Ep. 34: Self-Managed Abortion with Abortion Pills

LaKia Williams19min

LaKia Williams

00:01

Welcome to Black Feminist Rants where we center conversations on reproductive justice and activism. I'm your host LaKia Williams and let's begin. Welcome back to another episode of Black Feminist Rants. In this episode, we're going to be talking about self-managed abortion with abortion pills. Now, if you've been paying attention anywhere since Roe v Wade was overturned, you know that everyone has been talking about self-managed abortion, abortion pills and even more specifically mifepristone and misoprostol. And that is exactly what I'm going to be talking about in today's episode, which is brought to you by the SMA Fest or the Self-Managed Abortion Fest, which is a week of information sharing and stigma busting all about self-managed abortion, which is hosted by URGE, the Unite for Reproductive and Gender Equity organization. So getting right into it, what is self-managed abortion? A self-managed abortion is simply an abortion that someone obtains outside of the formal healthcare system. So "self-managed abortion" is an umbrella term that encompasses different methods of abortion. Typical methods of self-managed abortion include medication abortion aka abortion pills, which we're going to talk about in this episode, as well as herbal abortion and abortion with plants. Now, for the purpose of this episode, I'm going to talk specifically about abortion pills. And I will use the terms "medication abortion" and "abortion pills" interchangeably, but I'll focus more on the term "abortion pills" because people tend to be more familiar with that term rather than medication abortion. Now while I will be talking specifically about abortion pills in this episode, they are not the only method people can use to self-manage their abortion. As abortion pills and self-managed abortion have become more popular in mainstream discourse, self-managed abortion and abortion pills have been used synonymously, which is not the case. SMA or self-managed abortion is an umbrella term used to group together the different methods of abortion that can be used outside of the formalized healthcare system. However, it is important to distinguish self-managed abortion from abortion pills, because equating the two as one and the same erases the ancestral practice of using herbs and plants to terminate a pregnancy. As we center abortion access within the larger reproductive justice movement, it is important to interrogate inclinations to prioritize westernized medicine over the practice of our ancestors. By asserting medication abortion or abortion pills as the only self-managed abortion option, or the main self-managed abortion option, we are implicitly asserting that medication abortion is superior to other methods, which is a historical theme of westernized medicine to infantilize and discard the practice of indigenous people in order to assert their own westernized practices. So while this episode will not focus on abortions with herbs and plants, it is paramount that we do not forget them in discussions of self-managed abortion, and to not frame them as tangental to abortion pills. Because again, they are a necessary component of people having access to the full spectrum of care, although abortion pills are great, and I'm going to get into them a little bit later. And not everybody is going to have access to them. And that's why it's important that people have as many options as they possibly can. And if we only talk about one of the options within self -managed abortion, then people aren't going to have the information that they need to make the healthcare decisions that are available to them. So I've mentioned abortion pills many times. So what are abortion pills and how do they work? According to the World Health Organization, medication abortion or abortion pills is a multi step process involving two medications mifepristone and misoprostol, or a multi dose of misoprostol alone. Mifepristone and misoprostol are both FDA approved to end a pregnancy. Now I bring up FDA approval because there's a lot of rhetoric around self-managed abortion and abortion pills being unsafe, but those claims are false. Medication abortion is safe and effective and has been used for 34 years to end a pregnancy. So there are two methods to use pills to have an abortion. The more common method is to use two drugs mifepristone and misoprostol. Using mifepristone and misoprostol together is 95 to 98% effective and super common and will typically be available at most clinics that provide abortion care. The other method to have an abortion with pills is to use the misoprostol pill alone. Now, this method is a little less effective, but it is the more common method across the globe. Misoprostol outside of the US is really low cost and typically more accessible. You don't need a prescription. You can get it over the counter, so many people will use the misoprostol method versus mifepristone and misoprostol method. So now that we've talked a little bit about what abortion pills are, let's talk about why there has been this rallying cry around abortion pills specifically since Roe was overturned. As you can probably tell abortion pills allow people to have full control over the bodies and the termination of their pregnancy. Abortion pills allow for people to obtain their abortion in privacy, which is really important considering the stigma that exists around abortion. We've all seen or heard antis standing outside of Planned Parenthood's and independent clinics harassing people who are seeking care, whether that's abortion care or just reproductive health care, which is a very unpleasant experience for many people and can be traumatizing, which is even more of a reason for abortion pills to be more readily available

