The Network: Déjà vu

Summary

Summary of "Embedded" Podcast Episode: "The Network: Déjà vu"

Podcast Information:

• Title: Embedded
• Host/Author: NPR
• Episode: The Network: Déjà vu
• Release Date: June 12, 2025

Description: In the concluding episode of the "The Network" series, NPR's Embedded explores the burgeoning self-managed abortion movement in the United States following the overturning of Roe v. Wade. Hosts Victoria Estrada and Marta Martinez delve into how a global network of activists has adapted to the changing legal landscape, providing support and resources to women seeking abortions outside traditional medical settings.

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Introduction: Shifting Abortion Rights Landscape in the US

Kelly McEvers sets the stage by highlighting the global nature of the self-managed abortion movement and its newfound prominence in the United States after the reversal of Roe v. Wade. The episode emphasizes that while self-managed abortions with misoprostol have been common in countries like Brazil, Argentina, and Mexico, the US had largely been unaware of or dismissed the concept until recent legal changes made it essential.

“For decades, while people all over the world were embracing self managed abortion with misoprostol, most Americans had never even heard of it.” [00:00]

Medical Perspectives: Dr. Maya Bass’s Evolution

Dr. Maya Bass, a family doctor who provides abortions, initially viewed self-managed abortions as risky due to the lack of medical oversight. Her concerns included potential misuse of medication and the absence of necessary medical checks.

“I didn't think it was safe, you know, as doctors were risk averse and we like control.” [01:37]

However, after Roe was overturned in 2022, Dr. Bass witnessed a dramatic increase in women seeking self-managed abortions as a necessity rather than a last resort. This shift prompted her to reevaluate her stance, leading her to support the movement by volunteering for the Miscarriage and Abortion Hotline.

“I felt also excited, slash, maybe relieved. Like, this means that I can be less scared for people who are doing this.” [13:29]

The Texas Heartbeat Bill (SB8) and Its Aftermath

The introduction of the Texas Heartbeat Bill (SB8) in 2021 marked a pivotal moment, prohibiting abortions as early as six weeks into pregnancy. This legislation ignited a surge in demand for self-managed abortions, as traditional clinic-based options became increasingly restricted.

“SB8 made it illegal to aid and abet a woman having an abortion. But the law didn't define what that meant.” [07:03]

Vero Cruz, founder of Las Tibres in Mexico, leveraged her extensive experience to support US-based women by organizing the direct provision of abortion pills, thereby expanding the network's reach into the United States.

“We floated an idea to some other collectives in the Mexican network. Why don't we build a network to help people in Texas?” [07:44]

Building the Network: Cross-Border Collaboration

Despite initial fears among US activists about legal repercussions, Mexican collectives committed to providing abortion pills directly to American women. This collaboration marked a significant expansion of the network, transitioning from a primarily underground movement to a more organized and proactive support system.

“They met in a hotel conference room in Mexico. There were almost 50 activists there from different Mexican accompaniment collectives and a handful of people video calling in from Texas.” [07:46]

Organizational Growth: Emergence of Groups like Plan C

Plan C emerged as a pivotal organization within the network, focusing on distributing abortion pills via mail and ensuring their authenticity through rigorous testing. The organization connects individuals with international clinics and US-based mailing options, providing a safer and more reliable means of accessing abortion pills.

“Plan C tests the pills from all these sources to make sure they're real.” [11:04]

Activists also employed innovative methods to raise awareness, including billboards, social media campaigns, public demonstrations, and partnerships with mainstream media outlets like Cosmopolitan magazine.

“They put up billboards, threw parties, slapped stickers advertising abortion pills on bathroom doors, and they also pulled publicity stunts.” [11:45]

Legal Challenges and Opponent Strategies

Elizabeth Ling, a lawyer with reproductive justice organization if When How, discusses the intensified legal threats against both abortion seekers and support networks. Opponents have expanded their strategies to target women and their supporters through various legal avenues, including charges related to concealing a birth or abusing a corpse.

“Abortion opponents have broadened their strategy. They have realized that banning abortions after six weeks of pregnancy is not sufficient to stop people from ending unwanted pregnancies.” [21:20]

A particularly alarming case involved a Texas woman charged with murder following a self-induced abortion, highlighting the extreme legal risks faced by individuals within the network.

“She was arrested for murder after taking abortion pills, charged with murder because of a, quote, self-induced abortion.” [22:10]

Protecting Participants: Strategies Within the Network

To mitigate legal risks, the network employs various protective measures. Elle, an abortion doula, exemplifies these strategies by coaching women on secure communication methods and providing comprehensive support during the abortion process. The network emphasizes companionship and practical assistance to ensure safety and reduce the likelihood of unnecessary medical interventions.

“Elle explains that the pills are safe, but the side effects, like vomiting and heavy bleeding, can be alarming.” [26:58]

Personal Narratives: The Experience of Support

The episode shares the story of "H," a mother who turned to the network after feeling overwhelmed by public abortion protests. Her experience underscores the network's role in providing not just medication, but also emotional and practical support, creating a more humane and supportive environment compared to sterile clinic settings.

