The Post-Roe Abortion Underground

A multigenerational network of activists is getting abortion pills across the Mexican border to Americans.
A chain of hands passes abortion pills to a single hand below them.
Amid bans from Arkansas to South Dakota, women young and old are taking extraordinary risks to keep abortions accessible.Illustration by Rachel Levit

The handoff was planned for late afternoon on a weekday, at an underused trailhead in a Texas park. The young woman carrying the pills, whom I’ll call Anna, arrived in advance of the designated time, as was her habit, to throw off anyone who might try to use her license plates to trace her identity. She felt slightly absurd in her disguise—sun hat, oversized sunglasses, plain black mask. But the pills in her pocket were used to induce abortions, and in Texas, her home state, their distribution now required such subterfuge, along with burner phones and the encrypted messaging app Signal. Since late June, when the Supreme Court overturned Roe v. Wade, Texas and thirteen other states had effectively banned abortion, and more were sure to follow. In some of the states, laws that originated as far back as the nineteenth century had been restored. Providing the tools for an abortion in Texas had become a felony that could lead to years in prison, and a fellow-citizen could sue Anna and collect upward of ten thousand dollars for every abortion she was found to abet.

Anna wasn’t a fainthearted woman—someone who had recently approached her for pills noted her “cottage-core vibes” and steely calm—but she wasn’t reckless, either. She and other women defying abortion bans had turned to a model developed by Verónica Cruz, a prominent Mexican activist. Until last year, abortion was considered a crime in most of Mexico, the second-biggest Catholic country in the world, and women there had become adept at providing safe abortions in secrecy. (Given the legal exposure, pseudonyms have been used for Anna and other American women who let me into their underground networks.)

By the time the pregnant woman for whom Anna was waiting walked up, the trailhead was quiet enough to make the chirping of birds seem jarring. As Anna pulled a plastic bag of pills from her pocket and settled across from the pregnant woman at a picnic table, she registered the fear on the woman’s face. Her distress, as Anna understood it, was less about a breach of Texas law than about the possibility that her husband, who was violent, might find out what she was doing. Hands shaking, the woman told Anna that she was already raising three children and had been trying to save enough money to remove them from a dangerous home. The prospect of having another child, she said, was like “getting a death sentence.” She couldn’t vanish from her household for a day without explanation, travel to a state where abortion is legal, and pay seven hundred dollars to a doctor for a prescription. Anna’s pills, which were free, were her best option. Taking the baggie and some instructions on how to take the medication, the woman thanked Anna and fled the park, hoping that her husband would never realize she’d been gone.

Hear from women distributing abortion medication illegally, on The New Yorker Radio Hour.

The town of San Miguel de Allende, in central Mexico, is known as the birthplace of legendary independence leaders. It is just as famous for its charm: cobblestone streets, Baroque churches, bright houses, and lively cantinas once frequented by Mexican muralists and Beat poets. Some Americans visit for a week and decide to stay. Among those expats is Liz, a retired Southern woman in her seventies. On the morning of June 24th, as she was making coffee in a kitchen where photographs of her great-grandchildren covered the fridge, she heard on the radio that the constitutional right to abortion in the United States had ended. She maneuvered her walker to a nearby chair and sank down. She felt as she had as a child, in a house by the sea where she’d once lived, when a hurricane she’d been dreading made landfall. It was awful, yes, but knowing what was coming had given her a chance to gather her courage and make a plan.

Five years earlier, Liz had met Verónica Cruz, who runs a nonprofit called Las Libres—the Free Ones—out of the city of Guanajuato, some fifty miles west of San Miguel. At the time, Cruz was defying Mexican law by helping women—mostly poor women—abort at home. In part because activists like Cruz successfully reduced the stigma of abortion, the Supreme Court of Mexico decriminalized it in September, 2021. That same month, Texas moved in the opposite direction: a state law known as S.B. 8 banned nearly all abortions past the sixth week. Since then, Cruz had widened her remit, supplying free abortion pills to undocumented women in Texas.

Liz figured that, with Roe overturned and states from Arkansas to South Dakota implementing abortion restrictions, the demand for Mexican abortion pills would soar. If she lacked Cruz’s decades of experience working on the cusp between the lawful and the criminal, she was neither too old nor too diminished to take a risk. She picked up the phone to call Cruz and then some friends, to find out which of them would be game to join an underground network.

