On the day of the Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision, June 24, 2022, I was in the middle of writing a chapter for my book about feminism in the 1960s describing pre-Roe abortion horror stories. Of the 120 women I interviewed, most had had at least one illegal abortion, and each story was more harrowing than the last.
That ugly past had now roared into the present. Would American women living in abortion-ban states suffer again at the hands of back-alley butchers? Three years later, countless atrocities have indeed occurred, but there is one significant difference between illegal abortion in America in 1965 and 2025: mifepristone.
Journalist Rebecca Grant, in her riveting, sweeping new book, Access: Inside the Abortion Underground and the Sixty-Year Battle for Reproductive Freedom, tells the epic tale of women’s struggle to obtain their bodily sovereignty. Through her daring reporting and copious research, Grant has written a monumental masterpiece of feminist outrage, ingenuity, and perseverance. In page after page, Grant shows the striking similarities between the oppression women seeking abortions suffered in Argentina, Mexico, and Ireland before those countries decriminalized the procedure and what women in America are battling today.
Regardless of geography, class, religion, or political system, the theme of men seeking to dominate women’s bodies is hauntingly universal. Yet women, Grant proves, will find a way to control their reproductive lives. They always have and they always will. As dire as the current struggle is, Grant reveals that there is a glimmer of hope, a beacon that can lead women toward freedom with self-managed abortion (S.M.A.).
Grant traces the development of mifepristone from its infancy to its widespread use, both lawful and otherwise. When taken in combination with misoprostol, the drug enables women to terminate their pregnancies safely, in the privacy of their own homes, and without the need for medical intervention by a doctor or an abortion clinic. By the time the Supreme Court reversed 49 years of women’s constitutional rights, three years ago, 50 percent of abortions in the U.S. were “medicated,” the other half “surgical.” Despite these dramatic statistics, medicated abortion remains largely obscure to the general public and has only relatively recently been accepted by the established pro-choice movement.
Before the proffered freedoms of this wonder drug, Grant reminds us, women endured a nearly two-century-long slog on the road to reproductive rights. Access starts in New York in 1845 before abortion was criminalized, with the infamous abortionist Madam Restell, who was felled by the villainous, Puritan U.S. postmaster Anthony Comstock. Access then shrewdly jumps to the parallel reality more than 100 years later, when, in 1966, members of the women’s-liberation movement begin to challenge abortion restrictions through illegal means.
Grant tells us about Carol Downer and the West Coast Sisters’ Los Angeles clinic, where “menstrual extractions” were performed, and the Jane Collective, in Chicago, who learned to perform abortions themselves, without a medical license. By the time the Janes were arrested in 1972, the underground network had performed 11,000 safe abortions.
The Clergy Consultation Service on Abortion, operating in 38 states, helped 500,000 women obtain abortions in and out of the country between 1967 and 1973. By the time the Supreme Court legalized abortion nationwide, in 1973, one million women were finding ways to obtain abortions in and out of the country every year. As soon as abortion became legal, however, the Christian right devoted heavy forces to systematically and successfully chip away at abortion access in mostly Southern states. This would continue for 50 years.
It seems appropriate that the father of the abortion pill was also a member of the French Resistance during World War II. Dr. Étienne-Émile Baulieu began testing RU-486, or mifepristone, in 1982, and soon enough the World Health Organization conducted trials globally involving 20,000 women. The drug’s 95 percent success rate led France to approve it in 1987. It would take the F.D.A. another 13 years to approve mifepristone for the U.S. market, but even after approval, the red tape required to obtain a prescription was so onerous that the pills were not widely used.
While the F.D.A. spent years deliberating, the genie was already out of the bottle (so to speak) globally. An audacious Dutch doctor, Rebecca Gomperts, sailed a floating abortion clinic to the shores of Ireland, Poland, and Portugal, where she faced down authorities and distributed abortion pills to women in need. Realizing the potential for abortion access to travel worldwide through these pills, Gomperts pivoted from public seafaring delivery to the Internet. She founded the telemedicine service Women on Web in 2006 and mailed generic mifepristone, made in India, to women all over the world.
Grant profiles another radical resister, in Mexico, who wasn’t afraid to fight the country’s punishing criminal abortion ban. Verónica Cruz Sánchez, the founder of Las Libres, smuggled mifepristone into the country and publicly defended women wrongfully incarcerated for miscarriages and abortions. Cruz Sánchez, along with activists in Argentina, helped ignite the “green wave” that swept through Latin America and led to the legalization of abortion in Argentina in 2020, in Colombia in 2022, and in Mexico in 2023. Portugal had decriminalized abortion in 2007, and Ireland had in 2018. While all of these countries marched toward reproductive justice, America reversed course.
Soon enough, Americans would follow the fearless lead of activists such as Cruz and Gomperts, who knew how to dodge the law to distribute abortion pills. Some of Grant’s most suspenseful and newsmaking chapters are near the end of Access, when she profiles anonymous American underground activists who, after the closure of 66 abortion clinics in 15 states following Dobbs, found ways to distribute mifepristone to women living in those states.
Collectives calling themselves FTP (Fuck the Patriarchy), Old Hippies, ProgressiveRx, and Plan C use burner phones, encrypted e-mail, and anonymous P.O. boxes. One rebel described her group as a “nefarious chemical-abortion cartel.” Grant unveils this brave, undercover guerrilla force comprising “ordinary people—neighbors, mothers, grandmothers, health-care workers, friends, pet parents, anarchists, retirees—doing the extraordinary work of putting themselves on the line to resist, subvert, and undermine abortion bans…. They were everywhere.”
Right now, young women in states such as Texas, Georgia, and Idaho are losing their lives and future fertility because emergency-room doctors are too afraid of criminal prosecution to treat their pregnancy complications and miscarriages. The heroic stories in Access are a jolting call to arms. As Grant puts it, “No one is coming to save us. We have to save ourselves.”
Clara Bingham’s most recent previous book is The Movement: How Women’s Liberation Transformed America 1963–1973
