How a network of women in Latin America transformed safe, self-managed abortions

In November 1990, much than 3,000 women descended connected nan sleepy formation municipality of San Bernardo del Tuyú, Argentina, for what was becoming a legendary event.

Activists, doctors, academics, societal workers and lawyers from crossed nan Americas traveled each nan measurement to be a feminist gathering known arsenic an Encuentro.

While they publically debated their governmental demands, nan portion of accusation that made nan biggest effect connected nan early of abortion was exchanged successful private, successful whispers.

Alicia Cacopardo, an OB-GYN from Buenos Aires, was portion of those whispers. In betwixt sessions, she fell into speech pinch a group of Brazilian women successful nan hallway, who talked astir a pill she had ne'er heard of before: Cytotec, nan commercialized sanction of misoprostol. The supplier was designed to dainty tummy ulcers, but women successful Brazil were utilizing it for safe, at-home abortions.

Though Cacopardo was an master successful reproductive health, she was stunned — you tin person an abortion connected your own, conscionable by taking a pill?

"It's a immense change. It's brilliant," she remembers reasoning astatine nan time.

In nan years to come, other abortion-rights activists crossed nan region were thrilled erstwhile they learned astir misoprostol, and, for illustration Cacopardo did, wanted to dispersed nan connection to different women.

Activists connected nan dots: If women could get their hands connected misoprostol, they could extremity their pregnancies contempt nan terrible ineligible restrictions connected abortion astir Latin American countries had. With this caller pill, they wouldn't person to hold for nan rule to change.

Word spreads 

When Cacopardo returned to Buenos Aires aft nan Encuentro, she wanted to get her patients Cytotec. If she succeeded, women could extremity their pregnancies contempt ineligible restrictions connected abortion. At nan time, Argentina only allowed abortion successful cases of rape aliases erstwhile nan mother's life was astatine risk.

But Cacopardo ran into a problem: Cytotec wasn't disposable successful Argentina.

She flipped done a pharmaceutical directory and looked for immoderate narcotics that contained misoprostol, nan generic sanction of Cytotec. She only recovered 1 medicine successful Argentina: Oxaprost. But Oxaprost included a 2nd substance, called diclofenac, an anti-inflammatory supplier typically utilized to dainty arthritis and different problems.

So Cacopardo came up pinch a solution — 1 that required her patients to do a makeshift subject task astatine home. Cacopardo told them to bargain Oxaprost astatine nan drugstore and past crush nan pills to abstracted nan outer furniture of misoprostol from diclofenac, which was contained successful an soul layer. Cacopardo wanted her patients to debar immoderate imaginable broadside effects from taking excessively overmuch diclofenac, specified arsenic heartburn and different tummy issues.

It was difficult to crush nan pills, truthful immoderate women conscionable took nan full point — an denotation of conscionable really DIY it was astatine first to self-manage an abortion pinch pills. Cacopardo says that nary of her patients reported immoderate superior broadside effects and astir of them had complete abortions.

A technological stamp of approval

Kelly Blanchard, nan president of nan investigation and defense statement Ibis Reproductive Health, says that experiments pinch misoprostol successful nan 1990s represented activists doing "research successful existent time."

"In nan session setting, those innovations often travel from wellness attraction providers," she explains. "The activists are doing precisely nan aforesaid thing: reasoning astir and moving pinch group who request nan attraction and seeing what useful and what doesn't."

Researchers for illustration Blanchard yet ran studies connected women utilizing misoprostol to extremity pregnancies, gathering grounds from each astir nan world — from Peru to India to South Africa. Again and again, nan researchers recovered nan aforesaid thing: Misoprostol was a safe and effective measurement to person an abortion extracurricular nan general wellness attraction setting.

The studies conducted by these researchers besides persuaded awesome nationalist wellness institutions for illustration nan World Health Organization (WHO). As early arsenic 2003, nan WHO included misoprostol arsenic a safe abortion method successful nan first trimester (in operation pinch different pill called mifepristone).

