Front Burner - Underground abortion groups in post-Roe America

Episode Date: May 4, 2022

An unprecedented leak of a draft U.S. Supreme Court decision suggested plans to overturn Roe v. Wade, the landmark decision that enshrined abortion rights across the country in 1973. If Roe v. Wade is reversed, abortion could be banned in as many as 26 states, some starting almost immediately. Today on Front Burner, we talk to journalist and Nomadland author Jessica Bruder about the networks of underground abortion providers and what comes next for people seeking help.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hi, I'm Jamie Poisson. On Monday night, a draft of a U.S. Supreme Court opinion was leaked. This is something that has never happened. And what could be one of the most unprecedented leaks in modern history.

The draft, published by Politico, reveals a Supreme Court decision to strike down Roe v. Wade, the landmark case that legalized abortion across the United States 49 years ago. Let's talk about a developing story and one that's likely to shape the country's social discourse for decades to come. Last night, a report disclosed that a conservative majority of the United States Supreme Court is ready to overturn Roe v. Wade and uproot decades of precedent affirming a woman's right to an abortion. In the draft, its author, Justice Samuel Alito, writes Roe was egregiously wrong from the start and must be overruled. Although the Supreme Court has confirmed that the draft is in fact authentic, this hasn't

happened yet. It's possible that justices could change their mind before it's finalized, but if they don't, there is a lot at stake. And what we're witnessing tonight is the loss of a right, the loss of a constitutional right. And that is something that... If overturned, abortion could soon be banned in nearly half the states, including 13 that have so-called trigger laws

that would come into effect automatically. However, in several Republican states, including 13 that have so-called trigger laws that would come into effect automatically. However, in several Republican states, a post-Roe world is already a reality. Like in Texas, a state that's enacted a law called the SBH, or the heartbeat law, that bans abortions after six weeks. I'm in a state currently where there's a Planned Parenthood clinic a mile and a half from my house, and they're not able to provide me services past the six-week mark, and that's very frustrating. And I just know that that's going to be the reality for so many more people across this country. And so, yeah, it's a very hard... That's Emma, a 29-year-old living in San Antonio. Six months after SBA came into effect, Emma found out about her own unplanned pregnancy. And the local clinic told her

she should prepare to travel out of state. It was a conversation over the phone telling me that I needed to travel out of state, It was a conversation over the phone telling me that I needed to travel out of state, like not even looking at an option to have me speak with someone in person in the clinic. And that for me was very difficult of just knowing, like, no one's really willing to talk to me about this because I'm already past a certain point. But the pregnancy symptoms I was personally experiencing were very intense. I had a lot of fatigue. I had a lot of nausea. It was difficult for me to even make it through my house without feeling nauseous, let alone driving in a vehicle. I couldn't imagine having to take an eight-hour drive to New Mexico or be on a plane while pregnant. It just seemed

torturous to me, especially knowing that I would... In the end, Emma didn't go out of state. Instead, a close friend traveled to Mexico to bring her back misoprostol, which is a medication used to induce abortion. It's the kind of covert and complicated measure that advocates fear more and more people will have to resort to if and when Roe v. Wade is overturned. And Emma is particularly worried about the impact on racialized and marginalized communities. is particularly worried about the impact on racialized and marginalized communities. They're working low-income jobs where there isn't paid time off, there isn't paid sick leave. They may be barely scraping by, no opportunity to even look at the possibility of taking on travel. And beyond that, you know, specifically speaking to the Latinx community,

we are facing mixed immigration statuses that may limit your ability to even travel across this country freely, may limit you to an area where there is no abortion clinic nearby. Pushing forced parenthood onto a person when there's no safety net to catch them is unethical and cruel. Today on FrontBurner, with the legal avenues closing down and the specter of Roe v. Wade being overturned, a look at the covert abortion methods being employed in America and how this potential ruling could affect them. My guest is Jessica Bruder. She's a journalist and the author of several books, including Nomadland, which was turned into an Oscar-winning film. And she recently wrote a

feature for The Atlantic on the underground networks of people preparing to circumvent state abortion restrictions if Roe v. Wade is struck down. Hi, Jessica. Hi, Jamie. Thank you so much for making the time today. We're very appreciative. I want to talk to you about what's often referred to as the abortion underground and what it looks like right now and what it could look like once this Supreme Court decision comes down. But this movement started generations ago when abortion across the U.S. was still illegal before Roe versus Wade. And what did the abortion underground look like then? Before Roe v. Wade was decided in 1973, there were all sorts of different avenues and efforts for people who were seeking abortions. Everything from something called the Clergy Consultation Service, which was around 1,400 priests with a smattering of rabbis, I think,

