Stop It With The Fucking Coat Hangers

It's 2021. We need to educate ourselves and spread the word about safe self-managed abortion with pills.

September 01, 2021

UPDATE, MIDNIGHT 9/2/2021: The Supreme Court has allowed Texas’ unprecedented abortion ban and get-rich-quick scheme for anti-abortion creeps to go into effect.

Consider everything I wrote below to be approximately nine-thousand times as emphasized, with bells on and yelling in the alley outside your house.

Last night, the Supreme Court could have stopped Texas’ unprecedented abortion ban from going into effect. The Court could at least have allowed the abortion providers and abortion funders who are suing to block the ban to have a single fucking day in court.

(Shout out to the pundits who told us we were being hysterical when we said Trump’s SCOTUS appointees — a rapist and a right-wing religious zealot — would work to repeal abortion access by any means necessary. I certainly feel hysterical now, assholes.)

As of this morning in Texas, it is illegal to provide abortion care to anyone who is more than six weeks pregnant, and illegal to support access to abortion care for anyone who is more than six weeks pregnant.

The enforcement of this law rests not with the state, but with just any random motherfucker anywhere. If you think your neighbor or a Lyft driver or a doctor or a school counselor or a pastor or a clerk at the 7-Eleven helped somebody get an abortion after six weeks, the State of Texas is officially encouraging you to sue for civil damages and take home a $10,000 reward for your efforts. You don’t even have to live in Texas to collect your vigilante abortion bounty.

The anti-abortion lobbyists behind this law (who absolutely live to claim that there is a money-grubbing “abortion industry” out there doing Scrooge McDuck-style-dives into fetus-funded piles of blood money) have set up a convenient website for any random motherfucker to use if they’d like to get started earning cash today by reporting people they suspect of providing or supporting abortion care.

It is craven. It is devastating.

I don’t know if we can rely on the courts to set this right. I have been covering reproductive health, rights, and justice in Texas for over a decade. I’ve spent most of my career thinking and writing about abortion access. I genuinely believed that this case would get at least — at the very least — a hearing before it was allowed to go into effect.

So here’s what we do now.

We stop the fear-mongering around coat hangers and instead share good information about medically safe self-managed abortion care with pills.

When abortion is banned after six weeks, clinical care is effectively put out of reach for the vast majority of people seeking abortion. Pregnant people who do not want to be pregnant and who cannot access clinical care will be looking for answers and solutions. Imagine trying to figure out how you’re going to get un-pregnant and just running into news story after news story implying that there are only bloody and violent options for terminating pregnancy. That’s not useful. It’s terrifying, it operates in service of tragedy porn, and it doesn’t set people up to make the best decisions for themselves. We must stop illustrating our hot takes and our news stories with coat hanger images, and everyone needs to know that there are pregnancy termination options that don’t involve self-harm. Focusing on self-managed abortion as something fundamentally dangerous, physically risky, and even deadly, does not serve people who need abortion care when clinical access is out of reach. Renee Bracey Sherman laid this the fuck out for us years ago.

(Important semantic note: When I say “self-managed abortion,” I’m not talking about tele-health, wherein a person gets a prescription or treatment from a remote medical or clinical provider and takes pills at home later. I am talking about abortion care that occurs outside of the parameters of traditional clinical provision, and which likely carries with it some legal risk. Not all self-managed abortion happens with pills, but pills are proven to be safe and effective, and the pills one might obtain to self-manage their abortion from an international pharmacy or overseas doctor are the very same medications that would be prescribed or provided domestically by a doctor or other medical provider.)

There are two common, medically proven ways to end a pregnancy using medication. There’s the two-medicine regimen usually prescribed by physicians in the United States, using a combination of mifepristone and misoprostol. It’s also possible (though a little less effective) to induce abortion using misoprostol only.

Four years ago, I produced an episode of Traitor Radio (transcript here) that tells the story of two abortion activists who support people who aren’t able to access clinical care. The second half of that episode details the World Health Organization’s protocols for inducing abortion using misoprostol only, which is available over the counter in Mexico and Canada (among other locales) without a prescription. I suggest you give it a listen.

There are a number of resources that exist to help people make the decisions that are right for them when it comes to self-managed abortion. You should familiarize yourself with all of these and share them with your communities so that everyone knows there are safe, proven options for ending pregnancy outside of a clinical setting without self-harm:

We educate ourselves on the legal risks around self-managed abortion and the criminalization of pregnancy outcomes.