“When I was finished, H says she felt relieved, a feeling that stayed with her. And she also felt grateful to have had the experience outside of a clinic.” [36:31]

Global Context and Future Implications

Drawing parallels to Latin America, the episode highlights how the network in the US is poised to transform abortion access by decoupling it from traditional medical and legal frameworks. The World Health Organization's guidelines in 2022 support the safety and effectiveness of self-managed abortions, encouraging its integration into broader health systems as an empowering option.

“The World Health Organization published guidelines for self managed abortion that said it's safe and effective in the first trimester.” [39:13]

Conclusion: The Evolving Landscape of Abortion Rights

As self-managed abortion becomes more mainstream, the network continues to adapt and expand in the US despite ongoing legal challenges. Hosts Victoria Estrada and Marta Martinez ponder the enduring connection between access and legality, suggesting that with the persistence of the network, safe abortions will persist even amidst stringent laws.

“Can it end safe abortion as long as the network is around.” [42:35]

The episode concludes by affirming the network's resilience and the unbinding of access from legal status, forecasting a future where the network not only survives but thrives, fundamentally altering the landscape of reproductive rights in the United States.

“There’s no putting that genie back in the bottle.” [40:36]

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Notable Quotes:

• Victoria Estrada [00:00]: “For decades, while people all over the world were embracing self managed abortion with misoprostol, most Americans had never even heard of it.”
• Marta Martinez [07:03]: “Senate Bill 8 prohibits abortions after a fetal heartbeat is detected, which can be as early as six weeks.”
• Dr. Maya Bass [13:05]: “I was taught that you need to have an ultrasound and you need to have this and you need to have all this. So like I said, I didn't think it was safe.”
• Victoria Estrada [14:41]: “It feels like I'm just on the cutting edge of medicine. I'm practicing evidence-based medicine.”
• Marta Martinez [42:35]: “Can it end safe abortion as long as the network is around.”
• Victoria Estrada [40:36]: “There’s no putting that genie back in the bottle.”

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This comprehensive summary captures the key discussions, insights, and conclusions from the episode "The Network: Déjà vu." It provides an engaging and detailed overview for listeners who have not yet accessed the episode, incorporating notable quotes and structured sections for clarity.

Transcript

[Victoria Estrada]

This message comes from the Nature Conservancy. Nature is common ground for everyone and uniting to protect nature can help solve today's challenges and create a thriving tomorrow for future generations. Discover [e-mail] NPR Hey, I'm Kelly McEvers and this is embedded from NPR. We are back with our series the Network. If you haven't already heard the first two episodes, go and listen to those. We've been following this particular part of the abortion rights movement. From Brazil to Argentina to Mexico, these activists are part of a loosely connected network that helps women have abortions with pills but without a doctor. The network and their method took off in countries where women didn't have a legal option for an abortion. And now that's the situation for a lot of Americans since Roe v. Wade was overturned. So in this final episode of the series, hosts Victoria Estrada and Marta Martinez take us to the US here's the final episode of the Network. For decades, while people all over the world were embracing self managed abortion with misoprostol, most Americans had never even heard of it. And many of those who had dismissed.

[Marta Martinez]

It for being a foreign concept, it.

[Victoria Estrada]

Was always like, oh well, yeah, but those are other countries. That doesn't apply here for being irrelevant. Because for decades Americans had a legal right to abortion. There was a lot of disbelief that something like this was needed in the United States. A big part of our narrative is that we have abortion access, right?

[Marta Martinez]

Or they dismissed it for sounding dangerous.

[Victoria Estrada]

I didn't think it was safe, you know, as doctors were risk adverse and we like control.

[Marta Martinez]

This is Dr. Maya Bass, a family doctor who also provides abortions either by performing the procedure or prescribing pills. In the U.S. patients usually take two pills, misoprostol or miso, the pill we've been hearing about, and another drug called mifepristone, which makes the process go a little smoother. Early in her career, Maya learned a strict protocol around the pills with multiple appointments and tests designed to keep patients safe.

[Victoria Estrada]

Of course I'm going to confirm exactly how big this pregnancy is. Of course I'm going to confirm that my patient has enough blood to handle this. And yeah, I want to make sure that this worked for them. To Maya and many doctors, when she first heard about self managing, getting abortion pills without a prescription and taking them without a doctor's oversight, she thought it introduced a ton of risk. Gosh, what if people are dropping like flies because they're taking meds that are actually rat poison and hurting themselves? She imagined people only turn to Self managing as a last resort. If somebody really doesn't want a pregnancy and can't get to a clinic, maybe this is an option.

[Marta Martinez]

But after Roe was overturned in 2022 for lots of women, the last resort became the only resort.

[Victoria Estrada]

Please help me. How am I able to receive the pill asap? Please. These are emails American women sent to activists who share them with us. I'm inquiring about abortion pills and how to get them sent to me.

[Marta Martinez]

I'm in no way, shape or form.

[Victoria Estrada]

Financially ready to have a child. I'm desperate. In recent years, American women have been reaching out to the network by the hundreds of thousands.

[Marta Martinez]

The network in the US is trying to meet this demand. But like we've seen in previous episodes, when the network starts to grow, it's not clear what will happen next.

