The Abortion Underground
Matt Katz: This is On The Media. I'm Matt Katz sitting in for Brooke Gladstone. As you already know by now a draft of the majority opinion overruling Roe v. Wade was leaked to the media this week, as some background to the current groundswell of stories about abortion rights. Our colleagues at the experiment put together a piece about the resurgence of the abortion underground. The first voice you'll hear in the story belongs to the host of the experiment, Julia Longoria.
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Julia Longoria: Tell me the story of your coming-to-the-story.
Jessica Bruder: It’s actually bizarre. I love checking the schedules of hackers’ conferences.
Julia: Jessica Bruder is a freelance writer for The Atlantic and she’s not a tech reporter.
Jessica: I am not a coder. I’m not super, super tech-savvy.
Julia: The reason she likes hackers’ conferences is because of the kinds of people who attend them.
Jessica: My beat has essentially become subcultures.
Goldstein: Welcome to HOPE 2020.
Newby: There’s so much going on over the nine days of Hackers on Planet Earth 2020. HOPE seeks to build a vibrant, supportive community of hackers, and you’re here. Welcome.
Jessica: There’s always somebody doing something really smart for the hacker halftime show or something. [chuckles]
Newby: We have a talent show, Hackers Got Talent.
Jessica: I remember I was flipping through their sessions online and it was just what you would expect at a Hackers’ Conference privacy-
Speaker: Defending your system through binary recompilation.
Jessica: Coding-
Speaker: Resistance to the NSA-level global adversaries.
Jessica: The surveillance state and then
Speaker: I’m very happy to welcome Maggie Mayhem on "Hackers in a Post–Roe v. Wade World."
Jessica: Randomly, out of nowhere, abortion.
Maggie: I believe that abortion is information technology. This is a talk that will be very frank about abortion in all kinds of contexts.
Jessica: It was this session presented by a woman who called herself Maggie Mayhem, and she had this very riot-girl vibe, dark eyeliner, big earrings and she was talking about the criminalization of abortion.
Maggie: Since, right now, people are looking for self-managed abortion but that can be a really scary thing to hear. Self-managed abortion isn’t that a back alley abortion? Isn’t that the wire hanger that we’re all so afraid of. In this case in-
Jessica: When I was growing up in the mid-’90s, the idea that I had was when it came to abortion, it was either the clinic and the clinic was safe and warm or it’s the coat hanger, which is the back alley, which is what happens when abortion is restricted.
Maggie: It just may be that self-managed abortion is the solution we need until we can actually secure legal rights, and I’m going to reassure you on why it might be okay. There has always been a network of underground abortion. They eventually realized that abortion itself wasn’t maybe as complicated as they thought it had to be.
Jessica: She held up this thing I’d never seen before.
Maggie: The equipment looks simple basically a jar with tubes.
Jessica: -which was, in essence, a DIY-abortion device from the early '70s. It looks like a home-brewing or science-fair project with these long, clear plastic tubes coming out.
Maggie: It was based completely off of what doctors at the time would have been using, and you can find activists who are providing care using these right now in the United States.
Jessica: I’d never heard of a device like that. I wondered, "Where did this thing come from?" I also wondered, "What does this mean, given that Roe v. Wade could be overturned in June? What does this mean now?"
Mississippi Solicitor General Stewart: Mr. Chief Justice and may it please the court. Roe v. Wade and Planned Parenthood v. Casey haunt our country. They have no basis in the Constitution. They have no home in our history or traditions. They’ve damaged the democratic process. They poisoned the law.
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Julia: Since before Roe v. Wade was decided, pro-abortion activists have used the cautionary tale of the coat hanger as an argument to make sure abortions are legal, safe, and accessible inside doctor’s clinics.
Jessica: I think I still had the coat hanger and the clinic as poles in my brain when I started reporting this. There have been people in this gray area, in the middle, who were working outside the medical establishment, but not using coat hangers who were actually performing safe, respectful abortions and I think that was really news to me.
Julia: This week on the show, while the country awaits a Supreme Court decision that could result in abortion being illegal in about half the country, reporter Jessica Bruder embeds in the abortion underground. I’m Julia Longoria. This is The Experiment, a show about our unfinished country.
