Article Thumbnail

The Future of Underground Abortion Networks

With the legal risks varying wildly by state, some forums and support networks are shutting down. Where will they go, and what will take their place?

For a long time, if you were pregnant and you didn’t want to be, you could turn to Reddit for support. There, you might encounter a subreddit called r/AuntieNetwork, a forum “dedicated to providing information and resources to those in need of abortion services.” Members posted about everything from safe digital security to news about local abortion regulations, but its real allure lay in the anonymous, underground network it created to connect people in need of abortions to those who were willing to help. 

“Aunties” and “uncles” from all over the world offered pregnant women spare bedrooms, rides to clinics, medication shipments and deliveries, meals and addresses for shipping pills to. People in Virginia volunteered to escort women to nearby Washington, D.C. for services. Friendly faces in Colorado offered anyone rides up to 25 hours away to get the care they needed. Countless families advertised private, comfortable places to stay for women who couldn’t tell their loved ones they were pregnant or having abortions. All of these services were offered by vetted volunteers, for free. And while it’s unclear how much people actually relied on aunties and uncles for help — the sub’s moderators don’t do press — the fact that the option was there was comforting for the thousands of pregnant women who came to the sub for support.

Now, in light of Roe’s overturning, the subreddit has been forced to suspend its services. “We don’t have the budget, means or staff to background check everyone who volunteers, and although 90 percent of the applications we see are great people… it’s a gamble no longer worth taking,” a stickied mod message on the homepage reads. “We have been moved by the overwhelming number of you all willing to help, but frightened by the threats and attacks we see daily. … We love serving. We love helping. We do not want to be a source of danger for anyone.” Now, the only posts that are allowed are news and (still much-needed) educational resources.

Not only does r/AuntieNetwork’s shutdown highlight real concerns about how anonymous online communities can safely function in a post-Roe world, but it also raises questions about what will happen to other essential abortion networks, including more formal organizations. We’ve already seen the disastrous and life-threatening consequences of Roe’s overturning — not just in individual stories, but in how the move is set to chokehold the communities on which pregnant people previously relied. Now, with further restrictions potentially looming — for example, banning travel for pregnant people and certain methods of contraception — as well as the threat of digital surveillance being used to criminalize those seeking abortions from restricted states, will abortion support communities have to bury themselves even further underground in order to function? And what does that mean for those in need of their help?

“With heightened surveillance, people will need to be cautious about any online communication with strangers,” says Susan Yanow, a long-time reproductive rights activist. “Reddit isn’t a great way to organize, because people don’t really know each other.” (It’s nearly impossible for moderators to know who really needs help and who’s pretending they do in order to find, report and criminalize pregnant people). Instead, Yanow says it’s safer for people to identify ways they can support each other organically, in their own communities. 

For the most part, this is how underground abortion networks functioned before Roe was passed in 1973. Despite abortions being made illegal in the U.S. in the mid-1800s, many women continued to procure them through underground clinics, often located behind established practitioners’ closed doors or even in their private homes. In the 1930s, it was estimated that roughly 800,000 illegal abortions were performed a year, and in the 1950s and 1960s, this number remained between 200,000 and 1.2 million. Many women — and disproportionately low-income women — died from these procedures, with illegal abortions making up 17 percent of all pregnancy and childbirth-related deaths in 1965 alone. 

By the late 1960s and early 1970s, some states began to loosen their restrictions on abortion. It was during this time that a handful of notable underground abortion networks sprang up. One of these, the Clergy Consultation Service on Abortion (CCS), was set up by a group of New York-based ministers and rabbis in 1967, whose aim was to counsel and refer pregnant people to licensed doctors for safe, illegal abortions in the city. The rules were as follows: Counselors had to be clergy, in order to maintain confidentiality, and would only talk to those in need in person (who could get details via an answering machine message). When it came to referrals, they’d only use licensed physicians, and would refer out of state to confuse jurisdictions. The group was so successful that by 1972, it had established chapters in 38 states, and by 1973 — when Roe v. Wade was introduced — counselors had referred an estimated 450,000 people for safe abortions.

Over in Chicago, another underground abortion network was hot on CCS’s heels. Known as the Jane Collective, the group officially started operating in 1969 — though its founder, Heather Booth, had been privately helping women access abortions for a few years. After word spread that she found a doctor to help her friend’s sister procure a termination, Booth — under the pseudonym “Jane” — started taking calls at her dormitory, referring those in need to a safe abortionist. 

According to the New York Times, “The Janes’ tactics were worthy of a spy novel.” Women would leave voicemails for the collective, and would then get a callback from “Callback Jane,” who’d ask them for their information, which would be passed onto “Big Jane.” Patients would meet a “Jane” at one address (“the front”), before being led, sometimes blindfolded, to a different spot (“the place”), where a doctor — or a non-medical professional, as the case sometimes was — would perform the abortion. The group disbanded in 1973, following Roe, but, by then, had facilitated an estimated 11,000 abortions.