Locals called expats like Liz “the Old Hippies,” in English. In early July, weeks after the U.S. Supreme Court’s Dobbs decision negated Roe, six of them joined Liz on her terrace for hibiscus tea and a talk with Cruz. Most of the Americans were over sixty and recalled what life was like before the 1973 Roe ruling. One tactic Liz remembered for ending an unwanted pregnancy was to alternate between a tub of ice-cold water and a tub as scalding as you could bear it. Those who tried this method suffered, then usually had a baby anyway. Liz had a baby, too, as a teen-ager. Although she had cheered when the Roe decision was announced, knowing how many lives it would change, it had come too late to change hers.

Cruz, the fifty-one-year-old daughter of farmers, has appraising dark eyes and a booming voice, and is direct by nature. She asked the Old Hippies if they would raise money and buy pills in Mexico that would be distributed across the border. Cruz paused to let an Old Hippie translate for those whose Spanish was weak.

Medication abortion in the United States is typically a two-day process that involves taking mifepristone, which blocks progesterone, and misoprostol, which causes uterine contractions. The Food and Drug Administration approves the use of this two-pill regimen under a doctor’s supervision up until the tenth week of pregnancy. A prescription, which can be obtained in states where abortion is legal, is required. In Mexico, Cruz explained, misoprostol is sold over the counter. Mifepristone still requires a prescription, but Cruz had found suppliers, and when she ran short she relied solely on misoprostol, which can cause an abortion on its own.

“You really should see a therapist about your suggestion that I see a therapist.”
Cartoon by Liana Finck

Immediately after Dobbs, Cruz said, her existing crew of volunteers had slipped enough medication across the border to help two thousand American women have abortions. If the Old Hippies agreed to aid distributors in abortion-ban states, Cruz told them, Las Libres could help many more women. Each cell in the supply chain would know little about the other cells—safer for everyone that way.

Several Old Hippies wondered aloud about consequences, as the legal terrain was decidedly unsettled. In Louisiana, anyone who “knowingly performs” a medication abortion is subject to a five-year prison sentence and a fifty-­thousand-dollar fine. In Oklahoma, it’s a ten-year sentence and a hundred thousand dollar fine. More such laws were likely to come, although no criminal convictions had yet been reported. If charged, an Old Hippie told Cruz, they might end up at the mercy of a district attorney in, say, Mississippi, facing years of jail time. But Liz was an optimist—“You have to be,” she always said—and by meeting’s end everyone in the room had signed on to her plan.

To avoid what Liz called the “gringo price,” she recruited her housekeeper to call more than two dozen pharmacies in San Miguel and find out what they had in stock, at what cost. Then the Old Hippies tried to buy all the pills they could. One pharmacist agreed to sell more than a hundred boxes but cancelled the order at the last minute without explanation. A second pharmacist demanded a prescription for misoprostol, something not required by Mexican law; an Old Hippie had to persuade her doctor to prescribe it for an ulcer, a condition that she didn’t really have but for which the drug was also used. It was a relief when a third pharmacist agreed to sell more than a hundred and fifty boxes with no questions asked.

Many of the pickups were handled by Diana, another Old Hippie, who at pharmacies gravitated to younger female clerks—less judgmental about her purchases, perhaps, than older men. On the day that she unpacked the last of the hundred and fifty boxes on her kitchen counter, she burst into tears. Every box contained more than enough pills for two abortions, and she saw in the stockpile before her hundreds of younger women who would be helped. “All of a sudden,” Diana said, “I realized what we’re all doing.” Those boxes just needed to get to the States, but that part of the relay would be left to others, as Diana, Liz, and other Old Hippies planned their next buy.

Six weeks later, sitting at a long table in a house on a hill in Guanajuato, Cruz counselled a woman in Georgia by phone while responding to a text from Arkansas: “I would like help with a medication.” A window behind Cruz overlooked a lemon grove, and around the table were colleagues—some social workers, some lawyers, most of them young—fielding questions from pregnant women on both sides of the border. The atmosphere was convivial, and taped on one wall was a phonetic cheat sheet for those with limited English: “Jai, dis is Las Libres. Can ay jelp iu?”

Cruz’s work had long been funded by American nonprofits, and after Dobbs the phone number of her organization was passed around by informal networks of activists. Cruz said that she was now getting fifty requests a day from the U.S. for abortion pills. Some women created fake profiles on Instagram to get in touch with her, or sent messages on WhatsApp or Signal, or called her in the middle of the night.