It sounds like Maggie Mayhem sent you down a bit of a rabbit hole. What did you learn about the history of abortion in our country?
Jessica: To start, I hadn’t even heard about the quickening. Have you heard of the quickening?
Julia: No.
Jessica: It sounds like a film title, doesn’t it?
Julia: [laughs] Yes.
Jessica: In the early days of America, when they were still following what had been British common law, when there weren’t disposable pregnancy tests around, the idea was that there wasn’t anything that would be legally recognized or treated as a fetus until the woman felt the first fetal movement, which would be about four to five months into pregnancy so that at the time that first kick comes, then there’s something going on. Until the quickening, it was perfectly legal for women to go out and pursue treatments to bring down the menses as they called it.
Early in the 19th century, you could go to a midwife, you could go to other traditional healers, and that was pretty uncontroversial. By mid-century, you’ve got newspapers with all these advertisements for things like Madame Drunette’s Lunar Pills. Some of those commercial preparations could kill you. Some of the first laws set up to regulate abortion were really poison-control measures aimed at those concoctions. They weren’t there to make some sort of moral point. They were there to keep people from drinking stuff that might kill them.
Julia: When did social attitudes toward abortion start to change?
Jessica: It was around the 1860s that there was this shift in how abortion patients were perceived. There was a lot of racism and nativism going on at the time, stoking fears about white women having fewer children than immigrants and people of color. The anti-abortion leader Horatio Storer, who was running the anti-abortion campaign, he literally asked whether the West would be, "filled by our own children or by those of aliens" and said, "This is a question our women must answer. Upon their loins depends the future destiny of the nation." Horatio Storer led the campaign against abortion for the newly organized American Medical Association.
Julia: The American Medical Association was organizing against abortion in this way.
Jessica: Yes. At the time, doctors who were just about all male weren’t the ones who were delivering babies or performing abortions. Midwives were. The American Medical Association was trying to drive out competition, and they decided to campaign against abortion and it worked. With a new generation, every single state had laws that criminalized or restricted abortion.
Cronkite: Good evening. Tonight, the subject of abortion, the illegal termination of pregnancy has reached epidemic proportions in this country. Abortion will continue to be a critical problem and, for those involved, may call for desperate decisions that result in dangerous medical complications.
Jessica: Basically when you have abortion becoming totally criminalized, it goes underground, which means some people are going to resort to really dangerous methods.
Cronkite: The facts are astonishing. Hundreds of thousands of pregnant women, unmindful of what may happen to them, secretly seek abortions.
Jessica: Common causes of abortion deaths were poisoning, and there were also complications from people introducing a foreign instrument into the uterus something like the proverbial coat hanger.
Cronkite: For them, there is a wide gulf between what the law commands and what they feel they must do.
Jessica: By 1965, botched abortions accounted for one in five maternal deaths. Around that time, activists started organizing to make abortions safer. They knew how horrific they could be if they were done in the absence of good information and help, and they wanted to change that.
Carol Downer: It’s a dignity and control-of-your-own-body issue.
Jessica: One of those activists was Carol Downer. Earlier this year, I went to LA and we ended up sitting on her porch and just chatting for hours. Today she’s 88 years old but back when she was in her 30s, she had an abortion at an illegal clinic. This was in the early '60s and Carol had already had four children. She'd separated from her husband.
Jessica: What kind of method was used when you got an abortion?
Carol: The dilation in the curettage.
Jessica: One of the most popular methods until then was dilation in curettage, which involves essentially scraping out the uterine wells.
Carol: I can tell you from my own personal experience it was an incredibly painful procedure.
Jessica: Sounds excruciating. She had a really bad experience. It was painful, it was traumatic. That got her on the path of wanting to make abortion safer, more accessible, more humane. Although she didn't really know where to start.
Carol: I was a housewife. [chuckles] I had no way of connecting to activists, especially in the feminist movement, except the abortion committee.
Jessica: She joined the abortion committee of the National Organization of Women in LA.
