coat hanger sign at abortion rights rally

Supreme Court Justice Anthony Kennedy is retiring. His replacement — Donald Trump's second nomination to the high court in as many years — could be the decisive vote to overturn the foundational abortion rights ruling Roe v. Wade. But as HuffPost's Molly Redden noted this week, women in many parts of the U.S. are already living in a post-Roe world. We asked her about her story.

How did this story come about?

So, immediately when Justice Kennedy announced he was going to retire, one of the big, obvious questions became, What's going to happen to Roe v. Wade? You can look at Kennedy's record on abortion restrictions and imagine what kinds of rulings the Supreme Court might reach if somebody more conservative takes his place. But the discussions taking place about what would happen to actual people who wanted to have an abortion felt a little more abstract. "If Roe is overturned, then women will have to—"

I wanted to weigh in with real-life examples of what we already know can happen when states restrict abortion. Because the truth is, big parts of the country already resemble a pre-Roe landscape, with the nearest abortion provider hundreds of miles away and laws putting the procedure financially out of reach. I've met women who have traveled to Mexico to get a cheaper procedure, who have taken mystery pills they got from a friend, who've driven hundreds of miles, who've sold furniture or taken out payday loans, who have gotten on planes and flown halfway across the country. I've spoken to providers who have treated women who did dangerous things to try to terminate their pregnancies at home. It's important for people to be thinking about these specific stories reporters have documented, and so I decided to gather a bunch of them in one place.

What have you found in your reporting on this subject that was most surprising?

When I first started reporting on abortion restrictions, I figured there was a pretty straightforward relationship between all the new anti-abortion laws going on the books and the ability to get an abortion. But over time — and there's now some really good data to show this — I saw that the relationship isn't so straightforward. Waiting periods are a good example. Those are the laws that require people to wait 24, 48, or 72 hours between their first contact or first appointment with an abortion provider and the actual abortion, so they can reconsider. Waiting periods definitely delay people from getting an abortion, but the vast majority of people who make it to appointment #1 make it to appointment #2. Oh, and we still don't have great data on self-induced abortion. We don't really know how often people try it, how often it works, who does it, and why.

The forces that actually stop people who want an abortion from getting one are much more complicated and much less obvious. Money is almost always part of the problem. There are lots of laws that can make abortion more expensive. And some of the most important restrictions aren't new at all. We think about the anti-abortion movement scoring tons of victories in the past eight years — and it has — but states have been allowed to block abortion patients from using Medicaid for so long that it's almost part of the wallpaper at this point. It's almost invisible to us.

What's the hardest part of reporting on this subject?

No matter where you fall on the issue of abortion, I don't think many people would deny that hearing some of these stories about the desperation women are feeling can be incredibly difficult. Two years ago, I was able to read a trove of hundreds of emails that women in the U.S. had sent to an international nonprofit asking for abortion-inducing drugs. So many of these women were facing similar obstacles. Their partners were abusive and they were afraid their pregnancy would make it worse, or give their partners an excuse to stay in their lives. Or they had just gotten a new job after years of searching. Or they were teetering on the brink of financial ruin. Or they were teenagers who thought their parents would kick them out of the house for having a baby or an abortion. (The pills would make the abortion look like a miscarriage.) You would think that reading a version of the same story over and over again would allow you to have distance, but the impact personally was the opposite. Sometimes when you see the whole Matrix at once, it hurts more.

Then there's the fact that the people who are most profoundly impacted by abortion restrictions are often the most difficult to represent in our stories. Just like it's easier for people with means — a working phone, reliable internet access, money, a predictable work schedule, childcare, a supportive family — to access abortion, it's easier for those people to participate in news stories. Not just because someone with a complicated life might be hesitant to speak to me — sometimes, it's just a practical thing. They have five things on their plate that are more important than returning my call.

What do you want readers to take away?

The Supreme Court doesn't have to overturn Roe for the country to look like it did before Roe was the law of the land. In a lot of ways, it already does.

READ THE STORY

Love,
Nick and Sam

P.S. Don't miss our coverage of our hate mail, a bartender who was fired for being rude to Trump supporters and what happened when a lesbian sexual assault survivor went to work for Donald Trump.

Molly's full story follows below.

We Already Know What A Post-Roe World Looks Like

If abortion is made illegal again? “We’d use a coat hanger, like our grandmothers did.”

By Molly Redden

What would happen to women if the U.S. Supreme Court overturned Roe v. Wade?

