would show them. One client brought her fetal remains to be cremated at a funeral parlor. For other clients, though, the decision to end the pregnancy was uncomplicated and unemotional, or they didn’t want to talk too much about their feelings. These women liked chatting with Anna, sharing this secret with someone but not dissecting it.

When Melissa came to Anna, in the fall of 2015, she knew that she wanted an abortion at home. She’d gotten pregnant once before, when she was nineteen. She had googled around for a free clinic and ended up at a fake one—one of nearly 4,000 centers, mostly faith-based and nonlicensed, that masquerade as abortion clinics across the country. Graying women in white lab coats showed her the ultrasound on a widescreen TV and told her she might miscarry, encouraging her to wait out the early pregnancy. They offered her McDonald’s fries and handed her pamphlets titled Are You Good Enough to Go to Heaven? and You’re Considering an Abortion: What Can Happen to You? Melissa was terrified of telling anyone she was pregnant, particularly her parents. But she couldn’t afford the procedure. Medicaid wouldn’t pay for it—it covers medically necessary abortions in only seventeen states, and in twelve of them, a court order is required. Melissa tried hitting her stomach, drinking a lot, inserting a drumstick. It took several months before she confided in a friend. By then, the clinic in town said she was too far along to treat her. Her friend’s mom paid to fly her 400 miles for a second-trimester abortion, where she went through the two-day procedure alone.

Melissa talked to Anna about how depressed she had become afterward. “Because of all the shame of not telling people,” she says. (By some estimates, a full third of patients tell no one about their abortions.) Everyone treated abortion like something to hide—the fake clinic cast it as immoral, the real clinic hurried her out a back door into a car, away from the picketers, and it wasn’t a topic friends or family ever talked about. She avoided sex. She started imagining death, driving without a seat belt in a small attempt to court it. Each morning, when she turned on the shower, she let herself cry. Looking back now, Melissa says it wasn’t until she opened up to a therapist that she began to recover. She watched documentaries on abortion, learning how women in other countries bought pills without a trip to a doctor. Eventually, she started dating, and though she relied on condoms, she got pregnant again. She wanted to manage it quickly. Plus, she worked at a café and didn’t have much savings. A friend put her in touch with Anna.

After Anna walked her through her options, Melissa decided to take the misoprostol on her own—she would text Anna throughout the day. They estimated that she was seven weeks pregnant, and Melissa asked if she could try a lower dose; her body was sensitive to medication. She did but without success. A week later, Melissa tried again with the suggested dose, her boyfriend at her side. Every three hours, Melissa inserted four white pills up against her cervix. When the aches came, rolling through her stomach and lower back, she texted Anna to let her know. She asked her boyfriend for a warm Mason jar to hold against her belly. She felt a wave of nausea and walked into the shower. Standing there, she started to bleed.

In the hours after, Melissa kept in touch, sending Anna photos of the pads she soaked so Anna could monitor her blood. Everything seemed fine—no fever, no strange odors, no high blood pressure. Since Melissa had discovered she was pregnant, it had felt as if her organs were floating midair, like she was pulling over the top of a roller coaster. Now that sensation had left her body, and her limbs felt heavy again. The next morning, Anna came over to check in with Melissa. Anna didn’t have a babysitter, so she brought her child, who played with the cats. She let Melissa know she would be hyperfertile for a few weeks and asked if she wanted to talk about birth control. “If you need to come back to me, that’s totally fine,” Anna assured her. “There’s absolutely nothing wrong with what just happened.”

•••

Anna knew that home abortion had long been divisive in the prochoice movement. She and other providers talked about the Jane Collective, a group of women who ran an underground network in Chicago starting in the late 1960s, before abortion was legal. Without formal medical training, they provided 11,000 abortions by dilation and curettage—a surgical procedure that involves scraping the uterus—and no patients died. The women’s movement was asserting that abortion is a fundamental right; what distinguished the Janes and other similar groups was their activism around female-led care and their rejection of male medical authority. Around the same time, doctors were seeing thousands of women seeking emergency treatment after botched illegal abortions, and they pushed for laws that would allow them more freedom to perform the procedure. The two groups had different visions, but the combined effect of their advocacy helped change the law. Roe v. Wade was decided in 1973. In the majority opinion, the justices wrote that abortion “is inherently, and primarily, a medical decision, and basic responsibility for it must rest with the physician.” Within months, Jane shut down.

The feminist ideal of demedicalized abortion faded quickly as antichoice groups began picketing clinics and lobbying for strict regulations. In the decade after Roe, the most extreme members bombed and burned down clinics and assaulted staff. Prochoice groups were faced with an existential threat, and in response they shifted their focus from women-centered care to protecting clinical abortion. Still, the number of abortion facilities has nearly halved since the late 1970s, and today seven states have only one clinic. More than 1,100 abortion restrictions have passed, many of which shape the experience of care, like requiring ultrasounds or telling patients that personhood begins at conception.

These days, Anna notices, when home abortion enters the public debate, women-focused care is rarely mentioned. Instead, it is often cast as an act of desperation. One of the most influential academic studies on home abortion in the United States came out in 2015. It found that between 100,000 and 240,000 women in Texas had tried to end a pregnancy on their own. The authors wrote that clinical closures could be driving the large numbers. “Most people thought we were well past the days of women taking matters into their own hands,” said Cecile Richards, president of Planned Parenthood Federation of America, in response to the report, “but laws that make it impossible to get safe and legal abortion are taking us backwards.”

For Anna and others in the network, though, home abortion felt like a step forward—a way for clients to take control of the process. Several women had joined the network after years working at clinics because they disliked how patients were treated. “The reproductive rights movement has used a very powerful narrative for many years now,” says Jill Adams, the chief strategist of the Self-Induced Abortion Legal Team, a group established three years ago, “that if states continue to pass restrictions and clinics close, people will be forced to take matters into their own hands, and that will mean death and destruction. We need a new, accurate narrative.”

Some prochoice doctors have withheld support for home abortions over questions about patient safety. Their largest concerns are that women might not accurately date the start of their last period, could hemorrhage, or miss signs that they have an ectopic pregnancy. They point out that without data and oversight, there’s no telling whether providers like Anna are offering good care. Rigorous research is required. Recognizing this gap, providers in the network have begun to work with Alison Goldsmith, a public health researcher at the University of Washington. She recently surveyed nineteen providers in the network and studied thirty-one abortions. The sample is too small to extrapolate from, but she found the average gestational age was five weeks and four days. There were no instances of serious complications. The average price for the care was $35—about fourteen times cheaper than the clinical average. The network’s own estimations show that almost all the abortions are in the first trimester, the latest around eighteen weeks. About 75 percent are by misoprostol. There have been only two major complications, both hemorrhages after Del-Em procedures. The women were hospitalized and received blood transfusions.

Part of the divide between home providers and major prochoice advocates is generational—most of the network’s providers are in their twenties and thirties—but it also has roots in the competing philosophies before Roe. Lynn Paltrow, the executive director of National Advocates for Pregnant Women, likens home abortion to the underground health care provided during the AIDS epidemic, like distributing drugs that the FDA had not yet approved, or needle exchanges. In both cases, illegal networks ultimately changed the public health agenda.

A couple of years ago, Anna tried to track down members of the Jane Collective. She was hoping to feel a connection with the older generation of underground providers. But when she reached the founder, Heather Booth, she was disappointed. Anna felt that Booth didn’t understand the need for the network. She told Anna that in her view, today’s prochoice movement had to focus on keeping abortion safe, accessible, and legal. (When asked to comment on home abortion care, Planned Parenthood and NARAL Pro-Choice America declined.)

In Anna’s view and that of many legal scholars, Roe upheld a doctor’s right to perform an abortion, not a woman’s right to choose one. Choice wasn’t just whether a woman could seek an abortion but also how and when she wanted to have it, who she wanted around her, and where she wanted to be.

•••

Anna was now working with a new client nearly every other day, mostly in town, but some at a distance, mailing them pills and counseling them over the phone. Often she left the club at 3 a.m., napped until sunrise in her single-wide, and drove to clients’ homes under dawn skies, waking up with a yellow Red Bull. She felt incapable of saying no. She hated to think that if she did, those women could go on to have kids they didn’t want or couldn’t afford. She was growing to dislike the club, particularly the customers, so she cut back on dancing.

