Class Notes | Abortion
⤏ WRITTEN AND RESEARCHED BY GISSELLE PERNETT AND EDEN HAIN
⤏ EDITED BY CIANA ALESSI AND FAYE ORLOVE
Class Notes is a recurring series exploring topics that we find hard to understand (purposefully or otherwise!). Started as Instagram infographics, Class Notes has shifted into a monthly Jr Hi the Magazine feature which you can read here!
Terms You Should Know
14TH AMENDMENT: “All persons born or naturalized in the United States and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.” Adopted on July 9, 1868, the 14th Amendment addresses citizenship rights and equal protection under the law.
ABORTION: The termination of a pregnancy by removal or expulsion of an embryo or fetus.
CODIFYING: The process of turning a judicial decree into a law.
EUGENICS: The study of how to arrange reproduction within a human population to increase the occurrence of heritable characteristics regarded as desirable. Eugenics is discredited as unscientific and racially biased.
ROE V. WADE: A landmark decision of the U.S. Supreme Court in which the Court ruled that the Constitution of the United States gave U.S. citizens the right to have an abortion.
TARGETED REGULATION OF ABORTION PROVIDERS (TRAP LAWS): Medically unnecessary laws geared towards abortion clinics and patients to make providing and accessing abortions difficult. The goal of these regulations is to make it easier to shut down abortion providers when requirements aren’t met.
TITLE X: A federal grant program designed to provide reproductive health services including pregnancy testing, infertility services, and STD prevention and treatment. It was enacted under President Richard Nixon in 1970 as part of the Public Health Service Act.
TRIGGER LAWS: Laws passed by individual states that become enforceable once a key change in circumstances occur. For example, when Roe v. Wade was overturned on June 24, 2022, 13 states enacted “Trigger Laws” that restricted or eliminated access to abortions.
VIABILITY: In terms of abortion, viability is the capability of a fetus to survive outside the uterus.
ABORTION
Since this Class Notes is a bit longer than usual, we wanted to provide you with this handy Index so you can get exactly what you want out of this here explainer. Of course you can read this front to back, if you’d like (we worked really hard on this!) or you can skip around to the info you find most important. It’s up to you!
HISTORY OF REPRODUCTIVE HEALTH IN AMERICA
CIRCUMVENTING CRIMINALIZED ABORTION
HOW DID WE GET HERE: RESTRICTING REPRODUCTIVE RIGHTS FROM 1973-2022
PRIVACY + TECH
EFFECTS OF ABORTION RESTRICTION IN AMERICA
KNOW YOUR RIGHTS: CALIFORNIA
KNOW YOUR RIGHTS: THE UNITED STATES OF AMERICA
WHAT CAN WE DO NOW
Please note: Abortions are acquired by any impregnated person and are not exclusive to any gender. Many people who menstruate or can be impregnated are not women. There are also so many people who wish to carry a child who cannot.
In this piece, we are making a conscious choice to be as inclusive with our language as possible. If you are a person who does not believe in the importance of centering trans experiences in this conversation, we will not disallow you from learning (we are not gatekeepers of knowledge — it’s off-brand), but we will talk about you unfavorably in our Slack channel.
There are limitless reasons a pregnant person could seek an abortion, all of which are VALID. While often cited as a careless decision by a woman who singlehandedly made a wittle mistake, many abortion-seekers are children, survivors of rape, people who would otherwise endure harm or fatalities should they remain pregnant, or someone who is not capable of making an autonomous decision.
*Editor’s Note:
As this Class Notes is partially written and edited by a pregnant person, I cannot validate enough wanting an abortion for any reason at all. Nothing — no books, no sitcom births, no sitting bedside as my cousin tells me her horrifying C-section story — could prepare me for the experience of pregnancy. The effects on my physical body, emotional state, and mental health have been staggering, expensive, and overwhelming. Even with my wonderful support system, adequate health insurance, and slightly-above-minimum-wage job, there are days where I doubt I can Do This. The narrative that “doing your 9-months and popping out a kid” is easy, is radically far from the truth. Nothing about pregnancy has been easy, and I haven’t even done the hard part yet. Which reminds me, no one has told me how the baby comes out? Doesn’t seem like it’ll fit anywhere? Time will tell!
Jokes aside, parenthood, bearing a child, and giving birth are huge decisions, and we believe in everyone’s right to choose if and when those milestones suit them.
