Deep Care: The Radical Activists Who Provided Abortions, Defied the Law, and Fought to Keep Clinics Open

by Angela Hume

The story of the radical feminist networks who worked outside the law to defend abortion.  Starting in the 1970s, small groups of feminist activists met regularly to study anatomy, practice pelvic exams on each other, and learn how to safely perform a procedure known as menstrual extraction, which can empty the contents of the uterus in case of pregnancy using equipment that can be easily bought and assembled at home. This “self-help” movement grew into a robust national and international collaboration of activists and health workers determined to ensure access to reproductive healthcare, including abortion, at all costs―to the point of learning how to do the necessary steps themselves.

Even after abortion was legalized in 1973 with Roe v. Wade , activists continued meeting, studying, and teaching these skills, reshaping their strategies alongside decades of changing legal, medical, and cultural landscapes such as the legislative war against abortion rights, the AIDS epidemic, and the rise of anti-abortion domestic terrorism in the 1980s and 90s. The movement’s drive to keep abortion accessible led to the first clinic defense mobilizations against anti-abortion extremists trying to force providers to close their doors. From the self-help movement sprang a constellation of licensed feminist healthcare clinics, community programs to promote reproductive health, even the nation’s first known-donor sperm bank, all while fighting the oppression of racism, poverty, and gender violence.

Deep Care follows generations of activists and clinicians who orbited the Women's Choice clinic in Oakland from the early 1970s until 2010, as they worked underground and above ground, in small cells and broad coalitions and across political movements with grit, conviction, and allegiances of great trust to do what they believed needed to be done―despite the law, when required. Grounded in interviews of activists sharing details of their work for the first time, Angela Hume retells three decades of this critical, if under-recognized story of the radical edge of the abortion movement. These lessons are more pertinent than ever following the Supreme Court’s 2022 Dobbs   v. Jackson  decision and the devastation to abortion access nationwide.

Genres: History, Feminism, Nonfiction, Health, Medicine, Politics

432 pages, Paperback

Published November 14, 2023

Reviews

[Corvus · Rating 5 out of 5]

Angela Hume's Deep Care is a gorgeous ethnography of resilience and resistance. Hume's focus is predominantly on "Self Help" movements and other abortion activism and defense in the Bay Area from the 1970s-90s, which allows for a lot of interesting specificity and a deeper understanding of what it was like to be involved in feminist movements during these times in that area. "Self Help" in its original use and context was not a "get healthy with these 5 easy steps" book. It was a form of community healthcare and mutual aid based in knowing ourselves and each other and providing for all of our needs. She described her intent to create a work of historical scholarship and political theory in order to "educate, agitate, and inspire." Growing up conservative, she describes this book as "the biggest no of her life," after a life where she often wasn't allowed to say no.

Hume's writing style is accessible and inviting. I often felt like I was in the room with the people whose history she described (even to the point of having a little too much of an empathetic reaction during descriptions of procedures.) Hume uses materials and story telling from the time period to show the kind of education and practice that was going on in circles of the womens movement both before abortion became as politicized as it is now and after. There is a lot of focus on the legacy of Pat Parker- stellar organizer and poet- who is no longer with us to be interviewed. The people who were able to be interviewed varied greatly in both demographics and ability to be exposed, so pseudonyms are used at times. Some of my favorite people were anarchists using pseudonyms that I hope I can run into some day by accident.

I thought frequently during this book about how we discuss medical history- these brilliant white men and their knowledge and discoveries, sometimes bravely testing things on each other, sometimes horrifically practicing on enslaved and marginalized people. These men end up in history books and medical texts. I do not see the history of abortion providers and their amazing ingenuity, persistence, brilliance, and bravery in general texts. There is more inclusion of racial justice and sexuality in this book than other texts I have read about abortion. I had never heard of the group RAW (Roots Against War) before this book and they were one of my favorite organizations. As with any movement that spans identities and struggles, there is also much discussion of the struggles and infighting that occur in many radical movements. How do we pay for things while also not being profit driven? Is there an ethical way to use capitalism to pay for clinic services so they do not disappear? How do we get the word out while also staying safe? Race, sexuality, and class disparities resulted in conflict at times- much of which was solvable, some of which was not. The reality of sacrifice is very present through the entire book- people barely holding it together while making abortion and other gynecological healthcare their entire life. Lots of fear and burnout, especially when antis were showing up to beat and murder people. I know from my own experiences that many of them use anti-abortion as a smokescreen for misogyny and bloodlust. I have met anti-choicers who have said and done some of the most vile things I have ever seen, making it near impossible for me to believe any of them cares about wittle babies- especially the men.

There are also age-old disagreements about tactics and level of risk. Clinic defense was obviously a critical part of the movement keeping clinics alive at all- this book made me see this as even more prevalent than I realized. Yet, today some people (usually admirable and hard working clinic workers and volunteers from Planned Parenthood) argue that no one else but the antis (and clinic escorts) should be out there in order to reduce the commotion around the clinic. I very much understand this perspective and also disagree with it. The history in this book made me disagree with it even more.

