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Melissa Harris-Perry: It's The Takeaway. I'm Melissa Harris-Perry. In January 1973, the Supreme Court handed down its decision in Roe v. Wade, recognizing that the due process clause of the 14th Amendment protects the right to privacy, and with it protects the right to choose an abortion. According to Planned Parenthood, before Roe roughly one in six pregnancy-related deaths were caused by abortions obtained illegally, but in the nearly 50 years since Roe was decided, abortion has become a safe medical choice.

While abortion remains safe, in recent decades it has become far less accessible, as states across the country have limited the length of time, the places, and the means by which people can exercise their constitutional right to terminate a pregnancy.

The Supreme Court is set to issue a decision in Dobbs v. Jackson Women's Health Organization later this year. That decision could overturn Roe entirely or render it effectively meaningless. In anticipation, those who worked for reproductive rights prior to 1973 are once again preparing for a country where abortion may be illegal. For many, they've never felt certain that the right to abortion was stable.

Carol Downer: "Well, we didn't expect patriarchy to give up."

Melissa Harris-Perry: That's reproductive rights activist Carol Downer.

Carol Downer: "We didn't have any illusions that Roe v. Wade would bring in. I think we all thought it would get turned around sooner. We didn't think it was much of a law in the first place, and we thought abortion would not be governed by the law, period."

Melissa Harris-Perry: Well, Ms. Downer is in her late 80s, and she spoke recently with journalist Jessica Bruder. In the reporting that Bruder did for The Atlantic, and the WNYC co-produced podcast The Experiment, she connects the early '70s activism of people like Ms. Downer to the work being done underground today to ensure that pregnant people everywhere have access to affordable, safe abortion options. Bruder listened in to a hacker's conference in 2020. Now, this workshop was led by an activist who called herself Maggie Mayhem.

Maggie Mayhem: "It just may be that self-managed abortion is the solution we need until we can actually secure legal rights, and I'm going to reassure you on why it might be okay. There has always been a network of underground abortion. They eventually realized that abortion itself wasn't maybe as complicated as they thought it had to be."

Melissa Harris-Perry: Bruder saw firsthand how activists have worked to simplify the process, and she met earlier this year with one woman on a Southern California beach. That person asked not to be identified by her real name, and she demonstrated how a homemade abortion device could function by using a cup of coffee.

[suction sound]

Male Speaker: "Wow."

Female Speaker: "Yes, and that's how that would work. Whether or not this is something that someone uses, just knowing that there are options in the world and that the people who came before you had other ways of managing these things, that has always made me feel less lonely or less despondent."

Melissa Harris-Perry: That machine you just heard is called a Del-Em.

Jessica Bruder: Del-Em was devised in 1971 by feminist activists who were part of the abortion underground back then. It is a DIY device that they said could be used to extract your menstrual period with the idea of getting it over with all at once, but really it was devised for early-stage abortions.

Melissa Harris-Perry: I spoke with Bruder about the connections between current and previous generations of abortion activists.

Jessica Bruder: I think there already is a sense of solidarity among people in getting ready to push back if Roe falls. The truth is no matter what happens, there is no way to go back to the '70s, and I'll tell you why. There are two reasons. One is the internet. Because I think a lot of this is a knowledge battle for people, and that relates to reason number two: abortion pills, which many people still don't know about but can be learned about quite easily on the internet. The pills are able to safely and effectively terminate pregnancies in the first trimester, and according to the World Health Organization, sometimes even beyond that.

More than half of legal abortions that we know about in the US are now done with these pharmaceuticals with this medication. What's amazing is a lot of people still don't know about them. The fact that they're here-- I know cases of people, again in the underground, mailing them to people who couldn't get them. There's one activist I know on the West Coast who sent pills to a pregnant 13-year-old in Texas who was desperate to get them. The ban there was about to go through and she sent this teenager a care package with a novel and some other stuff and the pills.