THE HISTORY OF REPRODUCTIVE HEALTH
IN AMERICA
Abortion has not always been such a political topic — it was considered quite normal! In fact, America was founded on reproductive principles that center a pregnant person’s lived experiences. Before today’s discourse, many people believed that pregnancy was actually “a lack of something (menstruation) rather than the presence of something (a fetus).” This is when most abortions took place.
Through the 1800s, when gynecological studies were still in their infancy, a lot of pregnancy knowledge was based on rudimentary science and a lack of understanding. If an abortion took place before a pregnant person felt movement, it was not a crime. Really, it was a pregnant person’s word against anyone else’s! How are you going to tell someone what they feel inside their Nerveless Sack*? *Dibs on using this as a band name.
As the scope of reproductive health information evolved, even the Catholic Church changed its stance on when a fetus gains its soul in accordance with the development of gynecological studies. That’s right, not only did the Catholic Church prove its capacity to listen to science, but it has only held its current stance that life begins at conception since 1869. Before 1869, it was believed that the soul entered the fetus 40-80 days after conception, which had been the leading belief since the 5th century.
Just like every other history, race and social subjugation eventually come flying into the picture at full speed. Abortion restrictions truly begin, in their contemporary understanding, when we talk about the experiences of Black, enslaved women. Here “women” is specified because it is important to center the reproductive experiences that controlled and traumatized enslaved women.
While white women could drink their Pennyroyal tea fresh from their gardens, enslaved women’s uteruses carried the key to the white man’s success. Afterall, when an enslaved woman gave birth they were producing the plantation’s labor force. So white women got really good at getting abortions (and giving them to each other) and enslaved women got really good at facilitating births as midwives and doulas.
When enslaved people weren’t learning how to keep themselves and their babies alive in radically unfavorable conditions, they were becoming human test subjects for new scientific discovery. Michele Goodwin, law professor at the University of California Irvine explains:
“Male gynecologists claimed midwifery was a degrading means of obstetrical care. They viewed themselves as elite members of a trained profession with tools such as forceps and other technologies, and the modern convenience of hospitals, which excluded Black and Indigenous women from practice within their institutions…It was literally on the backs of Black women’s bodies that such tools were developed. Dr. Marion Sims famously wrote about his insomnia-induced ‘epiphanies’ that stirred him to experiment on enslaved Black women, lacerating, suturing, and cutting, providing no anesthesia or pain relief.
American hospitals barred the admission of African Americans both in terms of practice and as patients. And, the American Medical Association (AMA) barred women and Black people from membership. The AMA, founded in 1847, refused to admit Black doctors.”
That is until slavery was “abolished” in “1865” — for the sake of brevity, we will pretend this is a fact instead of a blatant lie to mask the continued systemic oppression of minorities ad infinitum — and white doctors started feeling threatened by newly freed Black women in medical spaces.
American politicians and gynecologists may not have agreed on the importance of gynecological research, but together they walked down the oft-treaded path of white supremacy and eugenics. When politicians began fearing that white women’s access to abortion would lead to Black people overtaking America as the dominant race, abortion became a permanent fixture in political debate. As white women gained suffrage and influence in the political climate, they were forced into homemaker roles, and as Black people gained freedom and the right to be paid for their labor, their ability to reproduce was no longer necessary to white slave-owners. Swiftly, the cultural relationship to birthing begins to dig itself into the trenches of eugenics.
CIRCUMVENTING CRIMINALIZED ABORTION
Starting in 1841 in Connecticut, each of the 50 states passed legislation that restricted their citizens' ability to receive abortion care. Abortion restrictions ramped up in severity through the 1860s until, by 1910, abortion was criminalized nationwide. This did not stop abortions from taking place (obviously) and many abortifacients circulated around with varying levels of effectiveness and varying levels of toxicity. People would try swallowing potent solutions of herbs they could find in their gardens, or the ever popular abortion by wire hanger. Without the guidance from a doula or doctor, the fetus might die, and the person carrying the fetus could arrive at the same fate, too. Even if you could find a gynecologist radical enough to give you a surgical abortion, it could cost upwards of $100, and you never knew if they were going to castrate you in the process.
