This is an op-ed by Allure contributor Dayna Troisi.
On January 22, 2019, reproductive rights activists celebrated the 46th anniversary of Roe v. Wade, 410 U.S. 113 (1973) — the landmark Supreme Court decision that affirmed the constitutional right to access safe, legal abortion. But access to abortion providers (and other reproductive health care services) is more at risk every day.
Currently, those who need an abortion have a choice between a medical and surgical procedure. (While many frequently refer to cisgender women when talking about reproductive rights issues like abortion, it's important to note that trans men and nonbinary people have abortions, as well, and that all people should have access to inclusive reproductive health care.) If a pregnant woman opts for a medical abortion, she will receive two FDA-approved medications: mifepristone, which is taken at a doctor’s office, and misoprostol, which is usually taken at home a day or two later.
According to Planned Parenthood, these medications work about 93 to 96 percent of the time when used before 10 weeks of pregnancy. In the case that medication doesn’t work or that a patient prefers not to have a medical abortion, an aspiration procedure can be done to terminate the pregnancy. This is a surgical procedure that removes the uterine contents by suction.
We are very fortunate to have these options, but that doesn’t mean that abortion is easily accessible for everyone. “Reproductive rights are under attack nationwide,” says Ana G. Cepin, assistant professor of obstetrics and gynecology at Columbia University Irving Medical Center. “There are issues around access and restrictions around how care is provided.” Class, race, and geography also play a huge role in whether someone is able to access a safe and legal abortion.
"We have always done what was necessary."
The presidential election of Donald Trump, who has been described by vice president Mike Pence as the “most pro-life president in history,” has only heightened the atmosphere of fear surrounding abortion rights. A few weeks ago, the Trump administration announced it will bar federally funded family-planning clinics from referring women for abortions.
What did women who needed an abortion do before Roe v. Wade, when abortion wasn’t legal, and are we in danger of having to go back to that era? What about women who need an abortion now but can’t access one?
They do it themselves.
Self-Induced Abortion Is Nothing New
“Women have been managing their fertility for as long as they've been having sex with men,” Loretta Ross, a visiting professor of practice in the School of Social Transformation at Arizona State University and cofounder of the SisterSong Women of Color Reproductive Justice Collective, tells Allure. “Don’t have it written up as if this is something new women have discovered. We have always done what was necessary.”
For many, the term “DIY abortion” conjures images of a hanger, a lot of blood, and even more pain. While this dark scene is certainly one of the ways women have performed their own abortions, it doesn’t encompass the gamut of creative, desperate, and sometimes deadly methods of DIY abortion that have been around since ancient times. The ancient Latin text Naturalis Historia by Pliny the Elder includes such advice as, “If a pregnant woman steps over a viper, she will be sure to miscarry.”
“Before the legalization of abortion, women sought abortions in a variety of ways,” Cepin says. Kelsey Knight, a registered nurse and cofounder of the Fifth Vital Sign, a project with a mission to use education as preventative care and encourage individuals to make informed choices about their health, says, “DIY abortion is something that's always been necessary, especially if we think about who can access abortion.”
A History of DIY Abortion Methods
The most ancient forms of DIY abortion date back to 1500 B.C.. The following list includes ways people have self-induced abortions:
- crocodile fecal matter: according to The Kahum Papyrus, one of the earliest medical texts in history, Egyptian women used crocodile fecal matter to induce abortion and as a form of contraception
- herb pennyroyal: Maya Lewis wrote about herb pennyroyal in her thesis, Drink Me and Abort Your Baby: The Herbal Abortion Tea, saying, "Pennyroyal [is an essential oil that] will almost certainly kill anyone who uses it carelessly...Nausea, vomiting, fatigue, liver and kidney failure, hallucinations and seizures are all caused by pennyroyal oil overdoses — typically by young women seeking to self-induce their abortion.”
- insertion of leeches or cayenne pepper into the vagina
- swallowing gunpowder
- throwing oneself down the stairs
- hitting oneself in the stomach with a meat pulverizer
- consuming turpentine
- spending a night in the snow
- consuming opium
- consuming tansy oil
- using the fungus ergot
- the infamous hanger technique
The methods on this list are dangerous: Ergot can cause gangrene and psychosis; tansy oil can rot internal organs; and a coat hanger can cause infection, sterility, hemorrhage, and even death. As late as 1965, 17 percent of all pregnancy- and childbirth-related deaths were due to women seeking illegal abortions, according to Planned Parenthood.