Other feminist groups got especially creative with their methods — even finding legal workarounds. In 1971, activists Carol Downer and Lorraine Rohman invented a procedure called menstrual extraction (ME), which allows women’s groups to perform their own abortions, without a doctor. The DIY technique involves using a kit, dubbed the Del-Em, to suction out the contents of a person’s uterus. As the procedure is only performed when a person’s period is due, and they don’t take a pregnancy test beforehand, it can be absolved of any links to abortion — rather, it’s just removing the uterine lining that would slough off during menstruation anyway. Because of this, those who practice or undergo it can say they’re simply passing their whole menstrual period at once, as a way of avoiding a heavy or inconveniently timed period. Menstrual extraction is legally performed in clinics and women’s groups around the world to this day, and is generally safe and effective in the early weeks of pregnancy

Brandi, a doula who’s involved in a menstrual extraction group in Albuquerque, says she performs the procedure on women several times a year, and researched and learned the practice to “return our own gynecological health to the hands of women.” But while she says there are ME groups all over the world and that there’s plenty of information about it on the internet in books and via word of mouth — it’s not exactly “underground” — she hasn’t seen an influx of people inquiring about it since Roe was overturned. 

This could be because most people simply aren’t aware of ME, but also because groups that perform it aren’t always easy to find. If you search “menstrual extraction” and the name of your city or state on Google, it’s uncommon for a women’s group or clinic that clearly offers the service to appear in the early results. “If you think about the context of abortion in the U.S, often [the pregnant person seeking a termination] is scared, young, and disproportionately in the U.S, low income. Because that’s who doesn’t have access to good birth control in our country,” adds Yanow. “So imagine a young, not particularly well-informed, scared person in Texas — how are they going to find these [inconspicuous ME groups]?”

Moreover, how is anyone going to find any underground abortion group when communities like r/AuntieNetwork can’t even post to public social media platforms? It’s a tricky question to answer, as underground networks are, well, underground. But, Downer at least has some insight into how people might find ME. 

“The information about their presence and activities are generally known by activists who are also involved in women’s health-care projects, such as doulas, midwives and self-help groups,” she says. “Since learning to perform menstrual extraction usually takes at least a couple of months, most women seek this out because they’re committed to spreading the technology, not because they have an immediate need. However, since the group needs practice, they generally let their immediate community of friends and fellow activists know what they’re doing. So, mostly it’s the friends and acquaintances of the group that are offered the service.” 

In other words, we may be back to word-of-mouth (unless you’re in a pro-choice state and plan to keep all your search habits and activies within state lines — in that case, you don’t have much to worry about). 

It’s unclear if groups like these — or ME itself — will be at risk post-Roe. As it’s a type of vacuum aspiration technique — which can be used to conduct surgical abortions in hospitals — they definitely could be. But since it’s often already performed in women’s groups, independently of clinics and formal medical supervision — and it’s still legal — things are unlikely to change significantly, at least for the time being. That said, Downer tells me there have been more people contacting her website, Women’s Help in Women’s Hands (WHWH), looking to “become more involved with menstrual extractions.” She says she’s been referring anyone interested to online presentations of Take Back the Speculum by bodyworker, coach and educator Pamela Samuelson. She adds that she knows people around the country who are in the process of forming ME groups, but, she adds, “this takes time, so I don’t expect it to be a viable option for the average woman who suddenly wants an abortion, at least not for a while.”

As for what’s next, Downer foresees a return to in-person organizing. “As time goes on, I think we’ll see abortion speak-outs, where women gather to share their abortions stories,” she predicts. “We’ll see events that take a while to plan and execute, such as organized boycotts, days of observance, giant fund drives and networks of referral services to bring women from states where abortion is illegal to states where it’s legal.” Downer also hopes that today’s movement — unlike pre-Roe, which was “largely composed of young, white, middle-class women” — will be more inclusive, lifting up “participation and leadership by women of color.” It’s unclear, though, how easy or legal it’ll be for activists to do this in abortion-restrictive states. 

For now, abortion activists, volunteers, pregnant women and the people who support them are just doing what they can. “Women of today are different,” Downer continues. “Millions of women have had abortions in a legal clinic setting. They know that abortion, especially early abortion, is safe and can be done in an outpatient setting. Women today know more about how their body functions, and they know that some feminist activists have trained themselves to perform early abortions safely.” 

Though, she admits, “even with these advantages, it may take a long time to organize a national movement to decriminalize abortion across the country.”