as well, connecting people with safe care to doctors who were doing it on the sly, to the Jane Collective. By the time Roe v. Wade was passed in 1973, the Jane Collective had performed an estimated 11,000 abortions. Which was a group of people who started out as a referral service and then learned how to do procedures themselves. Two people I spoke with for the story, including a group of feminists who created a device called the Dell M, which was basically a tool used to put abortion procedures back in the hands of women. And tell me a little bit more about the Dell-M. You get into this quite a bit in this really

interesting piece in The Atlantic that you wrote, and activists got really creative with variations on the device, right? Absolutely. So the Dell-M dates back to 1971, two years before Roe was decided. Activists did not want to wait until the law caught up with them. There were people who were pregnant who were seeking abortions and didn't have that kind of time. So I spoke with an activist on the West Coast named Carol Downer. She's now 88. I became involved in the women's movement at a time when a lot of women became involved. In the late 60s, I, along with another group of women, thought that maybe we should do our own abortions illegally, not ourselves, but I mean, become abortionists. And back in those years before Roe, she and members of her feminist group were shadowing a clinician in an illegal abortion

clinic in Santa Monica. And the guy's name was Harvey Karman. He had created something that is now known as the Karman cannula, which is basically a flexible plastic straw. And it enabled him to give non-traumatic early stage abortions. Basically, you pair it with a syringe that doesn't have a needle that creates a vacuum and it empties the contents of the uterus. So following him around and seeing him do this safely, these women started saying, this isn't rocket science. Maybe we could learn how to do this and teach more people. And maybe we could create a tool that's more easily accessible. So they took Carmen's cannula and his whole setup. And this woman named Lorraine Rothman brought it home and ended up hacking together a device of her own, which they called a DLM. them. It's basically a mason jar with a stopper that has two holes in it. And those holes hold tubing that comes out on one end is a cannula and the other end is a syringe. So the stopper can be pulled back for suction. And is it fair for me to say that this was really an attempt to address

such a lack of safe options at the time, right? Like it was extremely dangerous. It was dangerous when people were in the wrong hands. There were also doctors who were doing it safely. So yeah, the idea was definitely to take back some sort of autonomy and control. When I spoke with Carol, she was telling me about doctors who did the procedure and it was reasonable, but really were creepy with the patients too, who would leer at them or make them feel ashamed. And they were just done with all that between procedures that were shoddy and not safe for women's health and just women occasionally being treated like pieces of meat by these underground clinicians. They wanted to do something different. These activists that you talk to, Carol and others, what kind of stories, anecdotes did you hear from them about that time? Oh, gosh. Carol had a lot of stories. One of the most

them about that time? Oh, gosh. Carol had a lot of stories. One of the most fascinating ones to me was she and Lorraine ended up hopping on a Greyhound bus and over a period of six weeks, they hit 23 cities. They called themselves the West Coast Sisters. They brought a box of speculums. Some of your listeners may know that this is the medical tool that's used to basically hold back the walls of the vagina so a doctor can access the cervix. When I saw how simple the cervix was, I realized that we had to teach women. We had to show them because they'd never put up with, you know, having a needle put in, as you said, because you would have a coat hanger because you would have a picture. You would understand why that wasn't a good idea. And you might also understand some better, you know, things, even if you were going to do it illegally.

They brought a box of those, showed women how to do self-exams and also taught menstrual extraction. And that was the process that they called using the Dell M. The idea was it's going to extract your period. And yes, if you have an early pregnancy, that would go out too. But how did you know? The court, of course, ruled, as you mentioned, in 1973, Roe versus Wade, that abortion is legal in every state. And what happened then to the DLM and this abortion underground? Did anyone need it anymore?

Well, it's complicated. One would have expected, or I guess people who were fighting for the right to abortion in the dream world, the need for a device like the Dell M would evaporate and everybody who was seeking care would get it. We know that's not what happened. A few years later, the federal Hyde Amendment came into play. That meant that abortions were no longer eligible for federal Medicaid funding. That amendment was actually challenged in the Supreme Court in 1977, who found that it was constitutional. And so that amendment has been included in government funding bills ever since, in one shape or form. Lawmakers from both sides of the aisle, both Democrats... And that began putting them more out of reach for people in