Across the network, demand for care was rising, too, and it was bringing up new questions. Some providers advocated for a tightly managed system with efficient referral streams, but others worried that this would make them more vulnerable to law enforcement. Black and Latina providers pointed out they were more likely to face arrest. So far, no one had dared to compile a list of all the people in the network. “We’re safe because we’re anonymous and isolated,” said one provider. They remembered how midwives and herbalists had historically practiced independently and how organized medicine had dismantled them. None of the women wanted the network to come to the same end.

Still, some have begun to consider what it would take to expand. One model that’s been discussed is Alcoholics Anonymous, an organization that is vast, responsive, and above all, confidential. Home abortion workshops could be held like AA meetings. Referrals could go through a secure web platform, and providers, like AA sponsors, could support women who sought help. (The language that providers and sponsors use, one woman pointed out, is strikingly similar: “I’ve been there. Lots of people have been there. There’s a better way.”) Providers have started consulting with a security expert about the safe technology they would need. “My biggest fear,” Natalie says, “is that demand would overwhelm capacity, that if you could truly, equally seek a home abortion, the demand would be through the roof. We’re not quite ready.”

In the spring of 2017, Natalie asked Anna if she would consider teaching. Anna now had nearly a dozen people who referred clients to her. A wealthy woman Anna had cared for had become a kind of patron; she offered to pay if clients preferred clinical care but couldn’t afford it or needed a motel room for privacy. Anna was one of the best providers Natalie knew, and she embodied a lesson that Natalie had come to appreciate—that to do this work effectively and compassionately did not require a formal degree. Anna was nervous, but she recognized how overwhelmed the providers in the network had become, no longer capable of responding to all the requests for training. It was an honor, too, to be acknowledged as a peer, “like I was being knighted into the roundtable.”

Around the same time, Anna decided to have a child with her boyfriend, whom she had moved in with. He saw how little she liked stripping and how absorbed she was helping women with their abortions, so he offered to cover more of the bills if she chose to leave the club. She did, and she provided home abortions throughout her pregnancy. Anna knew the optics might be hard for clients, so she talked about it in their initial phone calls. “I’m pregnant. This is a wanted pregnancy, a planned pregnancy, and just as much as I support and respect people’s right to have children, I also respect people’s right to not have children,” she told them. “Just because it’s my time doesn’t mean it’s yours.” After her seventh month, she took only distance clients. She guided them over the phone through her final weeks of pregnancy, right up until the moment she felt contractions. One of her clients had just completed an abortion, and it was time for Anna to see how she was doing. Her midwife yelled at her to put down her phone and focus on labor. Anna texted anyway. “What’s your bleeding like?” she asked.

19

How to Give Yourself an Abortion
with Misoprostol Pills

by Arielle Swernoff
illustrated by Mattie Lubchansky

For as long as people have gotten pregnant, people have given themselves abortions. Sometimes these methods have been brutal, toxic, or bizarre.

But across history, there have been people who used plants and herbs safely and effectively. From the Bronze Age until the 1st or 2nd century BCE, silphium, a plant native to Libya, was used as a safe and effective contraceptive and abortifacient. It’s said the plant was so popular that it was harvested to extinction. More recently, enslaved Black people in the American South devised numerous herbal treatments to terminate unwanted pregnancies, some of which are still used today.

In 2022, one safe way to perform a self-managed abortion is with pills—the same ones administered at doctors’ offices. Unfortunately, safe and affordable medical care isn’t accessible everywhere or to everyone. Since the 2010 midterm elections, we’ve seen antichoice legislation spread across the country at unprecedented speed. From mandatory waiting periods to laws regulating the width of hallways in abortion clinics, targeted restrictions on abortion providers (known as TRAP laws) have shut down hundreds of clinics. As of this writing, the Supreme Court is poised to overturn Roe v. Wade, and it is expected that abortion will become illegal or heavily restricted in dozens of states.

Everyone deserves to control their own reproduction. This guide to self-managing your abortion using misoprostol (which causes uterine contractions), either alone or in combination with mifepristone (which blocks a hormone that allows a pregnancy to continue), is intended as a community resource and to help destigmatize self-managed abortion.

Disclaimer

The decision to terminate a pregnancy is a personal one, and this essay does not intend to influence or encourage any person’s individual decision, but rather to provide reliable information. I am neither a lawyer nor a medical professional, and this guide should not be a substitute for medical or legal advice. The information below has been compiled from a variety of sources, including the World Health Organization, Aid Access, Women on Web, Women Help Women, Reproaction, If/When/How, Plan C Pills, Safe2Choose, How to Use Abortion Pills, Aid Access, Self-Managed Abortion Safe and Supported, Ipas, and Robin Marty’s Handbook for a Post-Roe America, as well as from my own organizing work and relationships with reproductive justice advocates. This article is not regularly updated, and individuals who are considering self-managing abortion should refer directly to these resources for more detailed medical or legal guidance.

Understanding the Risks

To be clear: self-managed abortion is safe. According to a 2018 statement from Physicians for Reproductive Health, “self-administered medication abortion is as safe, effective and acceptable to patients and providers as healthcare facility-based medication administration.” Numerous medical groups, including the World Health Organization, have endorsed self-managed abortion in the first trimester as “safe, feasible, and acceptable.”

However, self-managing an abortion could put a person at legal risk. Since this article was initially published in 2019, state laws criminalizing abortion have multiplied. Advocates are aware of twenty-four people who have been prosecuted for self-managing their abortions between 2000 and 2021, some of them in states where the practice isn’t technically criminalized. And people who are disproportionately targeted by law enforcement (people of color, trans people, unhoused people, and undocumented people, for example) are at greater risk of legal punishment. For a few legal resources, check out the “More Information” section at the end of this article.

Make Sure This Method Is Right for You

First, check how far along you are in pregnancy. The FDA has approved medication abortion with mifepristone and misoprostol up to 10 weeks from the first day of a person’s last menstrual period, and the World Health Organization considers abortion with both medications safe and effective until 12 weeks since a person’s last period. Keep in mind that contrary to popular belief, pregnancy is not counted from the “moment of conception,” but from the first day of your last period.

You should not use this method if:

• You have a disease called porphyria

• You have a bleeding disorder

• You are taking anticoagulants

• You have chronic adrenal failure and/or use long-term systemic corticosteroid therapy

It’s very unlikely you would have any of the diseases or treatments listed above and not already know about it. Additionally, you shouldn’t use this method if you know you’re allergic to misoprostol, mifepristone, or prostaglandins. If you know you have an ectopic pregnancy (a pregnancy implanted outside the womb), this method will not work and you should seek medical treatment from a doctor.

It’s extremely rare to get pregnant if you have an IUD, but if that’s the case, you should have it removed before having an abortion.

Get Yourself Some Pills

When doctors perform medical abortions using pills, they use two drugs: mifepristone and misoprostol. Mifepristone is harder to obtain in person but is widely available online.

To have an abortion with mifepristone and misoprostol, you will need one 200 mg pill of mifepristone and four tablets of misoprostol at 200 mcg each.

To have an abortion with misoprostol only, you will need 12 tablets of misoprostol at 200 mcg each.

There are several ways you can get them:

Online

Abortion pills are commonly purchased online. There are several websites where people have been able to purchase mifepristone and misoprostol together. Plan C Pills (plancpills.org) has researched a number of telehealth services and online pharmacies that provide abortion pill delivery. Aid Access (aidaccess.org) also provides “online consult for abortion pills by mail.”

Some people who were not able to purchase misoprostol and mifepristone together have been able to find an internet vet supply store or online pharmacy (for humans!) that sells misoprostol only without a prescription.

In person

In addition to helping people manage abortions at home, misoprostol is sometimes used to treat stomach ulcers, so it’s kept behind the counter at most US pharmacies. In many Latin American countries, as well as in some border communities in the US, you can get it over the counter under the brand name Cytotec. If you’re trying to get misoprostol without a prescription in the US, advocates have found these tips helpful:

• Choose the right location: It might be easier to get misoprostol at a local pharmacy than at a chain like CVS or Rite Aid.

