Violeta Encarnación for NPR
In November 1990, greater than 3,000 ladies descended on the sleepy seaside city of San Bernardo del Tuyú, Argentina, for what was turning into a legendary occasion.
Activists, medical doctors, lecturers, social employees and attorneys from throughout the Americas traveled all the best way to attend a feminist gathering often called an Encuentro.
Whereas they publicly debated their political calls for, the piece of knowledge that made the largest influence on the way forward for abortion was exchanged in personal, in whispers.
Alicia Cacopardo, an OB-GYN from Buenos Aires, was a part of these whispers. In between classes, she fell into dialog with a bunch of Brazilian ladies within the hallway, who talked a couple of tablet she had by no means heard of earlier than: Cytotec, the business title of misoprostol. The drug was designed to deal with abdomen ulcers, however ladies in Brazil had been utilizing it for protected, at-home abortions.
Although Cacopardo was an professional in reproductive well being, she was shocked — you may have an abortion by yourself, simply by taking a tablet?
“It is an enormous change. It is good,” she remembers considering on the time.
Within the years to return, different abortion-rights activists throughout the area had been thrilled once they discovered about misoprostol, and, like Cacopardo did, wished to unfold the phrase to different ladies.
Activists related the dots: If ladies may get their fingers on misoprostol, they may finish their pregnancies regardless of the extreme authorized restrictions on abortion most Latin American nations had. With this new tablet, they would not have to attend for the legislation to vary.
Phrase spreads
A girl performs an acoustic guitar for members within the closing march of the fifth Encuentro Feminista Latinoamericano y del Caribe (Feminist Assembly of Latin America and the Caribbean) in San Bernardo, Argentina, on Nov. 24, 1990.
Claudia Ferreira/Getty Pictures
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Claudia Ferreira/Getty Pictures
When Cacopardo returned to Buenos Aires after the Encuentro, she wished to get her sufferers Cytotec. If she succeeded, ladies may finish their pregnancies regardless of authorized restrictions on abortion. On the time, Argentina solely allowed abortion in instances of rape or when the mom’s life was in danger.
However Cacopardo bumped into an issue: Cytotec wasn’t out there in Argentina.
She flipped by means of a pharmaceutical listing and regarded for any medicine that contained misoprostol, the generic title of Cytotec. She solely discovered one medicine in Argentina: Oxaprost. However Oxaprost included a second substance, known as diclofenac, an anti-inflammatory drug usually used to deal with arthritis and different issues.
So Cacopardo got here up with an answer — one which required her sufferers to do a makeshift science mission at dwelling. Cacopardo advised them to purchase Oxaprost on the pharmacy after which crush the tablets to separate the outer layer of misoprostol from diclofenac, which was contained in an internal layer. Cacopardo wished her sufferers to keep away from any potential negative effects from taking an excessive amount of diclofenac, similar to heartburn and different abdomen points.
Alicia Cacopardo, an OB-GYN from Buenos Aires, helped sufferers handle abortions after attending the primary Encuentro in 1990.
Marta Martínez
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Marta Martínez
It was tough to crush the tablets, so some ladies simply took the entire thing — a sign of simply how DIY it was at first to self-manage an abortion with tablets. Cacopardo says that none of her sufferers reported any severe negative effects and most of them had full abortions.
A scientific stamp of approval
Kelly Blanchard, the president of the analysis and advocacy group Ibis Reproductive Well being, says that experiments with misoprostol within the Nineties represented activists doing “analysis in actual time.”
“Within the clinic setting, these improvements typically come from well being care suppliers,” she explains. “The activists are doing precisely the identical factor: occupied with and dealing with individuals who want the care and seeing what works and what would not.”
Researchers like Blanchard ultimately ran research on ladies utilizing misoprostol to finish pregnancies, gathering proof from all around the globe — from Peru to India to South Africa. Time and again, the researchers discovered the identical factor: Misoprostol was a protected and efficient option to have an abortion outdoors the formal well being care setting.
The research performed by these researchers additionally persuaded main public well being establishments just like the World Well being Group (WHO). As early as 2003, the WHO included misoprostol as a protected abortion technique within the first trimester (together with one other tablet known as mifepristone).
