Warning: Abortion’s Deadly DIY Past Could Soon Become Its Future

On Election Day, the most-searched issue on Google was abortion. According to the Washington Post, searches for “Trump on abortion” rose by more than 4,000 percent in the late afternoon of November 8. Perhaps these searchers were unclear on the position of the candidate who in his pre-political life had supported Planned Parenthood but during the campaign suggested that women should be punished for having illegal abortions and in the final debate talked about abortion providers who “rip the baby out of the womb of the mother just prior to the birth of the baby.” Or perhaps the frantic last-minute searching was a manifestation of collective anxiety about what would become an early flash point in the Trump administration—and a first test of whether much of the social progress of the past 40 years can be undone over the next four.

Any wishful thinking that President-elect Donald Trump might have just been pandering to Evangelical voters with his anti-choice rhetoric during the campaign seems downright fanciful at this point. He has since surrounded himself with—and appointed to power — ferocious opponents of both abortion rights and contraceptive access, starting with his vice-president, Mike Pence, who passed some of the nation’s most restrictive abortion laws as governor of Indiana and, in Congress, co-sponsored so-called personhood legislation that defines life as beginning at conception and would thus make several forms of birth control illegal. Tom Price, Trump’s choice to lead the Department of Health and Human Services, has supported a nationwide ban on abortion after 20 weeks and is a proponent of so-called conscience clauses that would permit doctors and insurance companies to refuse to provide health-care services they don’t personally believe in. Trump’s attorney-general pick, Jeff Sessions, has voted to ban Health and Human Services grants to organizations that perform abortions and against a bill to reduce teen pregnancy through sex education and contraceptive access. Katy Talento, recently chosen by Trump as a health-care policy adviser, has written (falsely) that hormonal contraception causes miscarriage, cancer, and infertility, and called the idea of making birth control available over the counter tantamount to putting “dangerous, carcinogenic chemicals in the candy aisle at CVS.”

In September, Trump himself wrote a letter to supporters promising that if elected, he would sign a nationwide ban on abortions after 20 weeks, defund Planned Parenthood, make permanent the Hyde Amendment — the legislative rider that prevents Americans from using federal insurance programs like Medicaid to pay for abortions — and nominate “pro-life justices” to the Supreme Court. With one Supreme Court seat maddeningly open and three sitting justices over the age of 78, this last promise could have a long-lasting impact: It would take only two appointments to get to a Court that would likely overturn Roe v. Wade.

It’s difficult for many on the left to even wrap their heads around this possibility, which is at such sharp odds with how the country regards the rights of women to control their own reproductive systems. Poll after poll confirms that the vast majority of Americans continue to support legal abortion. A Pew study released the first week in January showed support for Roe at a rec­ord high of 69 percent, while a Quinnipiac survey conducted after the election put the percentage of respondents who believe abortion should be available in all circumstances at more than double the number who think it should not be legal in any circumstance. When it comes to contraception, the numbers are even more firmly on the side of reproductive freedom: Gallup found last year that 89 percent of Americans believe that birth control is “morally acceptable,” a higher percentage than believe the same about divorce, premarital sex, or gambling. And Planned Parenthood, one of the country’s largest providers of women’s health care, remains a pretty beloved organization; this summer, an NBC News–Wall Street Journal poll found its popularity to be 19 points higher than Donald Trump’s and 20 points higher than the Republican Party’s.

Anti-choice Americans may be in the minority, but they have empowered the GOP in recent years, all but clearing it of moderates sympathetic to reproductive rights. For the past decade, congressional Republicans have concerned themselves with reducing women’s health-care options through obsessive attempts to defund Planned Parenthood and repeal the Affordable Care Act, while state legislatures have created an avalanche of restrictions on abortion.

That the right wing’s focus is not simply opposition to abortion but also reducing women’s access to contraception gives away the game: Theirs is an effort to keep women from making decisions about when, if, and under what circumstances to have children, and thereby to keep them from exerting agency over their families, their work, their partnerships, their sex lives, and their bodies. That the restrictions on access most profoundly affect those with the fewest resources means that abortion is not just about women’s equality; it is at the very heart of economic and racial inequality.