LaKia Williams

04:57

because people deserve to experience care in safe and peaceful environments. And since our governments don't ensure that abortion seekers can have that in clinics, we will take that into our own hands. So this isn't really the topic of this episode, but we need abortion pills over the counter, we need people to be able to go into clinics, get their pills from Walgreens, walk home, and take care of themselves, especially since they're going to be harassed if they go into the clinic. Now, that doesn't mean that we don't need in-clinic care, we need abortion providers, abortion providers are part of our community and keep us safe. But for people who don't need to go in-clinic to have an abortion need to have that option at home, and then people who begin their abortion at home or may need to go into clinic, if they have questions, if they have complications, while complications aren't common, they could arise and it's great to have that resource on hand. So this is not advocating for us to get rid of abortion providers or in-clinic abortions. Some people might want to have their abortion in the clinic and have anesthesia. And you know, abortions come with a lot of pain. So they might want to have the abortion in the clinic and not go through the process of the removal at home that may take couple of hours or even longer than that. So definitely have abortions over the counter but not advocating for us to not have abortion providers. Also, y'all know me, y'all know I want to be an abortion provider, so I'm not going to talk my way out of a job. But we definitely need to have people having more onus, more power over their decisions and not have to always go through the healthcare system, if it's not practical or necessary for them. So that was my little tangent but back on the topic at hand, another benefit of self-managing an abortion with abortion pills is it can be cheaper than in clinic abortions, which may come with Doctor fees, which is also not covered by insurance. And it's also a simpler process of having your support system and or abortion doula with you as you go through the process if you're at home, in-clinics might have restrictions on how many people can come in if people can come in. We know since COVID, that has been greatly reduced. I'm not even sure what it looked like pre COVID. But I'm sure it's reduced since COVID. Now, again, in-clinic abortions are great and are necessary as an option to ensure that people have all the options available to them. But with the de-emphasis on community in westernized medicine, the process can feel isolating and lonely, whereas with self-managed abortion, someone can create the environment and the community that they wish as they pass a pregnancy. So again, so much love for abortion providers and any critiques ofwesternized medicine and in-clinic abortions is really coming from the institution of medicine that has been institutionalized and not even in this country. But in the West in the globe, I would say, and abortion providers, of course, have to abide by the systems that they work within, especially if you want to keep their license and whatnot. So not critiquing abortion providers at all. They do what they can with the systems that they are given to support us. But being very critical of the way that medicine has been. Medicine as a system has been an agent of capitalism to prioritize wealth over people's health. I just had an epiphany. When people say health is wealth, they don't mean "Oh, invest in your health, it is wealth." They mean if you invest in the healthcare system, you will be rich because we prioritize money over people's lives and their health. Y'all this world is sick, literally. Oh my God, I need to get in the studio because I'm finna, I'm finna be rapping. So back to the topic at hand again, we've talked about what self-managed abortion is, what abortion pills are, the benefits of using pills to end a pregnancy.