The WHO's stamp of support didn't alteration nan truth that abortion was forbidden successful galore parts of nan world. So activists had a problem: They knew of an effective method to person abortions extracurricular of nan aesculapian system, but really could they get much women entree to thing that was illegal?

Hotlines successful Ecuador and Argentina

The statue of a virgin, la Virgen del Panecillo, looms complete nan metropolis of Quito, nan superior of Ecuador. She has wings, for illustration an angel.

One time successful 2008, Ecuadorian activists and a group of European activists from nan abortion entree statement Women connected Waves hung a large achromatic banner connected nan pavilion of nan virgin statue.

The banner publication "SAFE ABORTION" successful Spanish, pinch a telephone number. That number was for nan first abortion hotline successful Latin America.

Later that day, that cellphone number blew up pinch dozens of matter messages and calls.

The thought for a hotline — and nan stunt promoting it — threw these abortion activists into a new, much nationalist era. They reached thousands of women this measurement pinch activity that was bold, organized and replicable.

In 2009, a twelvemonth aft nan Ecuador hotline launched, Argentina sewage its own.

The corporate Lesbianas y Feministas por la Descriminalización del Aborto (Lesbians and Feminists for Abortion Decriminalization) started nan hotline pinch a twelve volunteers.

"In nan beginning, nan hotline was truthful bare bones," says Ana Mines, 1 of nan first hotline volunteers. The group boasted a backpack they passed astir to 1 another, pinch a Nokia 1100, a notebook and flash cards.

They were short connected resources, but they were wished to springiness rigorous accusation connected really to usage misoprostol to person safe abortions. And they advertised nan helpline everyplace they could, putting up posters each complete Buenos Aires pinch their telephone number and talking astir it connected TV and nan radio.

The helpline volunteers referred to nan guidelines developed by world and location technological bodies, specified arsenic nan WHO. This investigation gave nan activists credibility. They thought it besides gave them a ineligible defense: They were conscionable sharing publically disposable information.

The volunteers delivered this disclaimer to callers — that they were not doctors but were providing nationalist accusation — earlier offering step-by-step instructions connected really to usage misoprostol. They answered nan callers' questions, specified as: If I'm overweight, will nan pills work? Can nan pills autumn retired of my vagina? Will infirmary unit beryllium capable to show that I took misoprostol?

In Argentina, nary 1 had ever done what this corporate was doing — speaking truthful openly astir abortions and really to person 1 connected your own. Mines says astir of nan volunteers for illustration her were frightened of getting arrested. And nan Argentine authorities had a grounds of going aft abortion cases. Between 1990 and 2008, astir 450 abortion cases were prosecuted successful Argentina.

Not each feminists were happy astir what nan corporate was doing. Mariana Romero, a salient reproductive wellness interrogator and advocator for abortion authorities successful Argentina, worried that nan helpline could inadvertently trim entree to misoprostol.

"I said, do we person to do this truthful public? You're nuts," Romero recalls. "You are going to make nan pharmaceutical institution that produced misoprostol return it retired of nan market." Despite nan publicity astir nan hotline, successful nan end, nary volunteers were arrested. And misoprostol remained available.

Barbie gets abortions 

In 2010, a twelvemonth aft nan hotline started, Lesbianas y Feministas sewage much provocative pinch nan measurement they talked astir abortion. They published a manual connected really to self-manage an abortion pinch misoprostol and without a doctor.

It did not look for illustration a accepted aesculapian text. The screen was pinkish pinch 2 large rainbows and illustrations of pills pinch smiley faces. On nan back, location was a image of Barbie successful a pinkish convertible, pinch sunglasses and a glamorous scarf complete her head, on pinch nan words "Barbie, how'd it go?"

"It was awesome," Barbie replies. The accusation was that immoderate female tin person an abortion — moreover Barbie.