Many women, especially young women, have long believed their reproductive rights were permanent, inalienable. It’s not as though a single election could suddenly curtail the freedoms of more than half the population, right? For better or worse, this nation is an ocean liner; it can take decades for it to change course. Women and their extremely popular rights to reproductive autonomy could not be so easily cast aside … right? But the party that has devoted itself to the rollback of abortion and contraceptive access now controls not only the White House but also the House and Senate and a record 68 percent of state legislatures. There is no presidential firewall, no authoritative Democratic opposition.

It’s easy to forget that it wasn’t so long ago that abortion was illegal; it wasn’t so long ago that contraception was illegal. And women suffered for it. I didn’t learn until I was reporting a story about abortion a couple of years ago that my grandmother, a social worker in Hell’s Kitchen in the 1930s, had had an abortion after getting pregnant during the Depression. My grandmother is long dead, but as my aunt explained it to me, she’d been lucky: Her procedure had been safe, and she’d gone on to have two children in the early 1940s. But my grandmother’s friend Rosie, who’d needed two abortions in the 1930s, was left infertile. My grandmother took her daughter and her friends to the Margaret Sanger Clinic in the 1950s to make sure they had diaphragms. When my aunt nonetheless became pregnant as a teen, my grandmother tried to help her get an abortion, but because she looked so young, no doctor would go near her. My aunt had the baby, my eldest cousin, but would go on to have several abortions, including one administered by Robert Spencer, the Pennsylvania doctor known for safely ending pregnancies in the years before it was legal, and another done by someone “who literally used a knitting ­needle.” As she told me in 2014, “I am lucky to be telling you about it.”

This isn’t ancient history; this was the lived reality of many of our mothers and certainly of our grandmothers. And it is entirely possible that it could become our future as well.

The truth is, conservative activists and legislators have been chipping away at American women’s access to reproductive health care for years, with more and greater restrictions in more and more states. “We started to lose ground the moment we decided that Roe was the end point and not the beginning point,” says Ilyse Hogue, the head of NARAL Pro-Choice America.

There has been some progress. Last year’s Supreme Court decision in Whole Woman’s Health v. Hellerstedt landed a hefty counterpunch to state restrictions, holding that states cannot place baseless regulatory roadblocks between women and their health-care options. And Obama’s Affordable Care Act acknowledged women’s reproductive realities by ensuring that they would not pay more for their care, in part thanks to a revolutionary requirement that insurers cover contraceptives with no co-pay. Activists had hoped to build on that momentum going into a Clinton administration. (In a debate with Trump over late-term abortion, Hillary Clinton had given the most full-throated defense of reproductive rights ever offered by a presidential candidate.) Instead, we are about to enter a period of Republican control — of the White House, Congress, statehouses, governors’ mansions, and very possibly the Supreme Court — not seen since the ’20s. Reproductive freedom in America could be wholly compromised, and it wouldn’t even necessarily take overturning Roe. Here’s how it could happen.

As House Speaker Paul Ryan announced last week, one of the GOP’s first legislative actions will be the defunding of Planned Parenthood. It’s been a passion project for tea-partyers throughout the Obama administration, with one such measure making it as far as the president’s desk in January 2016. Some Republicans even threatened to shut down the government last year by vowing to block any spending bill that included Planned Parenthood in it. Until now, the right-wing zeal for disemboweling the organization, which operates 661 health centers around the country, has been stemmed by Democratic opposition or by President Obama. But those protections are gone.

What “defunding” means, essentially, is legislating that Planned Parenthood can no longer accept federal insurance programs like Medicaid. The Hyde Amendment has ensured that those programs could not pay for abortions since it was attached to an appropriations bill in 1976. But if ­Congress voted to bar Planned Parenthood from accepting federal insurance for any services, it would mean that overnight, the 1.5 million American women — 60 percent of Planned Parenthood patients — who rely on those programs for Pap smears, breast exams, STD testing, and, of course, contraception would no longer be able to get that care from Planned Parenthood. For many, that would mean not being able to get treatment at all; 54 percent of Planned Parenthood’s clinics are in areas that do not have other nearby health-care options. Seventy-five percent of the organization’s patients live at or below 150 percent of the federal poverty level.