Carol: Had an abortion and had children. I was very aware of what that was all about.
Jessica: As part of an effort to educate herself, she started shadowing illegal abortion providers.
Carol: I was assigned the ex-military guy. This guy was a sexist pig if there ever was one. I was really appalled at some of the equipment that he used and these women were just trembling there and he was sitting back in his chair, admiring their vulvas. It was just nasty, it was really, really bad. We knew the abortion bills. We knew you took, who you could get.
Jessica: There was one abortion provider that Carol did feel she could learn something from. His name was Harvey Carmen, and he was running an illegal abortion clinic in LA.
Carol: It was right next door to the Christian Science reading room.
Jessica: What a trip.
Carol: I was brought up Christian Science trip pathway. [chuckles]
Jessica: Now the thing that was different about Harvey was that he had created a plastic cannula.
Carol: The Karman cannula.
Jessica: Which is essentially a straw that could be connected to a syringe for suction.
Carol: The suction device was in fact, a great improvement and much less pain and much less complications.
Jessica: It was a soft plastic flexible straw that could make a first trimester abortion much less traumatic than some other methods.
Carol: He had of name, the non-traumatic abortion.
Jessica: They called it a lunch hour abortion because you could go in, get it done safely, and then go back to what you'd been doing beforehand.
Carol: You can see the procedure that he's doing. This is something we could learn so that sparked us to start paying more attention and becoming even more hands on involved.
Jessica: The idea was, why shouldn't we know how to do that? Wouldn't that give pregnant people more autonomy than having to rely on a male dominated medical system?
Carol: When we first started, there was no manufactured Karman cannula. Harvey made his own.
Jessica: In 1971, a friend of Carol's who was part of the same feminist group, Lorraine Rothman borrowed one of Karman devices and tried to figure out how to make a version of her own.
Carol: What she did was just make a tube and then take a little razor blade and notch it. There was your cannula.
Jessica: Built something they called the Del-EM, which was a Mason jar, some aquarium tubing, a syringe to create a vacuum and a cannula which was what the person who was performing the abortion would carefully insert through the cervix. Essentially just created this device that could be used to safely empty the uterus. They showed hundreds of women how to have safe successful abortions. In that way. The Del-EM is the same device I first saw at the hackers conference with Maggie Mayhem.
Julia: What does Del-EM stand for?
Jessica: In the beginning they called it just a menstrual extraction kit, which gave it this plausible deniability, because the idea is, we don't know if we're pregnant. We want to get our periods over with, in a half an hour rather than several days. That way, if they ever got accused of performing abortions it could be, "Well, we didn't know."
They did demonstrations and a lot of it went over quite well, but then they met one doctor at a clinic who was just hostile to the whole idea of it and referred to what they were showing her as a dirty little machine and turned her nose up at it as it like, "How do you clean that dirty little machine?" Apparently it really cracked up these feminists. They turned it around, decided to reclaim that. Among themselves started calling it the dirty little machine as an in joke. They shortened that to DLM and then that became Del-EM. Much later they ended up pretty much disowning the idea that Del-EM ever stood for dirty little machine, because they wanted to be taken seriously.
It had been this really sassy way of asserting themselves to call it that. At this point they just wanted people to know that they knew how to create a sterile environment. That when it came to hygiene they meant business. Later I'm told Lorraine Rothman went on to tell people that Del-EM stood for, "Deliberate Emptying of the Men's Seeds."
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Carol and Lorraine basically took it on tour. They called themselves the West Coast sisters. They hopped on a Greyhound bus and over the course of six weeks went to 23 cities around the country, giving people speculums. If you've ever been to a gynecologist you know that's the tool that opens up access to the cervix and they showed people how to use the Del-EM.
Carol: I remember at the abortion demonstration. These women were just absolutely blown away in a bad way. Well, [unintelligible 00:16:07] abortions. That's all that's in their mind. They were getting green around the gills. I was afraid a couple were going to faint. I said, "Well, maybe this will help." I took the speculum, found a desk and adjoining [inaudible 00:16:25] and invited people to come over and looked at my [unintelligible 00:16:28]
Jessica: Showing them how once you can access your cervix, you can do something like a menstrual extraction.
