In her new book, Deep Care: The Radical Activists Who Provided Abortions, Defied the Law, and Fought to Keep Clinics Open, Angela Hume explores a queer-led movement of Bay Area-based feminists who took reproductive freedom into their own hands.
These activists influenced reproductive rights work all over the world, but their beginnings were humble. It all started in the early 1970s, when small “self-help” groups, generally consisting of about six to 10 people without medical licenses, would meet regularly to learn about and support each other’s reproductive health. They even performed abortions, even though to do so was illegal.
These activists eventually created their own clinics that were organized around feminist principles.
Deep Care focuses largely on one clinic, Women’s Choice in Oakland, which operated from 1973 to 2009. As right-wing anti-abortionists began to organize and target people seeking and providing abortions, particularly in the 1990s, Women’s Choice clinic became a community hub for militant abortion clinic defense organizing.
Hume recently spoke with us about her book, how it relates to other Oakland political movements, and the 2022 Dobbs v Jackson Supreme Court decision—which has restricted or eliminated abortion access in many parts of the U.S.
This interview has been edited for length and clarity.
Deep Care’s first chapter is about self-help groups. What’s self help in this context, especially as it relates to abortion?
When we hear the phrase ‘self-help,’ I think what first comes to our minds is the popular neoliberal idea that you can self-improve and self-actualize through your individual consumer choices, right? That’s not the self-help that I’m talking about in Deep Care. I’m talking about abortion self-help, which was a radical political movement.
From the early 1970s into the 2000s, mostly during years when abortion was a constitutionally protected right, activists practiced abortion outside of clinics in what they called self-help groups. Unlicensed lay people were teaching each other about sexual anatomy, pleasure, orgasm, fertility tracking, sexually transmitted infections, how to do cervical and pelvic exams, and importantly, how to empty the uterus to end a pregnancy with a simple suction practice called menstrual extraction that you can do with equipment mostly found at the hardware store, or today on the internet.
The self-help movement was working-class people led and inspired by leftist movements of the 1960s like the civil rights movement, feminist consciousness-raising, and Black radicalism. Eventually, these groups founded above-ground licensed feminist women’s health centers where lay people could get training and hands-on practice in gynecology, and where people could get abortions in a clinical setting. But even as the clinics operated, self-help groups still performed underground abortions.
Most people don’t know about the self-help movement and that there was an abortion underground during the years that Roe v Wade was in effect.
So the groups started before abortion was federally protected, and they did abortions illegally. But then after abortion became federally protected under the Roe decision, the groups still performed them illegally sometimes?
Yes. Activists performed these underground abortions even during the years that abortion was constitutionally protected. Why did the activists do that? There were many reasons but an important one is that, even under Roe, abortion was legal for many people in name only. After Congress passed the Hyde Amendment in 1977, the federal government no longer funded abortion for people on Medicaid. So abortion was only legal for people who had good insurance and the resources to access it.
Reproductive healthcare has always been inaccessible for many people. Abortion self-helpers understood that and were oriented toward coming up with community-based solutions to remedy that.
What led you to write about these groups? I think readers might be surprised to hear how much of a role poetry plays in this book. In the introduction, you write that you had initially set out to write an academic book about poetry and poets. How did that idea transform into a book about reproductive activism?
I did not set out to write a book about the radical abortion self-help movement in the Bay Area. I had been writing about feminist American poets. Many of them, like Audre Lorde, Judy Grahn, and Pat Parker were or are healthcare activists. So I was already doing research into radical health movements and how poets had played a role in these movements.
Parker was a radical Black lesbian feminist poet and abortion worker. She was working class, and not a poet who taught in the academy. Because of her identity, I think, there hasn’t been a lot published about her life. I started learning more about Parker in order to write my poetry book and I came across the fact that she had worked at an abortion clinic in Oakland for 10 years. This was the Women’s Choice Clinic.
I thought, that’s so interesting, I wonder what the story is there. So I reached out to Linci Comy, the long-time director of that clinic, and asked if she would be willing to meet with me and share about her experience working with Pat Parker. She said she’d be happy to do that.
That was the turning point. I really wanted to learn about the story of the Woman’s Choice Clinic. The more I learned, the more interested I got in the history of the feminist women’s health centers and the self-help movement.
Many of the activists who worked at Women’s Choice and were also involved in underground self-help and the abortion defense movement in the Bay Area were artists and poets. Because I’m a poet myself, I was deeply interested in the role of poetry and art in their movement. So I do bring quite a bit of poetry into the book.
I brought in some of Pat Parker’s poems and the poems of a couple of other activists as well. At the end of the book, I include a poem of my own. It’s a kind of documentary poem in which I collage together lessons that activists shared. As someone with an ear for poetry, and who believes art played an important role in abortion defense in the Bay Area, including poems just felt right.
You mentioned that Women’s Choice was in Oakland. So much of your book focuses on that clinic. Could you talk about it and why it was so important?
The Oakland Women’s Choice Clinic also went by the name the Oakland Feminist Women’s Health Center, but we’ll just call it Women’s Choice. It operated from 1973 to 2009—so it was a long-standing community institution.
Women’s Choice was founded by a 19-year-old named Laura Brown who had gotten trained in self-help and learned about how to start a feminist women’s health center in Los Angeles. She came up to Oakland to start the center.
In the early 1970s, Women’s Choice was at the heart of a whole bunch of radical lay healthcare and health justice stuff that was happening in the Bay Area. You could go there for abortion care, to get sexual health education and learn how to do a cervical exam or a breast exam. It was a participatory setting—kind of like the self-help groups—but in the context of a clinic.
You could get birth control and STI screening, phlebotomy, pathology, abortion counseling, and harm reduction supplies such as clean needles. If you’re a person with sperm, you could get a vasectomy. Eventually, you could buy sperm from Women’s Choice’s sperm bank and get help with self-insemination. It operated the first sperm bank to serve single women and lesbians. In the 1990s, before medical abortion was FDA-approved and widely available, you could get the abortion pills mifepristone and misoprostol through clinical trials.
Women’s Choice also allowed lay people to get hands-on practice assisting doctors during abortion procedures. You could even learn about menstrual extraction. (Editor’s note: Menstrual extraction is a suction process to empty the contents of the uterus. The procedure was and is used for abortion, but it also serves other purposes such as treating heavy menstrual bleeding.)
Women’s Choice became a place where you could go to plug into organizing. It was kind of the nexus of the clinic defense coalition that formed in the late 1980s called the Bay Area Coalition for Our Reproductive Rights, or BACORR.
To sum up, the clinic was really special because it responded to people’s physical, emotional, and spiritual needs.
What do you think was unique about Bay Area reproductive activism? How has it been influential and connected to work elsewhere?
Women’s Choice was not the only feminist women’s health center. There was a network of feminist women’s health centers spreading out across the country, and it started in Los Angeles.
Women’s Choice was a special feminist women’s health center, though. It was kind of the center for radical abortion defense activism happening for decades in the later 20th century into the early 20th century. I think some things that distinguish that movement is a sense of historical indebtedness and a focus on coalition work.
So I mentioned the clinic defense organization called BACORR which started out of Women’s Choice. That was a true coalition, both historically and horizontally. Some BACORR members were part of a group called Roots Against War, which was a people of color anti-imperial group that formed to resist the 1991 Gulf War. They saw themselves as direct descendants of the Black Panthers, the Young Lords, and the American Indian Movement. Other BACORR clinic defenders were involved in a group called Women Against Imperialism, which was a direct descendant of the Prairie Fire Organizing Committee, which grew out of the Weather Underground.
Bay Area Abortion Defense has absolutely been influential around the country and even around the world. They developed sophisticated tactics and training protocols that they brought to other places, such as Buffalo, NY and southern Louisiana in the 1990s, to help them form their own home defense organizations.
Deep Care focuses on the years Women’s Choice was open, 1973 to 2009. This timing interests me from an Oakland history lens because 1973 was around the time that Black Panther Party organizing peaked. And 2009 was just a few years before Occupy Oakland in 2011. Do you see the clinic and Black Panthers as having influenced each other? And what about Occupy Oakland?
Absolutely, yes. I’ll start with the Black Panthers.
Women’s Choice and the Bay Area abortion defense movement was influenced by and also influenced the Black Panther Party. In the early 1970s, the self-help movement was made up of largely working-class white women. But they were doing their work in the birthplace of the Black Panthers. Bay Area abortion self-help internalized and reflected Black radical ideas from the beginning.
The Panthers, founded in 1966, set up what they called people’s free medical clinics in the early 1970s. And they described this component of their movement as self health survival programming. For the Panthers, self health meant training lay people to defend the community against structural health injustices like malnutrition, sickle cell anemia, and involuntary sterilization.
To develop what was essentially a reproductive justice platform, the Panthers followed the lead of Black feminists who were writing on these topics at the time. The Panthers initially were focused on critiquing what they believed were eugenic sterilizations, and some made claims that abortion was Black genocide. But when Black feminists like Toni Cade Bambara and Frances Beal started saying no, we are Black women, we want access to abortion, the Panthers shifted their focus away from critiquing abortion to critiquing coercive sterilization.
At the same time abortion self-helpers were looking to what the Black Panthers were doing, they were also looking at what Black feminists were saying. And some of those Black feminists were part of the founding of the abortion self-help movement. By the 1980s, women of color were in leadership roles at Women’s Choice, and in fact, the poet I mentioned earlier, Pat Parker, was a former Black Panther herself.
To go on the question about whether self-help and radical abortion defense influenced Occupy Oakland is so interesting. No one’s asked me that question before. I would say absolutely.
Women’s Choice, over the years, especially in the 1990s, served many patients who were on MediCal, the state insurance plan. One of the reasons that Women’s Choice served so many patients on MediCal is because Women’s Choice became known for providing quality, trauma-informed care regardless of a patient’s income. It was predicated on the belief that everyone, not just rich people, deserve access to good health care. And it was about redistributing wealth, literal and figurative, resources, knowledge and power.
These were precisely the principles that catalyzed Occupy. So when people started marching during Occupy, you can bet that self-helpers who orbited Women’s Choice were there too, serving as medics in the streets and bringing tactics and lessons from their decades of activism. Clinic workers weren’t just reproductive freedom and justice activists—they were anti-imperialists, anti-capitalists and anti-war organizers.
And lots of them were anarchists and communists, yes?
Yes. A lot of anarchists and communists were involved in abortion work and activism in the Bay Area.
Is there anything else you want to say about menstrual extraction? As I read Deep Care, I remember being shocked to learn that lay people can, have, and do perform early-term abortions. It really challenged my assumptions about how abortion works and what everyday people can and can’t do.
Menstrual extraction is a simple procedure that self-helpers on the West Coast in the early 1970s developed for suctioning out the contents of the uterus. Researching and writing Deep Care truly led me to rethink everything I thought I knew about politics and medicine. I learned in the process of my research that menstrual extraction can be safely done in a non-medical setting by lay people who are trained in how to do it and who are also trained in sterile technique.
Without the guide of ultrasound imaging, manual suction abortion or menstrual extraction is a blind procedure, and this does pose additional risk. And yet, manual suction abortion is performed all around the world without imaging by lay people. It’s also performed in certain places by trained medical staff where adequate clinic and hospital infrastructure is not available. I learned in my research that in 2011, there was a study in India that showed that complication rates from these types of abortions between newly trained nurses and established physicians were the same, 98% successful.
I thought you approached writing Deep Care in a really interesting way. On the one hand, it’s meticulously researched. There are over 600 endnotes. And yet there’s this in-formalness to it because you bring yourself into the narrative and it feels like you’re friends with these people. Why did you speak in the first person so much and write about your experiences with your sources?
I wasn’t trained as a historian. I was trained as a literary critic. I went rogue and became a feminist historian along the way. I really wanted to think about what it would mean to tell history like a feminist—to draw on political methodologies and lessons of radical feminism, of Black feminism, and other women of color feminisms, of queer and trans feminisms. I think these feminisms teach us about the importance of knowledge produced through conversation and small group work, and of being immanently aware and mindful of how we do intimate relationships—improvising within those relationships and queering them when that’s what we need to do to get our work done and to be our authentic best selves.
Feminisms teach us about sharing and disseminating power. I wanted to uphold all of these principles through the writing of the book. To do this, I realized I had to put my body into the book—my heart and my mind, my gender, sexuality history, my trauma history, my experiences of race and class.
I had to be in embodied relationship—open to play, to love, to grief, to transition. Sometimes I had to be open to stepping back and sometimes to stepping up.
Are you still friends with some of the people in the book?
Absolutely. Linci Comy, Women’s Choice’s longtime director, became a political and personal mentor and friend—and others did too. Writing this book was the greatest privilege of my life, and it was transformative.
What do hope people learn from the radical activists, workers, and renegade abortion providers you wrote about? I ask this question, of course, with the current political climate in mind.
We need the lessons of the radical abortion defense movement now more than ever before. They are relevant and they are transferable.
One of the most important lessons is the insight that small groups of people working securely, closely, intimately, and dynamically together can make transformative change. Small group work is not easy, which is one reason that learning how to do it is a crucial political skill.
I talk at the end of my book about the importance of working with many hands as a key takeaway of radical abortion defense. We should offer our hands to each other. It takes a lot of hands to get many things done—like abortion and clinic defense.
Oftentimes in clinic defense, clinic defenders would link arms and be physically entangled with each other. They would use their hands to lift people up over anti-abortion extremists and help them get into a clinic. The image of many hands became an important lesson for me. It’s a lesson that self-help practice and clinic defense teaches us.
Today, abortion is banned or severely restricted in 21 states. People in those restricted states seeking abortions are more often going online to get abortion pills. Many people access abortion pills through an organization called AidAccess, which is an Austria-based fulfillment service that will facilitate the mailing of abortion pills to people in any country, regardless of the laws.
So abortion pills are available—legally and illegally—thank goodness for widely available abortion pills. At the same time, recently, the New York Times reported on how Polish scientists have developed lab testing that can detect if a person has taken mifepristone or misoprostol. If abortion pills become less available than they are now, we do have simple manual suction abortion—as we long have.
I think of one self-helper, whose pseudonym in my book is Max. Max said to me I want readers of your book to know that they can do this wherever they are. This is the sentiment I want to end with—not only with regard to menstrual extraction, but also with regard to all of it: small group organizing, learning, skill sharing, clinic defense, institution building and institution breaking, standing up for and demanding what you want, what you need and what you know to be just. You can do this wherever you are.
Correction: We incorrectly stated that MediCal insurance does not cover abortion. It does.