[Victoria Estrada]

In Argentina, the network led to cultural and policy changes. In Brazil, it faced backlash and restrictions. So in this episode we look at how the network in the US has expanded in the last few years and what effect that's having on this country.

[Marta Martinez]

How will the network adapt in the face of mounting abortion restrictions? From NPR's Embedded and Futuro Media's Latino USA, this is the Network, a series about the DIY method that took safe abortions out of the clinic and the.

[Victoria Estrada]

Women who made it happen. I'm Victoria Estrada.

[Marta Martinez]

I'm Marta Martinez and this is episode three, Deja Vu. For decades in the US the network was almost entirely absent, but not completely. There were a few places it began showing up. In the mid-90s, we just started hearing.

[Victoria Estrada]

That patients were taking some pills.

[Marta Martinez]

This is Dr. Mark Rosing, an OB GYN who works at a hospital in the Bronx. Back then he saw patients from immigrant and Spanish speaking communities taking miso.

[Victoria Estrada]

In Spanish, they called it the star pill because it's a hexagonal pill.

[Marta Martinez]

According to Mark, the women he was seeing in his hospital could have gone to a clinic. But he says many didn't know that in New York insurance or Medicaid would cover it. So instead they relied on the network.

[Victoria Estrada]

They would say, I got it from my aunt, I got it from my cousin, I got it from someone who knows samban. And then sometimes they would also say that they got it in some of the bodegas and the pharmacies around in Washington Heights.

[Marta Martinez]

For decades, the network stayed like small, underground, mostly tied to immigrant communities. But in the late 2000 and tens, the demand for the network began to grow. American women started to lose access to doctors who could give them an abortion. During this time, states passed hundreds of new restrictions that closed clinics and shortened the time frame women had to get an abortion.

[Victoria Estrada]

And then in 2021, one state passed a law that foreshadowed where the entire country was heading. The Texas Heartbeat Bill is now in effect. A year before Roe was overturned, Texas made national headlines for this new law. Senate Bill 8 or SB8.

[Marta Martinez]

Senate Bill 8 prohibits abortions after a fetal heartbeat is detected, which can be.

[Victoria Estrada]

As early as six weeks. Barely enough time to know you're pregnant. The new anti abortion law in Texas.

[Marta Martinez]

Has generated an unprecedented level of fear.

[Victoria Estrada]

And anxiety for both providers and abortion seekers in the state. The demand for self managed abortion in Texas exploded overnight.

[Marta Martinez]

For us, it was deja vu regresarnos veintianos atras.

[Victoria Estrada]

No, it was like going back 20 years. This is Vero Cruz, the founder of Las Tibres, who we met earlier in the series. Vero heard about SB8 from friends in the U.S. it reminded her of the severe restrictions Mexico had on abortion when she started the group in 2000. With two decades of experience supporting people through self managed abortions, Vero knew how to help. And she wanted to. She floated an idea to some other collectives in the Mexican network. Why don't we build a network to.

[Marta Martinez]

Help people in Texas?

[Victoria Estrada]

Toda es y mo si.

[Marta Martinez]

We all said yes.

[Victoria Estrada]

In January 2022, Vero helped organize a meeting to strategize how to do this. They met in a hotel conference room in Mexico. There were almost 50 activists there from different Mexican accompaniment collectives and a handful of people video calling in from Texas. Nuestra Idea Principal Our main idea was that Mexican networks would train networks in Texas and the Texas networks would do the work. But there was a problem.

[Marta Martinez]

The people in Texas were really, really scared. People were like, no, no, that's illegal.

[Victoria Estrada]

They can put us in jail. SB8 made it illegal to aid and abet a woman having an abortion. But the law didn't define what that meant. So it put pretty much everything the network does into a legal gray area. Vero says the activists on the US side of the call said they weren't ready to get involved in the way she was suggesting. So Vero and the Mexican collectives decided to step in. They would directly provide women in Texas with pills and help them self manage their abortions. And they were going to be very public about it. Vero held a press conference and posted La Sivre's phone number on social media. She wasn't sure it would reach anyone, but that day, ten Americans contacted her. Solo escribialo palabra. Help. They only wrote the word help in response. The Mexican collectives carried pill packages across the border and mailed them to the people in the US who had asked for them free of charge, just like they'd been doing in Mexico for more than two decades. And as work got out, Americans from around the country started contacting Vero. Some sent money, others asked how they could join the network.

[Marta Martinez]

People wrote and said, I want to help. How do I help? I spent every day having a lot of video conferences, giving workshops, explaining to.

[Victoria Estrada]

All the volunteers how it was done, how it worked, why it was safe, training them to do a companamiento accompaniment, being there during the whole abortion process, regardless of the legal risks. And from those people, we formed a lot of groups throughout the US.

[Marta Martinez]

Self managed abortion wasn't only getting support from across the border. There were other nodes simultaneously developing around the U.S. this is new.

[Victoria Estrada]

Abortion pills by mail is really, really new in the United States.

[Marta Martinez]

This is Alyssa Wells, one of the founders of an organization called Plan C, which focuses on getting people bills without having to go to a clinic in person.