The WHO’s stamp of approval did not change the truth that abortion was unlawful in lots of elements of the world. So activists had an issue: They knew of an efficient technique to have abortions outdoors of the medical system, however how may they get extra ladies entry to one thing that was unlawful?
Hotlines in Ecuador and Argentina
The statue of a virgin, la Virgen del Panecillo, looms over the town of Quito, the capital of Ecuador. She has wings, like an angel.
At some point in 2008, Ecuadorian activists and a bunch of European activists from the abortion entry group Girls on Waves hung a giant white banner on the balcony of the virgin statue.
The banner learn “SAFE ABORTION” in Spanish, with a cellphone quantity. That quantity was for the primary abortion hotline in Latin America.
Later that day, that cellphone quantity blew up with dozens of textual content messages and calls.
The thought for a hotline — and the stunt selling it — threw these abortion activists into a brand new, extra public period. They reached hundreds of girls this manner with work that was daring, organized and replicable.
Timeline of occasions
- 1986: Girls in Brazil uncover they will use Cytotec, a abdomen ulcer medicine, to have protected abortions with out the assistance of medical professionals.
- 1990: At a feminist gathering in Argentina, often called an Encuentro, phrase spreads about Cytotec (and the generic model misoprostol) amongst greater than 3,000 feminist activists throughout Latin America.
- 2000: Las Libres in Mexico begins supporting ladies all through their abortion course of with a brand new mannequin of care known as acompañamiento (accompaniment), serving to ladies use misoprostol to have protected abortions regardless of the authorized restrictions.
- 2008: The primary abortion hotline in Latin America launches in Ecuador, establishing a large-scale and public technique of spreading details about self-managed medicine abortion.
- 2009: Argentinian activists with Lesbianas y Feministas por la Descriminalización del Aborto launch an abortion hotline and start systematizing details about tips on how to have an abortion with misoprostol, making it extra accessible to ladies.
- 2010: Lesbianas y Feministas publish a step-by-step guide on tips on how to have an abortion with tablets.
- 2015: Accompaniment teams attain each state in México.
- 2018: The Argentine Congress first debates legalizing abortion.
- 2021: Argentina legalizes abortion as much as the 14th week of being pregnant.
- 2021: The Mexican Supreme Courtroom guidelines that criminalizing abortion is unconstitutional.
- 2022: Colombia legalizes abortion as much as the twenty fourth week of being pregnant.
- 2024: 50,000 ladies attend an Encuentro in San Salvador de Jujuy.
In 2009, a yr after the Ecuador hotline launched, Argentina obtained its personal.
The collective Lesbianas y Feministas por la Descriminalización del Aborto (Lesbians and Feminists for Abortion Decriminalization) began the hotline with a dozen volunteers.
“At first, the hotline was so naked bones,” says Ana Mines, one of many first hotline volunteers. The group boasted a backpack they handed round to 1 one other, with a Nokia 1100, a pocket book and flash playing cards.
They had been brief on sources, however they had been decided to provide rigorous data on tips on how to use misoprostol to have protected abortions. They usually marketed the helpline all over the place they may, placing up posters throughout Buenos Aires with their cellphone quantity and speaking about it on TV and the radio.
The helpline volunteers referred to the rules developed by world and regional scientific our bodies, such because the WHO. This analysis gave the activists credibility. They thought it additionally gave them a authorized protection: They had been simply sharing publicly out there data.
The volunteers delivered this disclaimer to callers — that they weren’t medical doctors however had been offering public data — earlier than providing step-by-step directions on tips on how to use misoprostol. They answered the callers’ questions, similar to: If I am obese, will the tablets work? Can the tablets fall out of my vagina? Will hospital workers have the ability to inform that I took misoprostol?
In Argentina, nobody had ever achieved what this collective was doing — talking so overtly about abortions and tips on how to have one by yourself. Mines says many of the volunteers like her had been terrified of getting arrested. And the Argentine authorities had a report of going after abortion instances. Between 1990 and 2008, practically 450 abortion instances had been prosecuted in Argentina.
Not all feminists had been completely satisfied about what the collective was doing. Mariana Romero, a outstanding reproductive well being researcher and advocate for abortion rights in Argentina, fearful that the helpline may inadvertently cut back entry to misoprostol.
“I stated, do now we have to do that so public? You are nuts,” Romero remembers. “You’re going to make the pharmaceutical firm that produced misoprostol take it out of the market.” Regardless of the publicity across the hotline, in the long run, no volunteers had been arrested. And misoprostol remained out there.
