by The Gainesville Radical Reproductive Rights Network
In 2022, the story of the Jane Collective experienced a resurgence in popularity. Read about them and ask yourself whether they did anything wrong, or if the state did. Abortion has long been under attack. Anti-choice actors worked for 50 years to overturn Roe v. Wade, which overturned abortion bans in several states. That includes Texas, where Roe was filed, and partly from where a 2023 Supreme Court case targeting access to Mifepristone originated. Dobbs led to Florida’s bans and our ability to vote Yes on Amendment 4 in November.
Defending abortion access in the face of the 6-week ban, we’re forced to weigh the options we have left. Naturally, we might ask whether abortion is better via pill or surgery, or perhaps, does medication abortion replace surgical abortion? As reproductive rights advocates who support the Amendment to Limit Government Interference, we also ask ourselves: how does Yes on 4 comport with further organizing?
The short answer to the first question is “no”; both are safe and legitimate, and we deserve all options for self-determination surrounding our abortion care. Factors influencing that decision-making include access, cultural practices, finances, and personal preference.
If one successfully ends a pregnancy, the other is not necessary. Medication is now the more popular option for U.S. abortion-seekers. However, about 1-2% of people who take abortion pills remain pregnant. In those cases, a person may repeat the process of taking abortion pills after ten days. Alternatively, if a person decides they don’t want to try another pill regimen, they can inquire about a surgical procedure by contacting their medication provider or the M+A Hotline. The M+A hotline connects people to clinicians and healthcare professionals who provide medical help.
Between eight and 12 weeks of gestation, pills are very effective but efficacy decreases. After about 12 weeks, efficacy decreases further, however, research shows medication abortion could occur at 13 weeks and beyond! Because there is a 6-week ban and abortion pills are only viable until about 12 weeks, increasing medication abortion access is imperative, but it doesn’t obviate the need for the surgical option.
There are different medical considerations when choosing between the two. Abortion pills should come with the expectation of some bleeding, cramping and pain, and the process may be more painful later in gestation. Clinician support and instruction is available if pills are procured in-clinic; Mifepristone can be taken at the clinic, with the patient taking Misoprostol at home. Both pills can be taken at home as long as the patient is two hours from a hospital. Complications are rare, but may be difficult to interpret because of the side effects.
Patients must weigh their comfort level with self-managing their abortion, especially if contraindications like severe anemia or hemophilia are present. Research may be done at plancpills.org or abortiononourownterms.org, and people can call the M+A hotline should complications occur. But remember: abortions done at home don’t have to be abortions done alone. Having a support network of friends and caretakers can make the transition easier to navigate.
Medication abortion networks are expanding, especially in response to increasingly hostile abortion bans. Many communities have care networks, providing logistical, financial, emotional, and physical support for people using medication abortion at home. Digitally, all medication abortion sources on Plan C’s website are vetted and the M+A hotline provides all types of support and directs people to even more resources. Networks which provide surgical abortions are also robust, accountable, and offer a comprehensive array of services alongside the procedure.
Plan C and Abortion On Our Own Terms also offer legal and financial assistance. Everyone capable of pregnancy should learn about their state’s laws surrounding abortion medication. Folks using online networks to access abortion should familiarize themselves with security culture to avoid criminalization. Those seeking abortions and those aiding and abetting should be free from that threat; however, our reality is one of state repression and a system that benefits from high rates of incarceration.
We need to prioritize protecting ourselves and each other. Abortion funds, the sites above, and clandestine networks, which often overlap with other channels of mutual aid, are full of advocates who work to provide low- or no-cost options.
There are good reasons most people who have abortions in the U.S. use pills but there are different considerations with medication and surgical abortion. Both must be accessible.
Enter Amendment 4. Given the opportunity in November to overturn the extreme ban, we must vote YES. A Yes vote is not everything but is necessary; we need a Yes And approach. The Amendment reads:
“No law shall prohibit, penalize, delay, or restrict abortion before viability or when necessary to protect the patient’s health, as determined by the patient’s healthcare provider. This amendment does not change the Legislature’s constitutional authority to require notification to a parent or guardian before a minor has an abortion.”
We don’t have to explain why the six-week ban is bad. Again, abortion pills can be obtained and stored for some time, but as aforementioned, are only effective until a point in pregnancy, around 12 weeks or possibly beyond. Amendment 4 would protect people’s right to choose for about twice as long, except in cases of threats to life or health of the pregnant person. In those cases, abortion will be allowed whenever necessary, as determined by their healthcare provider, as it is now.
The Amendment would not allow abortion “up until the moment of birth”. We have feelings on that. It’s the first thing GRRR! considered when deciding to take up this initiative last May. Abortion should be allowed at any time, for any reason, without apology! There should be no bans, and exceptions don’t change that but further stigmatize abortion. We dreaded promoting “before viability.” It’s a double-whammy when antis lie and say this amendment would allow for elective abortions in the third trimester. GRRR! wishes it did; it does not.
Then antis claim any healthcare provider would be allowed to perform abortions. We’re not going to get into the weeds on why that’s dumb and untrue. In the spirit of the Janes, we wish the amendment allowed for anyone to perform abortions; it doesn’t. Abortions must be performed safely but the state should not determine who can or can’t. The way to mitigate concerns of there not being a central authority is to educate prospective providers and patients.
The state currently dictates who can perform abortions partly by controlling where they happen. Abortion providers should be able to work from home. Would they lose their commitment to safety outside of a clinic? Think of all the people worldwide who perform safe abortions. Are they registered with the AHCA? Do they pay taxes to a racist state that imprisons people and supports genocide of indigenous peoples, at home and abroad?
The building of what shouldn’t have to be underground networks is vital for liberation from imperialism. That will have to happen if the amendment doesn’t pass, and even if it passes. It cannot and does not address issues outside of its text, per the single-subject requirement for amendments. It won’t change existing laws requiring parental notification, or have any real financial impact. It also will not itself create free community-supported abortion; we still have to do that.
Abortion access will always be a community responsibility. Part of that is voting Yes on 4.
We still have much to do including supporting abortion funds and clinics, repealing the Hyde amendment, providing comprehensive sex education, sustaining period pantries, distributing repro kits, prioritizing aftercare for abortions, creating space for abortion doulas as necessary care providers, and ensuring access to birth control emergency contraceptives.
The work goes on.
Follow the GRRR! Network at: instagram.com/thegrrrnetwork.
Learn more about Amendment 4 from Floridians Protecting Freedom at: floridiansprotectingfreedom.com.
Find medical, legal, and financial support on abortion pills at: abortiononourownterms.com, https://www.plancpills.org, and https://mahotline.org/.