The evasiveness and fear that she sensed when communicating with Americans reminded her of how Mexican women spoke of abortion when she was growing up. Her mother worked on a farm, harvesting corn, and the only way she and her girlfriends alluded to abortion and miscarriage was with the expression malas camas—“bad beds.” Such euphemisms were necessary in part because women in the state of Guanajuato could face up to three years in prison for ending a pregnancy, and so could the medical personnel who assisted them. Before last year’s Mexican Supreme Court decision, abortion, in all cases except for rape, was deemed a criminal act in Guanajuato, where state law presumed that life began at the moment of conception. There is no reliable estimate of how many women died annually from secret abortions; authorities and family members often blamed the deaths on infection or hemorrhage.

In 1995, Cruz had completed training as a social worker and was helping Indigenous farmers improve their crop yields and distribution when, in a coffee shop, she heard an older woman discussing abortion in a way she hadn’t heard in school. The woman, who had attended a United Nations conference on reproductive rights, was speaking about abortion unapologetically, as a matter of public health that disproportionately affected poor women and curtailed their rights. Cruz was surprised, and energized.

Word had been getting out, first in Brazil and then across Latin America, about an expensive American drug that allowed a person to end a pregnancy at home. Manufactured by Pfizer under the name Cytotec and otherwise known as misoprostol, it was available over the counter in Mexico to treat gastric ulcers—to this day, the only use of the drug that Pfizer supports. (“The industry has never been an ally of women’s struggles,” said Raffaela Schiavon, a respected obstetrician-gynecologist in Mexico City.) Cytotec came in boxes of twenty-eight pills. Pregnant women who could afford it consulted other women who had had abortions and calibrated the dosage that would suit their bodies and stages of pregnancy. Some women took four or eight pills orally, and others inserted pills vaginally. When the abortions were done, Cruz had noticed, they’d typically toss out the remainder of the pills—a small fact that would later change the course of her work.

Mexican supporters of abortion rights were, and remain, up against a coalition of conservative politicians and leaders of the Catholic Church. When, in 2000, Guanajuato state legislators voted to make abortion illegal even for rape victims, subjecting them to years in prison, Cruz joined other activists to protest. But she wanted to do more than march on a statehouse­—she wanted to make sure that rape victims could still get abortions. She started Las Libres and began asking those who bought boxes of misoprostol for an abortion to set aside the remainder of the pills for women who had been raped. Cruz recalled, “We said, ‘Keep them, and next time someone comes to us you’ll give them the pills and talk about your experience.’ ” The idea was to make abortion not just more accessible but less frightening. A pregnant woman could meet someone who had survived an abortion and gone on with her life. Cruz called the woman who shared her pills and her experience an acompañante—a person who accompanies another.

Eventually, opposition to the new state law became so great that the governor vetoed it, at which point Cruz decided to take her activism a step further and help women in Guanajuato who wanted an abortion for any reason at all. The acompañantes she recruited would bring pills and tips about how to use them, providing comfort and answering questions during the abortion process. Because the acompañante figure did not explicitly appear in Mexican criminal codes, Cruz argued that such a person would be immune to prosecution.

According to Georgina Sánchez, an academic at El Colegio de la Frontera Sur who has researched medication abortion in Mexico, some feminists were skeptical about the acompañamiento model. Ordinary citizens would have to shoulder the state’s responsibility to provide health care to women, and acompañantes would become vulnerable to the whims of authorities. They, and Cruz, might end up in jail. “Me being me,” Cruz recalled, “I told them, ‘Well, you’ll have to get me out!’ ” The way Cruz saw it, women had a moral duty to stand up for one another when the state failed to guarantee their rights.

“At first, women would come to us and say, under their breath, ‘I need an abortion,’ ” Cruz told me. But she began convening meetings in bars and cafés, where she spoke emphatically about abortion as a right to be asserted, not a clandestine affair. “It was our way of saying, ‘Don’t be afraid. You have nothing to be ashamed of,’ ” Cruz said, adding, “There were times when the waitresses would come by afterward and say, ‘How did you say one takes the pills?’ ”

The acompañante movement grew, and so did Cruz’s influence. Working with a team of lawyers, she visited ten jails in the state of Guanajuato, in search of women being held for abortion-­related crimes. They found nine wo­men charged with infanticide when circumstances suggested miscarriage or other birth complications. Most of the wo­m­en had been given sentences ranging from twenty-five to thirty years and had already spent more than four years behind bars. Javier Cruz Angulo, a criminal lawyer who worked with Cruz, said that not all of them could read or write, and that “none of them fully understood why they had been prosecuted.” In 2010, Las Libres finally helped secure the release of all nine women, and Cruz went on to investigate similar convictions in other states.