Barbie will get abortions
In 2010, a yr after the hotline began, Lesbianas y Feministas obtained extra provocative with the best way they talked about abortion. They printed a guide on tips on how to self-manage an abortion with misoprostol and and not using a physician.
It didn’t appear to be a traditional medical textual content. The duvet was pink with two huge rainbows and illustrations of tablets with smiley faces. On the again, there was an image of Barbie in a pink convertible, with sun shades and a glamorous scarf over her head, together with the phrases “Barbie, how’d it go?”
“It was superior,” Barbie replies. The implication was that any girl can have an abortion — even Barbie.
Lesbianas y Feministas created a guide on tips on how to self-manage an abortion with misoprostol and and not using a physician.
Lesbianas y Feministas
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Lesbianas y Feministas
The guide was thorough — greater than 100 pages lengthy — and it went into vivid element, together with drawings of tips on how to insert the tablets into the vagina.
“It was a bestseller,” says Mines, the hotline volunteer. “It had two printings of 10,000 copies every.”
Different helplines and feminist teams in Latin America began utilizing the guide to assist extra ladies. Mines herself was capable of assist hundreds of girls by means of the helpline.
However some abortion activists believed sharing data on the cellphone and thru written manuals wasn’t sufficient.
Mexico: The beginning of “accompaniment”
In 2010, the activist Veronica Cruz met volunteers from the Argentine helpline at a convention about protected abortions. Cruz is the founding father of a feminist collective known as Las Libres (The Free) in Mexico. She remembers a variety of hype round abortion helplines on the gathering, however she was skeptical.
“How have you learnt for positive that these ladies will not be in danger?” she requested the volunteers. “You gave them data after which what? Did she get the tablets? Did she observe the directions appropriately? Did she find yourself within the hospital? You truly do not know something.”
Cruz, then again, did know the way the ladies she helped in Mexico fared as a result of she used a distinct technique: “acompañamiento.”
In Spanish, acompañamiento means being with somebody, supporting them, or simply preserving them firm. When serving to a lady searching for an abortion, acompañamiento has come to imply being there for somebody all through the entire technique of an abortion, from starting to finish, whatever the authorized dangers.
Cruz began doing acompañamiento in 2000 — the identical yr she based Las Libres, and practically a decade earlier than any of the helplines began in Latin America. On the time, abortion in Mexico was basically banned. Within the state the place Cruz lives, the one exception was for ladies who had been raped. However even in these instances, hospitals typically denied ladies their proper to the process.
At first, Cruz centered her work on these ladies. By Las Libres, she labored with a gynecologist to assist ladies who had been raped get protected, authorized abortions. At some point, she noticed the physician use a brand new technique: misoprostol, the ulcer medicine that girls in Brazil first began utilizing for abortions within the late Eighties.
As she watched the physician administer the tablets, Cruz had a realization.
“I can simply purchase the tablets, inform the girl tips on how to use them? That was an unimaginable discovery for me.”
Veronica Cruz, who runs the abortion-rights group Las Libres within the central Mexican state of Guanajuato, speaks in Mexico Metropolis in 2022.
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Edgard Garrido/Reuters
Not lengthy after, one other girl got here to Las Libres who wished an abortion however wasn’t a rape survivor — which meant that she did not qualify for a authorized abortion. The place they lived, ending a being pregnant that wasn’t a results of rape, by means of any technique, carried a jail sentence for the girl and anybody who helped her.
Cruz determined to accompany the girl, regardless of the dangers. She advised the girl to purchase the tablets on the pharmacy. In Mexico, regardless that misoprostol technically required a prescription, you would typically get it over-the-counter. Then Cruz gave the girl the identical directions she had seen the OB-GYN give.
Despite the fact that Cruz had seen how the tablets work and the way easy it was to make use of them, she says it was nerve-wracking to assist somebody by means of an abortion and not using a physician. Cruz was on standby the entire time. It was late at night time when the girl took the tablets.
“So I slept with my cellphone on my chest,” Cruz remembers. “On a regular basis … in case it rang or one thing.”
The subsequent day, the girl went to a health care provider, who confirmed that the being pregnant had ended and that there hadn’t been any issues. It was Cruz’s first time doing accompaniment. And in her eyes, it had gone easily.