• Have a man go for you: A pharmacist is less likely to suspect a man of using pills to induce abortion, and is more likely to give him the pills.

• Have an excuse: Tell the pharmacist your grandparent with rheumatoid arthritis is visiting and forgot their pills at home.

Prepare Yourself

Having a medical abortion can be very physically unpleasant (think: bad flu), so plan on being out of commission for a full day after taking the misoprostol. Some people experience nausea, so consider eating lightly or sticking to foods that are easy to settle. Alcohol or drugs are a no-no—you want to be able to pay full attention to your body. The chances of something going wrong are extremely low, but just in case, it’s good to be within an hour of a hospital (make that half an hour if you have anemia).

Just like building IKEA furniture, managing your abortion is easier and safer with a friend. Make sure this friend is someone you trust to be discreet, to help protect you from legal risk.

Take the Pills Correctly

If you’re taking mifepristone and misoprostol together

The following is a summary of instructions from Women on Web and the World Health Organization on how to use mifepristone and misoprostol for a safe abortion up to 12 weeks of pregnancy:

You will take your pills over the course of two days. First, swallow your one tablet of mifepristone (200 mg).

Twenty-four hours later, put 4 tablets of misoprostol (200 mcg each) under your tongue and let them dissolve for 30 minutes. You can swallow your saliva. After 30 minutes, you can spit out any remains of the tablets.

If you’re taking misoprostol only

The following is a summary of instructions from How to Use Abortion Pills on how to use misoprostol only for a safe abortion before 10 weeks of pregnancy:

Put the first 4 tablets under your tongue and let them dissolve for 30 minutes. You can swallow your saliva, but don’t swallow the tablets until at least 30 minutes have passed. At that point, you can swallow what remains of the tablets.

After three hours, repeat with the next 4 tablets, making sure to dissolve them for 30 minutes under your tongue instead of swallowing. Three hours after that, repeat with the final four tablets.

(In the unlikely case that you purchased a pill with the brand name Arthrotec or Oxaprost, the misoprostol will be coating a painkiller. If that’s the case, spit out the pills after thirty minutes.)

DON’T swallow all the misoprostol pills together. Nausea is a common side effect, and you don’t want to puke them up.

DON’T put the pills in your vagina. If taken under the tongue as directed, a doctor won’t be able to tell if you’ve induced an abortion or had a “natural” miscarriage. If you put the pills in your vagina, a doctor can find the residue.

Have an Abortion

This part probably won’t be fun! You’ll know your abortion has begun when you start to cramp and bleed, which can happen anywhere from 30 minutes to several hours after you take the misoprostol pills. To avoid infection, use pads for the bleeding, and not tampons or a cup. Some unpleasant side effects of misoprostol can include dizziness, nausea, vomiting, diarrhea, and headaches, as well as fever and chills. You can take ibuprofen and anti-nausea medications as needed—they won’t interact poorly with misoprostol. Try to hydrate as best you can, and rest as much as you need to.

What to Do if Something Goes Wrong

Fewer than 3 percent of people self-managing an abortion with pills require further medical care. Women on Waves, Safe2Choose, and Women Help Women recommend immediately seeking medical care if a person has any of the following symptoms:

• Bleeding through two or more maxi pads per hour for more than two hours (this means that the pads are completely soaked through, front to back and side to side). This occurs in less than 1 percent of cases.

• A fever above 100°F for more than 24 hours, or a fever above 102°F for any amount of time. This could be a sign of infection, and it’s usually treated with antibiotics.

• Intense abdominal pain that lasts for more than a few hours.

The good news is, if you’ve followed the instructions, there’s no medical way for a doctor to tell you’ve taken pills to induce abortion. You can say that you think you’re having a miscarriage. The only way a doctor will know is if you or your friend share the information, which you absolutely do not have to do. Your symptoms, complications, and the treatment you’ll receive will look exactly the same as if you were having a natural miscarriage, which doctors treat routinely.

After Your Abortion

Don’t put anything in your vagina for five days after your abortion—that means no tampons, sex toys, fingers, or penises. You should also avoid intense physical activity. You can expect to bleed as though you’re having your period for anywhere from a few days to a few weeks after you take the pills. After four weeks, take a pregnancy test to make sure the abortion was complete (earlier than four weeks, and you may get a false positive).

If it comes back positive: There are a couple of things that could be happening here. For one, you could still be pregnant (this is more likely if you didn’t experience cramping or significant bleeding when you took the pills).

It’s also possible there is remaining tissue in your uterus, or that your pregnancy implanted outside of the uterus (this is known as an ectopic pregnancy). Doctors have safe and established protocols for dealing with these issues (remember: you don’t have to tell them you self-induced abortion), but both can cause serious complications if left alone. Ectopic pregnancies cannot be carried to term, and if you think you have one, you should seek medical care right away.

If it comes back negative: Congratulations! You have given yourself an abortion. You might not be in the mood to get busy right away, but if you are, use condoms or another form of birth control—you can get pregnant immediately after an abortion.

Resources and More Information

More Information: For more detailed information and Q&As on how people use these medications, you can check out Aid Access, Women on Web, Safe2Choose, How to Use Abortion Pills, or Self-Managed Abortion Safe and Supported (SASS). These sites all provide more detail than the length of this article allows.

Legal: If/When/How maintains the Repro Legal Help Line (www.reprolegalhelpline.org/), where you can get information about your rights around self-managed abortion. You can contact them by leaving a voicemail on their helpline (844-868-2812) or using their secure online form (www.reprolegalhelpline.org/sma-contact-the-helpline/#secureform).

The Repro Legal Defense fund provides financial support for criminal cases where someone is alleged to have self-managed an abortion, including bail/bond money, attorney fees, court costs, and more. You or your attorney can request help at reprolegaldefensefund.org/get-help/.

You can also contact National Advocates for Pregnant Women, which provides free legal representation to people charged with crimes in relationship to their pregnancies, at www.advocatesforpregnantwomen.org.

Speaking with a doctor or counselor: If you live in the United States, you can call or text the Miscarriage + Abortion Hotline at 1-833-246-2632. They are available between 8 am and 11 pm in all continental US time zones, and will respond within the hour.

You can also chat with a trained counselor and advocate by emailing info@safe2choose.org, or using their live chat counseling service at safe2choose.org/abortion-counseling. Each of these websites also includes instructions and Q&As for self-administering an abortion with pills.

Advocacy: If you want to get involved in the campaign to destigmatize and spread awareness of self-managed abortion in the United States, you can connect with Reproaction, a reproductive justice direct action group, at reproaction.org.

20

Self-Managed Abortion

It’s Safe, Effective, and Done All over the World

by Naomi Braine

As Roe v. Wade teeters precariously in the hands of a majority right-wing Supreme Court, feminists and people with unwanted pregnancies in the US can learn from a transnational movement for self-managed medication abortion (SMA), a movement that demonstrates every day that a safe abortion does not require a doctor or a clinic. Feminist activists, primarily in the Global South, have developed solidarity-based direct action strategies to provide information and support to people with unwanted pregnancies (partial list here), and changed global maternal mortality statistics.¹

SMA can be done with two drugs, mifepristone and misoprostol, or with misoprostol alone. Mifepristone is a medication developed and used exclusively for abortion, and has been subject to significant restrictions on prescribing and access in the United States. Misoprostol has multiple uses, from treating ulcers to inducing uterine contractions to preventing postpartum hemorrhage,² and is often more accessible because it is not just for abortion. If misoprostol is taken orally or buccally (under the tongue) then it cannot be detected by the time uterine contractions begin, erasing the difference between spontaneous miscarriage and abortion.

Research clearly demonstrates that SMA, with both drugs or with misoprostol alone, can be safe and effective without medical supervision.³ Basic scientific information in a form accessible to nonscientists can be found here, and a resource manual for community health workers and advocates is here. A feminist telemedicine group will train activists in the use of medication, as well as indicators that someone should not use medication or that they should seek medical attention during an abortion.

Activists around the world have developed three primary strategies for sharing information and support for SMA.