When I was involved in clinic defense in the past, it worked best when we worked with those who worked and volunteered at the clinic, rather than just show up and do our own thing. We did things like distract the "counselors" from harassing patients, created large affirming signs of support that we used to cover antis' grotesque and misinforming imagery, and found ways to drown them out while keeping things as chill as possible. Patients actually liked it as did escorts. We all learned about each others strengths and weaknesses. But, there came a time when it did get too rowdy outside as each side amplified their level of aggresison and we backed off. I still think it was and is the right thing to do to find ways to combat antis while showing support for patients. The kinds of clinic defense described in this book were creative and inspiring. After the repeal of Roe v Wade, and after reading about clinic defense against operation rescue (christo-fascist anti-choicers willing to kill abortion providers,) I wonder if clinic defense needs to hardcore come back into style. How much has seeing only anti-choicers with giant gory signs at clinics and never any dissenting voices affected abortion access overall? What I would like to see even more is organizing against fake clinics that pose as abortion clinics then lie to and abuse patients into staying pregnant.

Another discussion I liked was an opposition to the characterization as "just a medical procedure." I had not thought of it this way, but we can discuss how abortion is healthcare without trying to hide it as being exactly like anything else. It is a valid form of healthcare regardless of its similarity to other procedures. Lori (not her real name) was a favorite of the book as she talked frankly about death and complications. We don't need to pretend that abortion care- or any healthcare- never has complications (I am writing this while suffering cancer surgery and treatment complications despite having skilled and caring practitioners) nor do we need to pretend there is never any death involved in human life.

Those who moved on from Self Help to become trained nurses and doctors caution against seeing this history as a simple explanation of how things can be for abortion access. While these people created amazing Self Help movements out of necessity, abortion is still done ideally by medical professionals in a society where healthcare is free or at least affordable and in a setting that meets the medical needs of whatever the procedure is (be it pills to take home or an in office procedure.) I think the history in this book is important to understand how we got to more accessible abortion and how to get back to that and beyond, rather than as a call for everyone to learn and start practicing menstrual extraction. However, it may come to that and in the worst case, of abortion continuing to become less and less accessible, these types of groups may be the only option.

Hume includes various ideas for actions we can take going forward that are helpful and thorough. The only thing I yearned a bit more for in this book is a discussion of clinic defense today with the activists involved in clinic defense in the 80s and 90s. We do hear the perspective of a person who designed the (brilliant, necessary) clinic escort system. She suggests that patients don't want to walk through an even larger protest, which I understand. But, to the clinic defenders from RAW and BACAOR (Bay Area Coalition Against Operation Rescue,) do they believe the same kinds of actions should be taken today? What new tactics could be used to match things we have learned and diverging opinions about protesting antis and defending clinics? I could listen to anyone in this book talk for hours and never get bored.

Overall, this is one of the best texts of abortion history that I have had the pleasure to read. While the focus on the Bay Area limits the knowledge of the Self Help movements at large, it also allows a more intimate understanding and experience of part of the movement- something equally valid and important. This book is well written and absolutely did educate, agitate, and inspire me.

This was also posted to my blog.

[Sarah · Rating 5 out of 5]

I received an advanced reader copy of this book in exchange for an honest review, and DAMN this is one of my favorite free books I’ve ever received.

Deep Care is a history of “the radical activists who provided abortions, defied the law and fought to keep clinics open” as is listed in the front cover. Many of those who Angela Hume interviews were involved with the Oakland Feminist Women’s Health Center (OFWHC) during its 36 year run. OFWHC also played a key role in the abortion self-help movement, which I also hadn’t known about it until reading this book. Heck, I’ve volunteered and worked in abortion access for 7 years and I didn’t know a lot of the history covered in Deep Care.

Since the Dobbs decision, many well-meaning folks have turned to the pre-Roe/early Roe years to figure out how to handle this new chapter. What I love about this book is how it encouraged people to turn towards the values of the era & how to apply them in the 21st century. Our resources and general society have changed in many ways (we now have Plan C pills, abortion funds etc), but the values of bodily autonomy , community care and self-determination remain the same. Deep Care is an inspiring chance to think about how we can make these values a reality in a post-Dobbs world.

[Zack]

Really fantastic book. I was honored to be able to read an advanced copy of it and interview Angela Hume, the writer about it. Check out my interview here: https://oaklandside.org/2023/11/09/ne...

[Carrie Laben · Rating 5 out of 5]

Review in a forthcoming issue of ARB.

[Richard Derus · Rating 4 out of 5]

Rating: 4* of five

The Publisher Says: The story of the radical feminist networks who worked outside the law to defend abortion.

Starting in the 1970s, small groups of feminist activists met regularly to study anatomy, practice pelvic exams on each other, and learn how to safely perform a procedure known as menstrual extraction, which can empty the contents of the uterus in case of pregnancy using equipment that can be easily bought and assembled at home. This “self-help” movement grew into a robust national and international collaboration of activists and health workers determined to ensure access to reproductive healthcare, including abortion, at all costs―to the point of learning how to do the necessary steps themselves.