For years, the question was more of a rallying cry than an imminent possibility. But on Wednesday, after Justice Anthony Kennedy announced his plans to retire from the bench, the question became a lot less rhetorical. Kennedy, in his 30 years on the bench, frequently provided the swing vote that prevented the court from overturning the 1973 decision that established a right to abortion. And President Donald Trump is expected to nominate a surefire opponent of Roe in his place.

The potential impact of overturning the right to abortion is not a big mystery.

Already today the cost and difficulty of obtaining an abortion in a clinic are forcing an unknown number of women to get the procedure elsewhere. One recent study estimated that up to 4.1 percent of Texas women of reproductive age, at least 100,000 or up to 240,000, have at some point in their lives tried to self-induce an abortion. Multiple abortion providers have recounted to reporters how recent patients have tried to perform abortions on themselves. Amy Hagstrom Miller, who operates several abortion clinics in Texas, where the procedure is highly restricted, said patients frequently call her staff to ask for instructions on how to perform their own abortion. “When we tell them we can’t, they say, ‘How about if I tell you what’s in my medicine cabinet and under the sink?’” she has said. Renee Chelian, an abortion provider in Michigan, says her clinic treated a woman who tried to open her cervix with a sharp object.

In 2015, Women on Web, a group that mails abortion-inducing medication to women in countries where the procedure is illegal (so not, currently, the United States), received more than 600 requests for the medication from women in the U.S. Dozens of the women indicated they could not afford an abortion in a clinic. Many said they feared that their abusive husbands, boyfriends or exes would hurt them if they found out they were pregnant or would use the pregnancy to stay in their lives. One woman became pregnant from being raped, but her government-provided insurance refused to pay for a termination because she’d never called the police.

Some letter writers were minors whose parents were preventing them from having an abortion. Two women lived on the Big Island in Hawaii, a place of roughly 180,000 where there is no abortion clinic. Several indicated that without the help of Women on Web, they would keep Googling. All of them were willing to take matters into their own hands.

A Supreme Court that was suddenly much more favorable toward abortion restrictions could set the stage for cases like these to become much more common. Roughly a third of states have laws on the books that would or could outlaw abortion the moment Roe is no longer the law of the land. Short of overturning Roe, the court could greenlight attempts to restrict abortion much earlier than is currently legal or permit regulations intended to make it impossible for abortion clinics to operate.

Researchers are still not clear which anti-abortion laws, precisely, drive women to attempt their own abortions. But in the past seven years, states have enacted more than 400 restrictions on abortion ― so many that some states have begun to replicate the difficulties of obtaining an abortion in a pre-Roe era. Some of those restrictions have forced clinics to close ― one in five women now lives 43 miles from the nearest abortion clinic ― while others make abortion more costly or time-intensive for the patient. Some of the journeys women have taken in the shadow of these restrictions are daunting. A Texas nonprofit that funds abortion travel reported arranging trips of 350, 600 and even 800 miles.

Abortion providers and researchers have begun to see evidence that, alongside these new restrictions, the number of women who attempt their own abortions is growing. Seth Stephens-Davidowitz, an economist who analyzes Google searches, found that online searches about self-induced abortion almost doubled from 2008 to 2011, when the economy got worse and many new abortion restrictions were taking effect. Many of them were seeking online places to buy the abortion pill, which is vastly safer than the coat hanger in theory; in practice, it can be difficult for women to know how to use the medication properly and impossible to tell if they’ve purchased the real product.

And there’s evidence that laws which drastically increase the distance between a woman and her nearest provider by closing clinics reduce the number of legal abortions. This was precisely the type of law the Supreme Court declared unconstitutional in 2016 when Kennedy cast the deciding vote against a set of clinic restrictions in Texas.

Self-induced abortion is in a murky legal area. More than 20 women have been jailed or prosecuted for attempting to induce their own abortions since Roe.

But there are still sobering parallels between today, when abortion rights are being squeezed, and the 1970s, when abortion was only legal ― or in the immediate aftermath of Roe, only available ― in a handful of places. One of Louisiana’s only remaining abortion providers recalls how he was galvanized to start offering abortions because, as a medical student, he saw so many women harm themselves by trying to self-induce. Many of the women tried using turpentine, either by injecting it or attempting to place it in their wombs.

In 2016, a reproductive rights activist reported that her group prevented a woman from trying to cause an abortion by drinking turpentine with sugar.

“What’s gotten lost in the history is how many women died trying to give themselves abortions,” Chelian has said. Several years ago, she asked a group of college freshmen what they would do if abortion became illegal again. A woman replied, “We’d use a coat hanger, like our grandmothers did.”