LaKia Williams

08:20

So let's talk about ways to support someone as they are self-managing their abortion. So one of my faves is the Miscarriage and Abortion Hotline. If you didn't know, I'm the Social Media Manager for the Hotline, so if you go follow us on Instagram, that's all me posting on there, you know, follow us, you may get a follow back. I'm kidding, we're team follow back. But the Miscarriage and Abortion Hotline is an amazing resource for people who are self-managing their abortion or are experiencing a miscarriage. So the hotline is made up of pro-abortion licensed health care providers who have expertise in providing abortion care. The hotline is available in English and Spanish and the phone number and website will be listed in the Episode Notes below. But I can just say from the back end, one reason I really love the Miscarriage and Abortion Hotline, one because it's an amazing service, right? Like that's what we need, but also just seeing the thoughtfulness that the providers put into responding to people who are, you know, abortion seekers or abortion havers who have questions. I can also say from what I've seen, the abortion providers that support the Miscarriage and Abortion Hotline, yes, they have their clinical expertise, but they also see abortion as a form of liberation. And so they come into their practice with that type of care, which I think is really important for people to have, especially in general, but especially in this moment where abortion is so stigmatized. We're seeing so many attacks on the political level. We're seeing so many attacks, honestly on every level, to have people who are providing your care or who are supporting you through your care to have their politic being aligned with your politic or even if you don't have a politic having someone who maybe you're not sure about your abortion, maybe you have doubts about it. Maybe you have some shame around it because we live in a shameful society having someone who supports you and providing you care, who's letting you know that you don't need to feel shame that you shouldn't feel any shame, that they understand why you feel that shame. But that's not for you to hold. I feel like that's so important, that's so impactful. And I love that the abortion hotline is staffed by people who come from that space of not only supporting people because that's their clinical practice, but supporting people because of the love for people. So shout out to the Miscarriage and Abortion Hotline. So if you or someone you know is having an abortion or having a miscarriage and you have questions, you think something may have gone amiss, or you just, it's your first time and you have questions, definitely contact them, and they will be able to support you. Another resource for people who are seeking an abortion is If/When/How's Repro Legal Helpline, so I haven't mentioned this much, but criminalization is a very big risk, especially now with abortion care, and even more so with self-managed abortion. So we know that the people who are going to be criminalized are Black and brown people, queer and trans people, people who are already overpoliced in their communities. And as states continue to roll back abortion access and try to control people's access to health care, people are going to do what they need for themselves, right. And so what the state is going to do, and what it has already begun to do is to criminalize people, and the state has always found ways to criminalize the most marginalized people. And abortion is just another way for them to do that. So when we talk about self-managed abortion and having an abortion at home, it is so important for you to be aware of the risks of criminalization. People before Roe has fallen, people have been criminalized and arrested. And since Roe, it has only skyrocketed. So the risk of criminalization is very real, whether it's a miscarriage, whether it's an abortion, and we've definitely seen this attack on pregnancy, in general, and then even more specifically on abortion care. So that's why If/When/How is a really great resource to help kind of navigate you through any potential risks that you may be presented with or you may foresee. Another thing that I want to add that I actually learned from If/When/How was that when we think about criminalization, we often think, oh, specifically in this moment, Meta, Facebook, Google these like digital conglomerates that could be incriminating us with the data that they have. Now, while that may be a real risk, I can't really speak too much to that. Something that I learned from If/When/How is that

