Podcast Summary

Podcast: This Is Woman's Work with Nicole Kalil
Episode: Access, Agency & The Abortion Underground with Rebecca Grant | 358
Air Date: November 3, 2025
Host: Nicole Kalil
Guest: Rebecca Grant, journalist and author

Episode Overview

This episode explores the evolving landscape of reproductive rights in the U.S., focusing on access, agency, and the realities of abortion care post-Dobbs. Nicole and guest Rebecca Grant—an acclaimed journalist and author of Access: Inside the Abortion Underground and the 60 Year Battle for Reproductive Freedom—delve into the historical, legal, and social complexities surrounding abortion, the myths that persist, and the impact of recent legal and medical shifts. Above all, the conversation is a call to protect individual choice and equity for women.

Key Discussion Points & Insights

1. The Foundation of Choice and Reproductive Freedom

• Nicole sets the tone by underscoring the mission of the podcast: to redefine "woman's work" as whatever feels authentic and true to the individual.
• Expresses the difficulty and importance of honoring different choices:
  • “If I really mean it when I say you are the decider, then I have to leave space for someone else to choose differently, even if it's the opposite of what I would choose. And friend, that ain't easy.” (03:05, Nicole)
• Declares reproductive freedom as the “clearest, sharpest measure of whether women in any society actually have choice and equity.” (04:03, Nicole)

2. Historical Perspective on Abortion Rights in America

Rebecca Grant provides a historical overview:

• Got into reproductive rights reporting amidst a complacent yet transformative era (post-2010 Tea Party wave, rise of TRAP laws). (05:35, Rebecca)
• Describes legislative efforts that chipped away at access under the guise of safety:
  • “All of these laws were not actually about promoting women's health and safety. They were about making it harder to provide abortion care.” (07:18, Rebecca)
• Emphasizes non-linearity of abortion rights history—periods of progress and setbacks, with each advance met by new forms of opposition.
• The Dobbs decision (2022, overturning Roe v. Wade) was devastating but also a catalyst for transformation in the movement:
  • “For many people, the 2022 decision that overturned Roe Dobbs vs Jackson Women’s Health Organization was a wake up call… it has… transformed the reproductive rights movement…” (09:37, Rebecca)

3. The Persistence and Universality of Abortion

• Abortion is not new; it has always existed across cultures and eras:
  • “As long as there are people who can get pregnant, there will be people who don't want to be pregnant and will look for a solution... The idea that you could ever get rid of abortion is just… not true.” (12:08, Rebecca)
• Historical context: Early term abortion wasn't universally seen as abortion or as immoral. Euphemisms like “restoring the menses” were common. (11:24, Rebecca)
• Linkage of abortion with sin or murder is relatively recent, tightly associated with certain branches of Christianity in the late 1970s and 80s.
  • “Religious leaders were a major part of the movement for abortion in the late 60s and early 70s…” (13:14, Rebecca)
  • “That deep connection between religion... and opposition to abortion... didn't become as closely tethered… until the 80s.” (13:45, Rebecca)

4. Current Landscape & the Role of Medication Abortion

Most significant recent shift:

• Medication abortion (mifepristone and misoprostol) has transformed access.
  • Now, roughly 1 in 4 U.S. abortions happens via telemedicine. (17:21, Rebecca)
• The COVID-19 pandemic loosened restrictions, allowing mail distribution, which increased privacy and accessibility.
• The availability of abortion pills has led to increased abortions post-Dobbs, even amid restrictive state laws:
  • “Abortion has gone up since the Dobbs decision... There have been more abortions each year since Dobbs than there were before that.” (17:45, Rebecca)
• Shield laws in blue states protect providers serving out-of-state patients.

5. The Meaning and Evolution of the “Abortion Underground”

• Historically, the "underground" involved networks of referral and travel—notably the Clergy Consultation Service—providing safe access pre-Roe.
• Today, this encompasses:
  • Legal travel and support ("not underground"): Abortion funds, protected by law, help people leave restrictive states for care. (19:45, Rebecca)
  • Community support networks ("underground in the purest sense"): Discreetly source and mail medication to those in need, outside official channels. (23:10, Rebecca)
  • Modern context: “Underground” now often means resisting hostile regulations, but much of the vital support work is entirely legal.

