A Los Angeles mother of six, Carol Downer, is planning a January tour to 70 feminist centers across the country where she will teach women to perform abortions by using a kit made from ordinary items such as plastic tubing and canning jars.
In Chicago, women are talking about reviving an illegal abortion service called “Jane” which performed 11,000 abortions in the years before the Supreme Court legalized the procedure.
A Baltimore Quaker women’s group is compiling a list of people willing to assist in an underground railroad that would transport women from states where abortion is restricted to states where it is more easily accessible.
These developments suggest that, while the majority of pro-choice advocates are still dedicated to keeping abortion legal, part of the population has a new strategy.
If Roe vs. Wade is overturned or further compromised, a coalition of religious activists, midwives, feminist health-care workers and others intends to take abortion underground.
“We’re tired of men in federal and state government having control over women’s bodies. We want to take control ourselves,” said Mary Ellen McNish, associate executive director of Planned Parenthood of Maryland, and an organizer of the Quaker underground railroad.
The underground movement began to take shape in the months after the Supreme Court’s July 3 Webster decision, which was interpreted as giving states the right to limit access to abortions. Independently, several groups came to the conclusion that they would help women obtain abortions whether or not it was legal and whether or not doctors were willing to perform the procedure.
The Quaker approach is to revive a concept from the days of slavery when Quakers and others operated “safe houses” for slaves escaping to the North. They plan to spirit women from states like Pennsylvania where a new law bans abortions after the 24th week of pregnancy to more liberal states like New York. Quakers may also be getting help in their project from the Unitarian Universalist Assn. whose president, William Schulz, recently said Unitarians would be “eager” to help transport women in the name of freedom of choice.
However, the bulk of underground activity is not in transportation. Most activists are working to free women from dependence on the medical profession by teaching alternative abortion techniques that can be performed by lay people. Among the possible methods are ancient herbal potions that trigger abortion, the French abortion pill RU 486 that might be available in this country in a few years, and a technique called menstrual extraction, which was invented by a San Diego elementary school teacher, Lorraine Rothman, in 1971.
Menstrual extraction involves suctioning the contents of the uterus. The technique should not be tried as a do-it-yourself operation, but is best performed by groups of women who have been trained in the method, Rothman said.
Underground sympathizers are dividing their time between promoting alternatives such as menstrual extraction and marching in pro-choice rallies. While preparing to go underground, they haven’t given up on mainstream victory.
Rachel Atkins, spokeswoman for the Vermont Women’s Health Center, expressed a common sentiment when she said, “I think it’s important that we don’t give up the battle for legal abortion. But, I think we also have to be prepared and aware and strategizing for a worst-case scenario.”
Added Charlotte Taft, director of the Routh Street Women’s Clinic in Dallas: “This is a good time to do the planning, before we see laws that make it impossible to even talk about abortion.”
Taft and others believe that if alternatives to medical abortion are widely available, there is less chance restrictive legislation will be passed.
“It’s an intelligent public relations ploy,” said Peg Yorkin, West Coast chief of the Fund for the Feminist Majority. “It’s saying, ‘Listen, fellows, we’ve got these alternatives and we’ll use them.’ ”
Some believe the potential for a successful underground abortion movement is greater now than it was in the years before the 1973 Roe vs. Wade decision, which legalized abortion.
“There would be a lot more women involved this time around,” said Jody Howard, one of the original members of the “Jane” abortion network. “The medical mystique (surrounding abortion) has broken down. Now women realize they can help each other this way.”
While an underground movement would be facilitated by a wider range of support in the 1990s, Howard said, it would be hampered by aggressive anti-abortion forces that did not exist in the late ‘60s and early ‘70s.
Indeed, Andy Scholberg, assistant director of the Pro-Life Action League, is confident anti-abortionists could “crack” any underground system that developed. “They (the illegal abortionists) would always have to be wondering: ‘Is this woman a plant?’ ” he said.
Undeterred by the threat of infiltration by anti-abortion spies, some midwives are already talking about the possibility of offering their services in the event abortion is outlawed, according to Susan Bartlett, a certified midwife in New Hampshire and owner of Concord Midwifery Services.
“Personally, I would not be opposed to learning the (abortion) technique,” she said. “For centuries midwives have been involved in women’s reproductive freedom. When there was an unwanted pregnancy, midwives and herbalists have always been there with ergot, or blue or black cohosh (natural substances that are thought to help induce abortion).”
Aside from midwives and other health-care workers who might learn to perform abortions, an underground movement would require the participation of large numbers of lay abortionists, activists say.
Taft, of Dallas, believes this is not a far-fetched possibility. In fact, she envisions home abortion techniques someday being taught as widely as CPR. The analogy to the lifesaving technique is not metaphorical, she said, adding, “We know what happens with illegal abortions. Women die and lives are destroyed.”