In those states and elsewhere in Mexico, grassroots organizations were also campaigning for the liberalization of abortion laws. The capital, Mexico City, had already decriminalized abortion, in 2007. After sustained campaigns, the state of Oaxaca followed, in 2019, and in 2021 so did Hidalgo and Veracruz—just before the Supreme Court declared the criminalizing of abortion unconstitutional. “We are all pro-life,” the chief justice, Arturo Zaldívar, said, “only some of us are in favor of allowing women to live a life in which their dignity is respected, and they can exercise their rights fully.” The evening of the decision, which was unanimous, a 7.1-magnitude earthquake shook the capital—to some anti-abortionists, a sign of divine wrath.

In the following months, after S.B. 8 took effect in Texas and Cruz began sharing pills with activists there, she came to understand that she and some of her U.S. colleagues differed in their idea of what being an acompañante entailed. The Americans had been driving people to clinics and helping pay for the procedure for years; now they were planning to travel farther, to states with fewer restrictions. The Mexicans’ experience of aiding women had little to do with clinics. Rather, their model was one that Cruz believed her American contacts would need in the years ahead: a process of aborting that, in addition to being medically safe and effective (as a study of the acompañamiento practice in Argentina and Nigeria, published in The Lancet Global Health, had recently found it to be), also minimized the risk of criminal prosecution. If women avoided doctors and medical establishments and followed the blueprint of Las Libres, Cruz said, “there wouldn’t be a single trace. If the woman getting the abortion kept it to herself, no one would ever find out.”

“I was going to gnaw on those bones!”
Cartoon by Frank Cotham

In the Americas, one of the privileges of advanced age is getting the benefit of the doubt at security checkpoints. The first person to run the Old Hippies’ pills over the border was a gray-maned, soft-spoken Social Security recipient named Rosie. She would pave the way for the second border crosser, an octogenarian.

When Rosie first met Cruz, she was too intimidated to speak; the activist, she said, seemed “like a rock star to me.” But she returned home from the meeting brimming with purpose. Pouring her husband a glass of red wine, she said, “Honey, I’m going to be sneaking some pills across the border.” Her husband did not take this news calmly. What if the Texas governor, Greg Abbott, decided to make an example out of some grandma? What if all their savings went toward hiring lawyers and bailing Rosie out of jail? “Our retirement money is limited,” he told her. “What the heck are you doing?” Her kids, mercifully, were indifferent. “They don’t take their parents very seriously,” Rosie explained. No matter. Because she happened to reside in Mexico, she had an opportunity to change the lives, and maybe even save the lives, of younger women. “I have never felt so important,” she said.

Rosie’s specific assignment was to pick up a cache of pills, travel across the border, and mail them to a volunteer in Texas, who, in turn, would deliver the pills to women who had asked for them. Rosie had been told that crossing the border was necessary because packages sent from within the United States receive less scrutiny than those sent from abroad. Of course, U.S. Customs and Border Protection has its own rules and levels of scrutiny for goods entering the country. It requires that any medication brought into the U.S. have a doctor’s note or prescription and tells travellers not to carry more than a ninety-­day supply.

Rosie had been crossing the border for twenty years, and, as she planned her first journey with abortion pills, she realized that although Border Patrol agents had sometimes searched her luggage and X-rayed her car, they had never opened her toiletry kit. It was there that she tucked two plastic bottles containing three hundred and thirty-six pills of misoprostol. She placed the kit in an overnight bag, said goodbye to her husband, got in her pickup truck, and headed to Texas.

Not long afterward, she walked into a post office, the sound of rattling accompanying each step—hundreds of pills in plastic bottles, seeming to announce themselves from her bag. Unnerved by the noise, she packed the pill bottles into a box, approached a clerk at the counter, and reflexively pulled out a credit card to pay the postage. As the printer spat out her receipt, it dawned on her that she’d created the sort of paper trail illicit suppliers like herself were supposed to avoid.