One of the movements that set out to combat the epidemic of septic abortions that killed countless people who received botched abortions, was the Chicago-based Jane Collective — an underground surgical abortion movement created by ordinary women. “Jane” aborted thousands of unwanted pregnancies and provided counseling to any pregnant people who sought their help. Recently, a documentary was released tracking “Jane’s” history from its founding to its process of finding gynecologists who were willing to risk arrest to perform surgical abortions, to setting up their own travel clinics and training themselves to take the male doctors out of the equation to perform the abortions themselves. We cannot condone teaching yourself surgical techniques outside of an accredited educational environment, but we’re not going to stop you from watching The Janes on HBO. We also can’t stop you from learning from the generations of Black midwives and indigenous doulas who developed these techniques before and during colonization.
HOW DID WE GET HERE
RESTRICTING REPRODUCTIVE RIGHTS FROM 1973-2022
Well *spoiler alert* we’ve kind of already been here. Before the official federal overturn of Roe v. Wade on June 24, 2022, states (mostly Southern ones) implemented unnecessary hurdles, TRAP laws, mandated counseling, forced ultrasound viewings, and gestational age limits to make abortion inaccessible without completely banning it. Just look at Texas who had a slew of restrictive abortion laws including allowing doctors to spread anti-abortion propaganda to patients seeking an abortion. Going even further, Texas lawmakers then passed the Heartbeat Act in 2021, which not only made it illegal to terminate a pregnancy after six weeks, but also allowed citizens to sue anyone involved in the abortion. Yes, people were now being compensated for not minding their own business! This is complete narc energy. The Heartbeat Act meant that a complete stranger who found out you were planning to have an abortion could sue you, your doctor, whoever paid for the procedure, and the Uber driver who drove you to the clinic! And the Supreme Court refused to block the law because technically the state was not enforcing the law, the citizens were. Loophole!
Feeling left behind by their equally regressive state sibling, Mississippi then enacted the Gestational Age Act. Passed in March 2018, the Gestational Age Act prohibits pregnant people from having an abortion until a physician determines the viability of the pregnancy. After 15 weeks, pregnant people cannot terminate their pregnancies unless it is deemed a medical emergency.
Then comes the now infamous Dobbs v. Jackson Women’s Health Organization — the Supreme Court case that led to the overturn of Roe v. Wade. Jackson Women’s Health Organization, the only state-licensed abortion clinic in Mississippi, challenged the constitutionality of the Gestational Age Act and requested a temporary restraining order that would allow it to remain operational. As a rebuttal, Mississippi health officer, Thomas Dobbs, argued that the law was in fact constitutional, as medical advancements suggested fetuses can feel stimulation at 12 weeks. This fact, according to Dobbs, made a pregnancy viable earlier than previously thought. For context: the point of viability when Roe v. Wade was passed in 1973 was considered to be 23 or 24 weeks. The District Court and Fifth Circuit both determined The Gestational Act was unconstitutional, leading to a Supreme Court review of the case to determine whether banning abortions earlier in the pregnancy was unconstitutional.
To make an already long-ish story short-ish, here are the plot points:
Dobbs argued the “liberty” granted by the 14th Amendment did not include the right to an abortion, therefore, the Supreme Court should reject “viability” as a factor because it’s not in the Constitution.
Jackson Women’s Health argued the right to an abortion, the right to contraception, and the right to accept or deny medical treatment were all included elements of “liberty.” They further argued viability has been used in abortion cases for 50 years.
The Supreme Court determined there was no constitutional right to abortion and overruled Roe v. Wade and Planned Parenthood v. Casey.
Jackson Women’s Health Clinic closed its doors on July 6, 2022, a day before Mississippi’s trigger law went into effect, banning all abortions statewide.
EFFECTS OF ABORTION RESTRICTION
IN AMERICA
Surprise! Those same states that claim to care about life don’t implement the resources to support said life!
The inability to financially support a child is one of the most common reasons people choose to have an abortion. Research done by the Center for Reproductive Rights and Ibis Reproductive Health found that states with multiple abortion restrictions — like Mississippi and Texas — had the least amount of support programs for pregnant people and children. The report further states that restricted access to abortion can lead to an increased risk of mental and physical health problems, as well as domestic violence.
Physical health risks are increasingly detrimental to impregnated Black people, who experience a higher rate of maternal mortality due to racism. A 2018 report done by the National Partnership for Women and Families states, “Black women display signs of preeclampsia earlier in pregnancy than white women. This condition, which involves high blood pressure during pregnancy, can lead to severe complications including death if improperly treated.” Additionally, the report found impregnated Black people who experience pregnancy complications may experience “weathering,” advanced aging from chronic stress triggers such as racism and socioeconomic status.
