In the wake of the Supreme Court’s decision in Dobbs v. Jackson to overturn Roe v. Wade and end the constitutional right to abortion, the five states bordering Illinois banned and restricted abortion to varying degrees. Current access ranges from legal but restricted in Iowa, to legal but severely restricted in Wisconsin and Indiana, to illegal in Missouri and Kentucky. Illinois is an outlier in the Midwest, providing a “beacon of hope,” as Governor J.B. Pritzker put it, in a region that is largely anti-choice. In the past few years, Illinois legislators have passed multiple reproductive-health-expanding bills, such as the 2019 Reproductive Health Act, which established abortion as a fundamental right in Illinois. And, in early June, Pritzker approved the repealing of the Parental Notice of Abortion Act for minors, which had required parental notification before an abortion. After Dobbs, Illinois saw an influx of patients seeking abortion from nearby states; in June, for example, Illinois Planned Parenthoods provided 800 abortions to out-of-state patients, up from 100 the month before.
But despite seeming like an oasis at the moment, Illinois may not be safe forever—South Carolina’s Republican Senator Lindsey Graham introduced a bill a few weeks ago for a nationwide ban on abortion after fifteen weeks, which could go up for a vote if Republicans take control of Congress in the midterms. For those looking to support people seeking abortions and reproductive care, Robin Marty’s The New Handbook for a Post-Roe America provides a thorough guide for an increasingly abortion-restrictive country. Though written before the Dobbs decision, Marty had the foresight that Roe would fall, and provides a guidebook for preventing pregnancy, ending pregnancy, advocating for reproductive rights and maintaining your privacy in an uncertain era.
This book isn’t intended to be read cover-to-cover, but rather to be used as a hands-on resource to inform the reader and guide them to services they need. Each chapter centers on a broad topic and ends with a worksheet to assist the reader in acting on what they’ve learned.
The book starts with the history of the reproductive access movement and then turns to preventing and ending pregnancy for yourself. Marty spends some time making sure readers understand the menstrual cycle, as it is essential to managing fertility and navigating abortion laws. Most people have a twenty-eight day menstrual cycle, with day one being the first day of menstruation, when the uterus sheds its lining and results in cramping and bleeding. Ovulation typically begins around day fourteen and is when the person is at their most fertile. Sperm can survive in a uterus for up to five days and, “if live sperm is present either when the egg is released or within twenty-four hours of ovulation, fertilization will happen and the newly fertilized egg will begin to travel to the uterus and embed into the lining, a process that takes anywhere from seven to ten days.” If fertilization does not occur, the egg and the uterine lining will shed a few days later at the start of menstruation.
This knowledge is especially important in calculating the age of a pregnancy, since restrictive anti-abortion laws often institute the ban at a specific number of weeks. One method is gestational age, which is measured from the last menstrual cycle; another is post-fertilization age, which is measured from when the egg was likely fertilized around day fourteen, and so comes out to two weeks less than gestational age. Laws banning abortion at twenty weeks, for example, use post-fertilization age, but by the gestational age measure, which is more commonly used in medical settings, it would come out to twenty-two weeks.
Marty describes and explains a number of pregnancy prevention options, including proactive measures like birth control pills and condoms, as well as reactive methods like Emergency Contraception (EC). Birth control pills are commonly used and 91% effective at preventing pregnancy, but there can be barriers to their use, such as cost, access to doctors for a prescription, and transportation to the pharmacy. Condoms are 85% effective at preventing pregnancy and can prevent the spread of sexually transmitted infections. Long Acting Reversible Contraceptives (LARCs) like an IUD or a copper implant are 99% effective since there is no room for human error—however, they can be expensive out of pocket and require a medical professional to insert and remove. The most effective birth control method is sterilization via permanent surgical procedures like tubal sterilizations for people with ovaries and vasectomies for people with testicles.
Emergency contraception (EC) is commonly used when a person believes they may become pregnant following intercourse. A copper IUD is the most effective form of EC and will protect against pregnancy up to five days after intercourse, but it must be inserted by a medical professional. EC pills such as Plan B One Step, Next Choice One Dose, and AfterPill all work up to five days post intercourse, and are most effective within the first seventy-two hours. EC pills are available at pharmacies regardless of gender or age and without ID. For people looking for EC, afterpill.com has options delivered by mail.