• The abortion hotline is probably the most widely used: there’s a telephone number that people can call to talk with someone and get information about SMA. The hotline phone is usually shared among a group of activists so that each person is only responsible for a few days or a week at a time, and the group can support each other and problem solve together. In Latin America and sub-Saharan Africa there are websites for regional networks of hotlines.

• Accompaniment, or acompañamiento in Spanish, involves ongoing communication with a pregnant person through the abortion process, from an initial conversation about SMA to being in contact with the person (often by text/phone) as they take pills and the abortion happens, usually with some follow up to see how they are doing afterwards. This approach is most common in Latin America, where many countries have active acompañamiento collectives (for example, Argentina and Mexico in English).

• And, of course, there are websites that provide step by step instructions in the use of medication (in Spanish, in a video or online ’zine in English), some also provide manuals on SMA and women’s experiences with abortion (in Spanish, in Spanish with a chapter in Haitian Creole, and in English). Plan C has a good resource list for the US. There is also a US legal support website, If/When/How.

• Telemedicine websites provide an online consultation and medication with a flexible fee, some oriented internationally, like Women Help Women or Women on Web, and others directed primarily at the US, such as AidAccess.

And last but not least, is this really legal? Telemedicine is regular medical care, full stop. Activists throughout the world do the work described here—and are highly visible on the Internet—based on the right to information. It is legal to share information about SMA in the US, and organizations like ReproAction and the International Women’s Health Coalition have done it for years, but it’s important not to give advice or tell someone what they should do (that could be practicing medicine without a license).

People have been prosecuted in the US and around the world for buying abortion pills, and for engaging in SMA: sharing information about abortion is legal, but obtaining pills without a prescription may violate drug laws, and self-managing your own abortion may be illegal in some places (If/When/How can answer questions about specifics).

We have no idea how many self-managed abortions have happened in the US; it is impossible to know if someone has done it unless they tell you.

Resource Guide and Directory

Fight back, get an abortion, find legal resources, tell your story

by the Editors

Abortion Activism and Reproductive Justice

Shout Your Abortion is a decentralized network of individuals working to normalize abortion and elevate safe paths to access, regardless of legality. We create resources, campaigns, and media intended to arm existing activists, create new ones, and foster collective participation in abortion access all over the country.

shoutyourabortion.com

Request Materials for June SCOTUS rapid response!

Download posters here

The Liberate Abortion Campaign is an effort comprising more than 150 reproductive justice and rights organizations, groups, and abortion providers working in coalition to fight for abortion that is available, affordable, accessible, and stigma-free for anyone who needs it.

www.liberateabortion.org

We Engage works to advance an abortion-positive change in our culture by increasing public awareness surrounding abortion and abortion access by using factual, unbiased information about abortion, abortion access legislation, and the truth about what is happening outside abortion clinics when people come to their appointments.

www.weengage.org

National Indigenous Women’s Research Council. NIWRC provides national leadership to end violence against American Indian, Alaska Native and Native Hawaiian women by lifting up the collective voices of grassroots advocates and offering culturally grounded resources, technical assistance and training, and policy development to strengthen tribal sovereignty. NIWRC’s recent advocacy involves reproductive justice.

www.niwrc.org

Charlotte for Choice. Escorts & Defenders for A Preferred Women’s Health Center in Charlotte, North Carolina

@charlotteforchoice

Thank God for Abortion. Our mission is to eliminate the criminalizing stigma around abortion one t-shirt, one installation, one party, one rally, one conversation—one soul at a time.

www.thankgodforabortion.com

NYC for Abortion Rights is a coalition of individuals who believe New York City needs an unapologetic grassroots movement ready to fight for full abortion rights and reproductive justice.

www.abortionrights.nyc

@nycforabortionrights

Chicago for Abortion Rights is a network of activists in Chicago fighting for abortion rights and reproductive freedom for all.

www.chicagoforabortionrights.org

@chiforabortion

SisterSong’s mission is to strengthen and amplify the collective voices of Indigenous women and women of color to achieve reproductive justice by eradicating reproductive oppression and securing human rights.

www.sistersong.net

Abortion Funds

The National Network of Abortion Funds builds power with members to remove financial and logistical barriers to abortion access by centering people who have abortions and organizing at the intersections of racial, economic, and reproductive justice.

Find your region and state: abortionfunds.org/funds

The Yellowhammer Fund is a 501(c)(3) abortion fund and reproductive justice organization serving Alabama, Mississippi, and other areas in the Deep South.

www.yellowhammerfund.org

Frontera Fund is united under one fundamental mission: To provide financial support and a sense of community for those seeking abortions in the Rio Grande Valley.

fronterafundrgv.org

Indigenous Women Rising Abortion Fund. This abortion fund is open to all Indigenous people in the United States and Canada who have the capacity to become pregnant and seeking an abortion in the United States.

www.iwrising.org/abortion-fund

Our mission at Missouri Abortion Fund is to provide public education and support for people needing reproductive health services, primarily by providing financial assistance to Missouri residents who cannot afford the full cost of abortion care.

mofund.org

The Lilith Fund supports the rights of all Texans to make their own reproductive choices, regardless of income.

El Fondo Lilith da ayuda financiera a personas que quieren interrumpir un embarazo pero no tienen suficiente dinero.

www.lilithfund.org

www.lilithfund.org/espanol

Chicago Abortion Fund provides financial, logistical, and emotional support to people seeking abortion care in Chicago, in Illinois, and the Midwest.

www.chicagoabortionfund.org

Legal Resources

If/When/How Repro Legal Helpline. At If/When/How, we believe everyone should be able to access abortion care if they want or need it. Our attorneys and advocates provide legal information and support to people navigating complex laws in order to self-determine their reproductive lives.

www.reprolegalhelpline.org

Miscarriage + Abortion Hotline. The M+A Hotline is a confidential, private, and secure phone and text hotline for people in need of support for self-managed miscarriage or abortion.

www.mahotline.org

Self-Managed Abortion Resources

Aid Access supports women who cannot otherwise access an abortion or miscarriage treatment and protects their human rights.

aidaccess.org

Women on Web is an international online abortion service, providing access to safe abortion services.

www.womenonweb.org

Plan C provides up-to-date information on how people in the US are accessing the at-home abortion pill online.

www.plancpills.org

Choix is a telemedicine clinic providing reproductive and sexual health care in California, Colorado, and Illinois.

www.mychoix.co

Hey Jane provides medication abortion treatment for anyone who is at least eighteen years old in New York, California, Washington, Illinois, Colorado, or New Mexico.

www.heyjane.co

Just the Pill provides birth control, abortion pills, and sexual infection treatments via telehealth to those living in Minnesota, Montana, and Wyoming.

www.justthepill.com

Abortion Providers

The National Abortion Federation maintains a list of providers. The mission of the National Abortion Federation is to unite, represent, serve, and support abortion providers in delivering patient-centered, evidence-based care.

prochoice.org/patients/find-a-provider

Founded in 2008, Abortion Care Network is the national association for independent, community-based abortion care providers and their allies. Together we work to ensure the rights of all people to experience respectful, dignified abortion care.

abortioncarenetwork.org

Keep Our Clinics. Donate to the independent clinics that need the most support, often clinics who serve patients who cannot opt for medication abortion.

keepourclinics.org/donate

Share Your Abortion Story

We Testify is an organization dedicated to the leadership and representation of people who have abortions, increasing the spectrum of abortion storytellers in the public sphere and shifting the way the media understands the context and complexity of accessing abortion care. We Testify invests in abortion storytellers to elevate their voices and expertise, particularly those of color, those from rural and conservative communities, those who are queer-identified, those with varying abilities and citizenship statuses, and those who needed support when navigating barriers while accessing abortion care.

www.wetestify.org

Shout Your Abortion is a decentralized network of individuals talking about abortion on our own terms and creating space for others to do the same, in art, media, and at community events all over the country.

shoutyourabortion.com

Abortion Out Loud, formerly the 1 in 3 Campaign, harnesses the power of storytelling, grassroots organizing, leadership development, and policy advocacy to end abortion stigma and strengthen support for young people’s access to abortion.

www.advocatesforyouth.org/abortion-out-loud

About the Contributors

Arlen Austin is a Ph.D. candidate in the Department of Modern Culture and Media at Brown University, where he studies social movements and mass media.