[Victoria Estrada]

A lot of people still don't even know about it and when they find.

[Marta Martinez]

Out about it, they think, whoa, you.

[Victoria Estrada]

Know, that is, that's insane.

[Marta Martinez]

Planc's website links people to a variety of places where they can order abortion pills online. In many cases both mifepristone and misoprostol. The website lists international clinics and pharmacies abroad that sell the pills and also US based groups that mail free pills to people living in states with abortion restrictions. Plan C tests the pills from all these sources to make sure they're real.

[Victoria Estrada]

These are viable ways for people to access pills, especially if they live in a place where there are so many restrictions that they could be forced to carry a pregnancy to term.

[Marta Martinez]

Other groups in the network focused on raising awareness about self managing with pills. They put up billboards, threw parties, slapped stickers advertising abortion pills on bathroom doors, and they also pulled publicity stunts.

[Victoria Estrada]

Jackson, I want to start with you. You seem to be promoting abortion pills.

[Marta Martinez]

Like activist Jacks Blackmore, they're part of the organization Shout yout abortion. In 2022, they went live on a Detroit Fox Effect affiliate to talk about the pills and do an impromptu demonstration. Charlie, I just really.

[Victoria Estrada]

I want to show you how easy it is and save it is by taking it myself. You're taking it, are you? Are you not? Are you? You're not pregnant, are you? I would say that this is going to end a pregnancy.

[Marta Martinez]

And Then some groups focused on providing support. Activists answer questions on Reddit and US based hotlines, including a hotline run by doctors like Maya Bass, the doctor we heard from earlier.

[Victoria Estrada]

I was taught that you need to have an ultrasound and you need to have this and you need to have all this. So like I said, I didn't think it was safe.

[Marta Martinez]

She thought this until she read research to the contrary. Research that showed women around the world were taking miso on their own and doing it safely. Maya was shocked.

[Victoria Estrada]

Like, wait, what? Like, seriously, I never knew about any of this.

[Marta Martinez]

Studies Maya read showed that the protocol she used, the multiple appointments, the ultrasound wasn't always needed. And she felt bad realizing that I.

[Victoria Estrada]

Was unnecessarily putting people through hoops. That's hard. And then I felt also excited, slash, maybe relieved. Like, this means that I can be less scared for people who are doing this.

[Marta Martinez]

After Maya's realization, she wanted to offer women support.

[Victoria Estrada]

So it really became like, okay, how can I help? Right? At that point it's like, what can we do next?

[Marta Martinez]

She decided to become part of the network by volunteering for the support hotline set up by doctors. It's called the Miscarriage and Abortion Hotline. Maya knew self managed abortions couldn't replace all abortions. Some people need medical intervention or just prefer to go to the clinic. But to Maya, the hotline and the immediate access it gave women to doctors felt innovative. No long wait times, no expensive or unnecessary tests.

[Victoria Estrada]

It feels like I'm just on the cutting edge of medicine. I'm practicing evidence based medicine. That is the leading edge of what reproductive healthcare might look like.

[Marta Martinez]

In recent years, American doctors on the whole have gotten more comfortable with self managed abortion. The American College of Obstetricians and Gynecologists has publicly supported it. In a statement, they called on doctors to educate themselves and provide assistance for patients who self manage. Other doctors have acted more directly, prescribing pills from states with abortion protections to people in states with restrictions. This wasn't the network of the 90s anymore. Small and niche. In the span of just a few years, it had grown and become far more organized.

[Victoria Estrada]

And then on June 24, 2022, the Supreme Court upended nearly a half century of legal precedent. The day the network had been preparing for arrived. It's a moment advocates for abortion rights have feared and that opponents have been working toward for decades. In the case Dobbs v. Jackson Women's Health Organization, the court overturned Roe v. Wade. It left the legality of abortion up to the states. Thirteen of which immediately criminalized or nearly banned abortion. On the day Roe was overturned, the number of women reaching out to the network grew exponentially. Our website traffic went from about 3,800.

[Marta Martinez]

A day to 382,000 and it didn't.

[Victoria Estrada]

Stop once Ro fell.

[Marta Martinez]

We reached about 2,000 people a day.

[Victoria Estrada]

