It seems apropos, in light of the Supreme Court’s decision to defend Hobby Lobby’s right to refer to Plan B, Ella, and certain IUDs as “abortifacients,” that Texas women are hitting the black market in search of abortion pills.

“Miso,” as its known, is a revolutionary medication in Central and Southern America, where access to abortion is severely restricted and the ability to take a pill to quietly end a pregnancy in the early weeks can be life changing. Now, the medication has made its way across the border into a state that’s been repeatedly in the news for anti-choice legislation, and if the Supreme Court and the general social mood is any indication, misoprostol could be creeping further north with a little help from women fighting to get abortion services to those who need them.

There was a time in the United States within the living memory of many women when the only kind of abortion most women could access was illegal—save for the very wealthy with discreet doctors who could perform nebulous “procedures” that mysteriously made pregnancies vanish. In 1962, Bridget Potter endured shame and humiliation for her abortion, and Jan Wilberg still remembers her 1967 abortion, administered with a wire. Doctor Jane G. Goldberg was raped in 1968, and she sought an illegal abortion for the resulting pregnancy.

A vast network of women and doctors created a sort of abortion underground, leading women to people who could help them, or pass them along the line to someone who could. Poor women wound up with back alley abortionists who barely knew what they were doing, killing some, severely injuring others, leaving some with a life-long legacy of infertility.

According to the Guttmacher Institute, one in four childbirth-related deaths among white women in New York City in the 1960s was due to complications from illegal abortions. For non-white women and women of color, it was one in two.

In a world of unsafe abortions, women turned to each other for help, and in that climate, the Jane Collective was born. Members of the Chicago-based collective didn’t just refer women to abortion providers and help them access services. They took abortion into their own hands, training themselves and each other to perform the procedure so they could protect their access. Jane members performed 12,000 abortions pre-Roe, offering an affordable and compassionate alternative to the horrors of hotel rooms draped with stained sheets and filthy “clinics” with unsterilized tools.

In 1972, seven Jane members were arrested for performing illegal abortions. The very next year, the Supreme Court affirmed the right to medical privacy through Roe v. Wade. Now, 41 years later, that same body is informing women that their employers can refuse to pay for “abortifacients,” which are actually just birth control. 

It isn’t the first blow struck against women’s bodily autonomy and reproductive rights in recent years—a slew of states have passed anti-choice laws including mandatory ultrasounds, parental notification laws, required waiting periods, and other so-called targeted regulation of abortion provider (TRAP) laws, like holding abortion clinics to the same standards as “ambulatory surgery” facilities.

Given this environment, it’s not surprising that many low-income women are struggling to access abortion, especially in states where it has become nearly impossible to access abortion services. This is a climate that Kermit Gosnells thrive in, one where desperate women will do anything to get an abortion when they can’t access it through legal means. That includes inducing abortions with medications bought in Texas flea markets—and paying the consequences when they don’t know how to take them correctly.

In the Global South, Women on Waves provides a number of safe abortion hotlines with counselors to help women take misoprostol properly. It’s the new iteration of Jane, and, thanks to the Internet, Jane’s likely to go digital from here. The Internet provides a fantastic medium for quickly disseminating information and ensuring it’s spread across multiple points, making it impossible to take down. Women with access to misoprostol who can’t get abortions via other means are using such hotlines and networks to get assistance.

In an ideal world, people wouldn’t need to rely upon illegal abortions, secretive networks (which are not illegal, but protected by free speech laws), and other clandestine methods of accessing reproductive health services. If they are, however, it’s critical that they have access to accurate, detailed, and thorough information so they can make the best choices for themselves. The risks of improper misoprostol use are very real, including hemorrhage, infertility, septic shock, and more. While using the pill under ideal conditions won’t erase these risks entirely, it will radically reduce them, limiting the number of lives lost while the larger battle for abortion rights is fought.

Just like Jane did in the 1960s and 1970s, women today are fighting a war on two fronts. They’re thinking about the big picture and the need to defend abortion access for everyone, the need to repeal repressive laws and create a climate where patients can freely access reproductive health services.

But they’re also thinking about the now, and the fact that no matter what happens on the floor of the legislature next month, or next year, or next decade, desperate women need abortions today, and they can’t afford to wait for a policy debate.

Photo via Phil Roeder/Flickr (CC BY 2.0)