Melissa Harris-Perry: Certainly, at least in one way, we could potentially be "going back to the '70s." Which is to say that these practices, this underground, the reason that it's underground is the potential for criminal charges to be brought against folks who are in fact operating to attempt to make abortion and termination services available to those who are cut off by these new policies of restrictions. Just how dangerous might it get in this underground?

Jessica Bruder: Well, it's already getting weird, right? Ever since SB 8 went into effect in Texas we've seen some of the challenges beginning. One of the most powerful and frightening examples is the most recent one where a 26-year-old woman in Texas was basically accused of murder for - and we don't know the details - something involving a self-induced abortion. That's only a claim and the murder charge can't stick on something like that, but what that brings up, even though that charge was dropped, is that overzealous law enforcement or prosecution can pretty much do anything they want in many cases.

We've known this, and this particularly impacts communities that are overpoliced already: low-income communities, communities of color. That's one of the things that I think is really scary even now, is that regardless of what the law says people can get dragged through the mud. If Roe falls it looks like there will be, they're saying now, 26 states that are likely to ban or try to ban abortion. 13 of those states have trigger laws, which means the moment the Supreme Court gave the states the power to do so they would ban or just very, very strictly curtail abortion.

Melissa Harris-Perry: My mother was part of an underground network in the pre-Roe v. Wade days. Living and working in Seattle, Washington, which was a place where they were relatively progressive and open access to abortion, they worked to bring women from states where abortion was illegal to provide them with rides, with safe houses. It's definitely part of how I grew up, was hearing about these stories of the work that she'd done on that underground network.

That was not me as a journalist. That was just me as a kid learning about this, but some of the reporting that you've done does talk with folks like my mom. You didn't talk to my mom, but people like her who've been doing this work for decades.

Jessica Bruder: Well, I had a lot of confidential sources, so maybe I did talk to your mom.

[laughter]

Jessica Bruder: I'm not going to tell you that.

Melissa Harris-Perry: I would be so shocked if you talked to my mom and she didn't tell me. I mean, not impossible but--

[laughter]

Jessica Bruder: Yes. Well, people like your mom, fortunately for people who need care, have never gone away. That's the interesting thing too, is the abortion underground never went away. That's because ever since Roe was passed the states have passed some 1,300 restrictions on abortion. Nearly 90% of US counties do not have abortion clinics, so again there are many, many people for whom access is so complicated that Roe might as well not be of the law of the land already.

That's the reason that there are more than 90 abortion funds raising money to help people get access to care, along with practical support networks who are doing some of those things your mom told you about. Whether it's driving to an appointment, helping somebody get from one state to another, helping arrange childcare, and in pre-COVID times, lodging. People would let strangers stay with them. I think now people are helping raise funds for hotels, but that network never went away, and it's always been stretched to capacity.

Melissa Harris-Perry: Doctors will potentially play a very particular role here. When we talk about activists, when we talk about abortion funds, for the most part these are not people who can perform surgical abortions. They may be able to send the pills in the mail, but most of the folks we're talking about at this point aren't people who themselves can perform a surgical procedure. Do you have a sense of whether or not there is an underground network of maybe trained midwives and/or a trained network of abortion providers?

By abortion provider here I mean someone who could provide surgical abortions. Who will also purposely resist attempts to curtail abortion by in fact providing them, even risking their own freedom to do so.

Jessica Bruder: In the course of my reporting, I did speak with midwives and activists who knew how to provide what they call a procedural abortion because it's suction-based basically. It's interesting. People in the underground were using this because it is a non-traumatic technology. When they first came out with it they would refer to it as a lunch-hour abortion because people could go back about their business without being just kind of laid out, and there are people doing that.

There are midwives and others teaching the technology. One person I spoke with told me she had bought two manual vacuum aspiration kits on Amazon, where they're no longer available, and told me that they're still available on the internet. If you go on eBay now you'll see them. It's interesting because they are essentially the modern version of the Del-Em.

