June 13, 2025 • 41 mins
This week we’re presenting the first episode of “The Network,” a new series that Latino USA co-produced with NPR’s Embedded podcast.
In the mid-1980s, an OBGYN in Brazil noticed that far fewer pregnant women at his hospital were dying from abortion complications.
It wasn’t a coincidence.
Brazilian women had made a discovery that allowed them to safely have abortions at home, despite the country’s abortion restrictions. That discovery eventually spread across the globe.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Dear listener, It's Maria no Josa and before we start,
I want to give you a heads up because this
is not a regular Latino USA episode. Today representing the
first episode of the network, which is a new series
that let You Know USA co produced with NPR's Embedded podcast.
Speaker 2 (00:20):
Now.
Speaker 1 (00:20):
This series is about something that is really relevant in
the United States right now, and that is abortion. But
it's not the story you might be expecting. Our series
follows women across the Americas who discovered a method to
have safe abortions without doctors in countries where abortion was
(00:42):
pretty much banned, and these women changed how people access
abortion not only in their countries but around the world,
including right here in the United States today. For over
a year, Latin Know USA producers Victoria Estrada and Marta
Martinez have been reporting on this story and now they're
(01:04):
going to take us all over the Americas to follow
this movement made up of women's networks. Here now are
Martha and Victoria with the first episode of the network.
Speaker 3 (01:17):
It was one of those moments when people understand their
witnessing history, they remember where they were.
Speaker 4 (01:24):
I was standing at my standing desk in my house,
waiting and.
Speaker 5 (01:30):
I just started crying at my desk.
Speaker 2 (01:35):
It was totally surreal.
Speaker 6 (01:37):
They remember where they were when Roe versus Wade fell.
Speaker 3 (01:41):
The biggest change to abortion rights in the United States
and nearly half a century is here.
Speaker 6 (01:48):
The Supreme Court had made its decision.
Speaker 3 (01:51):
Ruling that ends the constitutional right to an abortion. While
abortion rights opponents celebrated the news that Rowe had been overturned,
many abortion rights supporters feared the US was going backwards,
back to the nineteen hundred.
Speaker 7 (02:08):
It's like, what are they going to take from us next?
Speaker 6 (02:12):
Back to a more dangerous time.
Speaker 4 (02:14):
This is an emergency, This is an extreme crisis.
Speaker 3 (02:17):
People will die across the country.
Speaker 6 (02:20):
Protesters gathered on the steps of the Supreme Court in Washington,
d c. Holding images of code hangers over their heads
right by by.
Speaker 3 (02:32):
The day after the fall of Row, thirteen states immediately
banned or severely limited abortion. Eventually nearly half of old
states did, and within a month of the ruling, dozens
of clinics stopped performing abortions, forcing many Americans to trouble
hundreds of miles to get one. Other laws targeted abortion providers.
Speaker 8 (02:53):
Are you scared?
Speaker 9 (02:54):
I am scared, and I think a lot of us
are because there's nowhere else in medicine that is policed
and regulated and now criminalized to such a degree.
Speaker 6 (03:13):
But not all abortion rights supporters felt this way.
Speaker 2 (03:17):
Everybody was so calm in the network.
Speaker 6 (03:20):
The network, it's what we're calling the diffuse set of
people who are expanding abortion access in an unconventional way.
They were not panicking.
Speaker 8 (03:30):
Everybody was like, we've been doing this work, We're going
to continue doing this work.
Speaker 2 (03:33):
Nothing is changing. Who cares.
Speaker 8 (03:36):
I'm actually energized.
Speaker 3 (03:41):
This network it's hard to even describe because it's not
formal or centralized. There's no ceo, no headquarters.
Speaker 6 (03:51):
Some people work together, but plenty don't know each other.
They're midwives and nurses, grandmothers and friends.