Carol: Absolutely. They were [unintelligible 00:16:35]. What we did was great because of our process.
Jessica: The idea was that you would have a group of people who knew each other well and who were there for each other just to make the whole experience more communal, less traumatic.
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Speaker: The other major story today, aside from the death of Lyndon Johnson and the hopes for peace in Vietnam is the decision of the United States Supreme Court.
Jessica: Then in 1973.
Speaker: The Supreme Court today ruled that abortion is completely a private matter to be decided by mother and doctor in the first three months of pregnancy.
Speaker: The freedom to have an abortion is now legal in every state. The basic legal fight is in effect over.
Jessica: When the Supreme court legalized abortion across the country in 1973. It would've stood to reason that the Del-EM would disappear. Nobody needs this anymore. Why keep that Mason jar and aquarium tubing in your closet if no one's ever going to need it.
Carol: We didn't expect patriarchy to give up. We didn't have any illusions that Roe v. Wade would bring it. I think we all thought it would get turned around sooner and we didn't think it was much of a law in the first place. We thought abortions would not be governed by the law, period.
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Ellie: [laughs] We've never done this on a beach before. I brought a bunch of stuff. We have like aquarium tubing.
Jessica: Instead, the Del-EM got handed down from generation to generation.
Ellie: Then the way you make it is very simple.
Jessica: Which is how a few months ago, I ended up on a beach in California learning how to build one.
Ellie: Then you want to take the syringe and attach it to this side.
Jessica: It's funny. I started thinking about the Del-EM as almost a bellwether for the level of abortion anxiety in America. Whenever it looks like something might happen to Roe, you see the Del-EM creeping back into the press.
Ellie: Last thing to do is attach the cannula, which you wouldn't do until you're ready to use it. Then that's it, like you've done it.
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Julia: After the break, the bellwether for abortion anxiety returns.
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I'm Julia Longoria. This is The Experiment. Reporter Jessica Bruder stumbled upon an abortion underground. A group of activists who for decades have tried to take abortion out of the hands of lawmakers and empower people to take control of their own care. In the 1970s, some activists did this work with the device called the Del-EM and today as various states passed laws around the country to further restrict and ban abortion, the Del-EM is back.
Jessica: When I was trying to learn more about the Del-EM, I was referred to this woman who I will call Ellie. She’s got her own business in reproductive health. I went out and met her, and she was just getting over COVID. She was also concerned about having me over to her place. She just didn’t want anything to be traceable, because she worried about harassment or even violence from anti-abortion extremists. We ended up in this really strange situation where we were sitting on a beach.
Ellie: [laughs] It wouldn’t be my ideal location to start.
Jessica: It was like she was laying out this unusual picnic because there we are on the beach. Maybe 10 yards away, there’s two teenagers practicing volleyball. There are people walking their dogs. There are pelicans.
Ellie: It’s cold. I’m freezing.
Jessica: It’s really windy, and we’re sitting there, and she starts showing me how to build a Del-EM
Ellie: I brought a bunch of stuff.
Jessica: -just on a couple of towels in the sand-
Ellie: Then the way you make it is very simple.
Jessica: -and to make it a little more clear on how it works.
Ellie: I bet we could do it with the coffee cup if we tried, like-
Jessica: She had a cup of coffee, and she decanted some into a jar and then stuck the cannula in.
Ellie: Very scientific. [laughs]
Jessica: Basically pulled the syringe and suddenly-
Ellie: There you go.
Jessica: -she’s extracting the coffee and it’s collecting in the device, and I was just watching it happen.
Ellie: That’s how that would work.
Julia: What was going through your head, sitting on this beach, watching coffee get slurped up by a Del-EM?
Jessica: It was really, really odd. Here we are, in the middle of the pandemic, using this homemade abortion device from the ’70s. It did make me wonder what reality I’d ended up in a little bit. [chuckles]
Ellie: I think whether or not this is something that someone uses, just knowing that there are options in the world and that the people who came before you had other ways of managing these things-
Jessica: Sure.
