How to Run a Back-Alley Abortion Service

It often happens when she's speaking at events. "Sometimes they wait until the event is over and then they catch me in the hall and say things like, 'Do you think…?' and 'Would you maybe…?' because they're testing me and they're nervous, and who can blame them?" Arcana tells Broadly. "But they do come out with it, ultimately. And some are much bolder than that of course, and say, 'So! How can we organize this and will you work with us?'"

Between 1969 and 1973, Judith Arcana and a hundred-odd other women helped women access illegal abortion services, operating under the codename "Jane." What makes the story of Jane—officially known as the Abortion Counseling Service of the Chicago Women's Liberation Union—so remarkable is the scale and audacity of the operation. It began simply as a referral service, sending handfuls of women to illegal abortionists, but it became a feminist collective in which members learnt to perform the abortions themselves. They would perform an estimated 11,000 in total before they folded in 1973, the year that Roe v. Wade made abortion legal in all states across America.

It began, fittingly, with a phone call. Heather Booth, a student activist at the University of Chicago, was called by a friend whose sister was desperate for an abortion. She managed to find a doctor to perform one. Then, slowly, she began to receive more and more calls. It became apparent to her that abortions were not rare occurrences—Booth began to realize that they were a common need and their illegality was life-threatening. Moreover, they left women vulnerable to incompetent practitioners who would often prey on them sexually, financially, and, in some cases, fatally. Booth organized a group of women to take over the work she had begun; they started answering the calls and referring women to abortionists they knew to have a good track record.

The new group, however, was unhappy with how little control they held. As Laura Kaplan explains in The Story of Jane: The Legendary Underground Feminist Abortion Service, not only did they have no guarantee that the women would receive competent and compassionate care, but they couldn't persuade the back-alley abortionists to lower their prices—which ranged from $500 to $1000 per procedure. Although Jane tried negotiating the cost down, for many women, the reduced fee was still astronomical. In time, one of the Janes built a relationship with one particular practitioner and discovered that he was not, in fact, a qualified physician. She realized that if he could perform the procedure, there was no reason that individual members of the group couldn't learn, as well. She persuaded him to train her, and thus the collective finally gained the ability to regulate the process from start to finish.

Having attained autonomy, the group refined their protocol. They got an answering machine to deal with the growing number of calls. Women would call Jane and leave a message; the "Call-Back Jane" would ring them back, obtaining a basic medical history and an estimation of the length of each woman's pregnancy. Jane would assign each woman a counselor who explained the process and made appointments. Each would come to "the Front", an apartment rented by the service as a kind of waiting room, before being driven to "the Place", where Jane abortion providers performed procedures all day. Jane would drive women back to "the Front" and give them painkillers to take home. The counselors would then follow up with each woman in the days after her prodcudure to ensure that no complications had arisen.

Since they occurred in the days before "medical" abortions—those performed with the mifepristone-misoprostol or RU-486 pill—all Jane abortions were surgical. Jane providers would use the dilation and curettage method; this involved dilating the cervix with a speculum, administering local anesthetic and then scraping fetal tissue from the uterine walls. This method is only suitable for early term pregnancies of up to 12 weeks; for longer term cases, a miscarriage had to be induced. This was more emotionally challenging, undoubtedly, but the members of Jane believed in a woman's absolute authority over her own body, whatever stage of pregnancy she had reached.

The idea was also less shocking then in the context of women's liberation than it might appear now: "One of the most radical things to come out of the women's movement was the change in medical culture. It was so paternalistic; how dare you even look at yourself or think about your own body! In the process of breaking with that, who knew where the boundaries should be?" For this reason, Janes would encourage their counselees to look on the process as collaborative—not least because everyone involved would have been liable for a ten-year prison sentence for conspiracy to commit abortion. The collective designed their process in the hope that the women's experiences would be educative and eye-opening; they would give out copies of the revolutionary women's health manual Our Bodies, Ourselves, and teach self-examination, showing many women their own cervixes for the first time in their lives.

In cutting out the illegal abortionists they had previously relied on, the Janes were able to lower the price of abortions to just $100. However, not wanting to replicate the imbalance of capitalism within their collective, they never turned away women who could pay nothing at all: "We figured if we averaged $50, we could make our expenses," Galatzer-Levy says. Financial contributions were seen as another way in which women could become active participants in the choice they were making, as any payment made aided other women to access their reproductive rights. Recognizing that America runs on women's unpaid labor, and with a constantly increasing number of phone calls, Jane decided to pay their own members, as well—their work was valuable.