In our first month. We have days now where the phone is kind of ringing all day. A waterfall of calls coming in groups that mail people pills were inundated. They got so many requests that it crashed their system. It just shows you how big the demand is for this service. Over the past few years, the network's role has expanded in the US and self managed abortion has become more mainstream. Cosmopolitan magazine even published a handful of articles about self managed abortion, including a complete how to Guide. But it's not just women who want abortions who are paying attention. We've certainly been called drug dealers, we've been called murderers, abortionists, you name it. The anti abortion movement is too people who are working in their communities communities to help other people access abortions. They are increasingly coming under the crosshairs. That's after the break. This message comes from NPR sponsor Rocket Money. These days, being smart with your money isn't just a good idea, it's essential. Managing finances can feel overwhelming, but luckily Rocket Money takes the guesswork out of it. Rocket Money is a personal finance app that helps find and cancel your unwanted subscriptions, monitors your spending and helps lower your bills so you can grow your Savings. Go to RocketMoney.com embedded today and reach your financial goals faster. This message comes from Thuma. Create your oasis with Thuma, a modern design company that specializes in furniture and home goods by stripping away everything but the essential. Thuma makes elevated beds with premium materials and intentional detail with clean lines, subtle curves and minimalist style. The Thuma bed collection is available in four signature finishes to match any design aesthetic. To get $100 towards your first bed purchase, go to Thuma Co NPR this message comes from Progressive Insurance. Do you ever find yourself playing the budgeting game? Well, with the name your price tool from Progressive, you can find options that fit your budget and potentially lower your bills. Try [e-mail], progressive Casualty Insurance Company and affiliates price and coverage match limited by state law, not available in all states. This message comes from stamps.com work takes up a lot of your day, but you should still have flexibility to decide how to invest your time. If your day is consumed by tedious mailing and shipping tasks, stamps.com gives you the flexibility to Focus on what only you can do. Go to stamps.com and sign up with code NPR for a special offer.

[Marta Martinez]

The legal landscape around abortion has been constantly shifting since Roe was overturned. With dozens of new state laws restricting abortion going into effect, it can be hard to keep track. And for people seeking abortions, all the changes have created a lot of uncertainty, confusion and fear.

[Victoria Estrada]

People are just absolutely terrified. They are experiencing spiraling anxiety.

[Marta Martinez]

This is Elizabeth Ling, a lawyer at if When How a reproductive justice organization. She helps run their legal helpline. She says they've been getting a lot of calls in the past few years with people asking questions about the safety of self managing their abortion or helping someone else. Not medical safety, but legal safety. If they do it, will they end up in jail?

[Victoria Estrada]

Is my Internet history being watched? Is my mail going to be searched? Is a lot of what if this happens? What if this happens? What if this happens?

[Marta Martinez]

She says the fear has made some people too scared to act.

[Victoria Estrada]

The chilling effect makes people afraid to even ask the question of what are my options? Because they are worried that like if I ask the question of what are my options, that is now somehow gonna get me into legal trouble.

[Marta Martinez]

The people who call into the legal helpline are not being paranoid. Seeking an abortion can put you at legal risk. It didn't used to be this way. Historically, abortion seekers have not been the target of restrictions. Doctors have and they still are. Some state attorneys general have sued the doctors who are doing the work we mentioned earlier, mailing pills from states with abortion protections to people in states with restrictions.

[Victoria Estrada]

But a self managed abortion with pills has taken off. Abortion opponents have broadened their strategy. They have realized that banning abortions after six weeks of pregnancy is not sufficient to stop people from ending unwanted pregnancies. Farah Diastello is a lawyer and colleague of Elizabeth's at if when how she's watched how abortion opponents have begun to target women. The the network and its method, self managing with pills. But bringing charges against women at least has been challenging because for the most part there aren't specific laws that criminalize ending your own pregnancy. With the exception of Nevada, it is not illegal for a person to self manage their abortion. So prosecutors are getting creative. They're using other laws to charge women. Laws that prohibit concealing a birth, that were intended to punish people for hiding out of wedlock births. Laws against abuse of a corpse, which are really about desecration of human remains and grave robbing. And on the most extreme end of the spectrum in some states, like we're talking about homicide charges that happened to a woman in Texas after the state passed its six week abortion ban. She was arrested for murder after taking abortion pills, charged with murder because of a, quote, self induced abortion. She's been arrested and will be arraigned Wednesday. Abortion opponents are also going after the people women are turning to for support. People who are working in their communities to help other people access abortions. They are increasingly coming under the crosshairs. In some cases, mothers who've helped their daughters self manage have been arrested. Cases like these have made news in Louisiana and Nebraska. A teenage girl and her mom in Nebraska are facing criminal charges following the teen's abortion. Police got their Facebook messages about it through a search warrant.

[Marta Martinez]

The pills themselves have also become a political target. For example, Robert F. Kennedy Jr. Brought them up at his confirmation hearing to become US Secretary of Health and Human Services.

[Victoria Estrada]

President Trump has made it clear to me that he wants me to look at safety issues.

[Marta Martinez]

He recently ordered the Food and Drug Administration to review federal regulations for one of the abortion pills, mifepristone. He referred to a paper from a conservative think tank that questioned the safety of mifepristone and called for more restrictions on the drug. But it wasn't peer reviewed and medical experts have criticized it for flaws in its analysis. More than 100 peer reviewed studies have found the use of abortion pills to be safe on the state level. Some laws fine people thousands of dollars for giving out pills if they are not licensed to provide abortions. A few make it a crime with the possibility of jail time. So far, only a few women have gone to jail for having abortions or supporting others through it. But Farah says that even for people who don't go to jail, there are still lasting effects.

[Victoria Estrada]

That person's name comes up again in Google searches and that creates this indelible, inescapable record. I've had former clients who have been unable to get work. I've had clients had to change their names because of the harassment they faced in their communities.