If you combine the defunding of Planned Parenthood with the dismantling of the Affordable Care Act, which saved women around $1.4 billion a year thanks to its mandated coverage of contraception, we are looking at a crisis in women’s health care. It wouldn’t even take undoing Obamacare entirely to reverse the contraception mandate, which is not written into the text of the ACA itself but is administered by the Department of Health and Human Services. Which will soon be headed up by one Tom Price, who has publicly opposed the mandate and who claimed in 2012 that “there’s not one” woman who can’t afford to pay for her own birth control.

The pre-mandate cost of oral contraceptives in fact ran from $15 to $50 a month, which is not an insignificant amount for large portions of the country. More effective contraceptive methods, including IUDs, cost hundreds of dollars more, leading many women to pick cheaper and less-effective options. Gila Leiter, associate clinical professor of obstetrics, gynecology, and reproductive science at Mount Sinai, says that since the ACA and state insurance programs began to cover the cost, “my IUD rate has gone way up. This is obviously very helpful in terms of limiting abortions, but also in terms of safety and efficacy.” If changes are made in what insurance programs must cover, fewer patients will opt for the more expensive IUDs and, in turn, residents will get less experience inserting them. Then, Leiter explains, “residents who don’t have practice or aren’t trained on IUDs aren’t going to want to present the option to their patients. It may sound like nothing, but actually it’s quite huge, from the perspective of maintaining a decreased rate of abortion, a reduction in unplanned pregnancies.”

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The pro-choice March for Women’s Lives rally in Washington, D.C., 1992. Photo: Marcy Nighswander

Adam Jacobs, who heads up the family-planning division at Mount Sinai, fears that defunding Planned Parenthood alongside the reversal of the contraceptive mandate could put “women — and clearly low-income women — in the situation of having to choose between food on their table and birth control. To force them to make a decision about whether to lay out $700 for an IUD? It’s disgusting. But it’s what it comes down to: looking at your daily budget and children and having to make a decision.”

Low-income women are also vulnerable to attacks on Title X, the program passed in 1970 under Richard Nixon to ensure that low-income families would have access to comprehensive family-planning services. Through Title X, a network of nearly 4,000 community-based clinics provides counseling and contraceptive services, as well as pelvic and breast exams and STD testing and treatment. Republicans have repeatedly called for Title X cuts since taking control of the House in 2010.

Title X is also part of the Department of Health and Human Services, which means that it, too, would be under the control of Price. Price was a co-sponsor of the Title X Abortion Provider Prohibition Act, which would have prohibited federal family-planning assistance to any entity that also provided abortion; it was an attempt to prevent grant money from going to Planned Parenthood, which currently receives a quarter of Title X’s funding. Price will select the administrator who heads up Title X. “He could put someone who literally doesn’t believe in birth control in charge of the program,” notes Planned Parenthood spokesperson Erica Sackin. Price, a proponent of parental notification when it comes to abortion, could also get rid of Title X’s confidentiality guarantee, which assures minors that whatever care they receive will not be reported to their parents.

Federal funds could be redirected, as has already happened in many states, to so-called crisis pregnancy centers, which cater to women with unplanned pregnancies but steer them away from abortion and future contraception use. “The number of CPCs is growing at an astronomical rate,” says Renee Bracey Sherman, a reproductive-justice advocate.

During NARAL’s undercover investigation of Virginia CPCs, the organization found staff at these centers passing on misinformation, including claims that abortion causes breast cancer, infertility, and mental-health problems; that medical and surgical abortions are dangerous; that condoms don’t work; that abortions cost more than carrying a pregnancy to term. Many of the centers that propagated these fictions receive government support. That’s less surprising when you consider that some states require doctors themselves to tell medically unsupported falsehoods —about nonexistent links between abortion and breast cancer or abortion and suicide, or about fetuses being able to feel pain — to patients who want an abortion.