Self-managed abortion with medication is physically safe and medically proven to be effective. However, there are legal risks — nationwide, not just in Texas or in “red” states — for people who self-manage their care and for people who help others self-manage their care. Politically motivated prosecutors, cops, and even medical providers have already targeted hundreds and maybe even thousands of people they suspect of self-managing their own abortions, or helping someone else do so.

Why don’t we know exactly how many people have been targeted in this way? Because in practice, these attacks can look a bunch of different ways. It doesn’t just mean someone might be charged with ordering pills online. Self-managed abortion isn’t even technically illegal in most states. But that doesn’t stop the cops. People can be charged with concealment of a birth, or doing harm to a fetus, or even abuse of a child. A prosecution doesn’t have to end up in a conviction to destroy someone’s life. Becoming embroiled in the criminal or civil legal system because of your private reproductive health decision can be costly and even dangerous — especially if it involves being forced to interact with police.

Rafa Kidvai, my friend and the director of If/When/How’s Repro Legal Defense Fund, which funds bail and defenses for people who are criminalized for self-managed abortion, lays it out pretty clearly here:

Criminalizing self-managed abortion does not improve public health or safety. It dissuades people from seeking health care, and may make medical providers believe they’re legally required to report cases of suspected self-managed abortion. (They’re not.)

It also puts those with the fewest resources, who are most likely to suffer at the hands of racist police and state violence, at the highest risk. It further traumatizes and creates cascades of harm for Black, Indigenous, and other people of color, women, people with disabilities, survivors of intimate partner violence and other forms of abuse, queer and trans folks, and those experiencing poverty.

If/When/How (full disclosure: I worked there until a couple of weeks ago! I am a big fucking fan of this organization!) provides what I believe are the two best legal resources available for people who need information and support around their legal rights and self-managed abortion:

  • Repro Legal Helpline, an online and phone resource staffed by advocates and attorneys who can provide legal information, advice, and referrals for people who fear they may be, or who have been, targeted by police or prosecutors for self-managed abortion.

  • Repro Legal Defense Fund, which provides bail and covers strong defenses for people who are arrested, policed, prosecuted, or otherwise embroiled in the court system for self-managing abortion or helping someone else do so.

We stop conflating the concepts of “safe” and “legal” when it comes to abortion care. (And, really, anything else.)

Abortion care needn’t be “legal” to be safe. And abortion care that is “illegal” is not necessarily unsafe. When we conflate “safe” with “legal,” — by saying, for example, that “your donation to Planned Parenthood helps protect safe, legal abortion” — we perpetuate a white supremacist, capitalist, patriarchal legal system that was built to serve the most privileged among us. We also imply that an often racist, fatphobic, trans- and queer-phobic clinical medical establishment is the only possible source of safe reproductive health care. We are saying that we will let the state determine what is good and safe for us, even when the state itself is the one saying: go collect a $10,000 bounty for reporting your neighbor’s abortion.

Conflating “safe” with “legal” also obfuscates a grim reality: there are a lot of things we do that are technically legal, even state-sanctioned and state-encouraged, but absolutely, fundamentally, irreparably abhorrent and harmful. Police violence and brutality. Incursions on voting rights. The motherfucking war on drugs.

The idea that things that are illegal are necessarily unsafe, or bad, or dangerous? Is the fundamental underpinning of our racist criminal punishment system and mass incarceration industry, and serves as a convenient stop to any inquiry about whether things that are illegal should be illegal, or whether someone who has done something “illegal” deserves to be treated as a human once or ever again.

We support the on-the-ground organizations and activists on the front lines of the fight to preserve abortion access of all kinds.

The Texas abortion providers, funders, and activists who are on the front lines of the fight against this new law need your time and your money.

And make sure you’re getting your information and action items from people who know Texas best: the journalists and activists on the ground.

(If you have recommendations for folks I’ve accidentally left out of this post, please holler at me and I’ll make sure to issue an update.)

Everything feels very hard and fucked up right now. But we can still support each other; we can only support each other. Let’s try to do that the best we can by sharing good information about safe self-managed abortion, without fear-mongering about self-harm, and making sure folks know there are strong legal advocates out there ready to provide support. Let’s make sure our resources are going to the people who know best how to defend us and fight back.

- Andrea