A separate study conducted by the ANSIRH, reports that people who were denied an abortion faced prolonged economic hardship and were four times more likely to live below the poverty line. The ANSIRH study concluded that:
Women who were turned away and went on to give birth experienced an increase in household poverty lasting at least four years relative to those who received an abortion.
Years after an abortion denial, women were more likely to not have enough money to cover basic living expenses like food, housing, and transportation.
Being denied an abortion lowered a woman’s credit score, increased a woman’s amount of debt and increased the number of their negative public financial records, such as bankruptcies and evictions.
PRIVACY + TECH
THROW YOUR PHONE INTO THE OCEAN
The year is 2022. Everyone is struggling to simply exist. And now, to make matters even worse, you’re supposed to worry about period tracking apps stealing your data.
When Roe V. Wade was overturned, it didn’t necessarily or even automatically criminalize abortion access. What it *actually* did was remove the precedent for privacy in and protection of reproductive care. Today, without “Roe’s” explicit demand for privacy in reproductive healthcare, all of our information is up for grabs.
Now, in a post-”Roe” America, the amount of information your employer is allowed to know about your reproductive care varies from state to state. The information a court is allowed to subpoena in a criminal abortion case has increased. The Constitution does not actually specify “privacy” as an American right, however, many have felt that our privacy has long been encompassed in the 14th Amendment, a point which is now essentially null and void.
“Once Roe v. Wade and Planned Parenthood v. Casey are overturned, it is possible that U.S. private businesses could become either voluntary or involuntary participants in the enforcement of state anti-abortion laws. In particular, numerous popular consumer devices and mobile apps collect an enormous amount of sensitive personal information from users—including precise geolocation, browsing or internet activity, search history, private communications, social media posts, photos, videos, financial transactions, and more—which would allow developers, data aggregators, advertisers, and other third parties to infer pregnancy status.
In many cases, this information may be used for targeted advertisements for pregnancy or baby-related products. But more consequentially, it could also facilitate a digital paper trail for law enforcement to compile evidence against individuals who choose to have an abortion.
In addition, data aggregators can compile and sell precise geolocation information related to people who visit reproductive health clinics; for example, SafeGraph recently offered location information of individuals who visit Planned Parenthood and other family planning facilities for approximately $160, including the frequency and length of their visits and other movement activity. Even if data brokers take steps to anonymize this data, it can potentially link back to specific individuals when combined with other information.”
— Caitlin Chin, Strategic Technologies Program at the Center for Strategic and International Studies
Basically, while we’ve joked that there is an FBI agent in your phone keeping track of your internet search history, what we actually have are Silicon Valley schmucks who sell your data without telling you when or why. Someone should really legislate a way to stop this, huh! Until the people we voted into office actually do something about this — which is likely never — the best thing you can do is treat your reproductive and digital health with an attitude of preventative care. If you live in a trigger state (a state that has abortion restriction laws that were enacted by overturning Roe v. Wade) and you are not currently pregnant, it’s time to study up!
Stay up to date with your state’s laws.
Create an action plan that is relevant to your state.
If you’re keeping track of your menstrual cycle, do so with a format that won’t sell your information (this may mean going with a pen and paper route).
Overturning Roe v. Wade doesn’t mean that HIPAA is out the window! Ask a medical professional any and all questions you have. ANY! And ALL! They STILL can’t share that information with anyone.
Be sure to restrict potentially risky conversations to encrypted communication methods (Signal etc.).
If you are pregnant and currently seeking a way to end your pregnancy, there are states and territories that will provide you with the help you need and won’t engage with a trigger state’s lawsuit (New Mexico and California). (Scroll to Know Your Rights: USA)
KNOW YOUR RIGHTS: CALIFORNIA
CALIFORNIA IS GOOD? MAYBE. WON’T PUT PEOPLE IN PRISON? YAY! THE BARE MINIMUM!
Abortion is still legal in California! The state is currently working on expanding abortion access to residents and non-residents with a series of bills including SB 1142, which would establish the Abortion Support Fund — to assist people who cannot afford to have an abortion — and AB 2091 — to protect the privacy and medical information of people seeking an abortion.
And head’s up to all CA voters: securing reproductive rights will be on the November ballot! Although abortion is implied in the state constitution, the constitutional amendment would make it so abortion and contraceptive rights are explicitly protected. Make sure to keep an eye out for Proposition 1, which would include:
The ability to get an abortion for any reason up until 6 months after you are impregnated. You can still receive an abortion after the 6 month period if the pregnancy will put your health at risk.