Among the most common lies passed on at crisis pregnancy centers is that women have lots of time to decide whether to have an abortion. This is strategic: If CPC staffers drag out the decision-making process long enough, they bring unwillingly pregnant women up against the 20-week abortion bans proliferating in states across the country, most recently Ohio, where the legislature in December passed a so-called heartbeat bill, banning abortion at six weeks, before Republican governor John Kasich vetoed it and instead signed a 20-week ban, trying to give the impression that this was somehow more humane.

Twenty weeks is the point at which anti-abortion activists now claim that a fetus can feel pain. Not coincidentally, it is also the point at which many fetal abnormalities are discovered through anatomy scans and testing. Twenty-week bans have been enacted in 16 states so far and blocked in two others. Like every other form of abortion restriction, these bans are hardest on the women with the fewest economic resources. Yamani Hernandez, director of the National Network of Abortion Funds, says, “People who can’t afford their procedures are especially punished,” because it’s more likely that “they haven’t had the health care they needed and don’t know they’re pregnant as early, or because they don’t have the funds or the logistical capabilities, or because they are unable to use their federal insurance programs to pay for an abortion and the process of saving money has drawn it out and made the gestational age higher.”

Pushed up against deadlines, the inequities for poor women only accumulate: They are forced to seek out the fewer and fewer providers willing to do later terminations, which in turn means longer distances to travel, scarcer transportation and child-care options, and more difficulty complying with other burdensome restrictions like waiting periods and parental-notification requirements. Many women, of course, cannot manage to jump through all the hoops and wind up having children they did not intend to have, incurring a whole other set of long-lasting consequences. The “Turnaway” study of 2012, which compared outcomes for women seeking later abortions, found that those who had managed to secure them were doing better in all respects than those who had been pushed over the limit and forced to give birth.

The disadvantages heaped on poor women are why activists in the reproductive-justice movement view reproductive rights as a single thread in a tapestry of economic, racial, and social injustice. True reproductive freedom, they argue, is tied not only to abortion and contraceptive access but also to women’s access to affordable housing, education, and employment; from criminal-justice reform to paid leave, subsidized child care, paid sick days, and higher wages, there are many policies that determine if low-income women have any actual choice about whether to have children. Poor women have always paid the punishing price exacted by legislators who might wish to restrict all women’s ­autonomy but can only exert their force on the most defenseless. As Henry Hyde said himself in 1977, “I certainly would like to prevent … anybody from having an abortion: a rich woman, a middle-class woman, or a poor woman. Unfortunately, the only vehicle available is the … Medicaid bill.”

Some look with hope toward the increased availability of medical abortion, via mifepristone and misoprostol pills, which in some cases can be ordered by mail, as the solution to shrinking surgical options. But the medical community is anxious about relying on continued access to the pills. “One thing I am very worried about is the availability of medical abortion,” says Leiter. “There have already been all sorts of questions of whether only physicians can prescribe, or only physicians who have sonogram capabilities.” Thirty-seven states unnecessarily require licensed physicians, as opposed to midlevel clinicians and health practitioners, to prescribe medical abortion drugs, and 19 require — for no good reason — that the clinician be physically present for administration of the medication, thereby limiting patients’ abilities to access this safe and effective termination option remotely.

If all other options fail, some women will take matters into their own hands. “I think you’re going to see more DIY abortions,” says Peg Johnston, a manager of an abortion practice in upstate New York. “And whether they’re punished or not is going to be an interesting question.” The idea of criminally charging and imprisoning women who attempt illegal abortions used to be unheard of in anti-abortion rhetoric — it was all about punishing the doctors and protecting the women. But in December, a poll was released showing that 39 percent of Trump’s supporters thought women seeking abortions should be subject to punishment.