Amelia Bonow is the Founding Director of Shout Your Abortion and serves on the board of directors of Abortion Care Network.

Dr. Mary K. Bowman is an abortion and trans healthcare provider who lives in Chicago, land involuntarily ceded by the Council of the Three Fires. They hate your boss and love your outfit.

Naomi Braine is a professor of sociology at Brooklyn College, CUNY. Prior to joining the faculty at Brooklyn, she worked in the nonprofit research sector on issues of drug use and HIV and consulted for community-based organizations and the New York State Department of Health. Her political and intellectual work addresses gender, sexuality, reproductive justice, wars on drugs and terror, and health and collective action, from an intersectional perspective. Her current work focuses on self-managed medication abortion as a social movement.

Jenny Brown was a leader in the fight to get the morning-after pill over the counter in the US and a plaintiff in the winning lawsuit. She is co-author of the Redstockings book Women’s Liberation and National Health Care: Confronting the Myth of America. While editor at Labor Notes magazine, she coauthored How to Jump-Start Your Union: Lessons from the Chicago Teachers. She writes, teaches, and organizes with the feminist group National Women’s Liberation and is the author of Birth Strike: The Hidden Fight over Women’s Work and Without Apology: The Abortion Struggle Now.

Crystal is a Planned Parenthood worker in a state that is unlikely to ban abortion for the time being.

Jen Deerinwater is a bisexual, Two-Spirit, multiply-disabled citizen of the Cherokee Nation of Oklahoma and an award-winning journalist and organizer who covers the myriad of issues hir communities face with an intersectional lens. Jen is the founding executive director of Crushing Colonialism and a 2019 New Economies Reporting Project and 2020 Disability Futures fellow. Jen is a contributor at Truthout and hir work has been featured in a wide range of publications, including Rewire.News, In These Times, and Bitch Media. Jen’s writing also appears in Disability Visibility: First Person Stories from the Twenty-First Century and the forthcoming Building Narrative Power for 21st-Century Social Movements and Crip Authorship: Disability as Method. Jen is the co-editor of the anthology Sacred and Subversive and is currently hard at work on hir own book.

Kim Gibson, a Mississippi native, joined the Pink House Defenders, the patient escort group at Jackson Women’s Health Organization in February 2017. A paralegal, Kim served as president and founding board member of the Mississippi Humanist Association and believes the struggle for abortion rights should be viewed as a separation of church and state issue as well as a human rights/equal rights issue.

Derenda Hancock, an Oklahoma native, has been the coordinator of the Pink House Defenders, the patient escort group at Jackson Women’s Health Organization since 2013. Derenda took part in the Occupy movement, helping to lead Occupy Jackson (Mississippi). A former restaurant manager, Derenda gave up managing corporate restaurants to focus more fully on activism.

Marian Jones is a New York–based community organizer, writer, and editor at Lux magazine.

Jessie Kindig is an editor at Verso Books, a contributing editor to Lux magazine, and associate faculty at the Brooklyn Institute for Social Research, as well as the editor of The Verso Book of Feminism.

Victoria Law is an author and freelance journalist who covers women’s incarceration. Her books include Resistance Behind Bars: The Struggles of Incarcerated Women, Prison by Any Other Name: The Harmful Consequences of Popular Reform, and “Prisons Make Us Safer” and 20 Other Myths about Mass Incarceration.

Amy Littlefield is the abortion access correspondent for The Nation and a freelance journalist focused on reproductive health care.

Mattie Lubchansky is a cartoonist and illustrator living in Queens, New York. You can find their work on The Nib, where they are associate editor, or at matt-lub.com.

Luna Lovegood (she/her) is a Black feminist organizer and co-founder of ReproJobs, an online worker support community for the reproductive health, rights, and justice movement.

Erin Matson is co-founder and executive director of Reproaction, a national group using bold action to increase access to abortion and advance reproductive justice. A longtime feminist leader with expertise in creating and deploying unique, forceful, national and state-level campaigns, Erin has appeared on MSNBC, CSPAN, Al-Jazeera English, ABC World News, BBC World News, and PBS’s To The Contrary. Erin served as action vice president for the National Organization for Women, and at age twenty-three she was elected to be the youngest NOW state president in the country. She also served as an editor at large for Rewire News Group. Her articles have appeared in a variety of publications, including Rolling Stone, and she has written three books. Erin serves on the steering committee of the American Society for Emergency Contraception and recently completed three terms on the NARAL Pro-Choice Virginia Foundation board of directors. Erin’s blog is available at www.erintothemax.com, and she is on Twitter @erintothemax.

The National Indigenous Women’s Resource Center provides national leadership to end violence against American Indian, Alaska Native, and Native Hawaiian women by lifting up the collective voices of grassroots advocates and offering culturally grounded resources, technical assistance and training, and policy development to strengthen tribal sovereignty.

Elizabeth Navarro is the 2022 Verso Books US fellow. She is a translator, editor, and educator from the Southwestern borderlands with over seven years experience organizing against mass incarceration and migratory justice.

Lizzie Presser is a journalist at ProPublica. Her work has won a National Magazine Award and a George Polk Award. She was previously a contributing writer at California Sunday Magazine.

Raquel Reichard is an award winning journalist with over ten years of experience reporting on body politics and Latinx culture. She is the deputy director of Somos, Refinery29’s cross-platform sub-brand for and by Latinxs. She has also been an editor at Latina magazine, Remezcla, mitú, and Mic. Her writing has appeared in the New York Times, Cosmopolitan, Teen Vogue, Bustle, MTV, HISTORY.com, Entrepreneur, Well+Good, Chopra, POPSUGAR, Bon Appétit, Fader, Vibe, Apartment Therapy, Kitchn, and other publications. Raquel is the founder of Borilando, an arts, culture and education nonprofit serving Puerto Ricans in Central Florida, and Herstoria, a history project about Latinx and Latin American women and femmes.

Cheryl Rivera is an abolitionist, organizer, and editor at Lux magazine living in Brooklyn.

Anne Rumberger is an activist with NYC for Abortion Rights and NYC Democratic Socialists of America, and her writing has appeared in Jacobin, Left Voice, and is forthcoming from Salvage. She is the US marketing director at Verso Books.

Verónica Cruz Sanchez is a feminist activist. For over three decades she has fought to decriminalize and destigmatize women’s decisions over their bodies. Verónica is founder and director of Las Libres since 2001, an organization dedicated to the defense, guarantee, and respect of human rights for women in the state of Guanajuato. Las Libres has a reach that extends across the entire American continent. Verónica was the first Mexican to be named Defender of Human Rights—the highest honor given by Human Rights Watch.

Shireen Rose Shakouri is deputy director of Reproaction. She is Iranian and Italian-American, and has a fire in her belly for reproductive justice work largely driven by a commitment to affirming the leadership of Earth-colored people, with direct action and direct service as her favored tools. This drive led her to building hard-hitting campaigns and managing special research projects at Reproaction before she was promoted to leadership in early 2021. Shireen is trained as an abortion doula and serves as a clinic escort at a local clinic. In her spare time, she is involved in various other local DC activism projects, and she writes on issues of identity, feminism, and culture. You can follow her work and activism on Twitter @sheermean.

Marie Solis is a writer based in New York with work in the New York Times, New Republic, The Nation, Vice, and elsewhere.

Arielle Swernoff is an organizer currently working on climate justice campaigns in New York. She previously worked in electoral politics, supporting progressive state and local candidates, and in public health communications.

Barbara Winslow had both an illegal and legal abortion and has been involved in the reproductive justice struggle for over fifty-five years. Along with her activism she is a retired Brooklyn College professor and founder of the Shirley Chisholm Project of Brooklyn Women’s Activism. She is the author of Sylvia Pankhurst: Sexual Politics and Political Activism, reprinted by Verso 2020, Shirley Chisholm: Catalyst for Change, Westview Press, 2013 and other edited collections, chapters, and journal articles. Her forthcoming book is Revolutionary Feminists: The Women’s Liberation Movement in Seattle Washington, 1965–75 (Duke University Press).