Speaker 3 (03:59):
This network cross borders and reaches people throughout the world,
from South Africa to Mian March to Mexico and all
over the United States. What unites the network is how
they are expanding abortion access by helping women have safe
abortions on their own without a doctor involved.
Speaker 6 (04:20):
Their method grew out of a very small thing. It
actually fits in the palm of your hand.
Speaker 3 (04:25):
But despite being physically tiny, when it comes to reproactive health,
doctors researchers and people working in this field say it's
been monumental, extraordinarily important.
Speaker 8 (04:39):
It's a lifesaver in so many ways.
Speaker 3 (04:41):
Is the equivalent to the discovery of penicillin, because it's
a before and.
Speaker 6 (04:45):
After, But unlike penicillin, this discovery has not been universally embraced. Instead,
it's the latest target of abortion restrictions that continue to
make the news.
Speaker 7 (04:57):
The future of abortion access could be impacted by a
new lawsuit just filed by the Attorney General of Texas.
Long dormant federal law prohibits the nailing of any supplies
used for abortions.
Speaker 6 (05:08):
Possession could be punishable by up to five years in prison.
Speaker 3 (05:17):
From NPR's Embedded and Futuro Media's Latino Usa, This Is
the Network.
Speaker 6 (05:22):
A series about the DIY method that tooks safe abortions
out of the clinic and the women who made it happen.
Speaker 3 (05:30):
Episode one, Santo Tech.
Speaker 6 (05:35):
I'm Victoria Estrada.
Speaker 3 (05:37):
And I'm Marta Martine. We're both producers at the public
radio show Latino USA. We've been covering reproductive rights in
the Americas for years now.
Speaker 6 (05:47):
And when we started to see more and more challenges
to abortion access in the US. We immediately thought about
Latin America because historically Latin America has had strict abortion bands,
not so different from what we're seeing now in parts
of the US.
Speaker 3 (06:02):
But as research from around the world shows, bands don't
stop people from getting abortions. They just lead them to
take more risks to end their pregnancies. That's where the
phrase bacali abortion comes from and where we get the
image of a woman using a code hanger self managing
her abortion.
Speaker 6 (06:21):
But nearly forty years ago, in Latin America, women developed
an abortion method that was medically safe and effective, no
doctor needed, and this new type of self managed abortion
transformed how abortions happened across the world today.
Speaker 3 (06:36):
It all started in Brazil, where this method was born
in the late nineteen eighties. Victoria and I took a
trip there last year in twenty twenty four, and one
of the people we interviewed was Jacqueline pe Tanki Hi.
Speaker 10 (06:50):
Jacqueline.
Speaker 3 (06:51):
Jacqueline is a longtime feminist advocate how was Your Day?
And she lived through Brazil's military dictatorship, which lasted for
more than two decades. When the dictatorship fell in nineteen
eighty five, she thought to get women's rights into Brazil's
new constitution, because women at the time had so little
say in their workplaces, marriages, or over their bodies.
Speaker 2 (07:17):
So here in front.
Speaker 11 (07:18):
You have the Christ.
Speaker 2 (07:20):
Oh, it's here, right here.
Speaker 3 (07:22):
From Jacqueline's falcony in Rio de Janeiro, we could see
what's probably the most iconic image of Brazil, the statue
of Christ the Redeemer. So you see it every day
in the morning when you wake up, like hello and yeah,
I say hello, Christ, how are you be good?
Speaker 2 (07:41):
Be good, Jesus Christ.
Speaker 3 (07:44):
Maybe you've seen it in a movie or photos. It's
this huge sculpture overlooking the whole city of Rio de
Janeiro on top of this spectacular cliff. It's interesting because
I was actually talking about this with Victoria this morning,
that religion is very resent in this city in a
very visual way, because you have the Christ up there
(08:04):
in the mountain looking at you all from everywhere.
Speaker 2 (08:08):
Yeah, everywhere, everywhere.