In 2011, Bei Bei Shuai, a Chinese immigrant to Indiana, was charged with attempted feticide after her suicide attempt while pregnant; another Indiana woman, Purvi Patel, was sentenced to 20 years for feticide after having procured a mail-order abortifacient and leaving the fetus she aborted in a garbage bin; her sentence has since been overturned and she was released from prison in 2016 after having served 18 months. Tennessee’s Anna Yocca, who attempted an abortion with a coat hanger while 24 weeks pregnant in 2015, was initially charged with attempted murder, though eventually that charge was reduced and she was charged with criminal abortion.

There have been too many other infringements on reproductive rights to even enumerate here — from the banal TRAP (“targeted regulation of abortion providers”) law requirements that clinic hallways be a certain width to gruesome attempts, in Indiana under Mike Pence and more recently in Texas, to mandate the burial or cremation of fetal tissue resulting not just from abortions but also from miscarriages and ectopic pregnancies. The idea that women should be forced to have transvaginal ultrasounds was embraced not just by disgraced Virginia governor Bob ­McDonnell but by politicians still in power, including Wisconsin governor Scott Walker. In three states, doctors are required to provide a verbal, detailed description of fetal anatomy to women seeking abortion. And anti-abortion activists are pushing for ever more Orwellian measures, suggesting that states keep databases of women who’ve had abortions.

All of this makes the big-ticket dream of anti-abortion activists — the possibility of fully overturning Roe — almost unnecessary and, by many standards, perhaps strategically unwise. (As long as Americans believe their reproductive rights are protected by Roe, they will be less likely to notice that those rights are being eroded past the point of recognition.) And yet any conversation about the not-so-distant future must address the question: Will Roe survive? Trump’s first, and imminent, Supreme Court pick won’t shift the balance, but it is actuarially unlikely Justices Ginsburg, Kennedy, and Breyer — all of whom support Roe — will all survive Trump’s administration.

Some have comforted themselves by pointing out that overturning Roe would simply mean a reversion of abortion decisions back to the states, where some would permit full abortion access and others would wholly prohibit it and most would fall between the two extremes. But it’s not clear how protected even staunch pro-choice states like New York and California would be in a post-Roe future in which there is no judicial barrier to Congress enacting national TRAP laws or a federal 20-week ban.

It’s also worth remembering just how bad things were in those patchwork days before Roe. “All I can say is that if you fall into the temptation to argue that it will be all right if it goes back to the states,” says Faye Wattleton, who was president of Planned Parenthood from 1978 to 1992, “I guess you don’t remember what a horror show New York was during the few years before Roe when abortion was legal here.” Wattleton was working for Planned Parenthood in Dayton, Ohio, in 1970, the year abortion was legalized in New York, three years before Roe made it legal across the country. “Women who had needed abortions would come back from New York with horror stories. Because every Tom, Dick, and Harry exploited the situation. Enormous amounts of money were made. Women came back injured, infected. It was not a pretty picture.”

Wattleton sees parallels between the early ’80s and today when it comes to divisions over reproductive freedom. When she took over in 1978, Planned Parenthood served around a million women and enjoyed strong bipartisan support. Over the previous decade, the Supreme Court had made contraception legal first for married people, then for singles, then had legalized abortion. But the country was also seeing the rise of a newly cohering religious right that stood in furious, explosive opposition to women’s increasing liberty. “Our clinics were under tremendous threat. Just before I became president, the Minnesota affiliate had burned to the ground.” It was one of the first of a series of bombings and arsons of abortion clinics in the late 1970s. “There were organized efforts to engage in guerrilla training camps, to organize people to commit terrorist attacks against Planned Parenthood and abortion providers,” Wattleton recalls.

Ronald Reagan rode the fundamentalist surge to the White House in 1980. “When Reagan was elected,” Wattleton says, “one of the first announcements that the administration made after the inauguration was that it intended to defund the left. And Planned Parenthood is the first organization they were determined to defund.” In the early ’80s, there was an effort to launch a constitutional amendment to overturn Roe; when that didn’t take off, ­reproductive-rights opponents turned their energies to the more incremental slog, “the slow erosion of Roe,” says Wattleton, “the ‘hundred-year war,’ as they put it.”

