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IT’S BEEN NEARLY 50 years since the United States Supreme Court decided Roe v. Wade, the landmark case that protects a woman’s right to abortion. The 1973 ruling didn’t guarantee your abortion access, however; instead, it set up a legal framework that lets states regulate the procedure and timelines—ostensibly in the name of “protecting” your health and the viability of the fetus.

In short, while your choice may be constitutionally protected, in the decades since Roe, anti-choice legislators have chipped away at abortion rights at the state level. Lawmakers also passed the Hyde Amendment in 1976, which prohibits the use of federal funds to pay for abortion, except to save the life of the woman, or in the case of rape or incest. This means Medicaid doesn’t cover most abortions.

And now, things could turn even more dire. Before his election in 2016, Trump declared that women who end their pregnancies should face “some form of punishment” should abortion be outlawed in the U.S. He later recanted on this statement, but his actions continue to speak volumes. Last year, Brett Kavanaugh—alleged sexual assaulter and Trump’s contentious choice for the U.S. Supreme Court—was appointed to the bench, tilting the judicial branch of the government even further right. Kavanaugh replaced Justice Anthony Kennedy, a more moderate judge who often served as an important swing vote on reproductive issues. 

Kavanaugh’s appointment likely means the continued erosion of our reproductive rights at the state level. Worse, Roe v. Wade itself could face possible peril. For example, last year, Iowa passed a so-called “heartbeat bill,” which would make it a crime for physicians to perform an abortion if a fetal heartbeat is detected. An ultrasound can pick up such heartbeats as early as six weeks into a pregnancy—a point at which most women don’t even know they’re pregnant. The ACLU sought and received an emergency injunction to prevent the bill from becoming a law, but anti-abortion activists have said they hope this litigation creates a pathway to challenge Roe

So, what can you do if abortion becomes inaccessible where you live? It’s frightening, but don’t panic. There are alternative means to get the health care you need. Long before Trump, women were creating access routes both within and outside of the medical establishment for gynecological care. Not just for abortion, but also for birth control, pap smears, and other services. In the pre-Roe era, underground networks of women such as the Jane Collective—a Chicago-based group that focused on creating alternatives to unsafe illegal abortions—formed to help women avoid disreputable black market health services. Today, while such networks still exist, there’s also a modernized framework of organizations focused on digital resources and online activism. Read on to learn about all the ways you can hack your reproductive health care, no matter what this administration sends our way.

 

Finding Financial & Travel Help

Abortion remains legal, but in some areas the law is basically a technicality because it’s so damn hard to find a clinic. Several states have only one, including Missouri, Kentucky, and West Virginia. And especially if you live in a rural area, you may need help getting to the closest abortion provider. “Thousands of women in California still find it nearly impossible to act on [their abortion] rights without a struggle,” says Justine Jennings, finance and operations manager for the California-based organization ACCESS Women’s Health Justice, which connects people to clinics through funding and transportation. Access—be it geographical or financial—“is everything,” Jennings says.

ACCESS is just one of many groups that have partnered with the National Network of Abortion Funds, a coalition of 70 chapters fundraising in 39 states to help you get the care you need no matter where you live. For example, if you need an abortion and struggle with the cost, NNAF executive director Yamani Hernandez advises that NNAF will help pay for the procedure and, in some cases, will also partially cover the cost of child care, transportation, and lodging. “People need hotels and homestays, that is pretty much what abortion funds provide,” says Hernandez.

 

Going The DIY Route

If accessing a clinic is out of the question, you may want to take the abortion pill instead. NNAF and other organizations like Planned Parenthood can provide access to and information about self-managed abortions (these are abortions performed outside of a medical setting, typically at home). The most common form of self-managed abortion is RU486—aka the “abortion pill.” Hernandez cautions that it’s “important for people to understand the legal risk” of pill-induced abortions, including laws in Texas, Missouri, Louisiana, Arkansas, Idaho, Utah, and West Virginia that prohibit “telemedicine abortions,” i.e., the remote distribution of abortion pills. Still, she adds that NNAF believes it’s important to educate everyone on their use. “We provide directions on how to use the pills on our website,” she says. 

To legally obtain the abortion pill in the U.S., you need a prescription, and many women are able to get it by visiting Planned Parenthood. But for those unable to get to a clinic there are online options. A quick Google search will result in multiple ads for the pill from internet pharmacies that often ship from India. Some people order them through veterinarians, since the same meds are used to induce abortions in dogs. The pills are also available over-the-counter in Mexico. 

If you are considering a self-managed abortion, however, especially in a state that bans telemedicine, Dena Robinson of the reproductive justice training org If/When/How advises you get legal advice first from a group such as the SIA Legal Team, which specializes in these issues. “Get in touch with attorneys well versed in the criminalization of abortion,” she says. “It’s important for folks to at least understand, minimally, what’s led to other folks being criminalized.” 

For more guidance and support, check out Women Help Women, a Netherlands-based online resource that offers info on self-managed abortions. Or try Women on Waves, an international organization that can  facilitate an abortion if you live someplace where it’s altogether outlawed. The group is famous for its Abortion Ship Campaign, in which early-term medical abortions are performed at sea, free from any country’s laws, but the group also has online tools anyone can use including training manuals, videos, and an app that educates on pills and self-managed abortions. Robinson says she sees such groups as the future of the abortion rights fight. “The [modern] underground network has a different look to it because so many people are able to obtain pills on the internet,” Robinson says.