The Del-Em is an ancestor of this technology. Manual vacuum aspiration kits are used by doctors, it's a medical standard, but in many countries around the world they're used by clinicians and people who are trained but who aren't-- they're essentially lay people.

One doctor I spoke with, Dr. Paul Blumenthal, - he is a professor emeritus at Stanford, a researcher, and a doctor who practices - told me that, "Look, you don't need a fancy degree or a piece of paper to wave around to learn how to do this. This sort of procedure isn't rocket science." I would not be surprised if we saw more of that. I think the pill would get increasingly popular, but there's a small percentage of people for whom there are contraindications with the pill. There are activists who really want to make sure all options remain on the table for as many people as possible.

Melissa Harris-Perry: On the one hand, your point that the internet makes it such that it can't be 1970 again, and part of that maybe is the capacity to get procedural tools from eBay, certainly the other part of it, presumably, is about the capacity for conversation and information to know. Again, and thinking about the things my mom said to me, is that part of the challenge was that many of the women who most needed termination services were also most isolated.

They were often women who had already several young children, who may have been in circumstances of domestic violence, who may not have spoken English as their first language, and it was just tough for them to even find out that these networks existed. As you reported, do you have a sense of how activists are engaging the digital world to ensure that when their services are needed that folks can find out about them?

Jessica Bruder: Yes. There are a bunch of things going on right now. There is a whole legal organization called If/When/How dedicated to self-managed abortion and legal safety and defending people. If you go online there's something called the M+A Hotline, which is out there to help people who are dealing with miscarriages or self-managed abortions. There's just a lot of information getting passed around because it's not illegal to share information. It's just definitely a very, very different world.

There are still many areas of the country, unfortunately, where the internet isn't as prevalent as one would think it would be in 2022, or at least good access to it. The fact that it's there at all, I think, leaves us in a different place than we were in the '70s.

Melissa Harris-Perry: As you are moving forward, I appreciate that we continue to say if Roe falls. [chuckles] It strikes me as a bit of an optimistic tone given that so many folks that I've talked to have said it's going to fall in some way. That it's difficult to imagine this particular court maintaining the core of the rights enumerated in Roe v. Wade. In your reporting, what seems like is next this summer when the decision comes from the Mississippi case?

Jessica Bruder: What's next is for people who can afford to do it or can get people to help support it. I think we're going to see a lot more people moving around. I think we're going to see these networks of people sending and delivering pills ramping up. We know that in Mexico activists are saying they want to help people in the US access pills. One of those pills that is used is misoprostol, and it is available over the counter in Mexico. On label use, it's for treating stomach ulcers. That's one thing that's going to be moving around quite a bit more.

Already states are setting themselves up to be sanctuaries. In California infrastructure is going up. New York is saying that people will be welcome here. People are talking about funding stuff, helping people who are coming in from out of state. I think there's a great reshuffling, and that what some people don't realize is that this will affect blue states as well. This will really affect everybody. Again, if Roe falls, Roe seems at least likely to be gutted if not fall, just like we saw with Texas, which was a dress rehearsal.

In Texas, basically 1 in 10 people who have the capacity to be pregnant, and are at that age, live in Texas. When SB 8 passed it was like a dress rehearsal. There was just this instant diaspora. Neighboring states were bottlenecked. People who usually could have taken the pills or had a much simpler manual vacuum aspiration procedure had to go and have more complicated second-trimester procedures. Then there were people who got stuck in Texas and forced to give birth.

Again, that was one-tenth of the people in the country who had the potential to be in this situation. If we end up multiplying that by even a bit, it's going to be a much bigger situation.

Melissa Harris-Perry: Jessica Bruder is a freelance reporter for The Atlantic, and you can hear about her reporting on the latest episode of The Experiment. Jessica, thank you so much for joining us.

Jessica Bruder: Thank you.

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