[Marta Martinez]

Farah's organization is if when how has been keeping track of the ways people get caught up in the legal system. About half of all criminal cases for self managing start in a medical setting, according to the organization's data. The vast majority of self managed abortions with pills do not result in any complications. But if a woman feels like something might be wrong and goes to the hospital, she increases her chances of coming into contact with law enforcement hospital personnel.

[Victoria Estrada]

Whether that was nurses, doctors, social workers reported them to law enforcement because they were suspicious of them Once that happens, it is like a train going down a track.

[Marta Martinez]

If healthcare workers think someone may have committed a crime, they're allowed to share information with the police that would otherwise be private, as we've said. Except in Nevada, self managing is not a crime. So there's no reason for doctors and nurses to call the police. But sometimes they do anyway.

[Victoria Estrada]

Farah has noticed that some people are more likely than others to end up in legal trouble. In the cases that we've worked on, it is mostly people who are trying to figure things out on their own. It has never been either somebody who was supported by an accompaniment network or somebody who was involved with an accompaniment network. The network has developed strategies to try to protect women who are having abortions. We spoke to a woman named Elle who does this work. She's an abortion doula. That's what many Americans who do a companamiento call themselves. We're not using Elle's full name because she fears potential violence against her. We're also using a voice actor. From the moment that women reach out, Elle coaches them on how to keep their communication secure. If they contact her on Gmail, she'll.

[Marta Martinez]

Tell them, this is not safe for you or us and I can't interact with you until you download an encrypted app.

[Victoria Estrada]

Once they're in touch, Elle explains that the pills are safe, but the side effects, like vomiting and heavy bleeding, can be alarming. She walks them through how to help prepare so they don't seek medical help unnecessarily.

[Marta Martinez]

You should have plenty and plenty and plenty of maxi pads. You should have your ibuprofen and you should have plenty of fluids.

[Victoria Estrada]

Elle also advises women on how to take the pills. Elle tells them to not insert the miso vaginally, where it can leave a residue, but to dissolve it in their cheeks or under the tongue. That way, if they go to the hospital, there's no evidence they've done something to cause an abortion.

[Marta Martinez]

The symptoms of an incomplete abortion and the symptoms of a miscarriage are identical.

[Victoria Estrada]

They can't tell once the abortion starts. Elle checks in often and if a woman needs or wants to see a doctor, Elle tells them to call the miscarriage and abortion hotline, the one run specifically by doctors. Or she points them towards doctor's offices that the network trusts. In some places we have friendlies, you know, we have clinics where we know we can safely send someone if they need to get care. Outside the network's connections, Elle runs through what to say to medical staff. We role play what would you say if? And I said, what's going on? What did you do? What did you take? Well, what's going on is, I don't.

[Marta Martinez]

Know, I think I might be having a miscarriage.

[Victoria Estrada]

I started bleeding all of a sudden.

[Marta Martinez]

The network is also taking measures to protect itself. When speaking in public, volunteers have learned how to use language that isn't incriminating. They talk in a code of hypotheticals, even in social media videos.

[Victoria Estrada]

I figured I would let you know.

[Marta Martinez]

What I would do if I were to find out I was pregnant and I wanted to have an abortion.

[Victoria Estrada]

Now please note, this is not medical.

[Marta Martinez]

Advice whatsoever, or at all. Just one person sharing resources with another.

[Victoria Estrada]

I would take four of the misoprostol. Have you ever seen a more iconic pill?

[Marta Martinez]

So far, the growing legal restrictions have not stopped the network in the US from helping women self manage their abortions. But there's another challenge. The network is struggling with a much broader invisible force. That's after the break.

[Victoria Estrada]

This message comes from Strawberry Me. You've worked hard to get where you are, but what's next? Strawberry Me career coaching helps professionals like you take the next big step with confidence by matching you with a certified career coach who understands your goals and challenges. This isn't just advice. It's a personalized, results driven approach to uncover hidden strengths, overcome obstacles and accelerate your career growth. Visit Strawberry Me NPR to claim your $50 credit. This message comes from BetterHelp. June is Men's Mental Health Month and every year 6 million men in the US suffer from depression. If you're feeling overwhelmed, the strongest thing you can do is ask for help. And BetterHelp can make it easy. Take a short online quiz and connect from home with a qualified therapist. Visit betterhelp.com NPR today to get 10% off your first month. That's betterhelphelp.com NPR the network is global, stretching all around the world. But in each place it shows up, it's different. It adapts to the specific culture it lands in and faces specific barriers.

[Marta Martinez]

In the US One of the largest barriers is awareness. For so long, access to abortion in the States was centered around clinics. As a result, many Americans don't know there's a way to have a safe abortion without a doctor's help.

[Victoria Estrada]

Research published in 2024 found that most Americans who have attempted to self manage their abortion in the past few years have done dangerous things like hid themselves in the stomach or drink alcohol. Only about a quarter of the women in this study use pills.

[Marta Martinez]

When Americans do find the network they're very American about the way they interact with it. They treat it like a service. Vero, who started Las Libres in Mexico, noticed this as she began supporting women in the States.

[Victoria Estrada]

I would take some time to reply.

[Marta Martinez]

To them and it was like, hey, answer me.

[Victoria Estrada]

I wrote to you five minutes ago.