 

Getting Birth Control & Screenings 

Of course, you have other reproductive health care needs—abortion is only one element. Birth control, STD testing, pap smears, and mammograms are equally important, and too often out of reach. If you rely on Planned Parenthood, that accessibility gap will only widen if the organization, which operates more than 600 health centers nationwide, loses additional federal funding.

There are other ways you can access these crucial services, however. Groups such as Access Women’s Health Justice and the Abortion Care Network supplement Planned Parenthood, providing free and low-cost resources for counseling, birth control, prenatal care, pap smears, infertility treatments, and STD testing. “Some of our clinics provide primarily abortion services and others operate more like an OB/GYN family practice, offering a broader range of services,” says Nikki Madsen, ACN’s executive director. “Because there are so few clinics left, these places provide the majority of abortion and contraceptive care services in their areas. If an abortion provider closes its doors, it’s difficult to open another clinic, so we’re particularly focused on expanding access to contraceptive care,” she says.

If you’re seeking care at an independent clinic, Madsen advises you thoroughly vet the location you’ve selected. “It’s important to make sure it is in fact a real clinic,” she says. “Many anti-abortion fake health centers are located near independent clinics and have purposely chosen very similar names as a way to confuse people.”  A real clinic, she says, “will talk with you openly” about options, prices, and other details. “If you don’t hear a supportive voice or you aren’t given straightforward answers to your questions, call another clinic,” she says.

If travel is out of the question, check the internet for online resources. The NURX app, for example, offers free and low-cost birth control, a critical resource if you’re under 18 and seeking contraceptives without parental consent. Likewise, it can be a vital resource if you live in an area where a pharmacist refuses to dispense birth control or an employer refuses coverage. The app, which operates through a network of legitimate doctors and pharmacists, also sells low-cost HPV-testing kits.
 

Lending a Helping Hand

If you don’t need an abortion and already have access to reproductive health care, now is the time to thank your lucky stars and get to work helping others. It’s crucial we all chip in to help make such services safer and more readily available to everyone in the future.

There are many ways to help, but if you’re feeling creative, try the Abortion Access Hackathon. Shireen Whitaker founded AAH in 2016 so innovators could pitch ideas for tools to address the online harassment of clinics and pro-choice websites. The initial event in Davis, CA, yielded big ideas as tech developers, law students, designers, and healthcare professionals brainstormed digital tools and apps that help prevent internet harassment and improve reproductive care access.

One of its most successful outcomes was #ExposeFakeClinics, a social media campaign designed to uncover “crisis pregnancy centers”—unlicensed, unregulated clinics that  deceive women in an effort to counsel them against getting an abortion. 

The Hackathon’s next event in San Francisco drew hundreds and produced multitudes of ideas, most of them now in the beta stage, including a Siri-like app that will let users tell it the last day of their period—and in return find out how far along a pregnancy is and where to get an abortion. Another app, also still in beta, will streamline the process of vetting volunteers for abortion access providers and pro-choice organizations. Both are expected to be released later this year.

A new Hackathon is in the works, and in the meantime, there are still ways to participate—even if you don’t have an idea to pitch. Do you know a little coding or simple HTML? Are you a whiz at social media? Volunteer time, skills, and other resources to do something as simple as setting up a clinic’s website or helping with their social media. “There’s a digital divide with organizations that are stretched too thin,” Whitaker says. “Tech could solve so many problems. People are organizing on social media and on Facebook,” she says, adding that in a post-Roe world, these sites could help educate and protect the legally vulnerable.

Speaking of being legally vulnerable, if you’re organizing for abortion access, it's advisable to bypass texting and email. Instead, Whitaker recommends encrypted messaging apps such as Signal. “Activists at Standing Rock used Signal to communicate without interference ,” she says. 

Whatever your mission,  remember that the internet is forever, so post wisely. “Not leaving an electronic trail when researching or obtaining an abortion isn’t just something for a person to consider once abortion is illegal,” writes Robin Marty, author of Handbook for a Post-Roe America. “For a significant number of pregnant people, even obtaining a legal abortion is something they would like to keep as private as possible, and they may prefer not to have a partner, friends, or family members know about the pregnancy or procedure.” Marty suggests using an encrypted cell phone instead of a computer as a primary research and communication tool and removing personal information (such as your home address) from public databases whenever possible.

But if privacy concerns are not an issue for you, you may want to use social media for activism and education. For example, Lindy West’s #ShoutYourAbortion social media campaign used Twitter as a way to digitally curate experiences around abortion and highlight real stories at the center of the debate. Launched in 2015 in the wake of cuts to Planned Parenthood funding, the campaign has since grown into a powerful online fundraising tool (shoutyourabortion.com) and a book by the same name.

Similarly, Andrea Grimes partnered her favorite snacks with a hashtag to raise money for abortion funds.  Grimes tweeted to her followers, inviting them to take part in her #TacoOrBeerChallenge. To participate, people filmed themselves eating a taco or drinking a beer (or both) and then donating to an abortion fund. “I made a video and said, ‘Here’s me eating tacos, drinking beer, and donating to abortion funds,’” she says. “Then it just snowballed.” That first year, supporters raised over $30,000 via the campaign. The fundraiser is now hosted annually by the National Network of Abortion Funds.

If the concept of starting your own activist campaign seems overwhelming, Grimes advises you to start small. “Take your lead from the grassroots organizers already on the ground. Find your local abortion fund and plug yourself in where you can—chances are, they’re hosting volunteer trainings, happy hours, and other events in your community,” she says. “Ask what they need most and help make it happen.”  

 

 

By Rachel Leibrock
Illustrated by Lan Truong

 

This article originally appeared in the March/April 2019 print edition of BUST Magazine. Subscribe today!

 

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