6. The Ongoing Need for Clinical Abortion Providers

• Medication abortion is not suitable for everyone—clinical options remain essential for later term, complicated, or wanted pregnancies with complications.
  • “Doctors... will always be necessary. ...Abortion bans make pregnancy more dangerous for everyone.” (25:50, Rebecca)
• Maternal health and abortion care are inseparable: bans exacerbate America's existing maternal mortality crisis, with notable provider exodus and hospital closures in states like Idaho.

7. U.S. Maternal Health Crisis

• America still fares worse on maternal mortality compared to peer nations—and the situation is worsening in many states.
  • “We're one of the only countries where our maternal mortality rates have been getting worse. That's pretty shocking.” (28:57, Rebecca)
• In states with strict bans (e.g., Idaho), pregnant women are increasingly seeking airlift insurance due to lack of local adequate care.
  • “Women in Idaho are increasingly getting airlift insurance because... they do not trust that they will be able to get timely urgent care.” (30:39, Rebecca)

8. Common Myths and Misinformation

Myth 1: “Making abortion illegal will reduce abortions.”

• In reality, abortion incidence has increased since Dobbs as people find new channels, especially via medication. (32:30, Nicole)

Myth 2: “Abortion is only for people who don’t want children.”

• 60% of abortion seekers are already parents; many make their decision “to be the best possible parent to the children that they have.” (33:13, Rebecca)

Myth 3: “Medication abortion is unsafe.”

• There’s vast, longstanding data on the safety of mifepristone; regulatory and political battles are not based in science.
  • “The idea that it needs additional review or study is ridiculous.” (35:25, Rebecca)

Myth 4: “Abortion is a Left/Right or religious issue.”

• People across the political and religious spectrum seek abortion; personal experience often trumps ideology.
  • “People from lots of different faith backgrounds and political backgrounds have abortions.” (36:39, Rebecca)
• Some patients protest clinics yet seek care for themselves—shows complexity and the need for empathy over judgment.

Myth 5: “Most people regret their abortions.”

• The landmark Turnaway Study disproves this; most people report relief, not regret.
  • “People do not regret their abortions. ... Generally [they] feel relief and this sense of freedom.” (39:22, Rebecca)

Notable Quotes & Memorable Moments

• "If you oppose abortion, don’t have an abortion. That feels fairly straightforward to me. But imposing that…on other people…I still have a hard time understanding."
  (37:24, Rebecca)

• "Choice is the foundation. It's the starting line, the through line and the finish line. The freedom to decide what is right, true and real for you… Without it, we cannot be free or have equity."
  (41:14, Nicole, episode closing)

• On the fundamental persistence of abortion:

  • “As long as there are people who can get pregnant, there will be people who don't want to be pregnant and will look for a solution... The idea that you could ever get rid of abortion is just… not true.” (12:08, Rebecca)

Timestamps of Important Segments

• 04:03 – 05:35: Nicole frames reproductive freedom as the "hill she'll die on."
• 05:35 – 09:47: Rebecca outlines the last decade of U.S. abortion politics and TRAP laws.
• 10:18 – 12:47: Historical depth—abortion as a persistent, pre-modern, cross-cultural reality.
• 13:14: Religion’s evolving role; abortion’s moral framing is recent.
• 14:47 – 17:50: The rise of medication abortion; changing the access landscape.
• 19:45 – 23:10: Defining the "abortion underground"—then and now.
• 25:50 – 28:35: Clinical needs remain post-medication abortion.
• 28:57 – 30:39: U.S. maternal health statistics and impact of state bans.
• 32:25 – 36:39: Busting abortion myths; complexity of personal choices.
• 39:22 – 40:11: Turnaway study findings—abortion regret myth debunked.
• 41:14: Nicole’s closing remarks on the primacy of choice.

Tone and Language

• Empathetic, evidence-based, urgent, and nuanced.
• The conversation is grounded in journalistic rigor (data, studies, firsthand narratives), including Rebecca’s lived experience in the field. Nicole is candid about her own biases while striving to focus on facts, inclusivity, and the foundational value of choice.

Conclusion

The episode underscores that "woman's work," and true freedom and equity, revolve around each woman’s power to choose—for her body, health, and future. Despite escalating legal and political battles, Rebecca Grant’s reporting (and history itself) demonstrates the enduring demand for, and innovation around, abortion access. The fight for agency and dignity continues, but the message is clear: choice is not part of the definition of freedom—it is the definition.