After that, when somebody contacted Las Libres for an abortion and so they weren’t rape survivors, Las Libres did not go to the gynecologist for assist. They dealt with it themselves.
“We promised ourselves that we had been by no means going to depart anybody with out entry,” Cruz says. “No matter we needed to do.”
If a lady could not afford to purchase misoprostol, which was costly in Mexico, Las Libres would give her the tablets free.
Typically ladies had leftover tablets and provided to provide them to Las Libres. Cruz advised them to pay it ahead.
“The subsequent girl who comes, you are going to provide her the tablets as a present and you are going to inform her about your expertise,” Cruz stated.
Cruz would arrange a gathering between the 2 ladies, in a park or at a mall. The girl who’d had an abortion would share her further tablets and her story. By connecting ladies instantly — one after the other — Las Libres was recruiting volunteers and constructing a community.
Las Libres helped create accompaniment networks that, at this time, attain each state in Mexico.
However through the years, some activists criticized Cruz’s strategy. At that convention in 2010, Cruz remembers activists telling her that “what we had been doing — of personally accompanying the ladies and giving them the tablets — was dangerous for us. For us and for the entire motion.”
These activists, who had been preventing to legalize abortion, did not need the motion for abortion rights to be related to individuals who had been breaking the legislation.
Many abortion-rights activists throughout Latin America discovered themselves on reverse sides: Some had been preventing to legalize abortion — these ladies had been taking part in the lengthy sport. Others, like Cruz, had been actively breaking the legislation, as a result of ladies who wanted abortions instantly could not wait till the legislation modified.
One group realized that they did not have to decide on between the 2 sides.
Argentina: From an artwork to a science
Folks collect in San Salvador de Jujuy, Argentina for an Encuentro final fall.
Marta Martínez
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Marta Martínez
Almost 35 years after that Encuentro in San Bernardo, within the fall of 2024, one other Encuentro kicked off in Argentina. This time, the annual gathering introduced 50,000 ladies to a small metropolis known as San Salvador de Jujuy, proper by the Andes Mountains.
They flowed by means of the downtown streets in a giant demonstration, like a river of girls.
In Jujuy, Ruth Zurbriggen was laborious to overlook. She was normally the particular person with the megaphone and seemingly limitless vitality.
Zurbriggen is likely one of the founders of an Argentine accompaniment community: Socorristas en Pink (First Responders Community). It is now the largest abortion accompaniment community on the planet. And to make that occur, she and the Socorristas determined to construct techniques, turning acompañamiento right into a science.
Ruth Zurbriggen (heart) speaks to a different participant at a march through the Encuentro. She is likely one of the founders of Socorristas en Pink (First Responders Community), which is now the largest abortion accompaniment community on the planet.
Marta Martínez
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Marta Martínez
Whereas Cruz, the founding father of Las Libres, thought that girls may determine accompaniment on their very own, the Socorristas constructed an entire accompaniment technique and also have a college to coach volunteers — La Escuela Socorrista (the Socorrista college).
At school, trainees study the Socorristas’ technique, which incorporates holding an in-person workshop for ladies who’re thinking about having an abortion and administering a survey. That survey is exhaustive. It asks simple questions, such because the particular person’s age and the way far alongside they’re of their being pregnant. Different questions are extra private, similar to why the girl wished to have an abortion, whether or not her accomplice supported her alternative and whether or not she expelled the embryo. They tracked the solutions in spreadsheets, fastidiously documenting developments in ladies’s experiences self-managing abortions with misoprostol.
One query on the survey inadvertently helped the Socorristas strengthen their relationships with medical doctors. They requested: How did you discover out about us?
“Thirty % had come to us beneficial by well being care professionals,” Zurbriggen remembers. “And that is after we stated, ‘What’s occurring? Who’re they?'”
Zurbriggen was stunned by that prime quantity. Most medical doctors in Argentina didn’t assist abortion at the moment. The Socorristas wished to grasp why medical workers had been referring sufferers to them, in order that they began scheduling appointments with these well being care suppliers, as in the event that they had been private appointments. That allowed the activists to speak to the clinicians in personal.