[Marta Martinez]

And it was like, hey, wait, no.

[Victoria Estrada]

Vero explained that Las Tibres was not a service or a business. It was just a bunch of volunteers sharing pills and offering support. Te pido paciencia y te pido respeto.

[Marta Martinez]

So I'm going to ask for your patience and I'm going to ask for your respect.

[Victoria Estrada]

And people were like, oh, sorry, I'm just very nervous. And just like a purchase. After women in the US got what they needed, that was it. It's very American in some ways to.

[Marta Martinez]

Say, oh look, there's a pill, let me get the pill. One sociologist we spoke to, Naomi Brain, has studied the self managed abortion movement across the world. She's noticed that Americans generally think that the pills alone can overcome abortion restrictions. But Naomi wants them to think bigger.

[Victoria Estrada]

This pill only comes to life in some way within a network. It only comes to life in the presence of solidarity. Otherwise you're alone with cramps in a bathroom and nobody knows. And that's really not a very liberatory experience.

[Marta Martinez]

Elle, the abortion doula is a bit more pretty. She thinks the pills in and of themselves are powerful. But like Naomi, she wants Americans to focus more on supporting each other.

[Victoria Estrada]

I wish there were more.

[Marta Martinez]

We need more people. But she doesn't see that happening anytime soon.

[Victoria Estrada]

I think that people are really heads down, trying to survive a lot and not necessarily thinking about linging arms and marching forward in solidarity.

[Marta Martinez]

Whereas in Mexico, I have the sense.

[Victoria Estrada]

That the circle keeps growing. The people who've been helped directly turn around and help others. But in our reporting, we have seen the circle widening in the US in ways that remind us a lot of how the network took shape decades ago in Latin America. We heard stories of older sisters who had self managed before helping their little sister through it. People getting pills and advice from their hairdresser, and several examples of people who had been supported by doulas getting trained to become doulas themselves. Yeah, I just wanted to be a part of it too, you know. This is H. We're using her initial because she fears harassment for what she did in 2019. H, a mom of four kids decided she wanted an abortion. She could have gone to a clinic, but she'd heard about protesters lining the sidewalks with Bullhorns and signs. She didn't think she could handle. Walking through all of that, I didn't feel shame, but I felt like I could have been persuaded to be shamed of what I was about to do. H worked in the reproductive health space and a friend in the same field told her about the network. H's friend was part of it and said she could get H pills for free. H was pretty surprised something like it existed with aliases and everything, like, oh, there's a whole group of you and you're all like underground and Secret Squirrel and using different names and all this stuff. It was just mind blowing.

[Marta Martinez]

Her friend, who's an abortion doula, offered to support H through a self managed abortion. H hadn't realized it was possible to do it this way, but she was in.

[Victoria Estrada]

I wanted some autonomy and control over the situation.

[Marta Martinez]

Her abortion doula friend helped H think through where she wanted to have her abortion and what she needed to be comfortable. When the day came that Friend, along with another doula friend and H, gathered in a hotel room with plenty of comfort food, H started by lighting a candle and taking time to reflect.

[Victoria Estrada]

I wrote out some negative feelings or anxieties that I was having and I ripped them up and we threw them away as like a release ceremony.

[Marta Martinez]

And then she took the pills. When she started bleeding and cramping badly, the women accompanying H reassured her, like, is this normal?

[Victoria Estrada]

Is this okay? You know? And they were like, yes, yes, yes.

[Marta Martinez]

To help her manage the pain, H's friend prepared the bath for her and poured cups of hot water down her back. They stayed with her all night through the next morning.

[Victoria Estrada]

When I was finished, H says she felt relieved, a feeling that stayed with her. And she also felt grateful to have had the experience outside of a clinic. I just wish that there was more of a focus on creating spaces for people that are going through this experience. Experience, that's my desire, is that everybody gets to experience being supported through their abortion and that it's not just this sterile thing that you have to go through. After her abortion, H wanted to create those spaces for others. And so she trained to become an abortion doula. She remembers supporting one woman as she managed her abortion at home. They were eating food and watching an episode of the sitcom Maude where the main character had an abortion. Walter, don't pat me there. That's what started this whole thing. We were just joking and laughing and then her cramping got a little bit harder. When the woman started cramping, H told her to get into a hot bath to help manage the pain, just as her doulo friends told her to do during her own abortion. She got out of the tub eventually and walked over to go open the sliding glass door and turned around and the pregnancy expelled as she was like taking the step and she realized what happened and instantly dropped to her knees, H says. The moment suddenly became still and quiet and then the woman went out onto her deck where she had plants. She was crying. She buried it in a pot of wildflowers that her other children had potted. And then we tucked her into bed like right before her husband brought her children home.

[Marta Martinez]

When H got involved with the network, she didn't know the history she was stepping into. How Brazilian women discovered miso, how Latin American activists built entire communities to support women using this pill. She didn't realize that her experience was part of such a large scale shift. The pills and the communities growing around them are already changing how people have abortions across the world.

[Victoria Estrada]

In 2022, the World Health Organization published guidelines for self managed abortion that said it's safe and effective in the first trimester. In our reporting, we found that parts of the network safely support people later into their pregnancies. The guidelines even mention accompaniment and say that women who self manage benefit from access to support, which doesn't necessarily have to come from a doctor.