Speaker 3 (08:15):
It's this constant reminder of the influenced Catholicism has had
on Brazil for much of its history.
Speaker 11 (08:21):
For the careful of church contraception has always been a
key issue.
Speaker 3 (08:28):
Until the eighties, many Brazilian women didn't have great access
to birth control before then. In the Burhish region of
the country, women had an average almost six children.
Speaker 6 (08:39):
We heard that some women just didn't know much about
their own bodies. For example, some women were afraid of
using tampons because they thought they might get lost inside
of their vaginas. We also heard that some women thought
that their vagina was connected to their mouth.
Speaker 3 (08:55):
This lack of knowledge had serious consequences.
Speaker 11 (09:00):
Significant let's call punishment. It was on women's bodies, death
or morbidity.
Speaker 5 (09:15):
Okay, could you just count to ten whom doyce.
Speaker 3 (09:22):
In the nineteen eighties, Brazil's maternal mortality rate was higher
than most of the rest of the world.
Speaker 5 (09:28):
UVV my, do we see you in Mohel?
Speaker 12 (09:33):
I lived through a time when women got sick and died,
died of infection, died of bleeding, young women, extremely young women.
Speaker 6 (09:43):
This is doctor Rivaldo Albuquerque so medicotetra.
Speaker 12 (09:50):
I am a gynecologist, I am a practicing Catholic and
I have been working with women's health since I was
a medical student.
Speaker 6 (10:00):
I visited Rivaldo in the coastal city of Recife in
northeast Brazil. It's the poorest region in the country. When
he started working in a public hospital in nineteen eighty five,
the state that Recife is in had the highest maternal
mortality rate in all of Brazil. Rivaldo saw it every
day in the emergency room, a lot of pregnant women
coming into a r with complications from a lack of
(10:22):
prenatal care, like chronically high blood pressure, and also complications
from abortion.
Speaker 3 (10:28):
Abortion was and still is illegal in most cases in Brazil,
and it was often seen as a sin, but that
doesn't mean women were not getting abortions. Research from that
time estimated there were between one and four million abortions
happening in the country every year.
Speaker 5 (10:46):
I spasushkity on.
Speaker 12 (10:47):
People who had the money could look for doctors who
did abortions in clinics in hospitals with every safety precaution,
using sterilized materials.
Speaker 6 (11:00):
In other words, people who had the money could go
see a doctor who was willing to break the law
for the right price. Those were not the women who
ended up in the emergency room where Rivaldo worked. His
patients had often gone to places that were less reputable
and unsafe.
Speaker 3 (11:18):
Others just tried to self manage their abortion.
Speaker 10 (11:21):
We heard about lots of ways, herbs, teas or drinks,
shahs beb in, session of foreign objects, the rods of
an umbrella, needles, and whatever medicines they could buy at
the pharmacy.
Speaker 4 (11:39):
You know all the horror stories that you read about.
Speaker 3 (11:44):
By the time women got to Rivaldo, they often had
perforations in their uterus, hemorrhages, and serious infections.
Speaker 6 (11:53):
Rivaldo told us about a specific case that has stayed
with him. It was a patient who was only a
few years younger, and he was at the time.
Speaker 5 (12:01):
Romomili Diziandois Feelius.
Speaker 12 (12:05):
She was a nineteen year old woman who had already
had two children.
Speaker 13 (12:10):
She came in with a generalized infection.
Speaker 12 (12:13):
It was a desperate condition and we didn't have any
background information about this woman. She wouldn't speak, She was
in no position to explain what had happened to her,
and the person who brought her in didn't want to
talk either.
Speaker 6 (12:31):
Rivaldo and the other doctors suspected she had an unsafe abortion,
and so they decided to do an exploratory operation.
Speaker 12 (12:38):
So that we could evaluate the abdomen what was happening
with this infection. And when we opened the abdominal cavity,
we found the uterus that smelled part of the word rotten.
Speaker 6 (12:52):
Rivaldo still remembers it.
