Embedded: The Network – Saint-o-tec
Release Date: June 5, 2025
Host/Author: NPR
Description: NPR's home for audio documentaries brings untold stories to light through deeply reported narrative series. This episode explores the global movement supporting self-managed abortions, focusing on the development and dissemination of the abortion pill Cytotec.
1. The Fall of Roe v. Wade and Immediate Aftermath
The episode begins with the historic overturning of Roe v. Wade, marking the most significant change to abortion rights in the United States in nearly half a century. Hosts Victoria Estrada and Marta Martinez describe the emotional and societal impact of this decision.
Victoria Estrada (01:13): "It was one of those moments when people understand they're witnessing history. They remember where they were."
Marta Martinez (01:33): "They remember where they were when Roe v. Wade fell."
Following the Supreme Court's decision, 13 states swiftly enacted bans or severe restrictions on abortion, eventually affecting nearly half of all states. This led to the closure of numerous clinics and forced many women to travel long distances to obtain abortions.
Victoria Estrada (02:28): "The day after the fall of ROE, 13 states immediately banned or severely limited abortion."
Opposition to the ruling led to widespread anxiety among abortion rights supporters, who feared a regression to the early 1900s in terms of women's reproductive rights.
Victoria Estrada (02:10): "This is an emergency. This is an extreme crisis. People will die."
2. Introduction to The Network: Saint-o-tec
Amidst the chaos, not all were panicking. A decentralized group, referred to as "The Network," emerged, dedicated to expanding abortion access through unconventional means. This network operates without formal organization, spanning across borders and connecting diverse individuals—from midwives and nurses to grandmothers and friends.
Victoria Estrada (03:37): "This network, it's hard to even describe because it's not formal or centralized."
Marta Martinez (03:32): "I'm actually energized."
The Network's primary method involves empowering women to self-manage their abortions safely, without the direct involvement of medical professionals.
3. The Birth of Cytotec: A Safe Abortion Pill
The narrative shifts to Brazil in the late 1980s, where Cytotec (misoprostol), initially developed to treat gastric ulcers, inadvertently became a revolutionary tool for safe abortions. Despite the FDA's slow approval, Cytotec was available in Europe and Brazil by 1986.
Victoria Estrada (22:22): "In 1973, the same year that Roe v. Wade was decided in the United States, something else happened that transformed reproductive healthcare..."
Cytotec's side effects—inducing contractions and causing miscarriages—made it a viable option for women seeking to terminate pregnancies discreetly and safely.
Dr. Rivaldo Albuquerque (03:02): "It was a lifesaver. In so many ways, it's the equivalent to the discovery of penicillin because it's a before and after."
4. Personal Stories: Women Navigating Abortion Access
The episode shares the poignant story of a woman referred to as R., who navigated two abortions under vastly different circumstances. Her first abortion in her early teens involved unsafe methods, leading to severe health complications and the loss of a fellow patient.
Dr. Rivaldo Albuquerque (14:16): "They are in a situation of suffering, of vulnerability. Their health and their life are at risk."
Her second abortion, facilitated by Cytotec, was markedly safer and more controlled, highlighting the transformative impact of the pill.
Unnamed Woman (25:28): "The Second time I didn't have a lot of side effects. I felt more comfortable."
5. Medical Community's Response and Transformation
Dr. Rivaldo Albuquerque, an obstetrician-gynecologist in Recife, recounts the drastic reduction in maternal mortality and abortion-related complications following the introduction of Cytotec. Initially skeptical, he observed a significant decline in severe cases as women became more adept at using the pill.
Dr. Rivaldo Albuquerque (21:01): "From 1986 to 1991, the time Sarah and Rivaldo were observing the World Health organization recorded a 21% drop in Brazil's maternal mortality rate."
The medical community's reception was mixed; while some doctors witnessed the positive outcomes, others remained hostile, even involving law enforcement to punish women seeking abortions.
Dr. Rivaldo Albuquerque (16:38): "Women who had tried to have an abortion were the last ones to be treated during our shift."
6. The Spread of Cytotec and Formation of a Support Network
As knowledge of Cytotec spread through word-of-mouth among women, a robust support network formed. Women shared information on how to use the pill effectively, transforming self-managed abortion from a risky endeavor into a safer, more reliable option.
Deborah Diniz (35:12): "Women know how to be scientists at home, when science is not offering what they need."
Sales of Cytotec skyrocketed, with over 50,000 boxes sold monthly in Brazil during the late 80s and early 90s. Its affordability and accessibility made it a preferred choice over traditional clinic-based abortions.
Deborah Diniz (36:15): "Five reasons. One, it was discovered by women. It was shared from woman to woman. It proved to work and to be safe. It was used for an essential need to women's lives. And it was available at the community level."
7. The Legacy and Global Impact of Saint-o-tec
Cytotec, known by various names such as Saintotec, has become the most commonly used abortion pill globally. The World Health Organization endorses its safety for self-managed abortions up to 12 weeks of pregnancy. The Network continues to expand, spreading knowledge and support across Latin America and into the United States, despite legal challenges.
Victoria Estrada (39:44): "Experts believe it's now the most commonly used abortion pill in the world, and the World Health Organization says it's safe to self manage with pills through 12 weeks of pregnancy."
The episode concludes by highlighting the ongoing efforts of The Network to support women, challenge medical and legal barriers, and ensure safe reproductive healthcare worldwide.
Jacqueline Pitangui (40:46): "Someone was going to do what we didn't dare to because we had a license and we were afraid of the law."
8. Production and Acknowledgments
The episode was produced in collaboration with Latino USA and supported by various foundations and contributors dedicated to reproductive health and justice in the Americas.
Conclusion:
"The Network: Saint-o-tec" delves deep into the grassroots movement that transformed abortion access through the dissemination of Cytotec. By sharing personal stories and expert insights, the episode underscores the resilience and ingenuity of women navigating restrictive reproductive laws, highlighting the critical role of community-driven solutions in safeguarding reproductive rights.