Some pro-choice supporters who recall the carnage resulting from botched back-alley abortions in the pre-Roe vs. Wade era argue that teaching lay people to perform abortions will only put women’s lives in danger again.
“It’s foolish to even use an ounce of energy on that option,” said Bill Baird, citing the hazards of non-medically supervised abortions. Baird, founder of the Pro-Choice Defense League, ran an illegal clinic with New York physicians before abortion was legalized.
While acknowledging that there are risks in taking abortion out of the medical arena, advocates of other alternatives say technological advances make an underground system safer now than it was in the days before Roe vs. Wade.
“It (abortion) is a much simpler procedure now than when Jane was in operation,” said former Jane member Howard.
The Jane group learned to perform dilation and curettage abortions by sitting in on sessions with a male abortionist who billed himself as a medical doctor, according to Jane members. When the women discovered the man was not a physician, they decided to continue doing the procedure themselves.
Because there was no over-the-counter early pregnancy testing at that time, Jane tended to perform abortions at 12 or more weeks, which pose the most risk of complications.
Even under those conditions, though, Jane members say their infection rate was about 3%, the same as that reported by physicians. They say none of their clients died as a result of the illegally performed procedure. (Seven Jane workers were arrested in connection with their activities in 1972, but charges against them were dropped when the Supreme Court legalized abortion.)
Now, Howard said, women are alerted to pregnancies earlier, making abortion a safer option.
Howard and other former Jane members have been in demand in the Chicago women’s community in recent months as enthusiasm builds for reviving a system like Jane. “I’ve heard lots of people talking about it and have heard there are doctors who are willing to teach women to do it,” Howard said. “I think it’s really important to stress the differences in technique between now and 20 years ago.”
Also changing the stakes this time around is the availability of the menstrual extraction method.
Since its invention in 1971, the product has been tested by more than 10,000 women in the United States and by hundreds of thousands worldwide, said Downer, who is founder of the Federation of Feminist Health Centers, a Los Angeles-based organization that operates 20 women’s clinics nationwide. And, to her knowledge, there have been no instances of uterine perforation and about a dozen cases of infection, the same incidence as with medical abortions.
But the Planned Parenthood Federation of America does not recommend it. “Every time you invade the uterine cavity, there’s a likelihood of infection,” said Dr. Louise Tyrer, a New York obstetrician and medical affairs vice president for the federation.
However, Dr. Keith Russell of USC, a former president of the American College of Obstetricians and Gynecologists and a pro-choice advocate, said menstrual extraction “is not a way-out procedure. It’s very common in developing countries.”
But, he warned, “it’s not as easy to do as its proponents would have you believe.”
Even Downer warns against careless use of the procedure, calling it “a safety net,” not a first-choice weapon in the abortion battle.
Underground organizers are not banking only on menstrual extraction to get them through a possible crisis, however.
An Orlando, Fla., women’s group has placed ads in feminist newspapers saying they are compiling a book of “ways to achieve the end of a pregnancy at home with another woman’s help or alone.”
Charlotte Taft is planning an international conference for 1990 that will explore alternative means of abortion.
And still other underground advocates are putting their hopes in the eventual availability of the French abortion pill, RU 486, in this country.
A pill that dissolves the fetal tissue safely within the first eight weeks after conception, RU 486 was put on the French market just over a year ago. Since then, the pill has been clinically administered to 30,000 women in combination with a prostaglandin agent, and has proved effective in 96% of cases.
Members of the medical community here believe that, although RU 486 has not been presented for approval to the U.S. Food and Drug Administration, it may be available in this country within three years. “If it’s not here legally, then it will be here on the black market,” said Russell, whose USC colleagues are testing the pill.
Downer, of the Federation of Feminist Women’s Health Centers, said her organization would distribute the pill if it were available on the black market, but only to clients who agreed to clinical supervision.
Some pro-choice women feel it’s a strategic mistake to even talk about underground options at this point.
“To think we can do it (perform abortions) ourselves is to acknowledge our lack of power in the political arena,” said Mary Jean Collins, spokeswoman for Catholics for a Free Choice. “We shouldn’t let the system off the hook.”
Others see going underground as a temporary, emergency measure that might be necessary until the right to abortion ultimately can be won in the courts.
And some believe that, no matter what happens politically, women need to wrest abortion from the control of male doctors and legislators and learn techniques that will put the procedure permanently in the domain of women.
“I don’t believe victory lies in begging male legislators to give us something that nobody can give or take away if we handle it ourselves,” said Charlotte Taft.
“I’m not interested in protecting something (the right to abortion) that can come and go every year,” she added. “‘I don’t think that’s winning.”