Ellie: -that has always made me feel less lonely or less despondent-
Jessica: The idea of the Del-EM, for Ellie, was almost this symbol.
Ellie: Again, are these the most effective methods? Are these the best methods? It's not necessarily.
Jessica: Ellie was telling me that, while this is pretty safe, it’s not what she would want to use. I did talk to a doctor who’s also a researcher and professor at Stanford to ask about all this, and he assured me that Del-EM is safe and essentially said that abortions aren’t rocket science. It’s not that different from manual vacuum-aspiration kits that are mass-produced, that are used in doctor’s offices, and that frankly some activists were telling me they had ordered online. Maggie Mayhem said she picked up a couple on Amazon, even though they’re not available there anymore.
The Del-EM, in a lot of ways, is a relic from the past. I wanted to get up to speed. I wanted to find out about the other methods that are out there. What methods are the abortion underground today? What are they rallying around?
[phone rings]
Voicemail: Your call has been forwarded to an automatic voice message system-
Jessica: As you might imagine, it’s really difficult to get people to talk about this stuff.
Voicemail: When you have finished recording, you may hang up or press 1 for more options.
Jessica: People don’t trust you right away and nor should they. Eventually, one person recommends you to another, recommends you to another. Hello, hello.
Maggie: Hello, hello.
Jessica: They want to make sure you can protect them.
Anonymous: What we’re doing is somewhere on the spectrum of, like, straight-up, really illegal to somewhere in a gray area.
Ellie: We live in a country where doctors have been killed because they provide abortions.
Jessica: A lot of them knew each other.
Anonymous: If I do bring you in and provide information about what we’re doing and how we’re doing it, I’m going to need to remain anonymous.
Jessica: What I saw was that people were getting really creative about getting around abortion restrictions. One of the most interesting examples of that came from this group called Abortion Delivered that ended up driving around, offering a abortion on wheels type delivery service.
Angela: In the abortion world, it’s always been this thing that folks have considered and jokingly said, "When I retire, I’m going to have a mobile clinic and-
Jessica: When something popped up involving vans, I was fascinated.
Angela: We would be in one town for 20 minutes.
Jessica: Then they’d be gone.
Angela: We’ve seen 1,300 patients. We started in Minnesota really focused on rural areas, because there’s so few providers in Minnesota. Then we started seeing folks coming over from the Dakotas, North Dakota, South Dakota. Also Wisconsin, Iowa. Everyone was crossing over to be able to get the medication.
Jessica: There’s something very Road Warrior almost Mad Max or Station Eleven about it. The group went on, and when I spoke with them, they were in the process of bulletproofing a couple of vans to send to just outside the Texas border.
Literally, bulletproofed?
Angela: Yes.
Jessica: I wish that we're able to be a euphemism in these strange times.
Angela: [laughs] I know.
Jessica: They’re worried about being so close to an open-carry, gun-enthusiastic, abortion-hostile state, doing what they’re doing.
Angela: As they try to restrict things, that will just make us push harder too.
Jessica: How does it all change if Roe just gets completely upended?
Angela: If Roe gets upended, we will just be driving up and down the borders.
Jessica: While some people are taking these sort of complex measures, from the Del-EM, to the vans, one of the newest and most accessible self-managed options right now is actually pretty simple, even though a lot of people still haven’t heard of it, and that is abortion pills. One of them is called mifepristone, which the FDA approved back in 2000 and the other is misoprostol, which women in Brazil in the 1980s realized could be used for early-stage abortions.
There was a label on the side of this medication that said you shouldn’t take it if you’re pregnant because it could cause violent uterine contractions. People began using it off-label to have abortions and the medical establishment has followed their lead on that. We’ve reached the point where more than half of all legal abortions in the US are done with a method that uses both of these drugs. Now-
Texas Governor Greg Abbott: Mail-order abortion drugs are now prohibited in the state of Texas.
[applause]
Jessica: -we’re in a situation where 19 states have already made it illegal for doctors to prescribe the pills via telemedicine or for anyone to send them by mail.
Vanderhoff: There’s a battle over whether people should be able to order the so-called abortion pill online in Kentucky.