Notes

Introduction

  1 She/hir are Deerinwater’s preferred pronouns. Randy Khrebiel, “Oklahoma House Sends Abortion Bill Modeled after Texas Law to Governor,” Tulsa World, May 20, 2022.

  2 Lux editorial board, “The Gentrification of Abortion Politics,” issue 3 (November 2021).

  3 Ni Una Menos, “Call to the International Women’s Strike,” 2017, quoted in The Verso Book of Feminism, ed. Jessie Kindig (London: Verso, 2020), 326–7.

Chapter 1. The Fight Is On

  1 Thomas Frank, What’s the Matter with Kansas? How Conservatives Won the Heart of America, New York: Henry Holt, 2004.

  2 Joan C. Williams, “#MeToo and the New Work Rules,” Financial Times, October 20, 2018, 1.

  3 Gallup has a time series here: news.gallup.com/poll/1576/abortion.aspx.

  4 Paul Ryan, quoted in Christine Emba, “Paul Ryan’s Recipe for a Robust Economy: Have More Babies,” Washington Post, December 15, 2017.

  5 Ross Douthat, “More Babies Please,” New York Times, December 1, 2012; Greg Ip, “Population Implosion: How Demographics Rule the Global Economy,” Wall Street Journal, November 22, 2015; Jonathan V. Last, “America’s Baby Bust,” Wall Street Journal, February 12, 2013.

  6 Ben Wattenberg, Fewer: How the New Demography of Depopulation Will Shape Our Future, Chicago: Ivan R. Dee, 2004, 116.

  7 Greg Ip, “The World’s New Population Time Bomb: Too Few People,” Wall Street Journal, November 22, 2015.

  8 Steve King (@SteveKingIA), March 12, 2017, twitter.com.

  9 “Editorial: Declining U.S. Fertility Rate a Warning Sign,” Tampa Bay Times, last updated June 4, 2018.

10 Sabrina Tavernese, “Fertility Rate Again Falls to a Record Low, Confounding Demographers,” New York Times, May 17, 2018.

11 Claire Cian Miller, “A Baby Bust, Rooted in Economic Insecurity,” New York Times, July 6, 2018.

12 Lola Akinmade Åkerström, “10 Things That Make Sweden Family-Friendly,” Sweden Sverige, January 4, 2016, sweden.se.

13 Libby Watson, “People Say They’re Not Having Kids Because It’s Insanely Expensive,” Splinter, July 7, 2018, splinternews.com.

14 Loretta Ross and Rickie Solinger, Reproductive Justice: An Introduction, Berkeley: University of California Press, 2017, 63.

15 Ross and Solinger, Reproductive Justice, 64–5.

16 Ross and Solinger, Reproductive Justice, 65.

17 The full statement is reprinted in Toni M. Bond Leonard, “Laying the Foundations for a Reproductive Justice Movement,” in Loretta J. Ross, Lynn Roberts, Erika Derkas, Whitney Peoples, and Pamela Bridgewater Toure, eds., Radical Reproductive Justice: Foundations, Theory, Practice, Critique, New York: Feminist Press, 2017.

18 Ross and Solinger, Reproductive Justice, 67.

19 Ross and Solinger, Reproductive Justice, 71.

20 Democratic Party, quoted in David Weigel, “Democrats Release Draft of Platform, with Shifts to Left on Death Penalty, Abortion, Taxes,” Washington Post, July 1, 2016.

21 Banner in the Redstockings Archives, Redstockings.org.

22 Even then, 40 percent of workers are ineligible. Your employer has to have over fifty staff, you have to have worked there over six months, and you have to have enough hours.

23 The term “choice” was introduced around 1971 by the abortion campaign arm of the Socialist Workers Party, the Women’s National Abortion Action Coalition. Many women’s liberationists thought it was a terrible substitute for the word “abortion”—pioneer Lucinda Cisler in New York later called it “that atrocious, emetic choice euphemism.” Lucinda Cisler, letter to Laura X, October 5, 2015, Redstockings Archives.

24 For the horrifying details, see Dorothy Roberts, Shattered Bonds: The Color of Child Welfare, New York: Civitas Books, 2009.

25 Of the money owed by “deadbeat” parents, 70 percent is owed by those who make less than $10,000 a year, an Urban Institute study finds. These parents are obliged to pay 83 percent of their income for child support, on average. Elaine Sorensen, Liliana Sousa, and Simone G. Schaner, “Assessing Child Support Arrears in Nine Large States and the Nation,” Urban Institute, January 14, 2009, Urban.org, 3, 69.

26 Frances Robles and Shaila Dewan, “Skip Child Support. Go to Jail. Lose Job. Repeat,” New York Times, April 19, 2015.

27 Sara Evans, Personal Politics: The Roots of Women’s Liberation in the Civil Rights Movement and the New Left, New York: Vintage, 1980; Carol Giardina, Freedom for Women: Forging the Women’s Liberation Movement, 1953–1970, Gainesville: University Press of Florida, 2010; Barbara Leon, “Separate to Integrate,” in Redstockings, Feminist Revolution, New York: Redstockings, 1975, 152–7.

28 I discuss this at more length in Jenny Brown, Birth Strike: The Hidden Fight over Women’s Work, Oakland: PM Press, 2019.

29 Katha Pollitt, Pro: Reclaiming Abortion Rights, New York: Picador, 2014, 126.

30 Pollitt, Pro: Reclaiming Abortion Rights, 23.

31 Maureen Tkacik, “Abortion and the Politics of Failure,” in False Choices: The Faux Feminism of Hillary Clinton, ed. Liza Featherstone, London: Verso, 2016, 122.

32 V.I. Lenin, quoted in Clara Zetkin, “An Interview with Lenin on the Woman Question” (1920), reissue, Marxists Internet Archive, last updated February 29, 2004, marxists.org.

33 Kristen Ghodsee, Why Women Have Better Sex Under Socialism and Other Arguments for Economic Independence, New York: Nation Books, 2018.

34 “To Lighten Household Chores for Women,” Women of Vietnam 1, 1970, 23.

35 Malgorzata Fuszara, “Abortion and the Formation of the Public Sphere in Poland,” in Gender Politics and Post-Communism, ed. Nanette Fund and Magda Mueller, New York: Routledge, 1993.

36 Steven Lee Myers and Olivia Mitchell Ryan, “Once Strict on Births, China Races for a Boom,” New York Times, August 12, 2018.

37 Ghodsee, Why Women Have Better Sex Under Socialism.

38 Katie J. M. Baker, “Cockblocked by Redistribution: A Pick-Up Artist in Denmark,” Dissent 60, no. 4 (Fall 2013), dissentmagazine.org.

39 Beverly Jones and Judith Brown, Toward a Female Liberation Movement, Gainesville, FL: Gainesville Women’s Liberation, June 1968, 31.

40 A video of the action is at https://youtu.be/Wgld5ibIQgU. More on the campaign is available at shoutyourabortion.com/abortion-pills.

41 Ninia Baehr, Abortion without Apology: A Radical History for the 1990s, Boston: South End, 1990, 10.

Chapter 3. Women Themselves Are the Solution

  1 Fatima Juárez et al., Unintended Pregnancy and Induced Abortion in Mexico: Causes and Consequences, New York: Guttmacher Institute, 2013.

Chapter 4. The Attacks on Native People’s Reproductive Autonomy

  1 The terms “Native,” “Native American,” “Indian,” “Indigenous,” and “American Indian/Alaska Native (AI/AN)” are used interchangeably to inclusively refer to the Indigenous peoples under the jurisdiction of the United States, including those within the lower forty-eight states, Alaska Natives, Native Hawaiians, and the Indigenous peoples located within US territories. Native Peoples include federally recognized tribes, which have a nation-to-nation trust relationship with the US federal government.

Chapter 7. What We Need Now Is More of What We Did

  1 The terms “women’s movement” and “women’s liberation movement” are not interchangeable. Women’s movement refers to more mainstream feminism, best characterized by the National Organization for Women. The women’s liberation movement refers to those activists who were unabashedly antiracist, anti-imperialist, socialist or anarchist feminists who wanted to overthrow the racial patriarchy.

