A Glimpse at a Post-Roe World

When discussing abortion in the classroom, I often ask my students what it would take for Roe to be overturned (answer: one more anti-Roe justice on the Supreme Court) and what a post-Roe world would look like. They often assume that we'd just revert to the pre-Roe situation: Women who could afford it would travel to states where abortion remained legal. Those who couldn't would reach for a coat hanger or knitting needle.

Only the first half of this scenario is plausible. The second half doesn't even accurately reflect history. Most abortions performed before abortion's legalization involved a doctor, midwife, or other black-market provider. Many of these abortionists were medically competent, and some were even caring. Only a minority of illegal abortions were self-induced, and by no means did they all involve sharp instruments. Other common techniques included poisoning oneself just enough to expel the fetus (eating match heads was one way to do it), inflicting blows to the abdomen, or trying to overheat/overcool one's body. Obviously, the more effective of these methods carried their own risks: The line between poisoning the fetus and fatally poisoning oneself was thin and treacherous.

In a world without Roe, women would not simply revert to the old methods. Most of them would turn to the Internet for help. Just as many senior citizens now import their Lipitor from Canada and ED patients order those little blue pills from India, unwillingly pregnant women would get their RU-486 online.

This is already happening in countries where abortion is harshly restricted, as Kate Harding reports on Salon's Broadsheet, relying on a BBC story. Among the more reliable services providing medical abortions is one called Women on Web:

Women on Web will send abortifacient drugs to women less than nine weeks pregnant in countries "where abortion is heavily restricted" -- also providing proper instructions, paperwork signed by a doctor and e-mail support. Audrey Simpson, director of the Family Planning Association of Northern Ireland, calls the site "very helpful and reputable" -- while being careful to add that her organization doesn't encourage breaking Irish law.

Unfortunately, at-home abortions are not without risks, even when they don't involve the proverbial rusty coat hanger. Besides Women on Web, there are rogue sites out there, sending "unmarked bottles with no instructions or paperwork," according to one woman who eventually used WoW. ... And the British Journal of Obstetrics and Gynaecology recently published a survey that found even among Women on Web clients, almost 11 percent had required a surgical follow-up.

This shows a real parallel to women's historical experiences in those countries that now have relatively liberal abortion laws. Incomplete abortions were a fairly common event in the illegal era. But once an abortion was in progress, a doctor would be obligated to help the woman, even if he knew or suspected that she wasn't just suffering a spontaneous miscarriage.

I'm not entirely sanguine about any of this. Liberal abortion laws save women's lives. Period. But I think that we proponents of reproductive justice serve our cause poorly if we don't recognize how a post-Roe world would differ from the pre-Roe situation. These differences - and not just historical amnesia - may help explain why the coat-hanger symbol is losing its resonance among young women. And I think we also need to recognize how resourceful women can be when faced with sharp restrictions on abortion rights.