Speaker 12 (12:54):
A terrible smell with several perforations. It was a classic
picture of an unsafe abortion. Since it's an illegal procedure.
The women must have stayed home for a few days
or didn't receive proper medication.
Speaker 6 (13:13):
Who knows how long she waited to go to the
hospital after signs that something was wrong, and now there
was nothing the doctors could do.
Speaker 12 (13:22):
Why did this woman die? I can't tell you without hesitation.
Because she was black and because she was poor.
Speaker 6 (13:31):
Poqueraigre Rivaldo told us he really felt for these women.
Speaker 12 (13:38):
They are in a situation of suffering, of vulnerability.
Speaker 13 (13:43):
Their health and their life are at risk.
Speaker 12 (13:47):
I know these women, many are Christians, Evangelical, Catholic, but
they are going through a specific moment in their life.
Speaker 13 (13:56):
They are in need.
Speaker 3 (14:01):
But Rivaldo was an exception. Many doctors did not treat
these patients well.
Speaker 12 (14:06):
Women who had tried to have an abortion were the
last ones to be treated during our shifts.
Speaker 3 (14:13):
So these women they would be in the emergency room
all day long without food or anything to drink.
Speaker 12 (14:21):
They spent the whole day fasting waiting for their procedure
on an empty stomach, and they are being punished because
they were the last ones to be taken care of.
Speaker 3 (14:33):
He remembers that some doctors wouldn't give the women enough
anesthesia before their diletion and curtash or DNC, so the
women would feel the pain of their cervix being dilated
and the walls of their urs being scraped.
Speaker 12 (14:49):
And the women cried out because of the pain of
their suffering. Unfortunately, I heard medical staff say, when you
did it, it was a lot of joy, a lot
of pleasure, and now you're crying.
Speaker 13 (15:06):
You don't know what you did. You killed the baby.
Speaker 6 (15:15):
One doctor told researchers at the time that his hospital
was doing two hysterectomies a week because of so many
botched abortions. Another doctor called working with these patients a
quote revolting process because she was presenting us with a
disgusting mess unquote.
Speaker 3 (15:35):
Some doctors went even further than insulting the women. In
some cases they called the police.
Speaker 12 (15:41):
And the police would come all the way to the
hospital and handcuff the women.
Speaker 13 (15:47):
They would chain them to the bed. Women were arrested.
Speaker 3 (15:52):
Rivaldo says his hospital never let this happen, but he
knew it happened elsewhere.
Speaker 13 (15:59):
The standard for these women.
Speaker 12 (16:02):
So these are things that I will never forget some causes.
Speaker 6 (16:09):
At the end of the shift, Rivaldo would make notes
about his patients, who lived, who died.
Speaker 12 (16:15):
How many birds, how many sea sections, how many surgeries,
how many abortions, how many infected abortions.
Speaker 6 (16:24):
And around the year nineteen eighty seven, he noticed a change,
a big change.
Speaker 12 (16:31):
Severe cases of infections, severe cases of hemorrhage.
Speaker 13 (16:35):
They disappeared.
Speaker 3 (16:37):
Women were still coming into the er, but they were
showing up with new symptoms, much less serious, ones.
Speaker 12 (16:44):
Like an increasing body temperature hyperthermia. And it didn't make
sense because you couldn't find an infections condition. Some women
also had astro intestinal symptoms. We realized that there was
something different, and this made us a little confused.
Speaker 5 (17:03):
So the show took Kofuzu.
Speaker 6 (17:06):
Around the same time, a researcher named Sara Costa was
working for Brazil's School of Public Health in Rio de Janeiro,
more than a thousand miles south from Recife, and she
noticed another big change.
Speaker 4 (17:18):
We were seeing this incredible decline in fertility.
Speaker 3 (17:22):
Suddenly women were having fewer children but.
Speaker 6 (17:26):
Why it was strange because there were no big policy
changes to account for it.