Jessica: Nine additional states are considering similar bills.
KCRG’s Jay Greene: Iowa House Republicans have passed a bill which would ban mailing abortion pills. The bill-
Jessica: In Iowa, there’s a bill that would make distributing abortion pills even if you’re a doctor punishable by up to 10 years in prison. All of this is why people in the abortion underground are now hyper-focused on the pill and making it accessible. I learned about this one international nonprofit called Aid Access that delivers abortion medication to all 50 states. They can’t be prosecuted for it, because they’re actually located overseas. I wanted to understand how people are sharing information about the pills. I got introduced to this activist named Susan Yanow.
Susan Yanow: I’m really happy that more and more people are coming into this space and understanding the potential of abortion pills.
Jessica: She let me sit in on one of her Zoom seminars, and she basically talks to people about how they can access and then use abortion pills without supervision by a doctor.
Susan: It’s not just the stigma, but the fear of the medical establishment to trust that we can do this by ourselves.
Jessica: I just remember, before the class, she instructed us all to go out and get Skittles and M&Ms, and I’m thinking, "All right, I’m trick-or-treating for abortion here. What is going on?"
Susan: Because it’s mifepristone and misoprostol. It’s M&M.
Jessica: She actually had us tuck four M&Ms into what you call the buccal cavity, which is that little pocket between your cheek and your gums, and you’re supposed to sit with them for 30 minutes, which-- I know I didn’t make it. I really like M&Ms so I was not going to just sit with them there in my mouth. That’s like giving a squirrel a peanut and saying, “Hang on to that, buddy." Good luck there.
With the pills, what I think a lot of people don’t realize is, even if you do go to the doctor, the doctor has you take the first pill and sends you home with the rest of the pills. You’re monitoring yourself for any complications. This is essentially self-managing abortions anyway. It’s more regulated. When we talk about the future, essentially, we’re already there.
Julia: What are the risks of going the self-managed route without a doctor?
Jessica: I think the idea of self-management isn’t this almost rugged American individualism. You cowboy up and you go out into the wilderness and you induce your abortion and then you come back. It's not. It's not that at all. The idea is you make sure that you've got people who are close to you who are around who know what you're doing. You make sure you're close to a hospital in case something goes wrong.
One of the interesting things, though, was there are some places where people have gotten in trouble when they went to the doctor after people found out that they used abortion pills for various reasons. If somebody goes to the emergency room, activists and others recommend that they say, "I'm having a miscarriage." Clinically, they would treat you the same way anyway.
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Julia: Taking a step back for a minute, it seems like you came upon this story almost by accident, and then as you've been reporting this, we're still waiting for a decision from the Supreme Court. We've seen new abortion restrictions crop up from several states in the last few months. I wonder what it's felt like for you working on this story, as the story is unfolding.
Jessica: It's been intense watching all of these restrictions snowballing in real-time. In Florida, they just signed a 15-week abortion ban into law. We have Oklahoma and Kentucky where abortion has now been effectively banned, so it's really coming to a head. After talking to people who've seen this coming for such a long time, and who really were willing to risk their lives and their freedom to help people get abortions, it was interesting to me because I think I thought we were in a place where maybe that wasn't needed in the same way anymore. What I learned was that the abortion underground never really went away.
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Alyssa Edes: This episode of The Experiment was produced by Gabrielle Berbey and me, Alyssa Edes, with help from Salman Ahad Khan, editing by Michael May, reporting by Jessica Bruder. You can read Jessica Bruder's full article, A covert network of activists is preparing for the end of row on our website www.theatlantic.com/experiment.
Fast check by Michelle Ciarrocca and Yvonne Kim. Sound design by Joe Plourde with additional engineering by Jennifer Munson. Music by Tasty Morsels and Joe Plourde. Our team also includes Peter Bresnan, Tracie Hunte, Emily Botein, Jenny Lawton, and Natalia Ramirez.
If you enjoyed today's episode, please take the time to rate and review us on Apple Podcasts or wherever you listen. The Experiment is a co-production of The Atlantic and WNYC Studios. Thanks for listening.
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