  2 I capitalize White as well as Black. I agree with Nell Painter: “In terms of racial identity, white Americans have had the choice of being something vague, something unraced and separate from race. A capitalized “White” challenges that freedom, by unmasking “Whiteness” as an American racial identity as historically important as “Blackness,” which it certainly is. No longer should White people be allowed the comfort of this racial invisibility; they should have to see themselves as raced.” Nell Painter’s editorial is available at www.washingtonpost.com/opinions/2020/07/22/why-white-should-be-capitalized.

  3 Fact, October 23, 1970. The police murdered Black protesters at Jackson State, a predominantly Black university, but the White students who were shot by the National Guard at Kent State in Ohio received much more public attention.

  4 And Aint I a Woman 1, no. 5, n.d., 5.

Chapter 8. Empty Choices

  1 Alexis Okeowo, “Fighting for Abortion Access the South,” New Yorker, October 7, 2019.

  2 Jael Silliman, Marlene Gerber Fried, Loretta Ross, and Elena Gutiérrez, Undivided Rights: Women of Color Organizing for Reproductive Justice, Cambridge, MA: South End Press, 2004, 28.

  3 Leonard Bond and Toni M. Bond, “Laying the Foundation for the Reproductive Justice Framework,” Collective Voices 4, no. 10 (Fall 2009): 11.

  4 Okeowo, “Fighting for Abortion Access the South.”

  5 Bond and Bond, “Laying the Foundation for the Reproductive Justice Framework.”

  6 Natelege Bond Whaley, “Black Women and the Right for Abortion Rights: How This Brochure Sparked the Movement for Reproductive Freedom,” NBCNews.com, March 25, 2019.

  7 Bond and Bond, “Laying the Foundation for the Reproductive Justice Framework.”

  8 Abigail Abrams, “How Advocates of Reproductive Justice Stepped into the Spotlight,” Time, November 21, 2019.

  9 SisterSong, “Reproductive Justice Sister Song,” www.sistersong.net/reproductive-justice. Accessed April 17, 2022.

10 Kimala Price, “What Is Reproductive Justice?: How Women of Color Activists Are Redefining the Pro-Choice Paradigm,” Meridians 10, no. 2 (2010).

11 Abrams, “How Advocates of Reproductive Justice Stepped into the Spotlight.”

12 American Civil Liberties Union. “SisterSong v. Kemp,” ACLU, October 22, 2021.

13 Oyez, “Dobbs v. Jackson Women’s Health Organization,” Oyez, December 1, 2021.

14 Allegra Kirkland, “Supreme Court Draft Decision Signals Roe Will Be Overturned, Politico Reports,” Teen Vogue, May 2, 2022.

15 Rachel Rebouche, “Reproducing Rights: The Intersection of Reproductive Justice and Human Rights,” UC Irvine Law Review 7, no. 3, December 1, 2017.

16 Maureen Tkacik, “Abortion and the Politics of Failure” in False Choices: The Faux Feminism of Hillary Clinton, ed. Liza Featherstone, London: Verso, 2016, 76.

17 Christie Renick, “The Nation’s First Family Separation Policy,” The Imprint, October 9, 2018.

18 Sarah Kliff, “The Secret History of Birth Control Pills,” Vox, October 23, 2014.

19 Sanjana Manjeshwar, “America’s Forgotten History of Forced Sterilization,” Berkeley Political Review, November 4, 2020.

20 Loretta J.Ross, “The Color of Choice: White Supremacy and Reproductive Justice,” in Color of Violence: The INCITE! Anthology, ed. INCITE!, Cambridge, MA: South End Press, 2006.

21 Jenny Brown, Birth Strike: The Hidden Fight over Women’s Work, Oakland: PM Press, 2019, 121.

22 Dorothy Roberts, Killing the Black Body: Race, Reproduction, and the Meaning of Liberty, New York: Vintage Books, 1998, 65.

23 National Partnership for Women & Children, “Past as Present: America’s Sordid History of Medical Reproductive Abuse and Experimentation,” Washington, DC: National Partnership for Women & Children, October 2020.

24 Angela Y. Davis, “Racism, Birth Control and Reproductive Rights,” in Women, Race and Class, New York: Random House, 1982, 1. g

25 Davis, “Racism, Birth Control and Reproductive Rights,” 11.

26 Davis, “Racism, Birth Control and Reproductive Rights,” 12.

27 Davis, “Racism, Birth Control and Reproductive Rights,” 13.

28 Roberts, Killing the Black Body, 23.

29 Kidi Tafesse, “What the ‘Mississippi Appendectomy’ Says about the Regard of the State towards the Agency of Black Women’s Bodies,” Movement for Black Women’s Lives, Black Freedom Struggles Blog, May 1, 2019.

30 Roberts, Killing the Black Body, 69.

31 National Partnership for Women & Families, “Past as Present,” 2.

32 Southern Poverty Law Center, “Relf v. Weinberger,” www.splcenter.org. Accessed May 21, 2022.

33 National Partnership for Women & Families, “Past as Present,” 2.

34 Gabriela Salas, “A Brief History of Sterilization Abuse in the U.S. and Its Connection to ICE Mass Hysterectomies in Georgia,” National Women’s Health Network, October 2, 2020.

35 Salas, “A Brief History of Sterilization Abuse in the U.S.”

36 NPR, “The Supreme Court Ruling That Led to 70000 Forced Sterilizations.” NPR, March 7, 2016.

37 Katherine Andrews, “The Dark History of Forced Sterilization of Latina Women,” Panoramas, October 30, 2017.

38 Kathryn Krase, “The History of Forced Sterilization in the United States,” Our Bodies Ourselves, 2014.

39 Raquel Reichard, “In Puerto Rico, a History of Colonization Led to an Atrocious Lack of Reproductive Freedom,” Refinery29, October 20, 2020.

40 Krase, “History of Forced Sterilization in the United States.”

41 INCITE!, “Dangerous Contraceptives,” incite-national.org/dangerous-contraceptives. Accessed 2 May. 2022.

42 Price, “What Is Reproductive Justice?”

43 INCITE! Women of Color Against Violence. “Dangerous Contraceptives,” INCITE!, incite-national.org/dangerous-contraceptives.

44 Price, “What Is Reproductive Justice?”

45 Jane Lawrence, “The Indian Health Service and the Sterilization of Native American Women,” American Indian Quarterly 24, no. 3 (Summer 2000): 400–19.

46 National Partnership for Women & Families, 3.

47 Price, “What Is Reproductive Justice?”

48 Roberts, Killing the Black Body, 6

49 Roberts, Killing the Black Body, 309–10.

50 Roberts, Killing the Black Body, 269.

51 Roberts, Killing the Black Body, 296.

52 Roberts, Killing the Black Body, 305.

53 Dorothy Roberts, “Reproductive Justice, Not Just Rights,” Dissent (Fall 2015).

54 Silliman et al., Undivided Rights, 11.

55 Silliman et al., Undivided Rights, 36.

56 Price, “What Is Reproductive Justice?”

57 Marlene Gerber, “The Hyde Amendment: 30 Years of Violating Women’s Rights,” Center for American Progress, October 6, 2006.

58 Silliman et al., Undivided Rights, 37.

59 Sam Rosenfeld and Daniel Schlozman, “Did the Democrats Fuck It Up? Abortion Politics and the Long Road to Dobbs,” N+1, May 19, 2022.

60 Kliff, “The Secret History of Birth Control Pills.”

61 Alexandra Zayas, “How the Pro-Choice Movement Lost the Battle for Roe,” Propublica, May 3, 2022.

62 Kliff, “The Secret History of Birth Control Pills.”

63 Guttmacher Institute, “Targeted Regulation of Abortion Providers (TRAP) Laws,” New York: Guttmacher Institute, January 2020.

64 Abigail Abrams, “Many Independent Abortion Clinics Are Closing, Permanently,” Time, December 2, 2020.

65 Miriam Berg, “Texas Law Will Ban Abortion at 6 Weeks and Let Anyone Sue Texans Who Help Someone Get an Abortion,” Planned Parenthood Blog, July 13, 2021.

66 Dan Mangan, “Texas Abortion Law: Supreme Court Allows Lawsuit to Proceed,” CNBC, December 10, 2021.

67 Planned Parenthood, “California Future of Abortion Council Releases New Report with Recommendations to Protect & Expand Abortion Access in California,” Sacramento, CA: Planned Parenthood Affiliates of California, December 8, 2021.