The recipient of the box was a Las Libres associate elsewhere in Texas, and Rosie had left the return address blank. Back home, searching the Internet, she learned that the lack of a return address was a red flag to postal inspectors—“like the kind of thing a drug dealer would send,” she said. Mailing pills within Texas to facilitate a self-induced abortion there is a felony punishable by up to two years in prison. If the pills eventually wound up in Mississippi, she could face up to five years in prison and additional charges for racketeering.

Two days later, the package arrived safely at its destination, and only then was Rosie able to sleep. Waking up the following morning, she wanted to do it again. Before long, her husband would be raising money for misoprostol buys, and associates in the syndicate would be referring to her by the nickname Pills on Wheels.

Three months in, the Old Hippies of San Miguel de Allende had raised ten thousand dollars to buy abortion pills—a decent haul, in the estimation of Liz, the great-­grandmother, given that they had to persuade people to part with their money while sharing little about what would be done with it. Keeping donors ignorant was crucial because, post-Roe, giving money to a network like theirs could be construed as a crime.

The end of Roe had emboldened conservative activists and politicians in the U.S. After the court ruling, the Department of Health and Human Services assured doctors from states where bans had taken effect that they would not face prosecution under federal law for performing an abortion when the mother’s life was on the line—a decision that prompted Ken Paxton, the attorney general of Texas, to sue the federal government.

Now that clinics in abortion-ban states had closed, conservative activists were targeting nonprofits that gave women money to travel for the procedure. These funds were now “criminal organizations,” in the words of Briscoe Cain, a Texas state congressman. As Mary Ziegler, a professor of law at the University of California at Davis, points out, one lesson of S.B. 8 is that a threat of legal consequences is enough to empty a state of abortion providers, regardless of whether there are prosecutions. This summer, many abortion funds in Texas ceased operation.

Conservative lawmakers were also threatening private companies, among them Lyft, that promised to reimburse employees for out-of-state travel to get abortions. Writing to an international law firm, Sidley Austin, which has offices in Houston and Dal­las, eleven legislators warned it not to help employees “murder their unborn children.” Texas criminal prohibitions, the legislators said, extended to medication abortions, “even if the drugs were dispensed by an out-of-state abortionist.”

One of the best-known attempts to prosecute a ring of abortion providers in the United States occurred in 1972, when seven women belonging to a group known as the Jane Collective were arrested in Chicago. Members of the collective, which evolved from the efforts of a Uni­versity of Chicago student to help a friend’s sister secure an underground abortion, lacked medical training; however, they had taught themselves to do the procedure ac­cording to clinical safety standards. Their hope was to improve the odds of pregnant wom­en sur­viving what the historian Alicia Gutierrez-­Romine calls “abortion roulette.” For most of the last century, women of means who sought to end a pregnancy turned to obste­tricians and gyne­cologists who, for a steep price, performed illegal abortions on the side, while women with fewer resources risked having a vital organ punctured or bleeding to death. The Janes had done thousands of abortions in the years before the seven women were arrested. Charged with performing and conspiring to perform abortions, each of them faced a sentence of more than a hundred years in prison if convicted. However, when Roe was announced, in January, 1973, the charges against them were dropped.

It’s not yet clear whether, after Dobbs, authorities will choose to prosecute people for involvement in networks like Cruz’s. Amy O’Donnell, a spokesperson for the Texas Alliance for Life, argues that state law already allows for the extradition on felony charges of those who bring abortion drugs into Texas from other states. How­ever, extradition of people who reside outside the country is a federal matter and, she speculates, would likely not happen without the election of a President with anti-­abortion views.

Even within Texas and other states with strong laws against abortion facilitators, the politics of enforcing penalties is complex, in part because the belief that abortion equals murder doesn’t appear to be widespread. A survey released last month found that, among Texas voters, sixty per cent ­favored abortion being “available in all or most cases,” while only ten per cent supported banning abortion completely. In this political context, David Donatti, a civil-rights attorney at the A.C.L.U. of Texas, says, “conservative legislators would benefit just as much from pretending no abortions are happening as they would from prosecuting abortions.”