low-income communities and communities of color, people who are already on the margins. Your typical abortion costs about $550, and most people pay out of pocket. But we have to factor in so many... And the system was not treating these people very well. So there was that problem. Meanwhile, the state started enacting restrictions, and 1,300 of them, more than 1,300, have been enacted since Roe v. Wade was passed. And as a result, in a lot of places in the country, even while Roe still stands, people say that it might as well not exist because access is so difficult. For so many people who are seeking abortion care, if they can get together the money, they still need the time off. They may need to travel. They may need to go back and visit more than once in some states. They may need child care. There's a lot of practical support that's needed. So for years

in the U.S., we've had a network of abortion funds who do a lot of that legwork. There are more than 90 of them now. Other things are a little different. We now have the abortion pill, and we know that more than half of legal abortions are now done via medication, via pharmaceuticals. So having those and being able to mail them discreetly has created a new avenue for the underground. And then there are people who are learning to use something like the Dell M manual vacuum aspiration is that basic procedure we talked about. Well, this isn't going to be nearly as common as the pill. The pill doesn't, you know, there are contraindications. If you have bleeding disorders or some other conditions,

you can't use the pill. So there are people who are trying to skill up. So if they need it, they have access to other modalities that aren't just pharmaceuticals. Can you tell me a little bit more about these two drugs? Yeah. So what many of us know as the abortion pill, as you pointed out, is actually two different medications. One of them is mifepristone, which your listeners may know as RU486 or the French abortion pill. know as RU486 or the French abortion pill. And the other is misoprostol, which is known also by a trade name Cytotec and was originally created and used for the treating of stomach ulcers until it showed up in Brazil in the 1980s and women realized that it had an off-label use. There was a label on it that warned people not to take it if they were pregnant because it would cause heavy contractions. Well, lo and behold,

it became an underground abortifacient. People started using it. Now there's a protocol endorsed by both the FDA and the World Health Organization that involves these two drugs together. health organization that involves these two drugs together. Mifepristone is taken first, and then 24 to 48 hours later, misoprostol. The first drug blocks progesterone, which is necessary for a pregnancy to continue, and the second induces contractions. I know you sat in on a Zoom class where people pop Skittles into their mouths. Can you tell me what happened? Yeah, that was very memorable. I sat in on a training session held by a group called Self-Managed Abortion, Safe and Supported. And we were taught by this wonderful trainer, Susan Yanow, in detail how people procure and use these pharmaceuticals. And part of that

involved bringing either skittles or M&Ms. I had M&Ms because I think they're delicious. And letting them rest in that pocket between the cheek and the gum in your mouth, because that's a way that people let mysoprostol dissolve. You don't swallow it. You don't want it going through your digestive tract. You want to have it absorbed. So we practiced that. And I think it was just more, it's a really good way to help people

remember things, just having people actually do something rather than just talk at them for a couple hours. Yeah. And these pills, are they legal? Well, absolutely. They are legal federally. In the US, we know that restrictions are coming down. Different states are making it illegal to prescribe or send them by mail, trying to make them illegal right now, even though Roe is the law of the land. What's going to happen next is what's a little confusing, because if Roe falls, we have more than half of the country, about 26 states, who are expected to ban abortion. And that would include the abortion pills. But unlike clinics, abortion pills don't require some sort of brick and mortar entity. For example,

right now there's Aid Access, which is a group out of Europe, and anyone can go online to get the pills. And because they're outside of the US, they mail to all 50 states. Mifepristone is expensive and misoprostol is cheap. So meanwhile, there are also people bringing in misoprostol. You can get it over the counter in Mexico. Again, it's commonly used for stomach ulcers. It's not as tightly regulated. So some people do a protocol that's just mysoprostol as well. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization,

empowering Canada's entrepreneurs through angel investment and industry connections. Hi, it's Ramit Sethi here. You may have seen my money show on Netflix. I've been talking about money for 20 years. I've talked to millions of people and I have some startling numbers to share with you. Did you know that of the people I speak to, 50% of them do not know their own household income? That's not a typo,

50%. That's because money is confusing. In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together. To listen to this podcast, and your partner create a financial vision together. To listen to this podcast, just search for Money for Cups. But what kind of risks are involved in taking these pills and, you know, essentially self-managing an abortion? Well, the risks with the pills are pretty low. Researchers tell us that they're medically safer than acetaminophen or Viagra in terms of people being sent to the ER. The risks in effect are the same risks that one would encounter during a miscarriage because that's what they're doing. They're inducing a miscarriage. So hemorrhage, bleeding too much, which would be going through more than two maxi pads per hour for more than two hours, for example. Or if there is, there's always a risk

with a miscarriage of retained tissue, just not everything that needs to pass from your body passes. So people need to watch out for that. And I guess if this is banned, and even though it's rare, what if someone needed to go to a hospital? That's a great question. Yeah. No, because it's definitely come up already. We saw that situation in Texas where somebody was arrested and charged with murder, which in that charge was already rolled back. There was no actual statute. A lot of the details aren't known, but it was believed that she took the pills and told a doctor in the hospital that she had done so, and the doctor had passed on the information. Again, that's not 100% certain. That's something a nonprofit told the press.