Beyond the "Back Alley"
That is not to say that every form of DIY abortion is grisly and deadly. Self-induced abortions have been proven safe and effective when performed correctly. From 1969 to 1973, a group of women in Chicago ran an underground feminist abortion "referral and counseling center." The women, who collectively called themselves Jane, usually gave patients a muscle contractor and an antibiotic before performing a dilation and curettage (D and C) surgical procedure, which involves dilating the cervix and using a curette to scrape tissue from the uterus.
According to NPR, “The group performed approximately 11,000 first- and second-trimester abortions. No deaths were ever reported of women who had abortions through Jane.” One member of the Jane was raided by the police in 1972, and seven members were arrested, but the Jane Collective continued until 1973.
Ross tells Allure that granny midwives in the black community also frequently performed abortions. “I myself was delivered by a granny midwife on my mother's kitchen table," she says. "This is what we did. So if a woman needed help delivering her baby, or as they used to call it, 'bringing back the menses,' a euphemism for abortion, that's what the granny midwives did, up until they got criminalized in the 1950s and 60s.”
Emily Varnam — who is a doula, educator, and co-founder of the Fifth Vital Sign — explains the practice of menstrual extraction to Allure, saying that it works by creating a vacuum to suction out the contents of the uterus through the cervix. “Extraction is a setup that [...] creates this suction that can remove the endometrium with the fertilized egg. Obviously, care is needed, and it's something that you would want to have someone who is trained to do.”
Access to Safe Abortion Is Necessary
However, just because DIY abortions are arguably possible doesn’t mean we should perform them. As Cepin says, “In order for women to receive the most effective regimen, they currently must see a provider.”
But the truth is, self-induced abortion is still being practiced today. While some of us are steeling ourselves for the fact that we may need to revisit this form of birth control if Roe v. Wade is overturned, many others are already doing so. The reason that we need this information today, even while abortion is still legal, is the reality of class, race, and geographical privilege. Those of us in more progressive states or with greater socioeconomic privilege and medical access may view DIY abortion as a scary part of the past, no longer practiced or necessary. But some simply do not have access to safe and legal abortion, and that number is likely going to grow in the Trump era.
Many feminists, activists, and doulas are fearful that Roe v. Wade could be overturned for multiple reasons, including the appointment of Brett Kavanaugh to the Supreme Court. But they also acknowledge that it may not happen. Instead, conservative lawmakers are more likely to systematically slice away at abortion access and narrow women’s options as much as possible.
"Even without the looming idea of Roe v. Wade being overturned, we need to have more options for abortion. When you need an abortion, you fucking need an abortion.”
“I think that the cascade of state-based laws trying to win their way to the Supreme Court is perilous," Ross tells Allure. "But there's a part of me — a semi-cynical part of me — that says these boys [in the Supreme Court] don’t want to go there right now. I think that they're concerned about how many conservative women will remain blindly loyal to them if they overreach on abortion...it's hard to calculate at what point they may snap into pragmatic sanity. It doesn't seem like there's a bottom… But I don't know if it's fair to predict that Roe will be fundamentally overturned, but they will certainly make accessing abortion as difficult as possible and it'll definitely become [more of] a class-based system.”
How to Get Involved in the Fight for Reproductive Rights
So what can we do? The most obvious answer is to vote and get involved with reproductive rights organizations, such as Women Help Women, and Abortion Pill Info, which provides secure information about DIY abortion pills.
Varnam encourages women to educate themselves about their bodies. “When we were trained, the person who trained us was like, ‘[Menstrual extraction is] not something that you come to when you're in a crisis. You have to create this relationship with it,’"she tells Allure. "So that's super important when we're looking down the barrel of this thing, [our current political climate]. We do need to be planting the seeds of choice and not relying on capitalism or the government structure.”
“We need [another] Jane,” Ross adds. “Wherever there are conscious feminists, they should learn the techniques of self-managed abortions, they should make sure that the information is out as far and wide as possible. We should set up the legal defense team for women who are obviously going to get prosecuted because people's bodies aren’t a political playground. Our families, our sisters, are going to come together — that’s what we are going to do. That's what we're going to do.”
Could DIY abortions be on the rise in the future? "Even without the looming idea of Roe v. Wade being overturned, we need to have more options for abortion," Varnam says. "Because when you need an abortion, you fucking need an abortion.”
Read more stories about reproductive health on Allure:
- What Trump's "Domestic Gag Rule" Would Mean for Reproductive Health Care
- See Maggie West's Powerful Portrait Series For Planned Parenthood
- Research Says You Can Safely Induce Your Own Abortion
Now, watch Lauren Cohan try 9 things she's never done before: