S1E42 - Bay Area Doula Project on Abortion and Abortion Access

Episode Notes

Episode summary

Margaret talks with two people who work with the Bay Area Doula Project. They talk about different kinds of abortions, histories of abortion methods, different kinds of self-managed abortions, clincal and procedural abortions, pharmacological methods vs herbal methods, and abortion access.

Guest Info

Bay Area Doula Project can be found on Instagram @BayAreaDoulaProject or on Twitter @BAPDtweets

Host and Publisher

The host Margaret Killjoy can be found on twitter @magpiekilljoy or instagram at @margaretkilljoy.

This show is published by Strangers in A Tangled Wilderness. We can be found at www.tangledwilderness.org, or on Twitter @TangledWild and Instagram @LiveLikeTheWorldIsDying. You can support the show on Patreon at www.patreon.com/strangersinatangledwilderness.

Show Links

If/When/How: Lawyering for Reproductive Justice We're a national nonprofit network of law students and lawyers who know that reproductive justice doesn't just happen. www.ifwhenhow.org

Places to donate: https://www.ifwhenhow.org/ https://abortionfunds.org/ https://accessrj.org/

Some history of misoprostol in Brazil: https://www.scielo.br/j/hcsm/a/X74PWDTg8njthWPPh5dVQSd/?lang=en

Some history and resources on Reproductive Justice: https://www.sistersong.net/reproductive-justice/ https://www.blackwomenradicals.com/blog-feed/black-feminism-and-reproductive-justice-a-reading-list Some info on trans-inclusive abortion care: https://translash.org/translash-guide-to-trans-bodies-trans-choices-my-abortion-saved-my-life/ https://www.optionsforsexualhealth.org/wp-content/uploads/2019/07/FQPN18-Manual-EN-BC-web.pdf

Criminalization California judge overturns 11-year prison term for woman whose baby was stillborn Adora Perez, who admitted to using meth, was originally charged with murder and pleaded no contest to voluntary manslaughter. www.latimes.com

Women who were recently imprisoned for their pregnancy outcomes in California:

Adora Perez: https://www.latimes.com/california/story/2022-03-18/california-judge-overturns-conviction-woman-whose-baby-was-stillborn

Chelsea Becker: https://www.latimes.com/california/story/2021-05-20/murder-charge-dropped-against-woman-who-suffered-stillbirth

For the following, folks may want to consider digital security. As in use a VPN to visit these links, TOR, ect...

We like hackblossom's guide: https://hackblossom.org/cybersecurity/and Digital Defense Fund also has great info: https://digitaldefensefund.org/ddf-guides/abortion-privacy

info on abortion with herbs: https://www.instagram.com/holistic.abortions/ https://holisticabortions.bigcartel.com/ https://we.riseup.net/assets/351138/22321349-Natural-Liberty-Rediscovering-Self-Induced-Abortion-Methods.pdf

info on abortion with pills: http://www.misoprostol.org/ https://www.plancpills.org/ https://hesperian.org/books-and-resources/our-mobile-applications/safe-abortion-sa/

Other Projects Awesome fund in Mexico City: https://www.fondomaria.org/ The New York Doula Project: https://www.doulaproject.net/

Literature They also have this great zine on being your own doula: http://www.diydoula.org/

Transcript

Margaret 00:14 Hello, and welcome to Live Like The World Is Dying, your podcast. It feels like the end times. I'm your host, Margaret killjoy. And this week I'm talking about some end times stuff. It's not really end times. End times is too complex... whatever. You've heard me talk about my opinion about end times and how complicated that is. But, I think that is absolutely happening right now is that people's ability to access abortion is being stripped away inside the United States. And so I'm talking today with two people from the Bay Area Doula Project, about self managed abortion, about the state of things, about the different types of abortions that one might seek to release their pregnancy. And I think that there's going to be a lot in here for every listener, including those who think it doesn't affect them directly. This podcast is a proud member of the Channel Zero network of anarchists podcasts and here's a jingle from another show in the network.

01:36 jingle

Margaret 02:13 Hi, if you two could introduce yourself I guess with your your names, your pronouns and kind of what you do what what brings you on the podcast today.

Aspen 02:25 I'm glad to go first. My name is Aspen I use they/them pronouns. I'm an abortion doula fertility awareness educator and also an herbalist. And I've been work doing abortion work for the past, I don't know, handful of years, seven years or so I've been deepening the relationship with the idea of abortion, the practice of abortion, the herbs that have been facilitating abortion for centuries. And I'm excited to be on this podcast just because it feels like a really but especially potent moment even thoughaccess to abortion has been on the front of my mind for a long time. I'm like thankful for this moment where it's in more people's awareness.

Cobalt 03:08 And I'm Cobalt, I've been doing abortion support work, you know everything from emotional support, to rides and hosting people who have to travel and also abortion, you know, education about self managed abortion with pills and abortion support education, helping other people kind of understand what their power is in supporting other people through their abortions, whether it's in or out of clinic. And I've been doing all of that for more than a decade now. And yeah, what Aspen said about why we're here. And oh, and we are with Bay Area Doula Project. Which, there are a bunch of doula projects around the country that have, you know, different ways of working that are just based on you know, what's appropriate for the area and the collectives. And, we are a pretty small group focused on, like you said, the supporting people individually and also helping other people learn how they can support their communities.

Margaret 04:06 So what does that look like with the Bay Area Doula Project? Is it you know, can people just reach out to you? Is it like, basically, people are like, "I'm hoping to have an abortion. I'm pregnant and wish I wasn't. Can you all help me in various ways?" Or what is the...what is the actual project kind of look like on a tangible level?

Cobalt 04:24 Aspen does a lot of the answering the emails, so I think they should talk on this.

Aspen 04:29 Yeah. So we definitely have like a platform for people to reach out if they're looking for...you know, as an abortion doula, we hold a lot of hats. You know, sometimes we provide counseling. You know, sometimes people don't...don't know their options, don't realize like, you know, they have options inside clinics, outside of clinics. And so meeting people where they're at whether they've already made their decision or they're still in that sort of uncertainty, space of uncertainty. We can pair people with abortion doulas, if that's what they're seeking. We do also partner with an organization called Access, which is our, our local California abortion fund. And through that sort of pathway, we can connect them with like ride support, child care support, hotel if the hotel if they need it, because sometimes abortions need multi or multi day procedures and they need overnight support. And especially if people are traveling, even in California people have to travel hours. So we also provide trainings and that's a lot of our work at Bay Area Doula Project is providing trainings so that people can learn how to support their communities as an abortion doula or an abortion supporter.

Margaret 05:36 So why do people have to travel hours if you're in the golden land of California, where everything is perfect and easy and accessible? And everything's great.

Cobalt 05:48 Yeah, because we still don't actually have that very many clinics, because the clinics that do exist in smaller towns tend to be extremely risk averse. And so they may not do procedures for people who have, you know, a pre existing medical conditions like a heart condition. Maybe even the reason that they need to terminate is also the reasons they'll be refused an abortion.

Margaret 06:11 Oh, cool.

Cobalt 06:13 People may be refused, because the anesthesiologist doesn't know their job and doesn't know how to work on fat people, or maybe the gestational limit that the clinic has. And so therefore, they need to travel to a place where they can get in hospital care, or something like that. And, yeah, so and or the clinic that's in their town is maybe only open one day a week, and it's not a day that they're able to do things.

Cobalt 06:36 How do people....you said that one of the things that you end up helping people do is pick between clinic and non clinic, clinic abortions? What kind of, I mean, obviously, you can't give the listener advice, because you don't know the listeners position. But like, How does someone go about picking between clinic or non clinic for their abortion?

Aspen 06:54 That's a good question. I think that...so so earlier, Cobaltt and I were talking about how we really complement each other and how we practice and how we move through this work. And so I'll talk from my perspective, as someone who identifies as a spiritual...like I and like, something that's big for me, when I'm walking someone through that process is like, consent is like the number one thing like every step of the way, they're making a choice. And it's their choice. And I think choice has been one of those big words around the abortion movement. And it's not just the choice to have an abortion and not have an abortion, but how they're going to have an abortion, who they want to be around. Do they want to be in their home releasing their pregnancy? Do they want to go to a clinic? Do they have the time to actually work with herbs over a couple of weeks? Or do they want to get it done sooner? Because it's just a matter of practicality? And like, what are they feeling? Because I think that when it comes to reproductive justice work, and when it comes to abortion, a lot of sometimes there's a lot of healing and doing what our body consents to, because most people in this world have had an experience where that consent has been crossed. And so I think that this is an opportunity to heal that within them spiritually and emotionally. So I think that, walking through that someone's process with that is asking a lot of questions and just meeting them where they're at.

Cobalt 08:13 Yeah, for me, I work with a lot of folks, but specifically with trans guys, and, you know, other folks who may deal with like, body dysphoria stuff, and, you know, for a lot of reasons, needing to get an abortion in clinic might just really add to that. So, you know, that's one of the reasons that a lot of people I work with might decide, you know, that they would just like to do some pills and have something that's like, relatively straightforward and doesn't involve anyone sticking any instruments anywhere. And, you know, but of course, all that's also limited by, you know, things like what's the gestational age that you're at, also by like any other health concerns people might have, how available pills are, things like that. So, you know, there's like a combination of physical safety concerns why someone might decide that working with the clinic is more important. There's also a lot of other things that can go in to making it so that doing things outside of clinic is both safe and practical and a much better experience.

Margaret 09:17 That makes sense, as a trans person who is very statistically unlikely to get pregnant, personally, pending various medical things that may or may not be on the horizon. I'm curious, though, you know, you say that you you do work with, with trans folks who, who do need abortions, and I'm wondering if you have any, like, advice around seeking abortions while trans whether how that impacts either the way that one might navigate the social and political environment of the medical industry or, and this is completely I have literally no knowledge about this about whether or not various medical transitioning that people might be doing, whether that impacts anything about the decisions that they might be making? Basically just like, so much of what we hear about about abortion applies, for good reason, you know, majority of the people who can get pregnant are cis women I would guess statistically, but I feel like there's not as much information out there for people who aren't.

Cobalt 10:15 Yeah, so let's see, there's a few things. First of all, so Miffy and Miso, the abortion pills, both are have have like very low incidence of side effects, but Miffy. Sorry, so I should first say slang terms, Miffy is mifepristone. Miso is misoprostol. Much easier to just say Miffy and Miso. So mifepristone is the Ru-486. It's a progesterone blocker, and it can help increase the effectiveness of the abortion. So you can do things with Miffy and Miso together or just Miso alone, like either one is safe and effective, but with Miffy is a little bit more. Okay, so that said, Miffy can increase blood levels of testosterone, Valium, Xanax, ibuprofen, and some other drugs. So you don't have to, like stop taking T or something in order to, you know, take medication abortion, but it may actually heighten your T levels in your blood for a little bit, you know, you should also be careful, if you're taking any of those meds to maybe calm yourself or reduce pain. You might need a slightly lower dose than usual. So that's like, one thing is like, just, you know, interactions and things to worry about. But as far as dealing with clinics, it can be really complicated. You know, even in the Bay Area, not every provider that you might go see is super, you know, trans informed. And you know, even if you have a support person with you, right, like, it can be really hard to make decisions about how much you're going to push back against anything, because it might compromise your care. And so people you know, may try to go stealth, you know, they may be out and you know, put pronouns on the door, and really, you know, like, make demands of people really just, yeah. That part depends on personality. Problems that can come up, people can hear a masculine voice on the phone and think it's your, you know, somebody's boyfriend calling to set up the appointment for them and just refuse to serve them.

Margaret 12:12 Oh, shit. Okay. No, that makes sense. I just, that never would have occurred to me. Yeah. Because they think that the, they think that the person who needs the abortion is not the one making the decision?

Cobalt 12:21 Exactly, yeah.

Margaret 12:22 Okay.

Cobalt 12:22 Yeah, they're worried about coercion. And so they're, like, "No, how, you know, the, the person who's getting the abortion has to call." and they're like, "But it's me!"

Margaret 12:31 Yeah.

Cobalt 12:32 And so that can be difficult. I've even heard, even heard of people having problems with insurance. Like if they had even if you have insurance, insurance might go "Well, well, your gender marker is male. And this is not...this procedure is not for men."

Margaret 12:46 Oh, god.

Margaret 12:47 Yeah. Yeah. It's awesome. And, yeah, and then there's, you know, just stuff like being in the waiting room can be kind of uncomfortable, right? Like, one of the reasons that, you know, we do like waiting room support is because, you know, you're sitting in the waiting room, and people are looking at you weird, because you're a like, dude, and why are you there? Or sometimes clinics will be conscious of that. But, their solution is to like, sweep you into a backroom somewhere. So nobody sees you. And like that could feel like crap too. Yeah. So yeah, those are a few of the challenges that I can think of.

Margaret 13:28 Yeah, I could see that impacting people's decision about clinic versus nonclinic, for example.

Cobalt 13:34 Yeah. And also, you know, if you're, you know, if the place you have to go is like "women's clinic", like it can be really hard to tell if they're gonna be, you know, yeah, kind, anything, giving you good service, give it give you you know, quality medical care. Yeah.

Margaret 13:50 So, let's presume that I don't know anything about how abortions work, which is not totally the case, but I try... whatever. How, you know, I've heard you've talk about abortion pills and herbal abortions so far, like on this, what are the what are the differences between this. I'm under the impression both can be used for both self managed and being taken care of, I don't know the opposite of self managed. You know, what, what are the advantages or disadvantages that people might be looking at?

Aspen 14:24 Yeah, I can start and please fill in any gaps I have Cobalt. So herbal abortions, herbal release. One of the incredible things I think about when I think of herbal abortion is it's an opportunity to connect to connect with your individuals ancestral medicine, like all of our lineages. There have been abortions that have happened within our lineages you know, we think we focus on the birth but you know, it's an opportunity to connect with the plants from your your lineages, connect with your families medicine to like take things slow and learn a form of medicine that can't be taken away by the governmen,t. Can't...there can't be distribution mishaps when you can grow these plants in your garden outside or in a pot even, or even on your windowsill like these plants are in grocery stores. They are literally under our nose are everywhere. And I'm, you know, talking from a place in California where things are growing a lot. So it's also... I'm in a position of privilege to, just how incredible the growing season is out here. But the thing about herbal abortions is that a lot of this medicine has been like scattered, it's been specifically targeted through many systems of harm, through colonization, through the witch trials, through even through like, medical Industrial Complex was like built on the backs of herbalist and medicine, people who knew this knew how to control their family size. And so there's a lot of reclaiming someone's power when they are working with plants and other medicines too. But I'm just talking specifically about this. But because that information has been so scattered and hurt and harmed, like a lot of it has contained, like that lineage of medicine has continued and has been resilient. And there's a lot of information, but a lot has been lost. And so one of the things I think has been lost is that either the information of how to induce an abortion later, later on after you know, six weeks and someone's last menstrual period isn't so accessible. So it's much better and safer. And someone will have better effects if they use plants earlier on, either even before they miss their period, which is just isn't an option for everyone. And so that's definitely a con of like herbal abortion is that people because we're trapped in this, in capitalism, people don't even realize that they missed their period. Because we're not taught how to track our cycles, or how to follow our own rhythm when we're following the rhythm of capitalism. And it can take two, three weeks of an herbal protocol where you're taking herbs all day long, on quite a regiment before the pregnancy actually releases. And so during that time, you're going through quite a phase of uncertainty. Are the herbs going to work? Are they not going to work? And you also have to really keep with it. And so for some people, that's a pro and some people that's a con but it definitely is a much more involved process than some of the other options. And I think that something that can really help for anyone who's releasing a pregnancy with herbs is to prepare for it. Prepare for your abortion a year before. So it means like building relationships with these plants. It's not just picking up the plants that you just met for most people. And so that's the herbal piece. There's also the medication piece, and someone can, depending on where they are, either access medications from a clinic, where they're given mifepristone inside the clinic and then they're given misoprostol to take within 48 hours. The mifepristone ends the pregnancy. It blocks progesterone and the misoprostol causes uterine contractions, which is cool, because that's the same thing that the herbs are doing. So that is an option for some people. And now, you know, and there's been really interesting developments since COVID, that telehealth, and people are able to access these medications by ordering them online. In some states, people can even order these medications, the abortion pills even before they're pregnant, just to have on their shelf. And so when abortion is like induced with medications, it can be more of that something's being done to your body, then your body is like just releasing the pregnancy on its own. So it can be more of a physical experience than the herbs. Do you want to add a little bit about medications before I move to like surgical and those kinds of things.

Cobalt 18:49 I was actually going to ask you to say something about combining herbs and medications.

Aspen 18:54 Yeah, so herbs and medications play really well together. You know, like we mentioned, like I mentioned before, this process of mifepristone, which is blocking progesterone and then misoprostol, which is inducing uterine contractions and stimulating the uterus, thi\s is actually the same template, herbs have been doing the same things that the way we ingest herbs that they induce on to the body. And so in some cases, some people can only access misoprostol because it's more easily accessible. It's cheaper than mifepristone and there is a beautiful legacy of around the world of misoprostol being used on its own. it is highly safe and effective. And so when someone doesn't have access to that first pill that mifepristone, this is where pills...or this is where herbs can come in. Herbs that block progesterone, pair really well at misoprostol, and so there are herbs that can help in combination with misoprostol help ease the process of abortion, but also herbs can come in just to help our nervous system, help calm us down, like I'm just I'm always about talking about chamomile to help you know ease our bodies leading into an abortion, after an abortion, and herbs are also there to help supplement all that blood loss with iron support and nutrition.

Margaret 20:08 Well, I've heard that both medicated and herbal abortions can be fairly intense, like, physically on you, and so the idea of like, working with something to sort of mitigate that, that makes sense to me.

Cobalt 20:20 Yeah, I was also gonna say, nausea can be an issue when dealing with all those uterine cramps to you, which is something where like, yeah, you can take a Dramamine. For that you can also yeah, have some ginger or some other...anything that kind of helps calm that nausea is a good idea. Also to add on to like the history of Miso was basically like, we owe a huge debt to people in Brazil, for miso it was originally an ulcer medication, it still is an ulcer medication, it's prescribed to humans, and also two dogs and horses, possibly other animals as well. And it was available in Brazil with a big warning on it saying that, you know, you shouldn't take it as a pregnant person. And it's known that it could cause interactions. And so people in Brazil started using this. And eventually, providers in Brazil were like, "We're seeing a lot fewer complications from more physical abortion techniques," right, from, you know, people, you know, sticking unsterile instruments in places that they shouldn't go or, you know, having like punctures, because of the instruments being, you know, used or misused, and were like, "Well, this is happening a lot less what's going on?" and you know, sort of like talking to, you know, patients and things. And that is how Miso got figured out. You know, it was really people creatively, you know, off label usage. And, yeah, and that was in like, the, like, late 80s and into the 90s, when that was going on, and then we got Miffy. If you're, if you're a human in the 90s, then, Ru-486. Right, was developed in France in early 90s, as well, and then we didn't get them as available in the US, the FDA didn't approve them. I shouldn't say available in US, but the FDA didn't approve them until 2000. So, yeah, there's gonna be a lot of, you know, Aspen mentioned, telehealth, you know, also allegedly, one could use an online pharmacy to order things they're often called, like a combo pack, where it just comes with like, you know, the Miffy is in like, one, you know, larger circle of the foil pack and then the the Miso pills that you need are in the rest of this, you know, smaller bits there.

Margaret 22:37 So when you say ""allegedly", is that because it's not always legal in all areas, and yet somehow might still be accessible in areas where it's not legal, which obviously no one should ever do.

Margaret 22:45 Yeah and actually, so this is the interesting thing about abortion generally, and, you know, abortion with pills specifically, and even just supporting people with abortions is that basically, there's no specific laws against it. So in a lot of ways, it's totally legal. But also, as we know, basically people can make anything illegal if they try hard enough if they really care. And so people will dig up practicing medicine without a license and abuse of a corpse and all kinds of other stuff that was never meant to criminalize, you know, a pregnancy loss of any kind. And yet, it happens all the time. It especially happens with people who use drugs and come to the hospital having a pregnancy loss. And that is like the most common way for people to get reported and in fact, there were like two cases within the last few years in California where we had like this one jackass prosecutor tried to charge two different women with murder for...

Margaret 23:41 Oh my god.

Cobalt 23:42 Yeah, for having admitted to using meth and then having....and there's no medical connection. Like there's literally like no research that indicates that that's...there's a correlation there, but he managed it. Luckily they've now both had their charges fully dismissed. But you know, it's still lost them years of their lives. So yeah, so yeah, so basically, I'm gonna say "allegedly", and, you know, in my craft and whatever else, so for some things. And Aspen...

Aspen 24:10 I also want to just add "allegedly", misoprostol is also used to stop hemorrhaging inbirth, and so midwives have access to misoprostol, allegedly, so they should have it in stock.

Margaret 24:20 Yeah. For births. Yes,

Aspen 24:23 Yes. Strictly, yes.

Margaret 24:26 Okay.

Cobalt 24:27 Yeah. I mean, it's also the standard protocol, when someone you know, has experienced a pregnancy loss, you know, the loss of a pregnancy that they wanted to keep, and there might still be some tissue around that needs to be expelled. So yeah, it's, it's used for a lot.

Margaret 24:44 What's the effective shelf life of....the prepper and me is coming out whenever like things can be acquired. I'm like, "Acquiring things! How long does it last?"

Cobalt 24:55 Yeah. I forget right now what the shelf life is, I'd have to look it up. I'm also fairly laissez faire, about expiration dates, you know, things like, it's always best to, you know, have the things as fresh as possible. And also, things often continue to work long past, you know what it says on the bottle.

Margaret 25:18 Yeah, I'm under the impression, it's like a, you just start losing some efficacy rather than entering danger. But then the danger might be that you're using something that is less effective than you need it to be is would be my concern. But I also don't know anything about applying or using these things. So I don't know whether you're like, "Oh, it's not working, just take more whether that's like ever the plan." I'm not trying to make y'all give medical advice on this show.

Aspen 25:40 Can't give medical advice. But I do want to say that like the general protocol, if someone does have...if someone is taking medication and like not, all the tissue doesn't actually release just to take another protocol of the medication within the week are within 48 hours. And so if an abortion is incomplete, the risks are, we'll get into the risks a little bit later, but there is like the potential for infection and things like that, even though those those those possibilities are lower than the reality that the body will just continue to release the pregnancy on its own. But it also, it also depends on how far along someone is. And so there's a certain protocol of taking a certain amount up until 12 or 13 weeks. And then after that point, actually, it's better to take less misoprostol to release a pregnancy. So it just depends on how how far along the pregnancy is.

Cobalt 26:34 Yeah, and that's because the the body gets more, I guess sensitized to the miso and more, you know, prone to do contractions as you get later in the pregnancy. And so you actually want less and there is a danger of taking too much in the sense that the contractions can get so strong that that becomes a danger, a uterine rupture. So yeah, like, there is such a thing as taking too much. Don't just ever be like, "Well, I think this is probably less than efficacy, I'll pop a few more," is probably not a good idea.

Aspen 27:09 Yeah. And the same with herbs. That's what I, you know, as an herbalist, I see that a bit too much on the internet, but people being like, here are the 20 herbs that I know that can cause on abortion, and it's like actually it works a lot better if using three or four with intention, that we know what they're doing, than throwing in the kitchen sink, whether it'd be with medication or with herbs.

Margaret 27:32 That makes a lot of sense to me. So okay, we've talked about medicated abortion, herbal abortion, and then what would you call things like D&C [dialation & currettage] ? Is that the medical abortion? Like, what's the, the taxonomy here is not super important. Do you all want to talk about other types of abortions?

Cobalt 27:49 Yeah, I would say procedural abortion. Some people will say surgical, which I find, you know, scary and like, there's no scalpels involved, and it just doesn't feel accurate. Other people will say therapeutic abortion, which also just seems like an odd word choice to me. So...

Margaret 28:03 That makes it sound like there's really nice music playing.

Aspen 28:09 Right, which like I hope?

Margaret 28:09 Yeah, no, I mean, I would want that. I've had some, this is a tangent, but I had some energy work done at one point, and I was like, "Why isn't that dentist like this? This rules. Like, this is so much nicer." Anyway, in terms of the atmosphere, I don't want my dentist putting crystals in my mouth. I want my dentist cutting abscesses out, but but I want but it would be really nice if you know, there....everyone's talking very calmly. And anyway, please continue. I'm sorry.

Cobalt 28:40 Yeah, so that's so yes, I say procedural, you know, this is stuff where like, when we're supporting people who are having, you know, in clinic abortions can become relevant, not something that I would generally encourage folks to do at home, you know, again, unless you're, although, you know, I will say like, I do know, folks who, you know, practice menstrual extraction on each other. And, you know, there are ways to do that, you know, safely but, you know, again, it's one of those things that you don't want to do it like, first time, you know, when it's critical. That's something that if people have a lot of practice in then it can be okay. And it can be a good way for people to get to know their bodies if that's something that they want to do. There's also, just want to plug there's an awesome papaya workshop. So papayas are vaguely uterus shaped. And you know, and they kind of have a wall with some soft stuff in it. Andthey're so I think it was UCSF developed a whole like a program where they like teach med students how to do IUD insertion with papayas and also teach them how to do an aspiration abortion with a manual. So there's two there's two different kinds of things that can be used for an aspiration abortion and one is like, like desperation...

Margaret 29:57 So what is an aspiration abortion?

Cobalt 29:59 Ah-hah, that is basically, that's something that can be done a little later than pills, is sort of the first like least invasive procedural method that can be used where basically they're using a vacuum either an electric vacuum and EVA for electric vacuum aspiration. It's a machine that is providing the suction or manual vacuum aspiration MVA that is using this kind of like, big kind of syringe shaped thing to....yeah, actually, this will not help podcast listeners, but this. [Holds up an MVA] and basically, you know, you pop the base, and then pull this out.

Margaret 30:45 Dear listener, they're holding a giant, weird syringe thing. I actually didn't catch your pronouns at the very beginning. I just use they for you.

Cobalt 30:52 Yeah, they/them is perfect. Yeah. And so when you, you know, so if I had had my hand on the end of this, you know, when it pulled it out, it would have like, stuck to my hand, right? You know, creates that vacuum. And then when you're using this on a person...

Margaret 31:05 There's no needle again?

Cobalt 31:07 There is actually...

Aspen 31:08 It's called a cannula.

Cobalt 31:09 Yes, cannula, which is this sort of straw that goes on the end,

Margaret 31:13 Which I pronounced wrong in my other podcast, and like four people yelled at me.

Cobalt 31:19 Haha, It's medical terms.

Margaret 31:21 Yeah.

Cobalt 31:23 So yeah, but then. So this is what you know, goes through the cervix, this, this is the part that needs to...the cannula is the part that needs to stay sterile, it's going into the cervix. And so that's definitely a place where infection can be introduced and stuff. But assuming you're all in a good clean environment, then this is what's used. So the, you know, the vacuum is working, it's pulling tissue in through the hole at the end of the straw. And then they're, you know, using that against the wall of the uterus and stuff to make sure they're getting out all of the tissue. Yeah, so the the advantage of that the fact that you have this manual aspiration is that it can be used anywhere, whether you have electricity or not, you know, it's something that's used in a lot of clinics all over the world, that don't necessarily have stable power.

Aspen 32:05 Or, you know, if you're outside of a clinic, then it's something that can be used in a living room with like someone who has the experience of it. And that's where you can get your music playing good, happy, you know, however, you can create the scene, however you'd like. And I think that's one of the things about, you know, having an aspiration abortion in a clinic, you have people who are in that medical model, or you could have one at home with someone who has the experience of using it. And you can really set the tone and the setting of who you want to be there. And how you want it to be. You can, you know, in every procedure, there should be the option, whether there is or not, there should be the option to slow down. But when you're in your when you're in your own space, you can really set the terms of slowing down and taking a break and having some tea. So that MVAs can work in or out of a clinic.

Margaret 32:52 When I...I'm really not trying to play like I'm the expert here. I did a...my other podcast, I did an episode about the Jane collective and in Chicago. And in it, I ended up talking about the people who invented the "cannula?" [pronounces carefully testing the pronunciation]

Cobalt 33:09 Yeah exactly.

Margaret 33:10 And then later, menstral extraction, the guy who invented...I don't have anyone's names in front of me, I don't have any notes in front of me...But the women who invented menstrual extraction, and so I'm kind of I'm framing this as a question...Basically, they were able to do it so that wasn't considered medical, and it wasn't considered an abortion, because it was just the like, an extraction of the menstrual products or whatever. And it was like a way to skirt...because it wasn't an abortion. It was just like, "Oops, we're just cleaning out all the menstrual products."

Aspen 33:43 Yeah,

Margaret 33:44 Is that....that seemed really hopeful to me in the era of post Roe v. Wade, that was going around.

Aspen 33:50 Yeah, those people...so there was a Jane collective up in Chicago, but the people who really worked with menstrual extractions lived in California. So in California, it's considered a home remedy. And I think that's the language that they've used. And it was sort of, you know, people can extract their period or their menses, even if they aren't pregnant. And it's actually what some people prefer to do, because they don't want to bleed. They could extract their menses, but it is a bit of like an involved experience. You have to have a cannula inserted into the uterus and have that be extracted, but then you're not bleeding for multiple days, which may be one of the ways to practice before someone's actually pregnant is to extract each other's menstrual cycles. But the thing about it is that, so someone, so by the time....So someone's inserting the cannula in with the MEs (Menstrual extraction). There's a little bit of a smaller syringe, and the person who's having the experience can actually pull the syringe and so it's much more of like I'm doing it to my own body too, which makes it a bit detached from like a providers providing a service who's not actually part of the clinic system.

Margaret 33:51 It's cool. I got really excited when I learned about it and I remain excited about it.

Margaret 35:01 Like in a dettached way.

Cobalt 35:01 Yeah.

Cobalt 35:02 Yeah, I think it's very cool. I appreciate people that are, you know, doing it thoughtfully and safely. And I'm also much more of a proponent for pills, like myself again, because like, I also deal with like, the dysphoria, and I'm kind of like, "I'd rather not deal." And also because they really are, you know, the pills, depending on you know, exactly how far along on your gestational age it's like, up to 97% effective.

Margaret 35:30 Okay.

Cobalt 35:30 And, you know, with with no risks of...very low rate, you know, you're not, you're not inserting anything there. So you're not introducing a possible infection vector that way. There's also no like risk of puncture. Although 1) it's better not to have an IUD in if you're inducing, pretty terrible cramps. But, uh, yeah, so but it's definitely an option for people who you know, don't like have access to pills, don't have you know, access to herbs, or not doing things that you know are the right time for that, it's definitely another option that is available to folks. And that can be done quite safely.

Aspen 36:07 And it's, it's all done on like a shorter timeline, like with with herbs and with....like herbs is one of the longer timelines and with medication, it's within a couple of days window, but someone's still going to be likely bleeding for a couple of weeks after that, even if they pass the tissue, their bodies still healing, and they're likely still bleeding. And with the menstrual extraction, and with the MVAs, you're you're taking out all the contents, and so it's much easier to go right back into getting back into your flow. You're not...there's a shorter healing time, maybe like

Margaret 36:37 Get right back to work?

Aspen 36:39 I was gonna say that. Honestly to me, and that's their priority. They're like, I don't want to be disrupted.

Margaret 36:47 We got to eat, you know?

Cobalt 36:48 Yeah, exactly. I can't afford to miss my job. So yeah.

Margaret 36:54 Yeah. Okay, well, to go back to kind of the doula project itself, I'm kind of curious about how things like this, you said, there's a whole bunch of these around, are they? Is it a network? Are these just completely independent and autonomous groups that use similar names and structures like, like, what's going on with doula projects?

Cobalt 37:16 So the original doula project is in New York, and they even have a book out about kind of their founding and some of the work that they do. The people that initially formed the Bay Area Doula Project, got a lot of their initial materials and like kind of training and inspiration from those folks. And I know a couple people associated with the project in New York, but we've not like strongly connected as any kind of organization. It's really been something, I believe, where people who want to set up a doula project, you know, may inherit some materials and just go with it. And again, do with it, what's possible and appropriate, in whatever location there they are.

Margaret 37:58 How would one go about starting in such a thing?

Cobalt 38:03 That's a very good question. We fell into...So, so history of theory of Bay Area Doula Project is that it's been through, my understanding is that it's been through sort of several incarnations where people have kind of, you know, some group of people have done it until they have gotten burned out or had other projects and then or been priced out of the bay area or whatever. Yeah, and they, you know, leave but have left behind some, you know, group of people who, you know, then try to, like resurrect it in a new like, new and different way that's appropriate for this, like new group who's taking it over. That's certainly what happened with us. So we came into this pre founded, Bay Area Doula Project has been around for in one or one or another form for a bunch of years now. But as far as like, trying to get started, I think it's, you know, find at least a few other folks with, you know, similar care about, you know, abortion and specific and emotional support around medical care, like, and, you know, start figuring out what is needed in your area, you know. One of the things here...so like the New York Doula Project, they do a lot of in clinic work, they have, you know, they train people to be in the clinic, and people work shifts, and they sort of help whoever comes in who, you know, to have somebody, you know, hand to hold and, you know, just someone you know, being there who's not practicing medicine upon them. And whereas here, you know, the local clinics do have, you know, some great people doing counseling and things already that are paid to do that. So it's not something they need volunteers for, you know, but so we focus more on the out of clinic stuff or on the waiting room support, you know, things like that, you know, helping people get from place to place and have...not feel so isolated, or scared while things are happening.

Aspen 40:00 I think that there's something beautiful in that like, we can't just be duplicated everywhere. And I think that the best thing people can do is go to their community and figure out what the needs are. I've seen some doula projects who focus like, mostly on more practical support. So like they're connected more with like the abortion funds in their area. I've seen doula projects do like Plan B drives where they distribute Plan B to a bunch of people. So it can look like you know, being an abortion doula can look so many different ways. And so I really just want to empower people to go to their communities and ask. Figure out what the need is.

Margaret 40:35 You talked about abortion funds, and one of the things that I've been running across in the wake of, you know, this thing that is happening, where Roe v. Wade is no longer the law of the land or whatever. And one of the things that I've been running across as people saying donate to abortion funds, rather than, say, for example, Planned Parenthood. Is that a framework you all believe in? If so, can you can you talk about what abortion funds are? And how people who want to help...how can people best help if they're not starting a doula project? Like with their money?Is it abortion funds? Is it something else? Is it you all?

Cobalt 41:18 It is definitely abortion funds. You know, Planned Parenthood does a lot of good things that they're also already pretty well funded. You know, everybody knows who planned parenthood is. Abortion funds are the people who fill in all of the different gaps, right, they, you know, in a lot of ways, a lot of times they do, you know, work directly with clinics, you know, help support clinics in you know, whatever way, so you're also helping support, possibly a Planned Parenthood or possibly a more independent clinic. And, you know, funds are also going to be helping with the things that make access actually possible. So again, helping with people who need to, you know, get a bus or train or a car, to travel costs or, or plane possibly hours to get to their appointment, helping people figure out childcare, and helping people afford meals while they're doing this traveling, you know, filling in all of those gaps. Not every fund does the practical support part, but a lot do and I think it's, you know, a growing thing. So that's really why I would say and again, not just in, you know, certainly certainly in the States, where, you know, abortion access is most restricted, but really everywhere, everywhere needs them. And also, the funds that are part of the NANF, if, you know, they kind of work together. They're, they're a network for a reason. And so it's been...

Margaret 42:34 What's the NANF?

Cobalt 42:35 Ah, the National Network of Abortion Funds.

Margaret 42:38 Cool. Thanks.

Cobalt 42:38 So jargony, Yeah, yeah. So it's a network for a reason. And when those, you know, if there's a clinic that's, you know, really low on money this month, and has a particular need, you know, the call will go out and it will get covered, you know, by however, we can make it happen. So, yeah, donate to your abortion funds.

Aspen 42:58 I totally agree with that, and that abortion funds are doing a lot of good, I really appreciate they're doing a lot of local work. It's not just this like overarching Planned Parenthood, even though Planned Parenthood, I want to keep I want it to keep on staying or sticking around. But like, I think that people should really be directing their energy elsewhere. But the thing about abortion funds is that their funding clinical abortions, which is just a part, just a sliver of abortions, which we've been mentioning throughout this entire podcast, so find your local abortion doulas who are doing work too and get...you know, we also need to be funded. And that's something that, you know, me personally, I'm trying to figure it out because a lot of the work that...the people who are providing and supporting abortions outside of clinics are supporting people who can't afford, you know, or access clinical abortions, which the abortion funds are filling to some extent. But, I mean, there's so many, like we mentioned before, there's so many reasons why people might not want to go into a clinic, whether it be just not aligned with what their what their what they're wanting, and yeah, abortion providers outside of community abortion providers are doing really great work and we need to be funded to.

Margaret 44:08 Yeah, no, that makes sense.

Cobalt 44:11 I also want to plug If/When/How. They have a repro[ductive] legal helpline, so anyone who has any questions about, you know, legality of something they might be considering, or especially if someone has been criminalized for a pregnancy loss of any kind, those are folks that will jump in and help. They are awesome. They're If/When/How, or they're like Lawyering For Reproductive Justice, I think is the name, is the full name, and they're just fantastic. There's a lot of other great orgs you know, doing work in the space. They're one of them. I also realized we've been using this term reproductive justice and I want to make sure that we call out like the, you know, history and origin of that, which is that in 1994 I think it was a group of black women, you know, really called out that like you choice just doesn't, you know, cover it right, like choice is not enough. And, you know, called out the you know that it's not just the choice to have an abortion, right, it's access to abortion, but it's also the choice to have a child when you want to, and to parent the children that you might already have, you know, in, in safety, and then health. And so reproductive justice is just like a much wider lens, and, you know, more inclusive of all of the, you know, things that come under bodily, bodily autonomy and parenting and yeah, so like, you know, the formula shortage that we've been having is definitely a reproductive justice issue. The fact that WIC doesn't cover diapers, the Women, Infants and Children program that like makes sure that kids have food doesn't cover diapers, and if you don't have diapers, then you often can't drop your kid off for daycare, because they'll require you to give them a certain number of diapers for the day. And so therefore, you can't like go...

Margaret 45:55 Have a job to buy diapers.

Cobalt 45:56 Exactly. You know, that's a reproductive justice issue. The asthma rate for often, you know, Black, or Latin or Native American, you know, places like asthma rates, worries about, you know, if you do have a child, can you safely breastfeed them because of the pollution that you know, is in your area, right, like, all of these things are also like big and important. And that is, you know, once again, black women like leading the way to think about all this stuff more broadly. So, I'm going to call that out.

Margaret 46:33 Yeah. Do you ever have those moments where you just, there's something you already know, but it still hits you as an epiphany, like, whenever I do this kind of....whenever I like, talk to people about this kind of thing. It's I don't know, I just have this moment where you're talking about like, "Oh, in case you're being criminalized for losing a pregnancy..." And I'm like, "What fucking world we live in?" It's like something I've been, like aware of for a very long time, right? Which is like every now and then it like slips through the armor that you build up. And you're like, oh, right, people aregoing to be locked into cages because they lost a pregnancy that they may or may not have wanted to lose.

Aspen 47:11 People already are. People are already incarcerated in the so called United States for miscarriages. And it's just going to increase because really, we are criminalizing bodies that are losing pregnancies, whether it's by an abortion or a miscarriage. And the thing is that they're, they're medically identical. So yeah, it's it's really concerning how many people are going to be harmed in general, but specifically the people who are going to be miscarrying losing pregnancies.

Margaret 47:41 Yeah.

Cobalt 47:41 And I was just gonna say, this is a good chance to circle back to, okay, so like things that can go wrong, especially specifically....

Margaret 47:47 Hurray!

Cobalt 47:48 Specifically about pills, which is, you know, you might be bleeding a lot, the recommended, or the sort of definition is, if you've soaked, you know, all the way through two or more pads an hour for two hours, then, you know, like, go seek help for blood loss. I feel like I would probably go in a little sooner, especially, you know, depending if people were showing other signs of blood loss, like, you know, being pale or like, you know, if their skin like, you know, if you the dehydration test, if you like kind of pinch the skin on your hand, and it stays up, you know, you don't have enough fluid in your body, like, that's another, you know, check, but definitely, if it's more than two pads an hour for two hours. So that should also be a consideration, you know, is like, how close are you to the hospital, you know, when you're sort of figuring these things out there. And then the other big thing is like infection. So you know, if you, in the days after develop a fever, or start having some really bad smelling, or strange looking discharge, then that's probably you need to go to the hospital. But, like, Aspen just mentioned, miscarriages or miscarriages. Medically, there's not a blood test that one could give for what pills a person might have in their system. There's like, no medical reason why one would need to say whether or not this miscarriage was self induced or not.

