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Reporter explores 'whisper network' of home abortion providers Date: 11/21/18

Lizzie Presser

By Emily Willingham

In some parts of the United States, a woman’s access to abortion is becoming increasingly restricted. Facing obstacles that can effectively mean no access at all, some women are having abortions in their homes, tapping into a hidden network of care providers who can give them healthcare they otherwise cannot obtain.

Before Roe vs. Wade established a woman’s protected right to abortion, women had a compendium of interventions that they knew about through whisper networks or transgenerational wisdom. Some of these practices go back centuries but can be lost to current understanding where pregnancy termination is safe, available, and affordable. When those factors are not in play for a woman in the United States today, her options are to attempt the termination on her own or to get her needs met through a community of about 200 home abortion providers scattered across the country.

Not all women who seek this network do so because of structural obstacles to care. In some cases, they have a personal reluctance to turn to the medical establishment. But if anything is a powerful social determinant of a woman's health, it's having her access to health care blocked by legislation and other structural obstacles.

Investigative journalist Lizzie Presser achieved a remarkable and difficult feat for her story about this network and the women it supports. In her piece for The California Sunday Magazine, Presser lays bare the realities that these women face, from the “abortion doulas” who gain training in performing the procedures to the women who seek them.

To write her stark and candid story, Presser had to gain access to women who, understandably, could be endangered in life and livelihood if their identities were revealed. Her work involved far more than establishing rules around covering identity. In this “How I Did It,” Presser discusses, where she is able, how she navigated the fraught legal implications of writing about these women, how she managed to find them in the first place, and why she believes in the power of “slow journalism.”

How did you navigate what must be some fear of exposure on the part of the women you interviewed? What kind of preparation did you do to discuss being an abortion provider, on one hand, vs having a home abortion on the other. Did you have concerns about managing their legal anxieties or personal feelings of stigma?

I did a whole lot of preparation for this story, in part because I spent a bunch of time waiting for sources to speak with me, and in the meantime, I researched. I read books on the history of abortion in the United States, on the Jane Collective, an underground network of women in Chicago who provided abortions before Roe v. Wade, on the history of midwifery and herbalism, on “witches.” I read international reproductive rights organizations’ studies and the WHO [World Health Organization] protocol booklets on abortions provided by non-physicians, among others. I also spent time speaking with doctors and midwives and abortion doulas to get a sense of the medical and emotional complexity of abortion care in general.

Navigating the fear of the women I wrote about in this story was extremely complicated. Some were excited to talk and really wanted information about home abortion to be more widely accessible, and they didn't have safety concerns. I did, though, and I walked them through the legal risks of being on the record talking about providing abortions or self-managing their own abortions. Some women spent hours on the phone with me and then ghosted -- they stopped taking my calls. Then there were those who wanted to talk with me, to tell me their stories of discovering the history of home abortions and the science around abortion pills, to describe the kind of care they offered clients, but who didn't want to be featured in the story, even if anonymously. They were too afraid that they'd be identifiable -- even if just to their mothers. I took a lot of time with these women, speaking with them regularly over six months, on the phone and in person, and over time, some of that fear fell away. I'm not exactly sure why, but I do believe in the power of slow journalism, the kind where I have time to listen to a source's anxieties, understand them, give sources space when they want to think things through, and get on a plane when they feel ready to talk.

I was constantly concerned while working on this story. I was lucky enough to have a fantastic editor, Kit Rachlis, who talked me through a lot of my concerns and helped me address the ones that needed addressing and let go of the ones that were misplaced. I was also extremely lucky to be writing about women who were open with me about their own anxieties so that we could talk through them together.

When you spoke with the women in your story, what methods did you use? Were your interviews in person (I know that there are images from behind of some sources), and if so, how did you have these intimate conversations with them while also ensuring that your recordings, etc., were being captured? 

Most of my interviews were in person. The topic is extremely sensitive and then of course there was the fear of exposure, so I quickly understood that the only way to do this reporting was to sit with these women. They were also very busy – they had jobs, kids, clients, and so I had to make myself available to them without demanding their time. I traveled to four states for this story, to some states more than once, and a number of times I told these women I was around and I could talk whenever worked for them – that meant driving to their homes at 8pm when their kids were asleep or meeting them at their offices when they had a break or coming over for a few hours in the middle of the day and sitting on their carpet while they breastfed or lulled their kids into naps. This, of course, is a privilege that comes with a reporting budget. I was lucky enough to have funding from The Nation Institute, which allowed me to do this work patiently.

I know that it's sensitive, but is there a way to describe how you identified and tracked down your sources? 

It was a classic snowball situation. Once I was connected with one woman who was involved in this network, she started to reach out to others, who reached out to others, and so it went.

How did you manage your own sympathetic feelings about these women's situations--did you have any process that you used? 

With this story, as with most of the stories I’ve worked on, I had all kinds of feelings–I’m not likely to spend months on a story unless I am drawn to it and see an opportunity to draw out the psychological complexities of the people whose stories shape the narrative. In terms of managing them, my interest in accuracy and drilling down on the truth also drive my reporting, and it’s not that those goals remove the emotional experience of this work, but they certainly keep it in check.

A reporter friend once gave me a great piece of advice, too: When you hear your source say exactly what you want to hear, push back, even if just a bit. I incorporate that in all my reporting, and it’s been hugely helpful in challenging my own assumptions.

The story gives a ballpark number of 200 or so women in the home-abortion-provider network. You seemed to have some demographic information about them--that many are low-income women, some are herbalists, etc. How did you pin down that information?

I unfortunately can’t answer this question because of my agreement with these women. I could write around the answer, but I’d prefer not to.

How does fact-check work with something that is this sensitive, especially given the potential legal threat for these women? Is this a process that you worked out with editors ahead of time, as it must have been somewhat unorthodox?

My editors and I did work through this. We all encrypted our hard drives and used Signal and encrypted email to communicate with one another. The fact checker on this story knew the sensitivities and also reached my sources by Signal.

What steps did you take to protect your sources, especially from legal repercussions?

We had legal review on this story as we always do, but I also asked California Sunday’s lawyer questions that were specifically on behalf of my sources and relayed the answers to them. I spoke with a series of criminal defense lawyers, too, to ask about legal repercussions and bring those answers back to my sources as well. We were also extremely careful about research material, as I described earlier, not only with textual notes and contact information, but also with metadata and photos.

What legal protections, if any, did you ensure for yourself? 

Besides asking for legal advice from criminal defense attorneys and encrypting all my reporting materials, I also worked out an agreement with the magazine about how we’d respond if we were subpoenaed.

Finally, how did you prepare for what must have been – and may still be –  blowback on such a candid treatment of one of this country's most incendiary topics? Did you have any personal concerns?

I encrypted my hard drive and eventually wiped my computer to protect against hackers, and I took my phone number off my website. But I wasn’t all that concerned about myself – I was far more concerned about the women I was writing about. I knew that I had a magazine behind me, the Nation Institute, and the ability to go public if I came under attack. My sources weren’t as well-resourced. Even licensed abortion providers in this country can be at risk of violence, and they have major institutions behind them – the women I wrote about were flying solo, unprotected by organized affiliations. My focus was on doing everything in my power to protect them. 

Lizzie Presser is a contributing reporter at ProPublica and was previously a contributing writer for The California Sunday Magazine. Her writing has appeared in The Guardian, This American Life, Harper's, The Independent and elsewhere.