68 Marie Solis, “The Limits of the Mainstream Abortion Rights Movement,” Jezebel, October 7, 2021.

69 Solis, “Limits of the Mainstream Movement.”

70 Solis, “Limits of the Mainstream Movement.”

71 Solis, “Limits of the Mainstream Movement.”

72 Monica Simpson, “To Be Pro-Choice, You Must Have the Privilege of Having Choices,” New York Times, April 11, 2022.

73 Pamela Bridgewater, “Transforming Silence: The Personal, Political, and Pedagogical Prism of Abortion Narrative,” in Radical Reproductive Justice: Foundations, Theory, Practice, Critique, ed. Loretta J. Ross, Lynn Roberts, Erika Derkas, Whitney Peoples, and Pamela Bridgewater Toure, New York: Feminist Press, 2017, 236–8.

Chapter 9. Sovereignty Lost

  1 “So-called” is often used by Indigenous people in the US and Canada as a way to acknowledge that the land is older than the colonizing nations that currently occupy it and belongs to tribal nations.

Chapter 12. White Supremacy and the Antiabortion Movement

  1 Crystal M. Hayes, Carolyn Sufrin, and Jamila B. Perritt. 2020. “Reproductive Justice Disrupted: Mass Incarceration as a Driver of Reproductive Oppression,” American Journal of Public Health, no. S1 (January 2020): S21–24.

  2 Randall Balmer. “There’s a Straight Line from US Racial Segregation to the Anti-Abortion Movement,” Guardian, September 8, 2021.

  3 Alex DiBranco, “The Long History of the Anti-Abortion Movement’s Links to White Supremacists,” Nation, February 3, 2020.

  4 “Economic Justice—NAPAWF,” National Asian Pacific Islander Women’s Forum, n.d., Accessed April 26, 2022.

  5 Balmer, “Straight Line from US Racial Segregation.”

  6 Balmer, “Straight Line from US Racial Segregation.”

  7 DiBranco, “Long History of the Anti-Abortion Movement’s Links to White Supremacists.”

  8 Shireen Shakouri, “White Supremacy and the Pro-Life Movement,” Reproaction, February 2, 2018.

  9 Shakouri, “White Supremacy.”

10 DiBranco, “Long History of the Anti-Abortion Movement’s Links.”

11 Susan Rinkunas, “The ‘5 Fetuses’ Story Just Got a Lot Weirder,” Jezebel, April 5, 2022.

12 @PAAUnow on Twitter, Twitter post, April 10, 2022.

13 DiBranco, “Long History of the Anti-Abortion Movement’s Links.”

14 Moira Donegan, “White Nationalists Are Flocking to the US Anti-Abortion Movement,” Guardian, January 24, 2022.

15 Laura Bassett, “Anti-Abortion Leader Emerges as White Nationalist,” HuffPost, April 17, 2018.

16 Sophie Sherry, “White Supremacist Group Patriot Front Crashes Anti-Abortion Rally in the Loop,” Chicago Sun-Times, January 10, 2022; Renee Bracey Sherman and Lizz Winstead, “Patriot Front’s Anti-Abortion Advocacy at March for Life Sends a Clear Message,” NBC News, January 25, 2022.

17 @Reproaction on Twitter. Twitter post, January 27, 2022, 1:35pm.

Chapter 14. Abortion Behind Bars

  1 Wendy Sawyer and Wanda Bertram, “Prisons and Jails Will Separate Millions of Mothers from Their Children in 2022,” Prison Policy Initiative, May 4, 2022.

  2 Carolyn Sufrin et al., “Abortion Access for Incarcerated People: Incidence of Abortion Policies at U.S. Prisons and Jails,” New York: Guttmacher Institute, 2021.

  3 Interview with Carolyn Sufrin, May 5, 2022.

  4 Alabama Code Title 26. Infants and Incompetents, §26-15-3-2.

  5 “Lauderdale Co. Inmate Sues Sheriff for Right to Have Abortion,” WAFF48, July 21, 2015.

  6 “Lauderdale Co. Inmate Sues Sheriff.”

  7 Tom Smith, “DA: Parental Rights Issue Will Have Bearing on Abortion Request,” Times Daily, July 29, 2015.

  8 “Alabama Prisoner Who Sought Abortion Changes Her Mind,” Aljazeera America, July 29, 2015.

  9 Tom Smith, “Federal Judge Dismisses Abortion Lawsuit,” Florence Times Daily, July 31, 2015.

10 Craig A. Conway, “A Right of Access to Medical and Mental Health for the Incarcerated.”

11 See, for instance: Victoria Law, “U.S. Prisons and Jails Are Threatening the Lives of Pregnant Women and Babies,” In These Times, September 28, 2015; Victoria Law, “After Giving Birth, These Women Were Placed in Handcuffs, Leg Irons, and Waist Chains,” Nation, December 2, 2015; Sharona Coutts and Zoe Greenberg, “Deprived of Care, Incarcerated Women Suffer Miscarriages, Stillbirths, Ectopic Pregnancies,” Rewire News Group, March 31, 2015.

12 Court Defines Right to Abortion in Prisons: Monmouth County Correctional Institution Inmates v. Lanzaro, 834 F.2d 326 (3rd Cir. 03/19/1987).

13 Rachel Roth, “Obstructing Justice: Prisons as Barriers to Medical Care for Pregnant Women,” UCLA Journal of Gender and Law 18, no.1 (2010).

14 Diana Kadsdan, “Abortion Access for Incarcerated Women: Are Correctional Health Practices in Conflict With Constitutional Standards?” Perspectives on Sexual and Reproductive Health 41, no. 1 (March 2009): 59–62.

15 “Abortion Shuttle Refused,”Washington Times, October 17, 2004.

16 San Diego Union Tribune, October 16, 2004. Accessed in August 2015; link has since broken.

17 Lyle Denniston, “Court Allows Inmate’s Abortion,” SCOTUSBlog, October 17, 2005.

18 United States Court of Appeals, Jane Roe v. Larry Crawford, No. 06-3108. Decided January 22, 2008.

19 Order in pending case, Crawford v. Roe, October17, 2005.

20 ACLU, “Court Rules that Sheriff Joe Arpaio Can No Longer BlockPrisoners’ Access to Abortion Care,” October 20, 2009.

21 Sufrin interview, May 5, 2022.

22 Roth, “Obstructing Justice,” 10.

23 Bernadette Rabuy and Daniel Kopf, “Prisons of Poverty: Uncovering the Pre-Incarceration Incomes of the Imprisoned,”, Northampton, MA: Prison Policy Initiative, July 9, 2015.

24 Gabriella Borter, “Oklahoma Governor Signs Near-Total Abortion Ban,Threatens Prison for Providers,” Reuters, April 13, 2022.

25 Sufrin interview, May 5, 2022.

26 Tom Smith, “Federal Judge to Issue Ruling on Friday for Inmate’s Request for Abortion,” Times Daily, July 28, 2015.

27 Victoria Law, “Alabama Case Illustrates Difficulties Women Behind Bars Face When Seeking Abortion,” Rewire News Group, August 5, 2015.

28 Lauren E. Glaze and Danielle Kaebele, “Correctional Populations in the United States, 2013,” US Department of Justice, Bureau of Justice Statistics, December 2014.

Chapter 18. Maybe Abortion Isn’t as Complicated as We’ve Been Led to Believe

  1 All the names of providers and their clients have been changed in this story.

Chapter 20. Self-Managed Abortion

  1 B. Winikoff and W. Sheldon, “Use of Medicines Changing the Face of Abortion,” International Perspectives on Sexual and Reproductive Health 38, no. 3 (2012).

  2 R. Allen and B. M. O’Brien, “Uses of Misoprostol in Obstetrics and Gynecology,” Reviews in Obstetrics and Gynecology 2, no. 3 (2009).

  3 H. Moseson, et al., “Self-Managed Abortion: A Systematic Scoping Review,” Best Practice & Research Clinical Obstetrics and Gynecology 63 (February 2020): 87–110.