“We began making a bond with skilled medical workers. After which we began asking them ‘what’s the issue in the event you write two prescriptions a month for us? Nothing, proper?’ They usually’d write us two or three prescriptions for us with completely different dates. And we would get male names from pals or sons, and the prescriptions could be beneath male names,” Zurbriggen says. She describes the method as “very DIY.” It was additionally unlawful — and the Socorristas do not do it anymore.
Docs and nurses had been typically keen to assist regardless that they risked shedding their license by doing so. One OB-GYN named Gabriela Luchetti, who labored within the public well being system for 30 years, says she felt “reduction” sending individuals who wanted an abortion to the Socorristas.
Luchetti stated, “Somebody was going to do what we did not dare to as a result of we had a license, and we had been afraid of the legislation.”
The struggle to legalize
Many feminists who had centered their struggle on getting a legislation to guard abortion weren’t comfy with Zurbriggen and the Socorristas’ work. Simply as activists criticized Cruz’s accompaniment work in Mexico, they believed Socorristas would injury their nation’s motion for abortion rights as a result of it might be related to prison exercise.
However the Socorristas’ accompaniment work all the time went hand-in-hand with the struggle to legalize abortion. In 2018, when the Argentine Congress first debated passing an abortion legislation, Zurbriggen and different Socorristas had been there, chatting with representatives, together with different abortion-rights teams.
They shared information that they had been rigorously monitoring for six years. In that point, they’d accompanied practically 20,000 abortions. Their information challenged stereotypes Argentinians had about abortion. They confirmed that the ladies who’re most definitely to have abortions are already moms, and that a lot of them are non secular.
Among the different feminists who testified in entrance of Congress, just like the researcher Mariana Romero, had been essential of the Socorristas. However she, and different skeptics, got here round. “They had been radical, however, in the event that they weren’t, I do not know if issues would have occurred the best way they occurred,” Romero says.
In December 2020 the senate voted to legalize abortion in Argentina and in January 2021 it was formally signed into legislation. Now any girl can go to a hospital or a neighborhood clinic and ask for an abortion as much as 14 weeks, no clarification wanted.
Demonstrators have fun after the proper to an abortion is legalized on Dec. 30, 2020, in Buenos Aires, Argentina.
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Marcelo Endelli/Getty Pictures
The marketing campaign in Argentina impressed feminists throughout Latin America. Argentinians made the inexperienced bandana the image for his or her motion and the struggle to legalize abortion throughout the area grew to become often called the Inexperienced Wave. Inside a few years, Colombia and Mexico additionally decriminalized abortion.
One may suppose that when abortion was legalized in Argentina, the work of Socorristas would not be crucial anymore. Girls may go straight to medical doctors for the process. And but, Socorristas are simply as busy as they had been earlier than abortion was legalized.
The yr after abortion grew to become authorized in Argentina, greater than 13,000 reached out to the Socorristas. Of these, greater than three-quarters selected to have a self-managed abortion with the collective’s assist. In different phrases, the overwhelming majority of those ladies most popular to self-manage their abortions with acompañamiento over going to a health care provider.
Some OB-GYNs like Luchetti, who signed prescriptions for the Socorristas each from time to time, perceive why so many ladies are making this alternative. She says, “The Socorristas technique is much superior to medical care and is completely different and higher. It is heat, pleasant, dedicated.”
One other physician, Nadya Scherbovsky, talked about that Socorristas make themselves out there 24/7, whereas the general public well being system has strict schedules.
Individuals who want an abortion aren’t the one ones who’re reaching out to Socorristas. Zurbriggen says she generally will get calls from OB-GYNs who ask her about tips on how to use abortion tablets, as a result of she has extra expertise with medicine abortion than many medical doctors in Argentina.
The Socorristas have turn out to be worldwide specialists on self-managed abortion with tablets. A 2022 examine printed in The Lancet International Well being checked out their accompaniment technique for pregnancies beneath 9 weeks, and it discovered that it was simply as efficient and protected as a drugs abortion managed in a clinic.
“Misoprostol is a technological revolution that if you put it within the fingers of girls and people who want an abortion, it generates one other revolution,” Zurbriggen says. “It is a cultural, social, political, medical revolution.”
Reporter Victoria Estrada and editor Rhaina Cohen contributed to this text. This reporting was supported by the Worldwide Girls’s Media
Basis’s Reproductive Well being, Rights, and Justice within the Americas Initiative.
