The ship was Gomperts’s brainchild. At the time, the World Health Organization estimated that 78,000 women died each year from unsafe abortions, many of them in countries where abortion was criminalized or inaccessible. Using maritime law, which holds that a ship in international waters is governed by the laws of its home port, Gomperts thought she could sail a vessel from her home in the Netherlands, where abortion was legal, and provide abortion care offshore from countries where it wasn’t. It was a provocative and daring thing to do—“abortion pirates” was what conservative opponents called them—but Gomperts, who had served as a doctor on a Greenpeace ship in the late 1990s, knew the publicity power of direct-action campaigns and believed it was well worth creating a stir over 78,000 women’s lives.
Though the hotlines were long-term projects, the drones and robots in particular weren’t set up as sustainable models for abortion access. Instead, they were stunts intended to send a message: Access to abortion can’t be stopped, and women could—and would—self-manage their abortions safely, law be damned. As Gomperts put it, the project was this: “How could we create a space where the only permission a woman needed was her own?”
The conversation about abortion politics in the United States often focuses on laws—on winning rights and taking them away—and on morals. Grant, adamantly, focuses on access: getting people the reproductive care they seek. As the activists she profiles believe, and as her book illustrates, to focus on access is to wholly transform the conversation about what abortion is: a decision a woman makes, a procedure a woman has, something women will always seek regardless of laws. This is no small feat in a country where the anti-abortion right has successfully weaponized terms like life and heartbeat and baby, and where mainstream abortion politics have been stuck in a defensive crouch of lobbying and debating “choice.” Reading Grant’s history raises the question: If Planned Parenthood had sent abortion boats down the Mississippi and into the Gulf of Mexico, working with local activists to build safe abortion hotlines in Texas, Florida, Louisiana, Alabama, would things look different today?
Through the mid–nineteenth century, abortion until “quickening”—when the fetus is felt to move, usually during the second trimester—was common practice and legally permitted. This changed in 1847, with the founding of the American Medical Association, which sought to institutionalize medicine and put power in the hands of (male) doctors. Its members were particularly incensed about midwives, and it was in the 1850s that the movement to criminalize reproductive care, from contraception to pregnancy to abortion to birth, began. The AMA formally adopted an anti-abortion stance in 1859, and criminalization laws really began to enter the books in 1860.
Grant’s story begins in 1966, when three women known as “the Army of Three” begin challenging California’s abortion restrictions by handing out lists of reputable abortion providers on San Francisco sidewalks. Just a few years prior, a sophomore at the University of Chicago had used her civil rights movement connections to help a friend access an illegal abortion, and the calls kept coming. With fellow feminist activists, she started an abortion counseling service to connect women to safe providers. Security was of the utmost concern, and so the women chose the most generic name for themselves: the Jane Collective.
They were taking abortion care out of the hands of doctors, politicians, and men—and putting it back in the hands of women.
One of the revelations of Grant’s book is that Roe is a sidenote, rather than, as with liberal rights–based stories of abortion, the central story. Rights only matter if they are enforced and only if people can exercise them freely: Roe made no provision for either. At the same time that abortion clinics began to pop up across the country, anti-abortion politicians sought to limit the law, eventually winning passage of the Hyde Amendment in 1977, which banned use of federal Medicaid funding for abortions. Women—especially poor women and women of color—began dying.
Meanwhile, the anti-abortion right organized, town by town and state by state, to make abortion harder to access and harder to provide. Between 2011 and 2013, over 200 abortion restrictions were passed. In the United States, activists organized abortion funds to help local women pay to travel out of state, pay for procedures, and cover costs of childcare or lost wages. But the need was overwhelming: By 2014, 90 percent of counties in the United States had no abortion clinic.
“This was groundbreaking,” Grant writes, and the development of medication abortion—the drugs misoprostol and mifepristone—is the watershed moment in the story she tells. Rather than hinging on finding safe and trustworthy abortion providers, medication abortion made it possible for women without specialized training to safely end their pregnancy on their own terms and in their own communities. All a woman needed was the pills, usage instructions, and a support system in case there were complications. And now, feminists had the internet.