Even after abortion was legalized in 1973 with Roe v. Wade, activists continued meeting, studying, and teaching these skills, reshaping their strategies alongside decades of changing legal, medical, and cultural landscapes such as the legislative war against abortion rights, the AIDS epidemic, and the rise of anti-abortion domestic terrorism in the 1980s and 90s. The movement’s drive to keep abortion accessible led to the first clinic defense mobilizations against anti-abortion extremists trying to force providers to close their doors. From the self-help movement sprang a constellation of licensed feminist healthcare clinics, community programs to promote reproductive health, even the nation’s first known-donor sperm bank, all while fighting the oppression of racism, poverty, and gender violence.

Deep Care>/I> follows generations of activists and clinicians who orbited the Women's Choice clinic in Oakland from the early 1970s until 2010, as they worked underground and above ground, in small cells and broad coalitions and across political movements with grit, conviction, and allegiances of great trust to do what they believed needed to be done―despite the law, when required. Grounded in interviews of activists sharing details of their work for the first time, Angela Hume retells three decades of this critical, if under-recognized story of the radical edge of the abortion movement. These lessons are more pertinent than ever following the Supreme Court’s 2022 Dobbs v. Jackson decision and the devastation to abortion access nationwide.

I RECEIVED A DRC FROM THE PUBLISHER VIA EDELWEISS+. THANK YOU.

My Review: By limiting her scope to activists in the Bay Area of California, Author Hume enables herself to dive deeply into the whys, hows, and wherefores of the activists who believed then, and will inspire others now to believe, in the truest expression of "self-help." There is a huge weight of wrongheadedness and immorality bearing down on women's rights. There always has been, of course; patriarchy isn't a new idea, and making up a matriarchal past from evidence so fragmentary as to be useless for tendentious argument is not particularly helpful to resisting the current, powerful, well-funded assault.

Author Hume does not shy away from graphic evocation of the procedures she enumerates the activists providing. It's astonishing to me how very difficult pregnancy is...to start, to finish, to understand in its myriad complexities. It was not always pleasant to encounter this information.

The broader framework of resistance and activism on multiple social fronts in that fifty-years-gone time and place is not skimped. The long-gone groups, their interlocking aims, their interpenetration of membership, wildly proliferate and birth acronym after abbreviation thus are correspondingly difficult to keep track of. As is so often the case among resisters of any facet of the status quo, the vicious internecine fights are hard to read about. I have this wild, unruly desire to scream at the idiots fighting over nonsense to grow up and get a grip! Fight the right-wingers in charge, not each other! It's just handing the rotters victory in their efforts to control and exploit everone for fun and profit to fight among yourselves!

I took long breaks from this read to avoid having more strokes from fury at the dimwits who refuse to accept impure, compromise positions because they are RIGHT and that should be OBVIOUS so everyone should do as they say! Which is, oddly enough, exactly what the right-wingers say.

Funny, that.

The thrust of this book is, as I see it, what worked before can work again. Get your gloves out, the literal healthcare ones and the metaphorical battle ones. The world's going to go into reverse unless we all do a LOT OF RESISTING, at ballot boxes, at clinic-defense events, at community meetings.

It worked before, it can again, but not without personal, individual commitments to show up in the flesh. Slacktivism is helpful to direct the conversation but more is needed to oppose the wave of nightmare invasive evil laws.

[Ems · Rating 5 out of 5]

This was my first read of 2024 and I already know it is going to be one of my top reads of the year. So much incredibly important history packed into one book. Dense but accessibly written and so well researched.
My heart was filled with so many stories of collective care, from folks providing underground, feminist-forward health care to women travelling across a country to literally put their lives on the line to be clinic escorts.
Hume doesn't sugar coat anything either- she is honest in sharing the stories of the mistakes made as well. The book really ties together the past movements and attacks on reproductive health and how they have grown into what they are today.
Enormous respect for everyone involved in this movement past, present and future!

[Rob McB · Rating 5 out of 5]

I have to agree with the reviews by Corvus and Sarah--it's an excellent book on many levels. I would just emphasize that the author is a great story-teller and she also gets great stories from the many folks she interviewed. Much of the book has a conversational style that makes it accessible, so don't be put off by its size. For people who want the nitty-gritty documentation, you have only to go to the footnotes; Hume dug deep into archival and academic sources.

[Artnoose McMoose · Rating 5 out of 5]

This is a well-researched history of the underground reproductive health and abortion movements, especially in California. It is very graphic with its medical descriptions and candid about what it was like to be an abortion provider or clinic escort in the 90s and beyond.

[Lotus · Rating 5 out of 5]

Ohhh I love this book! Rarely do you get a historian who is both laser focused on their chosen time period and topic who also has a clear point of view and also brings in so many contrasting perspectives on the topic of focus. This book goes deep it's awesome!

[Peter Z. · Rating 1 out of 5]

"Radical feminists outside the law" -- or just run-of-the-mill baby killers? You be the judge.

But glorifying lawbreaking and murder, there is an even deeper place for people like that.

[Savannah Elmore · Rating 4 out of 5]

Overall a nice read. There's some nuggets in the conclusion of the book that have good suggestions on how we can move forward after Roe V. Wade was overturned.

[Brooke · Rating 5 out of 5]

A view into a world I never knew existed and am incredibly intrigued by