Confidentiality regarding your abortion, no matter what your age is. You do not need permission to get an abortion if you are underage and a doctor does not need to inform a parent or guardian of your abortion.
The ability to start birth control at any age, without requiring permission from a parent or guardian to receive a prescription.
The ability to have an abortion in California without being a California resident
Not every medical provider offers abortions and not every medical provider is required to offer them.
KNOW YOUR RIGHTS: USA
OVERVIEW OF ABORTION LAWS THROUGHOUT THE U.S., Courtesy of the © 2022 Guttmacher Institute
WHAT CAN WE DO NOW?
THERE HAS TO BE SOMETHING, RIGHT?
PLACES TO DONATE
Abortion funds by state: https://donations4abortion.com/
Provides pro bono legal help to people facing legal repercussions for obtaining abortion services: https://www.ifwhenhow.org/repro-legal-helpline/
Mutual aid fund for legal services helping people facing legal repercussions for obtaining abortion services: https://reprolegaldefensefund.org/
Mutual aid fund for legal services helping people facing legal repercussions for obtaining abortion services: https://abortionfunds.org/
Funds for independent abortion providers: https://keepourclinics.org/
Find an abortion clinic and relevant abortion funds in your state: https://www.ineedana.com/
KEEP UP TO DATE WITH THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
The HHS specifies that birth control is still available for no additional cost under the Affordable Care Act in ALL STATES.
States that provide abortions through medication are FDA-approved and safe.
Medicaid covers abortion in cases of rape, incest, or therapeutic in ALL STATES.
Title X Family Planning Clinics provide a broad range of family planning services and provide preventive health services that benefit reproductive health, such as STI and HIV testing, HIV counseling, and HPV vaccines. Find a Title X Family Planning Clinic near you.
The Emergency Medical Treatment and Labor Act (EMTALA) requires that, for any individual showing up to the hospital with an emergency medical condition, the hospital is required to provide you with the emergency care necessary to save your life, including abortion care.
GET ABORTION PILLS DELIVERED TO YOU
Aid Access delivers at home abortion pills throughout the United States (including states with abortion restrictions, but takes 3+ weeks to deliver/arrive) and will deliver pills whether you are actively pregnant or want to have the pills in case of future pregnancies.
See if you can get Plan C pills delivered to you in your state.
Guidelines on how to use abortion pills.
An in-depth (and non-denominational) guide on at-home abortions
For more facts and figures about contraception and what actually happens when a pregnancy is aborted, see our old Class Notes on Instagram!
SOURCES AND ADDITIONAL READING
What Privacy in the United States Could Look Like without Roe v. Wade by Caitlin Chin
Democrats urge Google to limit location tracking to protect people seeking abortions by Carly Page
Roe v. Wade by Center for Reproductive Rights Editors
NATIONAL WOMEN’S LAW CENTER FACT SHEET from August 2018
Overturning Roe v. Wade could restrict more than abortion, according to experts by Sarah McCamon
Abortion Is Central to the History of Reproductive Health Care in America by Planned Parenthood Editors
The Racist History of Abortion and Midwifery Bans by Michele Goodwin
From Commonplace to Controversial: The Different Histories of Abortion in Europe and the United States by Anna M. Peterson
HISTORY OF ABORTION excerpted from Our Bodies, Ourselves for the New Century by the Boston Women's Health Book Collective
Dobbs v. Jackson Women’s Health Organization by Tori Staley and Jenny Guo
Mississippi's last abortion clinic shuts down. The owner promises to continue working by Jaclyn Diaz
What Does the Texas Abortion Law Mean for the Future of Roe v. Wade? by Joel Brown
The Turnaway Study by Diana Greene Foster, PhD, M. Antonia Biggs, PhD, Heather Gould, MPH, Katrina Kimport, PhD, Sarah Raifman, MSc, Lauren Ralph, PhD, MPH, Sarah Roberts, DrPH, Corinne Rocca, PhD, MPH, Gretchen Sisson, PhD, Ushma Upadhyay, PhD, MPH, Katie Woodruff, DrPH
Limiting Abortion Access Contributes to Poor Maternal Health Outcomes by Anusha Ravi
After Roe: What happens to abortion in California? by Alexei Koseff and Kristen Hwang