Today, we are again seeing a rise in anti-abortion violence, with the 2009 murder of the abortion provider George Tiller and Robert Lewis Dear’s 2015 attack on a Colorado Springs Planned Parenthood clinic in which three people were killed. In the weeks after the 2016 election, threats to abortion clinics spiked, with protesters throwing rocks through the windows of a Kentucky clinic. Reproductive-rights opponents have notched a startling number of wins in that hundred-year war, and Roe still hangs in the balance.

When I ask what the game plan should be now, Wattleton laughs a little grimly. “Honey, I don’t know what to tell you. It would be lovely to say we’ve got some fancy new bullet to hit this with. But really it is just hard, backbreaking political work. You have to gird your loins for the battles ahead, because that is what they are going to be: battles. But look, we defeated [Reagan’s 1987 anti-abortion Supreme Court nominee] Robert Bork. Supreme Court nominations can be defeated. Frankly, I am baffled by people who say, ‘What are we going to do?’ What are we going to do? We’re going to fight.”

The fight has many fronts, and all of them are fraught. On the legislative side, Congress is stacked against the Democrats for at least two years and possibly for much longer. Still, at the end of December, 105 Democratic members of the House, led by California’s Barbara Lee, who in 2015 championed the EACH Woman Act in opposition to the Hyde Amendment, sent a letter to the president-elect reaffirming their commitment to abolishing the policy, which so negatively affects low-income women and women of color. Constituents can bring powerful pressure to bear: Just five years ago, when the immensely popular Susan G. Komen breast-cancer-research foundation announced it was cutting ties to Planned Parenthood, the negative reaction was swift and intense — 1.3 million tweets; $3 million donated to Planned Parenthood; calls to politicians who in turn sent their own protest letters; women who pledged to drop out of Komen-sponsored events. Komen promptly reversed its decision. With that in mind, Planned Parenthood just issued a press release announcing more than 300 marches and rallies that will take place throughout the spring, across 47 states and in 150 cities.

The future of the Supreme Court might be shaky, but several organizations intend to pursue legal challenges to abortion restrictions given the strong precedent recently affirmed by the Whole Woman’s Health decision and a federal court system that, for now, is still friendly to abortion rights. In the weeks after Trump’s election, the Center for Reproductive Rights, along with Planned Parenthood and the ACLU, filed simultaneous lawsuits challenging abortion restrictions in Alaska and in North Carolina, where they are challenging a 20-week ban. Planned Parenthood and the ACLU are also challenging a set of restrictions that has left Missouri with only one licensed abortion provider. And the CRR is fighting the Texas fetal-funeral requirement. “We’re going to be looking at every single thing they’re doing and looking to use every legal avenue we have to stop them from setting us back on women’s health,” says Nancy Northup, head of the CRR.

But there are more subversive ways of thwarting abortion restrictions at the state, local, and even physician levels. Seventeen states currently circumvent Hyde by using their own funds to cover medically necessary abortions for Medicaid patients. In Texas, after the state cut its funds to Planned Parenthood, the City of Austin said it would chip in with funding. When it comes to access to contraception and abortion, the possibility of safe-haven states as well as cities “might be absolutely crucial,” says Amanda Lerman, an adolescent-health physician in Philadelphia.

And doctors themselves could play a more strategic role both in making the case for protected — and expanded — reproductive rights and by shifting their training practices to better get around funding cuts and restrictions. One of Lerman’s ideas, for instance, is that the medical community “can bring sexual-health approaches into primary-care settings.” If more primary-care physicians and nurse practitioners were trained to insert IUDs or administer injectable long-lasting contraception, for instance, they might better fill in the gaps left by defunding efforts. In other words, patients who could no longer use their insurance at Title X clinics might be able to receive necessary care from general practitioners, still permitted to accept Medicaid. “I think you’re finding physicians realizing that if they don’t get themselves engaged, there is no stopping this,” says Adam Jacobs at Mount Sinai.