Given the relatively low cost of a Jane abortion, the group's waiting rooms became a rare point of diversity in the otherwise white, middle-class landscape of women's liberation. This is perhaps unsurprising, since, as Galatzer-Levy puts it, "any woman can become pregnant who doesn't really want to be." And, while Jane's membership largely reflected the whiteness of consciousness raising groups and union activists, they constantly tried to diversify in order to better cater to the wide demographic coming to them. Poor African-American and Latina women's reproductive rights were especially endangered during that time period, as they faced the added threat of routine forced sterilization.

In her paper "African-American Women and Abortion" Loretta J. Ross elaborates how Black women were divested of their reproductive control on more fronts than their white counterparts: "White conservatives saw family planning as an assault on traditional values of motherhood, while some Blacks saw it as a race- and class-directed eugenics program. That such disparate forces aligned themselves against African-American women demonstrated that both white bigots and Black sexists could find common cause in the assertion of male authority over women's decisions regarding reproduction." The legacy of such pressure still informs how Black women are targeted by anti-abortion groups today.

There were only a few women of color in Jane's membership at any one time, and Lois Smith was one; in interview with Ross, she remembers: "…we could never develop a critical mass. […] But we didn't look on it as a Black or white women's issue; women needed termination of pregnancies, and there was a unity created by women who were desperate." The sentiment is echoed by Galatzer-Levy: "Everybody was a woman and that gave us a hell of a lot of common ground! It was certainly a basic tenet of the women I worked with in Jane that there was just an enormous respect for everyone."

While the group was, as Arcana puts it, "fostered and bolstered by the politics of our moment," a note of caution creeps into her voice when asked if Jane was unique to its sociopolitical context: "Women have always been doing this, so the notion that a grand political happening in the world is required for women to take action, I think, is a little wrongheaded: too simple, too stark. It makes Jane and its members too different from other women and it's been my experience—not only then but ever since—that there's a lot of good stuff going on."

Both Arcana and Galatzer-Levy cite, as an example of this "good stuff," the work of Dutch doctor and activist Rebecca Gomperts. She has started two separate organizations, Women on Web and Women on Waves, both of which help women access medication abortion in countries in which it's illegal. To Arcana and Galatzer-Levy, this suggests that providing "unlawful" abortions can, in some ways, be easier now: "It doesn't require your presence in the room… But of course it's very limited to very early term abortions and then past that, I don't know."

Although abortion is now a constitutional right in the United States, the culture surrounding abortion has changed indelibly in the forty years since Roe v. Wade—a ruling that "was not exactly a bargain to begin with," as Arcana puts it. "A lot of people do not realize that Roe was not actually about women being able to determine what they needed or wanted to do; it was about doctors being able to make the decision," Arcana observes. While what Jane did in the seventies was both illegal and clandestine, their work was tolerated—appreciated, even—by the society in which they operated; it was not uncommon, for example, for police officers' wives or mistresses to seek help from the service.

Now, opposition comes from a devastatingly forceful anti-abortion movement, whose influence is such that, as Galatzer-Levy notes, "in many states it's as difficult now to get an abortion as it was before Roe v. Wade." "Their radically violent wing is very active and extremely dangerous," Arcana warns, alluding to groups like Operation Rescue, whose extremist activities against abortion providers are tantamount to domestic terrorism. "So the danger to women who are attempting to do the good work now comes not only from the officials, from the politicians and cops and the people who police the net, but also from the serious bad guys."

Those in the (very vocal) anti-abortion movement tend to frame abortion as a shameful, irresponsible choice akin to infanticide. Media coverage of abortion is skewed such that, even if you happen to be agnostic on the issue, it is inevitably filtered through the opposition's lens—a fact most recently demonstrated by the media furor over manipulated footage of Planned Parenthood's fetal tissue donation process. This kind of manipulation has informed an entire generation born after Roe v. Wade, says Arcana: "[Women now] have feelings about the fetus that I do not share. [The anti-abortion movement] has managed in the past four decades, quite brilliantly, to change the culture, the mindset, the thinking and even the feelings: the emotional responses to abortion, motherhood, pregnancy."

For Galatzer-Levy and many of the women in Jane, abortion and motherhood aren't diametrically opposed—rather, they're deeply connected, part of a larger spectrum. "Being a mother was very important to me," says Galatzer-Levy. "Much of what made it such a pleasure and so comfortable was the choice. I've had an abortion; I've also had an adoptive daughter; so in some ways I represent the whole spectrum. It's a contradictory world and there aren't simple answers, but there has to be an ability to make choices."

Speaking about the growing unrest surrounding reproductive justice in the United States, Arcana shows the same excitement. "I'm actually hopeful, if you can believe it, because the young ones are so smart. They're tough and they really, really are pissed off. There aren't millions of them yet, but there are thousands and thousands all over the country and they're doing it! And I just think: 'Okay! Let's get going here!'"