But whatever happened, it was definitely chilling because there have already been situations where, I'll give you one example. There was a woman named Jennifer Whalen in Pennsylvania whose 16-year-old daughter got pregnant and didn't want to be. So Whalen went online and ordered pills for the daughter who took the pills and then got scared when the symptoms hit. Understandably, having a miscarriage is scary, right? So if things were going the way they do go with the pills. It's not comfortable to have a miscarriage, but she got scared and they went to the hospital and the mother explained that they had taken the pills. Lo and behold, the daughter's miscarriage went just fine, but the mother ended

up in jail for practicing. I believe it was for practicing medicine without a license or giving medical advice. But just for, again, that was what they got her on. So right now, when I talk to activists, they urge people to not talk about the pills in the ER if they're in an abortion hospital state. They say, just say you're having a miscarriage, which is true because this treatment is the same. And the people doing that work, the activists trying to help women access abortions, I imagine that they are already having to walk a very fine line, that there are already severe repercussions for them, right? Well, it's challenging. People I spoke with for the Atlantic story,

when I spoke with people who were community abortion providers, yeah, those people could be a target more so than before. And that's why in the story, all their sources are anonymous. And I didn't use names. But for people who are educating each other, that should remain legal. The protocol for how to take abortion pills, you can get that online at the FDA website. You can get that online at the World Health Organization website. So part of what they're doing is also trying not to be construed as giving medical advice. So basically saying, look, this is advice that's freely available. Here is where it is. This is what people do.

I wonder if you could compare for me the work you're seeing now to what you learned about what activists were doing in the 60s, right? Like, how is it different? How is it the same? The same in terms of, I'm seeing a great solidarity in the face of adversity. It's not that there's one underground network and everybody has a membership card or something. It is very grassroots, but there's that sense of common cause, again, in the face of adversity. But there's also the internet, which they didn't have back then. So the whole process of disseminating information is very different and in some ways easier. And the other big difference is obviously abortion pills, which are easy to send in the mail, which can be found again, if you cross the border into Mexico, Mesoprostol is there. So it remains unclear how states that

ban abortion will be able to keep them out, if they'll be able to keep them out, and how. Right. And on a related note, I know that you wrote in your piece that a post-Roe world will not resemble a pre-Roe world. And can you talk to me a little bit more about that? It can't resemble a pre-Roe world because of abortion pills. That is just a huge innovation. resemble a pre-war world because of abortion pills. That is just a huge innovation. We know that more than 90% of abortions happen with pregnancies in the first trimester. That's when people are using abortion pills. They're reshaping the landscape really quickly, regardless of what's happening with the Supreme Court. There's no way to go back to a time where everybody needs to get a procedure and go somewhere and spend a lot of very close-up time with somebody they may not trust.

The scenes you've been describing, the work that these activists you've reported on have done has, of course, all taken place in a context where Roe v. Wade still does stand. And so how much more difficult and potentially dangerous might this work become if Roe is struck down? Well, I think it will probably be more dangerous for the providers than anyone, I think it will probably be more dangerous for the providers than anyone just in terms of abortion being criminalized. Again, just in terms of peril, in terms of people who need abortions, it will be a mess because, yes, people who are wealthy will be able to travel. People will come to Canada, right? are wealthy will be able to travel. People will come to Canada, right? People will go to Mexico, where activists in Mexico are actually already organizing to get pills into the US. I am very

curious to know if activists in Canada are doing the same thing. And if anybody in your audience knows about that, they should reach out to me. But people will be at risk. And we do know that childbirth is actually more risky medically than abortion. So again, this could have a bad effect on maternal mortality. And we do know in some cases already in Texas that there are already people who have been essentially forced to carry a pregnancy to term who didn't want to. All right, Jessica, thank you. Thank you so much for this. Thank you. My pleasure. All right, that is all for today. Thanks so much for listening. We'll talk to you tomorrow. For more CBC podcasts, go to cbc.ca slash podcasts.