But many of these are small fixes, Band-Aids on a serious wound. “Inarguably, we’re still playing checkers while they’re playing chess,” says NARAL’s Ilyse Hogue. “And that’s not because they’re smarter than us or more sophisticated; in fact almost exactly the opposite. We’re still focused on policy and data and how many women will be restricted and how to get enough money to get women to safe states. And that’s all really important. But I’m looking at a poll today that says that 40 percent of Trump supporters think that women should be punished. We’re still operating in the world of the intellect, and they’re going for the visceral. And we’re living in visceral times.”

It may be that the biggest opportunity for the reproductive-­freedom movement at this critical point in history is a change not in strategy but in mind-set, in the very tenor of the conversation.

The first march I ever attended in Washington was a pro-choice rally in 1989 that drew half a million people. I was 13 years old, and I didn’t understand why the protesters wore pins and carried signs with pictures of coat hangers on them. That’s when I was told, by women for whom illegal abortion was just 16 years in their past, about how women, desperate to end pregnancies in days when it was not legal, untwisted coat hangers, inserted them into their vaginas, into their cervixes, cutting themselves, causing bleeding, infections, and often infertility.

Fifteen years later, at the 2004 March for Women’s Lives, I watched Whoopi Goldberg take the stage, gripping a coat hanger and yelling accusatorily: “You understand me, women under 30? This is what we used!” At the time I thought this was unfair: The whole point was that young women shouldn’t have to know about coat hangers. The not-knowing was its own victory. But in 2015, Anna Yocca tried to self-abort by using a coat hanger in Tennessee. Our past is reaching into the present.

Renee Bracey Sherman, the reproductive-justice advocate, says that when she speaks to multigenerational crowds, she often hears from older feminists who say, “Kids these days don’t know how hard it was to get an abortion; they don’t know we had to smuggle people and they don’t know about coat hangers or how my cousin died or my best friend died.” She often asks these women if they have grandchildren; many do. “How many times have you told your daughter or your grandkids your story?” she asks them. “That’s how young people don’t know. We don’t talk about it. It’s hard because it was such a scary time, and it hurts to talk about it, to say, ‘Yeah, that’s how so-and-so died’ or, ‘I had to get on this bus and someone blindfolded me and took me to this farm.’ We don’t like to tell these stories. But that’s where the conversation got lost, because people thought, ‘Oh, it’s legal, we don’t have to tell these stories.’ ”

But the telling of abortion stories serves a purpose. The pre-Roe horrors remind us what’s at stake for women should they lose their ability to determine their own reproductive lives. Many of us have forgotten, or perhaps never seen, the graphic photograph of Geraldine Santoro, a 28-year-old woman who bled to death after an illegal abortion in a motel room in 1964. Santoro’s fate was not unique; around 200 women a year died as the result of illegal abortions in the mid-1960s.

Telling any abortion story — legal, illegal, surgical, medical — serves to normalize the procedure as the very common part of life that it is. “Thirty percent of all women are going to have an abortion in their lifetime, most of them already mothers,” says Peg Johnston, the abortion-clinic administrator in upstate New York. “This is a normal reproductive experience.”

And we shouldn’t forget the part of the story that comes after the abortion or the successful use of contraception — the high-school or college or graduate-school studies that were continued; the household budget that was kept, barely, intact; the existing children who were better off; the bad marriage that was avoided. “Abortion and birth control are part of the fabric of American life,” says Katha Pollitt, the author of 2014’s Pro: Reclaiming Abortion Rights. “They’re the reason you can have later marriage, and why women can have a sex life and also go to college and graduate school and have professions; they’re how there can be the small families that most people want and most people can afford. It’s why marriage is better! You don’t have to marry some guy who got you pregnant. That’s all part of a package that people like.” And the more that connection is made in the collective understanding, the harder it will be to unwind, even in an administration that is set on curtailing reproductive rights. As Pollitt points out, “Even if people don’t like abortion, they like the things that it brings them.”

*This article appears in the January 9, 2017, issue of New York Magazine.

Abortion’s Deadly DIY Past Could Soon Become Its Future