Early on in her American mission, trying to assess the sorts of risks volunteers might encounter crossing the border with pills, Verónica Cruz arranged a trial run. Five hundred pills arrived in Texas unhindered. Her methods for determining whether the people she chose to make the runs were sincere and not setting her up for trouble were somewhat less concrete. She made those decisions, she said, “by feeling.” When Claire, a California woman who spent part of the year in Mexico, heard about the network and contacted Cruz about becoming a pill runner, she didn’t get an assignment immediately. Instead, Cruz came to her house in San Miguel and spent hours “sniffing me out,” Claire said. Claire didn’t know about the Old Hippies and didn’t need to. As Cruz said once she came to trust Claire, one person could be a network of her own.

Claire slipped her first batch of pills into the States in May, and mailed packages to women all over the country. Three months later, shortly before her second run, she dashed through an artisan market, past a woman charring corn over an open flame, to a stall that sold flower-shaped earrings crafted by Huichol people in the Sierra Madre mountains. Each piece was made of colorful glass beads.

“Sorry for the short notice, but I’m actually destroying New York this evening—are you around for a drink?”
Cartoon by Jason Adam Katzenstein

Hola, ¿cuánto cuesta? ”

Cincuenta pesos.”

Two dollars and fifty cents. Paying in cash, she bought twenty pairs of ear­rings—sunflowers, camellias, roses—to camouflage the abortion pills she’d be bringing back to the U.S. She would put the earrings in cardboard jewelry boxes that had a layer of ­cotton padding. The earrings would go on top of the cotton, and the pills would be embedded inside, the better to keep a husband or parent from finding them. But Claire, who had had two abortions herself, liked the idea of placing earrings in every package for reasons other than discretion. “It’s so stressful to be pregnant when you don’t want to be,” she said. “You have all these hormones going, you don’t like the way your body feels, you just want it to be over, and so I thought, It’d be nice to get a pair of earrings when you’re in that kind of mood. You know, an abortion and a present!”

She made her way out of the market, past portable shrines for the Virgin of Guadalupe and hearts of blown glass, and ran home, where Cruz was waiting at her door, navy-blue backpack in hand. “Little earrings,” Claire called out, “para las chicas! ”

At the kitchen counter, Cruz unzipped the backpack and pulled out blister packs of mifepristone and misoprostol, and Claire took a pair of scissors from a drawer. They cut open each of the packs, combining six pills of misoprostol with one of mifepristone—usually sufficient for one abortion. Each envelope would also contain instructions on the abortion process which Cruz and Claire had written together. The notes ended, “Hugs, the pill fairy.”

The pills that Claire and other fairies would be sending remained cheaper to obtain from a Mexican pharmacy than from a doctor in the U.S. But, after Dobbs, the price of a box of Pfizer pills in several establishments in San Miguel de Allende had markedly increased. In one pharmacy, the price rose from about two thousand pesos per box to more than three thousand, or from roughly a hundred dollars to a hundred and sixty. The cost of generic misoprostol fluctuated wildly—forty-five dollars in one pharmacy, seventeen in another—and at the nearby Costco you could encounter two different prices for the drug in a single day. If the inflation seen in San Miguel pharmacies suggested private-sector opportunism, it might also have reflected well-meaning expats dominating the market, clearing the shelves on behalf of Americans and, in the process, jacking up the price of abortion for Mexican wom­en—an ethical dilemma that some of Cruz’s associates had yet to think deeply about.

As they divvied up pills, Claire mentioned to Cruz that crossing the border with pharmaceuticals was not, for her, a big deal. “I have Global Entry,” she said. “I’ve never been stopped by customs in my life.” But, when she’d asked a friend if she would consider joining her as a pill runner, the friend had responded, “I’m Black. I can’t do that. Isn’t that obvious to you?”

On Claire’s first mission, she’d sent pills to women in seven states where, if her actions were discovered, they could be seen as a crime. But she was given less to paranoia than to curiosity. Preparing to send her first lot of pills, she had Googled the addresses where they would land: trailer parks, run-down apartments, a house valued at thirty-four thousand dollars. She’d envisioned women with other children and tapped-out bank accounts who couldn’t travel out of state for an abortion. She had to force herself not to Google any further, should authorities uncover the digital footprint she now regretted having created. This time, she had resolved simply to cross the border, mail the earrings and pills in an envelope with a fake return address, pay the post office in cash, take a photo of the tracking number, and destroy all receipts. She would later delete the photo of the tracking number, too.

