IIn the run-up and year following the US Supreme Court’s reversal of Roe v Wade in June 2022, a narrative of return emerged: that abortion in states where it was suddenly banned would return to the underground. It would be a return to 1972, when diffuse, partly anonymous groups such as the Jane Collective, a secret network of abortion providers in Chicago, immortalized in the documentary The Janes and in a feature film starring Elizabeth Banks, legalized reproductive health care in its own right names.
In reality, the end of Roe did not so much return the US to the pre-1973 landscape of unsafe abortions, but to a bleak and unprecedented one future of criminalized pregnancy. And by the way, the abortion underground never disappeared under Roe. Quite the contrary – in a new book, feminist historian, critic and poet Angela Hume draws on dozens of interviews with former unlicensed abortion providers, community clinic workers and volunteer clinic advocates who made up the vibrant, multifaceted and undersung group. radical side of the abortion movement.
Deep Care: the Radical Activists Who Provided Abortions, Defied the Law and Fought to Keep Clinics Open is, in part, an oral history of the loose collective of activists and clinicians who orbited a single feminist clinic in Oakland, California, for three decades. It is partly a collage of organizational tactics, art and poetry, the creative side of political consciousness. And it is, in part, a roadmap for how small-group, community-based, intersectional care can be practiced, inside and outside the law and often against extreme hostility, even while Roe was technically on the agenda.
“This is a story of revolutionary deep care,” Hume writes in the foreword. “Community care that transforms and empowers us from within, through practice and over time.”
Hume, who lives in the Bay Area, initially wanted to write a book about feminist poets and health care advocates, and in particular the work of Pat Parker, a radical black lesbian feminist and poet who worked at the Oakland Feminist Women’s Health Center (OFWHC ). ) from 1978 to 1988. But as he spoke with Parker’s former colleague Linci Comy, director of the clinic for more than thirty years, Hume came to see OFWHC as a crucial community center, a bastion of reproductive rights activism, and the hub of several overlapping, related movements .
First, the oft-forgotten self-help abortion movement, a West Coast-led political movement that began in the 1970s and encouraged laypeople—like those outside the medical profession—to learn about and practice gynecology with each other. This included cervical self-examination and “menstrual extraction” (suction abortion), with the aim of opening up the practice within their own communities. Self-help was a group educational practice offered by the clinic for a fee; the idea was that “abortion is normal, and abortion is natural. It’s a normal process and it’s a natural process,” Hume said. “And that small groups of laypeople, trained in sterile technique and menstrual extraction, could easily do this.”
After Roe protected the right to abortion, at least nominally, some underground self-helpers shifted to the clinical setting; OFWHC, renamed West Coast Feminist Health Project/Women’s Choice in 1988, was founded in October 1972 by 19-year-old Laura Brown as a self-help clinic offering pregnancy screenings and abortion referrals, as well as workshops on the female body. And many continued to work outside of clinical settings, guided by the certainty that medical resources and knowledge would spread beyond the long discriminatory system of institutionalized medicine and the practice that just because abortion was legal did not mean it was affordable or accessible. “Self-helpers understood that abortion was legal in name only for many people,” Hume said, especially after the passage of the Hyde Amendment in 1977, which banned Medicare payments for abortion and effectively limited access for poor people.
The Hyde Amendment was evidence of what many of Hume’s interviewees explain in the book: “We cannot rely on the state to provide care,” Hume summarized. “We couldn’t do that then, and we can’t do that now.” The self-help movement “teaches us how to strengthen, defend and care for each other,” she said. “And if we can do this, we can strengthen our community from within, and we don’t have to depend on the state.”
Deep Care proceeds largely chronologically, as the defense of abortion expanded to include a street movement to defend clinics from escalating attacks from the Christian Right, which became increasingly organized and violent in the 1980s and 1990s. Hume spoke with several former volunteers and organizers from Bay Area Coalition Against Operation Rescue (later Bay Area Coalition for Our Reproductive Rights), a group organized in the late 1980s against a radical anti-abortion group that blocked clinic entrances. She delves into the weeds: how they recruited, how they built and deployed an emergency response network, how and where they stood outside the clinics to create literal entry points; meeting minutes, posters, a street theater wedding that mocked the faux piety of the right, which built on the creative tactics of its sister movement Act Up to end the AIDS crisis.
The activists know exactly what was driving the right’s persistent focus on abortion, which by the late 1980s had become a coalition-building issue: it was always an expression of social and political control. Ten years into Roe-era America, Hume writes, “the right had discovered how to defuse their racism and build their strength around abortion in a way that enabled their followers to feel moral,” a strategy which has evolved into modern-day daily attacks on healthcare. “Today, the right is recycling the anti-abortion playbook to destroy access to health care, or even the possibility of it, for transgender people. We see the same distortion of information, intimidation and attacks by lawmakers,” Hume said. “History tells us that there will never be no need for community-based healthcare solutions.”
Whether self-help circles, independent clinics or underground clinic defense networks, the capacity of small groups and communities is “at the heart” of the book, Hume said. “Deep care takes time. It means learning how to enter into intimate relationships in a different way. And it means recognizing that we share power by caring for each other as well as ourselves.”
Hume was finishing the book when the Dobbs decision came down, and it looms; she ends this astonishing historical work with notes for the future. Among them: accompanying each other, fighting to keep clinics open, resisting the body cops. And crucially: make the referral. “History shows us that the key to safe abortion is referral to informed, reliable care, and referral has been a tool of underground abortion workers for centuries,” she said. With the wave of recent bans and widespread access to abortion pills by mail, above and below ground, through organizations like HelpAccess or Plan Cthe reference is “more important than ever before”.
And, crucially, the power of long-term, close-knit, compassion-based work at the local level – for example, helping with access, or tracking down funding for local crisis pregnancy centers that covertly discourage abortion, or fighting misinformation within one’s own community. “When small groups of people work together closely, safely and dynamically, they can create revolutionary change,” said Hume. “It can be challenging and takes a lot of patience and practice, but if you do it successfully you can really build community strength. It is one of the most important political lessons there is.”