The manual was thorough — much than 100 pages agelong — and it went into vivid detail, including drawings of really to insert nan pills into nan vagina.

"It was a bestseller," says Mines, nan hotline volunteer. "It had 2 printings of 10,000 copies each."

Other helplines and feminist groups successful Latin America started utilizing nan manual to thief much women. Mines herself was capable to thief thousands of women done nan helpline.

But immoderate abortion activists believed sharing accusation connected nan telephone and done written manuals wasn't enough.

Mexico: The commencement of "accompaniment"

In 2010, nan activistic Veronica Cruz met volunteers from nan Argentine helpline astatine a convention astir safe abortions. Cruz is nan laminitis of a feminist corporate called Las Libres (The Free) successful Mexico. She recalls a batch of hype astir abortion helplines astatine nan gathering, but she was skeptical.

"How do you cognize for judge that those women are not astatine risk?" she asked nan volunteers. "You gave them accusation and past what? Did she get nan pills? Did she travel nan instructions correctly? Did she extremity up successful nan hospital? You really don't cognize anything."

Cruz, connected nan different hand, did cognize really nan women she helped successful Mexico fared because she utilized a different method: "acompañamiento."

In Spanish, acompañamiento intends being pinch someone, supporting them, aliases conscionable keeping them company. When helping a female seeking an abortion, acompañamiento has travel to mean being location for personification passim nan full process of an abortion, from opening to end, sloppy of nan ineligible risks.

Cruz started doing acompañamiento in 2000 — nan aforesaid twelvemonth she founded Las Libres, and astir a decade earlier immoderate of nan helplines started successful Latin America. At nan time, abortion successful Mexico was fundamentally banned. In nan authorities wherever Cruz lives, nan only objection was for women who were raped. But moreover successful those cases, hospitals often denied women their correct to nan procedure.

In nan beginning, Cruz focused her activity connected these women. Through Las Libres, she worked pinch a gynecologist to thief women who had been raped get safe, ineligible abortions. One day, she saw nan expert usage a caller method: misoprostol, nan ulcer medicine that women successful Brazil first started utilizing for abortions successful nan precocious 1980s.

As she watched nan expert administer nan pills, Cruz had a realization.

"I tin conscionable bargain nan pills, show nan female really to usage them? That was an unthinkable find for me."

Not agelong after, different female came to Las Libres who wanted an abortion but wasn't a rape subsister — which meant that she didn't suffice for a ineligible abortion. Where they lived, ending a gestation that wasn't a consequence of rape, done immoderate method, carried a situation condemnation for nan female and anyone who helped her.

Cruz decided to travel nan woman, contempt nan risks. She told nan female to bargain nan pills astatine nan pharmacy. In Mexico, moreover though misoprostol technically required a prescription, you could often get it complete nan counter. Then Cruz gave nan female nan aforesaid instructions she had seen nan OB-GYN give.

Even though Cruz had seen really nan pills activity and really elemental it was to usage them, she says it was nerve-wracking to support personification done an abortion without a doctor. Cruz was connected standby nan full time. It was precocious astatine nighttime erstwhile nan female took nan pills.

"So I slept pinch my cellphone connected my chest," Cruz recalls. "All nan clip … successful lawsuit it rang aliases something."

The adjacent day, nan female went to a doctor, who confirmed that nan gestation had ended and that location hadn't been immoderate complications. It was Cruz's first clip doing accompaniment. And successful her eyes, it had gone smoothly.

After that, erstwhile personification contacted Las Libres for an abortion and they were not rape survivors, Las Libres didn't spell to nan gynecologist for help. They handled it themselves.

"We promised ourselves that we were ne'er going to time off anyone without access," Cruz says. "Whatever we had to do."

If a female couldn't spend to bargain misoprostol, which was costly successful Mexico, Las Libres would springiness her nan pills free.