Finishing up, as salsa music drifted in from another room, Claire asked Cruz about the varieties of civil disobedience that led the Mexican Supreme Court to decriminalize abortion. Cruz told her that she thought of herself as part of an ant colony: one of countless workers toiling beneath an unbroken surface, carving intricate paths toward their goal. “Was all of this hidden from the public eye?” Claire wondered. Cruz shook her head. From the start, Las Libres members defied the system openly. In the United States, as in Mexico, Cruz predicted, the more people who got involved in the movement, the harder it would be for anyone to stop it.

A few days later, as Cruz trained future acompañantes in Yucatán, Claire packed abortion pills and earrings in a carry-on alongside her perfume, oregano-­oil capsules, and shea butter and caught an early-morning bus to the airport in Mexico City.

“Bringing anything back, Ma’am?” the customs agent asked when she arrived in San Francisco.

“Just some souvenirs.”

Handing her passport back, the agent said, “Welcome home.”

When you risk years in prison to distribute abortion pills to wom­en who wouldn’t otherwise be able to access them in Texas, you tend to appreciate more straightforward aspects of existence. So Anna delighted in an okra plant in her small garden that, by September, had sprung up to twice her height. Her tomatoes were thriving, as were the rosemary and parsley, and one day, as she picked up some jalapeño seeds left over from a seasonal planting, it occurred to her to hide pills in a packet of seeds. You never knew which recipient might have a patch of dirt in which to plant them.

It had taken some time for Las Libres to find collaborators like Anna. After S.B. 8 went into effect, Cruz and her colleagues identified thirty abortion-rights groups in Texas that they thought might be interested in receiving pills from Mexico. The first meeting of the Mexican and American activists had been awkward, though. The Mexicans had gathered in a conference room; the Texans joined the meeting individually, via Zoom. Most of their cameras were off, and the sound was bad. At the end of the meeting, when Cruz asked who was interested in collaborating, only one person raised her hand. There followed a long silence, until one of the Texans unmuted her sound. “The law has won,” she said. “They accomplished what they wanted: scare us to the point where we feel there is nothing to be done.” Only later did messages from some of the participants begin to trickle in, on Signal. They had been reluctant to assert their intention on a video call, but they were ready to work with Cruz.

Anna’s first move had been to post on social media that she could be of help to women in need—a post that never mentioned abortion directly. She said the same to strangers and friends in bars and cafés, just as Cruz used to do in Mexico, even as the penalties she might face increased.

“Food always tastes better between a gruelling morning’s work and an afternoon of exhausting office drudgery.”
Cartoon by P. C. Vey

Many of Anna’s pills almost certainly came from the Old Hippies of San Miguel de Allende, but she eschewed such precise information, for her own protection and that of others. She found mailing the pills especially nerve-racking; for reasons she couldn’t quite explain, she chose as a fake return address a shopping mall where, in third grade, she’d made a joyful trip with her mom to get her ears pierced. It was better to hand off the pills in person, she thought, because those exchanges were harder for authorities to track and safer for women who lived in homes where an envelope with a dubious return address might be opened by the wrong hands.

She’d set a hard rule for herself, early on: to meet pregnant women only in parks or other public spaces that could not easily be linked back to her neighborhood or her job. Some days, self-conscious about her disguise, she thought she’d be the last person in Texas still wear­ing a mask outside. Other days, sympathetic, she decided hard rules could be broken, as when she capitulated to the grandmother of an eighth grader who insisted that the only place she’d feel safe collecting pills was in Anna’s own home.

The pregnant eighth grader seemed almost in shock when she arrived with her grandmother and an aunt, who were furious at the girl. “It was, like, ‘You fucking idiot! You have a child in you! How did we get here?!’ ” Anna said. In the living room, lights dim and blinds closed, Anna tried to ignore the tension and focus on practical details: what to expect as the abortion progressed, and what to do if complications ensued. “If you have two regular menstrual pads and you’re soaking them front to back, side to side, completely full of blood, for two hours in a row—that would be too much blood,” she said. Across the room, Anna recalled, three sets of eyes widened. She quickly added, “Medication abortion is very safe.”

The eighth grader’s procedure went smoothly, but the grandmother told Anna some weeks later that the girl was still depressed: “She’s just walking around in a big hoodie all the time, even though she’s not pregnant anymore.” Anna felt haunted by all she hadn’t been able to do for the girl. “In other states, or under another law system, her grandmother could have taken her to a sexual- and reproductive-health clinic, where they could have had a conversation with her, taught her about condoms, given her birth control, and sent her home feeling empowered with more information,” she said. “Instead, she had to go to some random person’s house. I’m sure they did not feel safe or comfortable here.”