Medication abortion is a simple, common, and safe procedure, according to the World Health Organization and decades of data-driven research, but the experience lasts over several days, and can be painful, frightening, and lonely—especially for a woman trying to keep her abortion secret from a disapproving or abusive family member. Las Libres didn’t want anyone to be alone and, in order to combat shame or stigma, wanted each woman to be guided by someone who had also gone through the process. Often, women would come to the collective after the abortion in gratitude and ask, “What can I do to ensure another woman can have this freedom?” “That,” Cruz told Grant, “was the lightbulb moment.” Each woman would accompany the next woman, and on and on, creating a sisterhood of compassionate and judgment-free abortion care, a practice known as acompañamiento, or accompaniment. In 2009, Las Libres began seeding accompaniment collectives across Mexico.
Here’s what one interaction, quoted in Vessel, a documentary about Women on Waves and Women on Web, looks like:
Dear Women on Web,I retrieved the pills from the post in Nairobi yesterday–I kissed the medicine when it fell into my hands.I am in the hotel and have just taken the second medicine now…
Dear Emma,How are you doing now?Has the process started?
My stomach aches, really bad, it is really painful…Is this normal?
Cramping is normal, it means the misoprostol pushing the pregnancy out.You can take Ibuprofen for the pain.
This by far is the loneliest I have been.I am not a monster,I just cannot have the baby.
Emma,You are not a monster for wanting an abortion.1 in 3 women worldwide will have an abortion in her lifetime and we are not monsters!You are being so incredibly strong and even if you feel alone you are taking good care of yourself.That is something to be very proud of.
Good morning. It was a long 15 hours but I feel ok now. I will go for an ultrasound to confirm. I am overwhelmed by your kindness. I thought it would be some automated reply, and instead there was a real human being there, who wanted to help me.May I know your name? Just to keep you in my prayers?
Thank you for your kind words, Emma.We cannot tell you the name of the woman who was with you as we are a collective and many of us have been working last night.We are always here if you ever want to write us again.Hugs, Women on Web
As the world expanded for women across Latin America, it contracted for women in the United States, who were headed down the tunnel of increasing abortion criminalization. One of the strengths of Grant’s book is that she follows activists in both Mexico and the United States through the 2010s and into the 2020s, making the disparity painfully clear. In the same year that Ni Una Menos exploded, two American reproductive health workers, stunned by the ease of getting over-the-counter medication abortion at an Ethiopian pharmacy, launched Plan C, a nonprofit website guiding pregnant people in each U.S. state through the complex and changing route to access. A few years later, Women on Web launched a U.S.-focused service, Aid Access, to do the same. Existing abortion activist groups, like the irreverent Shout Your Abortion, based in Seattle, began sharing resources in English and Spanish for people to self-manage their own abortions.
“Alana,” an American expat living in Mexico, was friendly with Cruz, and asked if she might create a network of expat volunteers who could function as an American wing of Las Libres and handle all the new requests from the north. Cruz loved the idea, and Alana convened a “summit of the ‘old hippies,’” who sipped hibiscus tea while Alana told them she needed people to buy misoprostol in Mexico and smuggle it into Texas. One of the first to volunteer was Katie, a retiree in her sixties—and once Katie had success, it led to a trickle, and soon a stream, of older white women, nicknamed the “Juanas” after the Janes, carrying pills into the United States so that their granddaughters could enjoy bodily autonomy.
In that Texas post office, Katie might have mailed the pills she carried to an activist in Louisiana, or New York, or Ohio, or Georgia, who would then carefully count the loose pills into proper dosages, package them, and ship them out to a list of addresses given to them by another member of the network. Packagers send along instructions, of course, but also sometimes handwritten notes or festive packaging; sometimes with earrings to disguise the pills’ jangling; sometimes with tea and ibuprofen—anything to help the person receiving them know that they are not alone.
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