Sometimes women had leftover pills and offered to springiness them to Las Libres. Cruz told them to salary it forward.

"The adjacent female who comes, you are going to springiness her nan pills arsenic a gift and you're going to show her astir your experience," Cruz said. 

Cruz would group up a gathering betwixt nan 2 women, successful a parkland aliases astatine a mall. The female who'd had an abortion would stock her other pills and her story. By connecting women straight — 1 by 1 — Las Libres was recruiting volunteers and building a network.

Las Libres helped create accompaniment networks that, today, scope each authorities successful Mexico.

But complete nan years, immoderate activists criticized Cruz's approach. At that convention successful 2010, Cruz recalls activists telling her that "what we were doing — of personally accompanying nan women and giving them nan pills — was risky for us. For america and for nan full movement."

These activists, who were fighting to legalize abortion, didn't want nan activity for abortion authorities to beryllium associated pinch group who were breaking nan law.

Many abortion-rights activists crossed Latin America recovered themselves connected other sides: Some were fighting to legalize abortion — those women were playing nan agelong game. Others, for illustration Cruz, were actively breaking nan law, because women who needed abortions instantly couldn't hold until nan rule changed.

One group realized that they didn't person to take betwixt nan 2 sides.

Argentina: From an creation to a science 

Nearly 35 years aft that Encuentro successful San Bernardo, successful nan autumn of 2024, different Encuentro kicked disconnected successful Argentina. This time, nan yearly gathering brought 50,000 women to a mini metropolis called San Salvador de Jujuy, correct by nan Andes Mountains.

They flowed done nan downtown streets successful a large demonstration, for illustration a stream of women.

In Jujuy, Ruth Zurbriggen was difficult to miss. She was usually nan personification pinch nan megaphone and seemingly endless energy.

Zurbriggen is 1 of nan founders of an Argentine accompaniment network: Socorristas en Red (First Responders Network). It's now nan biggest abortion accompaniment web successful nan world. And to make that happen, she and nan Socorristas decided to build systems, turning acompañamiento into a science.

Whereas Cruz, nan laminitis of Las Libres, thought that women could fig retired accompaniment connected their own, nan Socorristas built a full accompaniment method and moreover person a schoolhouse to train volunteers — La Escuela Socorrista (the Socorrista school).

In school, trainees study nan Socorristas' method, which includes holding an in-person shop for women who are willing successful having an abortion and administering a survey. That study is exhaustive. It asks straightforward questions, specified arsenic nan person's property and really acold on they are successful their pregnancy. Other questions are much personal, specified arsenic why nan female wanted to person an abortion, whether her partner supported her prime and whether she expelled nan embryo. They tracked nan answers successful spreadsheets, cautiously documenting trends successful women's experiences self-managing abortions pinch misoprostol.

One mobility connected nan study inadvertently helped nan Socorristas fortify their relationships pinch doctors. They asked: How did you find retired astir us?

"Thirty percent had travel to america recommended by wellness attraction professionals," Zurbriggen recalls. "And that's erstwhile we said, 'What's happening? Who are they?'"

Zurbriggen was amazed by that precocious number. Most doctors successful Argentina did not support abortion astatine that time. The Socorristas wanted to understand why aesculapian unit were referring patients to them, truthful they started scheduling appointments pinch these wellness attraction providers, arsenic if they were individual appointments. That allowed nan activists to talk to nan clinicians successful private.

"We started creating a enslaved pinch master aesculapian staff. And past we started asking them 'what's nan problem if you constitute 2 prescriptions a period for us? Nothing, right?' And they'd constitute america 2 aliases 3 prescriptions for america pinch different dates. And we'd get antheral names from friends aliases sons, and nan prescriptions would beryllium nether antheral names," Zurbriggen says. She describes nan process arsenic "very DIY." It was besides forbidden — and nan Socorristas don't do it anymore.

