november11–24, 2019 | newyork 49Wen was talking about a time when abortion was techni-
cally legal, yet the story rhymed with the pre-Roe era, when
doctors and lawyers spoke of being radicalized by women fill-
ing their wards with blood and desperation, the same night-
mare the familiar pro-choice rhetoric warns will soon be upon
us. Behind the scenes, however, a vanguard of the abortion-
rights movement implored Wen, directly and through inter-
mediaries, to stop talking about “home abortion” in such dire
terms. Not because they weren’t horrified by what had hap-
pened to that woman, not because they didn’t want better for
her, but because these activists—doctors, lawyers, even people
running abortion clinics—have concluded that “home abor-
tions,”or, intheirpreferrednomenclature,“self-managed
abortions,” need to be normalized in the abortion-rights con-
versation. And they didn’t think the president of the most vis-
ible pro-choice organization in the country should be scare-
mongering about it.
“People throughout the world, including here in the U.S.,
have been since the dawn of time ending their own pregnan-
cies,” says Jill Adams, executive director of the legal nonprofit
If/When/How. “And since the advent of abortion pills,they’ve
been doing it safely and more effectively. It’s no longer the
Chicken Little narrative, where if you pass restrictions, clinics
will close, people will be forced to take matters into their own
hands, and it’s certain death and destruction from there.
Instead, abortion will become even less accessible, and some
people will self-manage abortion and most of them willbe per-
fectly fine.” These activists know you think this is radical. They
believe it’s the future.
This debate is taking place inside a movement that,despite
abortion rights’ being broadly popular, is on the precipice of
losing everything. Brett Kavanaugh was installed over the literal
shouts of women, and the walls are closing in on clinics in red
states now that the Supreme Court
has agreed to revisit a recent prece-
dent over whether states can regu-
late them out of existence. In many
states, the crisis is not hypothetical;
58 percent of American womenof
reproductive age—or 40 million—
live in states the Guttmacher Insti-
tute says have “demonstrated hostil-
ity to abortion rights,” a proportion
that has risen by nine points since
- The South lost 50 abortion
clinics between 2011 and 2017,the
Midwest 33. Almost 500 statelaws
enacted in the past nine years
restrict abortion, from forcedultra-
sounds to 72-hour waiting periods
to outright bans that, for now,
Supreme Court precedent barsfrom
enforcement. The latest casebefore
the high court, from Louisiana,may
not outright overturn Roe v. Wade,butthethreatlooms,espe-
cially if Trump gets to appointonemore justice.
In its safest permutation, self-managedabortionmeanstak-
ing the same pills, mifepristoneandmisoprostol,that a doctor
at an abortion clinic would giveyouif youchosea medication
abortion rather than a surgicalone.Medicationabortionsnow
account for a third of all clinicabortions,anoptionthat has
risen in popularity by 25 percent since 2011. If the Court takes
an ax to Roe v. Wade, self-managed abortion will be a backstop,
but activists don’t want to stop there. They want the post-
clinic abortion to be an option even in places where the proce-
dure is legal, as a matter of patient privacy and personal pref-
erence. And the notion is starting to gain purchase in
mainstream reproductive-rights groups: In the past two years,
in Massachusetts, New York, and Nevada, parts or all of the
statutes that criminalize self-induced abortion were repealed.
“There has been a veritable sea change in just a few years’ time
within our movement,” says Adams. “Folks who were con-
cerned, perhaps even mildly suspicious, today are becoming
advocatesforthedecriminalizationandnormalization of self-
managed abortion.”
Wen lasted only eight months as president of Planned Par-
enthood before an acrimonious parting that was just now for-
mally resolved. The debate over how to talk about abortion
outside a clinic wasn’t why she left, but it paralleled broader
concerns that she was trying to drag the movement back to an
era of respectability that activists believe helped get us to this
wretched point. To members of the movement’s resurgent left,
the grim turn of events under Trump has its roots not only in
the right’s single-minded four-decade-and-change focus on
banning abortion but in their own side’s approach. “We saw the
rise of acceptability politics in abortion,” says Pamela Merritt,
co-founder of the more confrontational group Reproaction. “If
we wear our nice suits and we go in and we don’t yell, then
these people won’t be able to frame us as these loud, crazy femi-
nists. And that, of course, didn’t work.”
Merritt’s home state of Missouri shows how bad the situa-
tion has gotten. The state is down to its last abortion provider
after repeated legislative onslaughts from Republicans. To
meet the demand for abortions, Planned Parenthood of the
St. Louis Region and Southwest
Missouri built a large- capacity
clinic 13 miles away, just across the
Mississippi River in Illinois. The
facility, which opened last month,
would be a “regional abortion-
access hub” primed for a “post-Roe
world,” its president told the New
York Times.
Yamani Hernandez, who runs
the National Network of Abortion
Funds, knows all about helping
abortion seekers cross state lines.
She says local groups, largely
staffed by volunteers, already help
patients pay for the procedure as
well as travel, lodging, child care,
and other expenses, but it’s
nowhere near enough. “The aver-
age budget of an abortion fund is
$175,000,” she says. Last year, the
localfundsgotaround170,000 calls—and could meet just
one-fifthoftherequests.
Inresponsetothisclimate, blue states are firming up their
localabortionprotections. And some liberal parts of the coun-
try,like CaliforniaandNYC, are looking for ways to help out-of-
statepatientsgetabortions in their jurisdictions, mainly by
helpingthempay. “My biggest fear is that Planned Parenthood“Overturning‘Roe’ isn’tthe endgame.Banning abortioneverywhereis the endgame.”