The coat hanger has become a symbol of a post-Roe world and references one of the many dangerous methods pregnant people used to induce an abortion prior to the passage of Roe. While the coat hangers acted as a graphic and effective reminder of the past, Marty reminds us that pregnant people have far more options when terminating a pregnancy than they did fifty years ago.
Many abortions can be done safetly at home using medications like Mifepristone, which have been legal in the US since 2000. Medication abortions conducted independently of a medical provider have been shown to be safe and effective for first and second trimester abortions. Taking Misoprostol alone is 80–85% effective for pregnancies before twelve weeks and Mifepristone combined with Misoprostol is 95–98% effective before ten weeks—taken later in the pregnancy, stronger bleeding or cramps become more common. Mifepristone blocks progesterone receptors, terminating the pregnancy, and Misoprostol induces contractions and should be taken after Mifepristone. Most abortion clinics can provide information about accessing abortion-inducing medications. In a number of states, including Illinois, you may qualify for medication by mail by visiting teleabortion.net.
If a pregnant person decides to pursue an abortion within a clinical setting, Marty warns caution when selecting a clinic. Across the United States, anti-abortion activists have set up Crisis Pregnancy Centers (CPCs), clinics that claim to be “full-scale, full-service reproductive health clinics,” but in reality do not provide abortion or accurate information. Despite Chicago’s progressive policies regarding abortion access, Reproaction Education Fund lists 110 CPCs in Illinois and eight in the Chicago area, including Aid for Women Inc. in Back of the Yards and Lawndale Christian Health Center in North Lawndale.
Marty also warns readers about manipulative language that anti-abortion activists use when talking about abortion. For instance, abortion activists often claim fetuses feel pain, and while it’s well documented that the receptors needed to feel pain develop by twenty weeks gestation, it’s not until near the third trimester that the fetus’ nervous system is able to transmit the pain to the fetus’ brain. They also use terms like “born alive”, “viability” and “infantacide” to garner sympathy for their cause. The use of these terms is misleading because while fetuses may be born “alive” prior to twenty-two weeks’ gestation, their lungs “lack the surfactant necessary for them to inflate and deflate without tears or collapse,” making survival impossible.
Despite reproductive health care rights being codified into law in Illinois, Marty emphasizes that since it is no longer a constitutional right, remaining vigilant during elections is essential, especially during local elections. In Arizona, the midterm race for Governor will determine the state’s access to abortion after the Arizona Supreme Court banned nearly all abortions. Gubernatorial candidate Katie Hobbs has promised to repeal the abortion ban if elected whereas candidate Kari Lake is strongly “pro-life.”
Volunteering at abortion clinics as an escort or assisting pregnant people as an abortion doula are other ways to directly assist pregnant people. Frequenting businesses near the clinic as well as those that work with the clinic is another way to support clinics as intimidating abortion clinic vendors is a common tactic used by abortion opponents. Marty stresses the importance of centering abortion movements created and led by Black people, Indigenous people, and people of color (BIPOC) and not replicating efforts. “We must deliberately and purposefully bring antiracism into every action we take. That means centering BIPOC in every level of activism and stepping back our support of white-led organizations that ignore—or even worse outright appropriate—the cause of reproductive justice as their own.” This is essential so that reproductive services are accessible and inclusive to everyone, not just cisgender white women.
In order to safely access abortion services and help others do so, it may be important to avoid surveillance and not leave a digital trail. Marty suggests purchasing a burner phone if possible or choosing one device to research and plan on. Additionally, avoiding open phone lines and instead opting for encrypted texting apps like WhatsApp, Signal and Jitsi will ensure phone records can’t be subpoenaed during a trial. Practicing digital safety by using strong passwords, enabling two-factor authentication and clearing your search history are also in general good ideas. Marty warns that if a legal investigation occurs after a miscarriage, prosecutors may use visits to an abortion clinic website or texts expressing uncertainty about the pregnancy as evidence. In August, for example, Nebraska prosecutors charged a mother for helping her daughter perform an abortion after subpeoning their Facebook messages, which showed the two had discussed using abortion medication.
This book is informative and straightforward. It talks plainly about the state of reproductive rights in America and tells truths that just months ago many would’ve found pessimistic. But the author was correct to predict the downfall of Roe and The New Handbook for a Post-Roe America is a practical book to help people make their own decisions and take bold actions.
Ella Beiser is a lifelong Hyde Parker and is currently a sophomore at Bates College studying politics and digital and computational studies. In her free time she enjoys writing for her school newspaper and sharing music with friends.