Doctors and nurses were often consenting to thief moreover though they risked losing their licence by doing so. One OB-GYN named Gabriela Luchetti, who worked successful nan nationalist wellness strategy for 30 years, says she felt "relief" sending group who needed an abortion to nan Socorristas.

Luchetti said, "Someone was going to do what we didn't situation to because we had a license, and we were acrophobic of nan law."

The conflict to legalize 

Many feminists who had focused their conflict connected getting a rule to protect abortion weren't comfortable pinch Zurbriggen and nan Socorristas' work. Just arsenic activists criticized Cruz's accompaniment activity successful Mexico, they believed Socorristas would harm their country's activity for abortion authorities because it would beryllium associated pinch criminal activity.

But nan Socorristas' accompaniment activity ever went hand-in-hand pinch nan conflict to legalize abortion. In 2018, erstwhile nan Argentine Congress first debated passing an abortion law, Zurbriggen and different Socorristas were there, speaking to representatives, on pinch different abortion-rights groups.

They shared information they had been rigorously search for six years. In that time, they'd accompanied astir 20,000 abortions. Their information challenged stereotypes Argentinians had astir abortion. They showed that nan women who are astir apt to person abortions are already mothers, and that galore of them are religious.

Some of nan different feminists who testified successful beforehand of Congress, for illustration nan interrogator Mariana Romero, had been captious of nan Socorristas. But she, and different skeptics, came around. "They were radical, but, if they weren't, I don't cognize if things would person happened nan measurement they happened," Romero says.

In December 2020 nan legislature voted to legalize abortion successful Argentina and successful January 2021 it was officially signed into law. Now immoderate female tin spell to a infirmary aliases a organization session and inquire for an abortion up to 14 weeks, nary mentation needed.

The run successful Argentina inspired feminists each complete Latin America. Argentinians made nan greenish bandana nan awesome for their activity and nan conflict to legalize abortion crossed nan region became known arsenic nan Green Wave. Within a mates of years, Colombia and Mexico besides decriminalized abortion.

One mightiness deliberation that erstwhile abortion was legalized successful Argentina, nan activity of Socorristas wouldn't beryllium basal anymore. Women could spell consecutive to doctors for nan procedure. And yet, Socorristas are conscionable arsenic engaged arsenic they were earlier abortion was legalized.

The twelvemonth aft abortion became ineligible successful Argentina, much than 13,000 reached retired to nan Socorristas. Of those, much than three-quarters chose to person a self-managed abortion pinch nan collective's support. In different words, nan immense mostly of these women preferred to self-manage their abortions pinch acompañamiento complete going to a doctor.

Some OB-GYNs for illustration Luchetti, who signed prescriptions for nan Socorristas each erstwhile successful a while, understand why truthful galore women are making this choice. She says, "The Socorristas method is acold superior to aesculapian attraction and is different and better. It's warm, friendly, committed."

Another doctor, Nadya Scherbovsky, mentioned that Socorristas make themselves disposable 24/7, while nan nationalist wellness strategy has strict schedules.

People who request an abortion aren't nan only ones who are reaching retired to Socorristas. Zurbriggen says she sometimes gets calls from OB-GYNs who inquire her astir really to usage abortion pills, because she has much acquisition pinch medicine abortion than galore doctors successful Argentina.

The Socorristas person go world experts connected self-managed abortion pinch pills. A 2022 study published successful The Lancet Global Health looked astatine their accompaniment method for pregnancies nether 9 weeks, and it recovered that it was conscionable arsenic effective and safe arsenic a medicine abortion managed successful a clinic.

"Misoprostol is simply a technological gyration that erstwhile you put it successful nan hands of women and those who request an abortion, it generates different revolution," Zurbriggen says. "It's a cultural, social, political, aesculapian revolution."

Reporter Victoria Estrada and editor Rhaina Cohen contributed to this article. This reporting was supported by nan International Women's Media
Foundation's Reproductive Health, Rights, and Justice successful nan Americas Initiative.