If Anna was sometimes frustrated and uncertain, she appreciated that sensible counsel was coming from Mexico at a moment that flipped “the narrative that America is this beacon of democracy and hope and progress.” She had begun to see herself as part of an age-old global tradition: women helping other women with their reproductive-­health concerns because they knew they couldn’t count on institutions for protection. As Gutierrez-Romine, the historian, notes, physicians began functioning as “­gatekeepers” for women seeking to end their pregnancies only in the nineteenth century.

In this new era of criminalized underground abortions, doctors were still occasionally required, though. One morning, Anna delivered pills to a slight woman in her thirties, a friend of a friend, who was eight weeks pregnant. When they were going over the instructions, the woman mentioned that her health had been precarious. Anna reassured her that the risk of developing an infection or hemorrhaging was low—less than one per cent in each case, studies showed. But, within an hour of taking the medication, the wom­an texted Anna that she was feeling dizzy. She’d thrown up, and her palms were itchy. She was at her parents’ house, the woman told Anna, and no one there was aware that she was having an abortion. She texted Anna again shortly afterward to say that she had lost consciousness twice.

Panicking, Anna advised her to rush to the nearest emergency room. Eventually, the woman confided to her mother, “I took some pills. We’re going to the hospital. And you cannot tell them that I took some pills.” For the next four hours, Anna heard nothing. None of the tricks she used to calm herself—Wordle, Spelling Bee, mindless scrolling through her friends’ feeds on Instagram—worked. She was sick with fear that the woman had died.

Midafternoon, a text arrived: “I’m stable.” The woman explained, “I was hooked up to all these I.V.s, so I couldn’t text you. Let’s go out for drinks in a couple of weeks.”

That night, in tears, Anna told a friend, “I don’t know if I can do this anymore. I thought I had killed somebody.” Her friend reminded her that the people who had failed this woman, and others, were the officials who had stripped them of their right to reproductive care under medical supervision.

In June, the day before Roe’s overturning, the Journal of the American Medi­cal Association published an editorial warning of an imminent crisis of abortion ac­­cess, citing research indi­cating that maternal mor­tality would rise by at least twenty per cent. The authors estimated a rise of ma­­ternal mortality among Black people of upward of thirty per cent. The biennial maternal-­mortality report in Texas, due to be released last month, has been delayed until after the midterm elections.

Not long ago, on a Thursday morning, a Texas woman named Sarah sat on her toilet, watching a pregnancy test develop a second red line. She was pregnant—a big problem given the complex circumstances of her life at that moment, among them the needs of the toddler daughter just outside the bathroom door. Still inside, she texted a friend for advice. The friend suggested contacting Plan C, a project that links U.S. women and abortion-pill providers around the world. Within minutes, Sarah had chosen a provider in Austria, paid a hundred and seven dollars by credit card, had a “telehealth appointment” with a doctor she never actually spoke to, and ordered a set of abortion pills that would be mailed to her from India. The problem was that the pills could take almost a month to get to Texas. She couldn’t bear to wait that long.

Her friend, concerned, was also text­ing other people. “I might have a local contact,” she wrote a few minutes later. By eleven-thirty that same morning, in a quiet working-class neighborhood, Anna was handing Sarah a plastic bag of pills.

Afterward, Sarah’s abortion complete, the toddler laid claim to the party hats a few of her mother’s friends had brought over to keep her cheerful during a ­process they’d taken to calling a “Texas miscarriage.” (Just in case “Zuckerberg is tracking our texts,” Sarah said, half in jest.) Empty cans of White Claw the friends had also brought were in the recycling bin. Sometimes, Sarah grieved. She could imagine wanting a second child at a different time in her life, but she also knew that she was fortunate. Many other wo­men in states where abor­tions had been banned didn’t have the support of friends like hers.

Weeks later, when the package she’d ordered from India arrived and she was stowing the abortion pills in a drawer, it suddenly occurred to her that nothing but stray fear stood in the way of her doing what Anna did. She didn’t know Verónica Cruz or the Old Hippies or Claire or anyone besides Anna who worked with them, but she imagined an expanding constellation of women, operating in secret and in concert, to help other women. “Try to arrest all of us!” Sarah said to herself. She grabbed her phone and texted Anna: “Hey! How do I start doing what you do?” ♦