Cobalt 48:01 There's...like it should not change the treatment plan or the plan of care of a doctor at all. So there's literally no reason for you to self disclose, and certainly no reason for a doctor to or a nurse or anyone to pry. So one thing is a lot of the guidelines for self managed abortion, encourage people to take things by mouth. And that's partly because one could also take it vaginally, but if you swallow it, it's gone. If you spit things out into the trash, or if there's like residue leftover in the vagina, that could be something that can be used to criminalize a person. So that's why it's like kind of the protocol is to let things dissolve in the mouth. And then once they've been in the mouth for the required amount of time, you know, you could swallow them or spit them out. But the the choice, the best choice is generally to swallow them. So yeah, but the most important thing is, yeah, there's no medical reason why you would need to say anything about, like, what started the sequence of events, and just that you're there, you know, you think you might have lost a pregnancy and you're bleeding a lot, or you might have an infection. Yeah.

Margaret 48:01 Okay.

Margaret 49:18 Okay

Aspen 50:26 Yeah.I appreciate you Cobalt naming like those, like those big things like the, like, possible complications, or like bleeding too much, and also infection. But the reality is that the biggest complication and risk of, of abortion is being incarcerated for it and being criminalized for it. So that is honestly like the biggest harm or the biggest, like concern of abortion, to be honest.

Cobalt 50:50 Yeah, it's also important to say this is a lot safer than carrying a pregnancy to term. As far as like likelihood of side effects, likelihood of harm, especially, you know, again, frankly, especially if you're a person of color in America, and especially if you're a Black person in America, you know, the mortality rates are absurd, for people who are getting for black people who are giving birth, so there's multiple, there was multiple points buried in there. One is that it's super safe. And two is that like, we need to do better by Black folks, and they are linked together, but also separate.

Margaret 51:25 The fact that the most dangerous part about seeking an abortion is that someone might try to lock you into a cage and ruin your life for doing it is so just fucking dark. I don't know. Like, again, not in this like surprising way. But every now and then I just have like these moments where I'm like, there's someone right now who's in a cage for like, smoking weed, and the fact that we live in a society that has people in cages period, just like walking around being like, oh, that's the place where everyone's kept in cages as if that's like this, like normal thing. But every now and then it just, yeah, I don't know why it's just every now and then just like hits me like this horrible dark epiphany, that of something I already know. But...Aspen, at the very beginning, you talked about how one of the things that you do is teach people how to track fertility. Is that something that there's like a really short, useful way to talk about to an audience? Or is that? Or maybe like how people can go about finding this out? Or?

Aspen 52:25 Yeah, I mean, so I am a fertility awareness educator. So looking at those terms, fertility awareness, there's a directory via the Read Your Body app. So if you look up, there's like a Read Your Body fertility awareness directory, and there's like, a bunch of fertility awareness educators, so you can really find someone who like who meshes with you and who you're interested in learning from. There's also like, it's possible to also self teach or like, be self taught when it comes to fertility awareness. In my own journey. I was self taught for a while until I just really needed another human to be like, "You're doing it, right." So I also want to validate like, needing that community support and that like, you know, it's it's also okay to, to learn from someone. And I think that...so I'm excited about cycle tracking, not only it for...for me, it feels like a huge resistance against the laws that are being passed that are restricting abortion to a certain certain week, because it's essentially capitalizing off the fact that most people who bleed haven't been taught much about their cycle, they've just been taught that it's like a pain. And that's pretty much it. Which if for some people, it is just a pain, which is okay. But I track both...I take my temperature every morning. Every time every morning, when I wake up, I take my temperature and I write it down. Every day I check for my cervical fluid. Every time I use the bathroom, I look in my underwear and when why when I wipe across my vulva, I look at the toilet paper, and I see cervical fluid. And that is what...in those combination of combination of information. I know when I'm fertile. I know when I'm infertile. And it might be news to someone to learn that. If you have a uterus, you're not fertile every single day of your cycle. That was news to me. I was really raised with like the hyper fertility myth. And so just bursting that bubble in the first place, I think is important. And knowing that it's totally possible to check cervical fluid to take someone's temperature every morning, and to make different decisions to use condoms certain times of the month, to abstain certain times of month, to have different types of sex and intercourse in different types of the month, to avoid pregnancy pretty effectively.

Margaret 54:32 Hell yeah. Alright. Is there last stuff? Is there stuff that I should have asked you but I didn't? Like, I mean, obviously, there's a lot more about all of this. Well, for example, actually, we didn't talk about like specific herbs and I was guessing that that was kind of an intentional thing of like, not trying to just go tell people to drink pennyroyal tea or whatever. I'm using that as a specific example of what you shouldn't go do, to my understanding, but...

Aspen 55:00 Yeah i i Like don't call out certain nerves, because I think that I really want to elevate people building their relationship with herbs and there are so many herbs out there but since you mentioned Pennyroyal and that's a friend of mine like there's a lot of slander on the internet right now against pennyroyal. I just want to push against it for a second because pennyroyal is so great in a tea. There has been harm caused to some body because they've ingested the essential oil. So never ingest the essential oil, but Pennyroyal tea is such a great ally and friend when it comes to releasing pregnancies. But I do want to name a couple resource books, "Natural Liberty" by the Sage Femme Collective is a really great book, that's like a pretty extensive resource book about a lot of different types of self managed abortion. It does use gendered language so just as a content warning. There's like a if you can go through go through your TOR and your VPN, there is like a Rise Up pdf of it online. So it's easy. It's like free online, or you can purchase the book. Holistic Abortion