[Marta Martinez]

In places with abortion restrictions, like the country where we started the series Brazil, self managed abortion may be the only option for most people who want to end their pregnancies. But the WHO encouraged doctors to not look at self managed abortion as just a last resort, but a potentially empowering and active extension of the health system. Plenty of women already see self managed abortion this way. Like in Argentina. The year after abortion became legal there, thousands of people reached out to the accompaniment collective we mentioned in the last episode, the Socorristas. More than three quarters of those people chose to self manage women with the socorrista support instead of going to the public health system. So the network has totally changed what abortion looks like in Argentina.

[Victoria Estrada]

Will the network do the same for the US too? There's no putting that genie back in the bottle. This is Dee Redwine. She's American, but for 30 years she worked for Planned Parenthood Global in Latin America. She watched as the pill and the network swept across the continent and now she's seeing signs that something similar is happening in the us. That wave is coming. It's here. It's like crashing over the shores of the United States. And it is going to change entirely the landscape of abortion just like it did globally.

[Marta Martinez]

The entire ecosystem around abortion pills in the U.S. activists, doulas and doctors has contributed to a surprising statistic. Since Roe fell, Americans are having more abortions even in states with bans.

[Victoria Estrada]

The irony of this post Dobbs World is that if it goes the way that I think it will, which is what I saw in Latin America, in some ways abortion ironically will become more accessible but less legal in the minds of many Americans. Access and legality are inextricably linked, but these two things are becoming untethered because of abortion pills and because of the.

[Marta Martinez]

Network in the years to come. There's a question, but both abortion rights supporters and opponents will be asking the government can make abortion illegal, but can it end safe abortion as long as the network is around.

[Victoria Estrada]

Foreign this was the final episode of the network. If you want to learn more about the network, like how Dr. Maya Bass and other doctors changed their minds about self managed abortion, go to npr.org embeddednetwork that's npr.org embeddednetwork.

[Marta Martinez]

The network from embedded is a collaboration with Latino USA, a production of Futuro Media.

[Victoria Estrada]

This episode was reported by Abby Wendell.

[Marta Martinez]

And me Victoria Estrada and me Marta Martinez. This episode was produced by Ariana Garrett Lee, Adelina Lancianniz and Abby Wendell, with production support from Monica Morales Garcia.

[Victoria Estrada]

Raina Cohen edited the series, fact checking by Donya Suleiman.

[Marta Martinez]

Robert Rodriguez mastered the episode.

[Victoria Estrada]

Liana Simstrom is our supervising Senior producer, Katie Simon is our supervising Senior editor, Irene Noguchi is our executive producer, and Colin Campbell is the Senior Vice President for podcasting at npr.

[Marta Martinez]

The Embedded team also includes Luis Reyes.

[Victoria Estrada]

And Dan Girma from Latino usa. Our executive producers are Marlon Bishop and Penile Ramirez, and our production managers are Jessica Ellis and Nancy Trujillo.

[Marta Martinez]

Thanks to our Managing Editor of Standards and Practices, Tony Kavin, and to Johannes Durgi and Micah Radner for legal support and Tommy Evans, NPR's managing editor.

[Victoria Estrada]

Editorial Review and thanks to NPR correspondents Selena Simmons Duffin and Alyssa Natworny.

[Marta Martinez]

Our Visuals Editor is Emily Vogel. Original tile art by Luke Medina, voiceovers.

[Victoria Estrada]

By Andrea De Alva Alvarez, Barbara Trihar, Justine Yan, Liana Simstrom and Abby Wendell.

[Marta Martinez]

And thanks to Matthew Ahlstrom for the engineering assist. This is our final episode of the network and we want to thank the many people that we've talked to who didn't appear or weren't mentioned in the series, including Phoebe Abramovic, Amelia Bono, Simone.

[Victoria Estrada]

Denise, Angel Foster, Jessie Hill, Jen Carlin, Vanya Maia, Ariella Messing, Maureen Paul, Jamila.

[Marta Martinez]

Parrott, Mariana Brandini, Catherine Romanos, Roos Doulas, Lupita Sanchez, Kerry Sistra, and Susan Yano.

[Victoria Estrada]

Your knowledge and experience helped us shape this series, and we're grateful for the time you gave us. And a big thanks to our Embedded plus supporters. Embedded is NPR's home for ambitious journalism, and Embedded plus helps us keep that work going. These supporters get early access to every Embedded series, and they get to listen Sponsor free. Find out [e-mail] embedded funding for this.

[Marta Martinez]

Series provided in part by the Levi Strauss foundation, outfitting movements and leaders fighting for a more just and abundant world world and the International Women's Media foundation as part of its Reproductive Health Rights and Justice in the Americas initiative. I'm Marta Martinez.

[Victoria Estrada]

I'm Victoria Estrada.

[Marta Martinez]

This is Embedded from npr.

[Victoria Estrada]

Thanks for listening.

[Marta Martinez]

Muchas gracias for escuc.

[Victoria Estrada]

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