Underground Abortion: Lack of Access, Cost Spurs Clandestine Operation

By Jose Olivares

Abortion. It’s a topic few like to talk about, but one everyone has an opinion about. And when people do talk about it, merely sharing opinions can lead to heated debates.

There is only one clinic in Northern Nevada, and this clinic has persistent protesters holding large, graphic signs out front whenever it’s open. Planned Parenthood in Reno does not provide abortions, so anyone looking for this service is required to go to the clinic.

For those who won’t or can’t get there, or afford to go to the sole provider in town, there is another, very much illegal and underground option.

She goes by the name “Jane.” Jane performs underground, holistic and pill-based abortions. She has been providing abortions in Northern California and Northern Nevada for about four years.

Because of the illegal nature of her work, Jane wears a ski mask to protect her identity. She is holding a menstrual extraction kit, which she makes using commonly found supplies. (Photo by Jose Olivares)

The work she does is illegal. In fact, it’s a felony in the state of Nevada. We agreed not to publish recognizable photos of her and have distorted her voice.

“I provide holistic abortion provisions to people who otherwise may not be able to access it,” she says. “[Holistic abortions are] a combination of different procedures. I can provide herbal abortion care, medication only, as well as menstrual extraction and manual vacuum extraction. These are all things that I can do for people at home as opposed to a clinic.”

“Jane” explains the origin of her name.

Her Own Abortion

Jane began performing abortions after her own negative experience at the local clinic.

“I became pregnant after already having a live birth. I knew that I could barely take care of myself and my child,” Jane told us when we met recently in a secret location.

“So I ended up going to the clinic here in town and I had a really horrible experience — it was very cold and awful. It made me realize that there was something that needed to be done.”

Jane sought out and ended up meeting others who had secretly been providing people with at-home abortions and began to train under them. She charges very little and often times provides the service for free.

“When I do charge, it’s based on a sliding scale. I wouldn’t charge anybody more than $400, which is about half the cost of an abortion anywhere else,” she says.

On the mornings when the West End Women’s Medical Group, the only abortion clinic in Reno is open, protesters hold signs and pray out front. The clinic responds by playing loud music and displaying its own signs including “We are Pro-Choice” and “Guns don’t kill people. Radical Pro-Lifers kill people.” (Photo by Jose Olivares)

A Sliding Scale of Abortion Costs

The West End Women’s Medical Group—the only legal abortion provider in Northern Nevada — charges a minimum of $700. According to the clinic, the price may go up to as much as $2,100, depending on how far along the pregnancy is.

The clinic accepts only cash payment: No checks, no money orders, no credit cards. Full payment must be made in cash prior to receiving the services. According to the clinic’s website, this is the only medical office in Reno certified by the National Abortion Federation.

According to the Guttmacher Institute, 49 percent of U.S. abortion patients in 2014 had incomes below the federal poverty level.

The minimum wage in Nevada is $8.25 per hour. This means a minimum wage worker, working 40 hours per week would have to work two and a half weeks in order to pay for an abortion. With other necessary expenses taken into account (food, rent, insurance, etc.), this may prolong the amount of time a minimum wage worker may take to raise the funds for an abortion.

Free Abortions and Word of Mouth

Jane recognizes how expensive abortions can be. That’s why she sometimes provides her services for free.

“Sometimes I have to charge money for the people who I know can afford it,” she says. “And usually the people who can afford it have absolutely no problem paying for it. Because they know that a week later someone is going to contact me and not have any [money].”

The anonymous abortion provider meets her clients through mutual friends who know what she does. Word of mouth and trusted communication lead people to Jane.

“I typically serve around 10 to 20 people per month on average,” she says. “It’s definitely not as hefty of a load as any clinic for sure, but it definitely is a hefty load for just one person.”

(Photo by Jose Olivares)

Different Methods, From Herbs to Pills and Jars

Her methods are varied. She provides herbal abortions, which take the longest—up to two weeks. The patient will take a mixture of different herbs every two hours, in either a tea or in tincture form. She also provides the “abortion pill” Misoprostol, which is her most common method. She dispenses three doses of four pills. The pill stimulates contractions. The other method involves a device made from tubes, a jar and a syringe for suction called a menstrual extraction kit.

“Misoprostol-only abortion care is really only effective until about 12 to 13 weeks,” Jane says. “So I really don’t go beyond that.”

Jane gets the Misoprostol in bulk from others who have access to the drugs.

Safety Issues

When it comes to safety, Jane insists the equipment she uses is similar to the equipment used in legal clinics. She also says she provides post-abortion care.

“Post-abortion care is crucial to me,” Jane says. “Very often part of the reason people feel a lot of guilt, shame, and remorse around their abortion is because there really is nobody to talk to afterwards. They feel really alone and scared and to me post-abortion care is crucial.”

Fear of Getting Caught

Jane is aware of the risks revolving around the work she does.

“My fear of legal repercussion is really strong. Jail, incarceration, prison, whatever — that isn’t really what scares me,” Jane says. “What really scares me is knowing that if I do get arrested for this, you know, my child wouldn’t have me around.”

Current Nevada law states only physicians can perform abortions. Illegal abortions are classified as Class B Felonies. In other words, abortion performed by a non-physician will be punished in the same manner as voluntary manslaughter.

Although remaining anonymous, Jane hopes to continue to add her voice to the national narrative around abortion. She is aware of the increasingly restrictive legislation being passed and the continuous closing of clinics around the country.

Asked if she feels courageous she responds: “To me it has nothing to do with courage. It has everything to do with knowing that there’s a need for the work that I do.”

“Like I said, if I’m not going to do it, then nobody else will. So I suppose where the courage really comes from is knowing that there are people out there that need this help and that they need somebody there for them.”