LaKia Williams

12:15

the one large risk to being criminalized is actually healthcare providers, and healthcare providers not being sure about the fact that they don't have to report someone as potentially having an abortion. So it's really unfortunate that someone could self-manage their abortion at home, they could have a question, they could have a complication or for some reason, they decide to seek out professional care from a healthcare provider. And then the healthcare provider could either be told, hey, you know, I had an abortion at home, or they could just assume that you had an abortion, and they could report you. And then that could lead to your criminalization. So again, I've talked about how much I love abortion providers, and how necessary they are to our community. Now, abortion providers who are in the movement are aware of this, they're not gonna, they're very unlikely to report you. But if we just go to the ER, like, those people aren't in repro, they're not in the movement, they don't have, they may not have this, I'm not gonna speak to their knowledge, but they may not have this frame of knowledge or come from the space that repro providers who are working in the space come from, and they may not be acting maliciously, they may not know, they may think they have to report, you know. That is a real risk, so I just say that so that you're aware, if you're ever seeking expert healthcare advice, specifically in the ER after having an abortion, not to discourage you, not telling you what to do, or what you shouldn't do. But I think it's important that people know what could happen. So that if this does arise, you know, you know all the information so you can make decisions that are best for you. So that was a really great thing that I learned, because I didn't know that. And then another risk of criminalization is just people that you know, so if you disclose to someone they could potentially report you. Now that one was, it's really hard to wrap my head around. I don't know if it's because of my friends are all in repro. And like, I couldn't even imagine them doing that. But yeah, you could tell someone, and they could tell someone and maybe that person I don't know, could report it. So that's what happens when you live in a stigmatized society. People report on each other, which is so sad because we talk about abortion as being community care, and you know how to build systems of support around yourself as you're having an abortion but then also being mindful that the people around you can also be a threat of risk. So it's like telling you to pull in community but also to fear community at the same time, which feels really gross to say, but that is another risk to being criminalized. But if you're not someone who would report a friend or someone you know, or a friend of a friend or having an abortion, I want to talk a little bit about the way you can get involved in supporting people access abortion care and supporting people through their abortions. And just you know how to be a support system, even though I just said everything I just said about the potential risk of criminalization. So again, we've talked about what self-managed abortion is, what abortion pills are, the benefits of abortion pills. Now let's talk about how you can support the fight for abortion access and support the people in your community. One of the first things that come to mind when talking about supporting abortion access and supporting abortion havers is becoming an abortion doula. For those of you who don't know what a doula in general is, a doula is typically assumed to be a birthing doula. However, there are abortion doulas, as well as death doulas, as well as many other types of doulas. So typically a doula will provide emotional support for a birthing person as well as serve as an advocate for the birthing person during labor. So that can look like if you have a birthing plan and you really want the labor process to look a certain way. You know, while you're giving birth, you might not be in the best mindspace to advocate for yourself. The abortion doula will know your wishes and can advocate on your behalf to the health care staff. Abortion doulas, however, provide emotional and practical support to someone having an abortion especially a self-managed abortion. Abortion doulas will typically answer questions about the abortion process, provide emotional and mental support to the abortion haver, they can coordinate childcare, and just make sure that the abortion haver is feeling supported and has everything that they need, from material needs to educational needs and just knowing about the process. So becoming an abortion doula is a great option to supporting abortion access because it highlights the community aspect of our reproductive lives, whether that is pregnancy, childbirth, abortion or bereavement. Unfortunately, because of colonization, we now live in isolated, individualistic societies that have deprioritized community care, but by becoming an abortion doula, you can honor the tradition of centering community by supporting abortion havers in your community, and ensuring that they have a support system during the abortion process.

LaKia Williams

16:51

Also, on a personal note, I'm hoping to start my abortion doula training soon. I don't have a specific date, but I've been thinking about it for a while. So it's something I really want to get into. So if you're also thinking about it and you wanna connects and, you know, kind of be in community as we're, you know, virtually in community as we're getting our abortion doula training, let me know or if you've already done the training, and you have advice, or you just want to be a resource, let me know as well. But another great way to support abortion access is ensuring that you and the people you know are well educated on the abortion process, so that you can support people. So that can look like being an abortion doula, but it doesn't have to be. There are likely to be people in our lives who self-manage their abortion, who may need support, who aren't necessarily an abortion doula client. That's why attending a self-managed abortion info share, or a self-managed abortion buddy training is important for everyone. Because again, we really need to, we really should be moving towards centering community in our healthcare. And one way to do that is ensuring that when people are going through different medical procedures, whether that's in the clinic, or by themselves, they have a community of support who understands the process. And because abortion is so stigmatized, there has been little education until recently about the process about what it is. Many people don't even know how an abortion works, what it is, the process. And just by having that knowledge, you can support someone as you're going through that process at a later date. So that is all I have for this episode. Thank you all so much for listening. If you have other things within the abortion conversation that you'd like me to talk about, please let me know. I'll leave a little, if you're listening on Spotify, there's like a comment section that I can add. So I'll add that on Spotify. So if you're not listening on Spotify, and you want to leave a comment, you can just go into Spotify and just like put the comment there or, you know, DM me on Instagram or leave a comment under this episode post on Instagram or whatever. Reach out to me some way and let me know what you want to talk about. I should put- Oh y'all so the website is updated. Go check out the BFR website. Me and and Annaya worked really hard updating it. Annaya found a great template. If you don't know Annaya is a production assistant from Spelman. But yeah, check out the website if you want to be a guest speaker, there's a form for that. If you want to sponsor BFR like URGE sponsored this episode, you can go to the website and fill that out. Yeah, thank y'all so much for listening to this episode. If you'd like to learn more about self-managed abortion, you can go to URGE, Unite for Reproductive and Gender Equity, their website and find some more great resources and some more self-managed abortion info shares. And yeah until next time, thank y'all so much for tuning in and for all your support.

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