Speaker 4 (17:32):
The government wasn't providing much information about how to control fertility,
and the borshin was still illegal. So something just wasn't
adding up. Was its spontaneous use of oral contraception. How
were they getting it?
Speaker 3 (17:50):
So in the early nineties, Sarah began talking directly to
the women and we conducted.
Speaker 4 (17:56):
Those interviews over a period of several months and analyzed
the results.
Speaker 3 (18:02):
She and her team interviewed more than eight hundred pregnant
women in seven hospitals in Rio de Janeiro. Many of
those women had come into the hospital bleeding. Hospitals in
Rio and in other parts of the country had been
seeing more cases like this in the past few years,
of women who seemed like they had attempted an abortion.
Speaker 4 (18:22):
We thought we would actually discover a lot more complications,
serious complications, but most of the women went into hospital
with bleeding, had a cure tage and left left.
Speaker 3 (18:38):
They didn't get stuck in the hospital with infections or
other complications.
Speaker 4 (18:43):
It was a bit of a surprise.
Speaker 6 (18:47):
In Recife, Rivaldo had noticed a similar pattern.
Speaker 13 (18:51):
We had a downward curve.
Speaker 12 (18:55):
Downward curve in abortion completion, and then there was a
moment when you almost didn't see any complications of abortion
at all.
Speaker 5 (19:05):
Praticamuniting now via complicate.
Speaker 6 (19:11):
Fewer complications from abortion meant one thing.
Speaker 13 (19:16):
Women stopped dying.
Speaker 3 (19:22):
Or at least far fewer were dying. From nineteen eighty
six to nineteen ninety one, the time Sarah and Rivaldo
were observing, the World Health Organization recorded a twenty one
percent drop in Brazil's maternal mortality rate.
Speaker 12 (19:39):
It seemed like magic, or a better word, familiari.
Speaker 6 (19:43):
A miracle, the cause of what Rivaldo calls a miracle.
After the break.
Speaker 3 (19:57):
In nineteen seventy three, the same year that Wade was
decided in the United States, something else happened that transformed
reproactive healthcare, but in a much more roundabout way. An
American pharmaceutical company called CERL developed a new drug to
gastric ulcers, kind of like TOMS or pepto bismo or
(20:18):
milk of magnesia. It was a small, white hexagon shaped
bill with a tiny figure of a stomach edged on
one side.
Speaker 6 (20:27):
Not a belly, the actual organ.
Speaker 3 (20:30):
It's actually the stomach that makes me remember this bill.
Speaker 6 (20:33):
It's called Cytotech and.
Speaker 3 (20:36):
Even though it was created by an American pharmaceutical company,
the Food and Drug Administration was slow to approve it,
several years before being available in the US. Cideattech first
made its way to Europe and then Brazil in nineteen
eighty six.
Speaker 6 (20:54):
And here's where it's hard to know what is fact
and what is part of the myth of side attech,
because in Brazil this ulcer pill took on a new
life for starters. We know that the original side attack
box came with a warning, but because it's been forty years,
people remember that warning differently.
Speaker 3 (21:13):
Jacqueline Petangi, the sociologist who says hello to the Christ
statue every morning in Rio de Janeiro, remembers that the
warning was written out.
Speaker 11 (21:22):
It's that little paper that comes with the medicine that
says you should avoid to take it if you were
pregnant because it could cause contractions.
Speaker 6 (21:33):
Doctor Rivaldo Albuquerque remembers the fine priner more specifically, there was.
Speaker 12 (21:38):
A very clear paragraph that said that it should not
be usually in pregnant women because it could cause uterinin
contractions and lead to miscarriage.
Speaker 3 (21:49):
Debra Denis, a Brazilian anthropologist and law professor who grew
up in the eighties remembers the warning as an image
on the box.
Speaker 7 (21:58):
It was a profile of a pregnant woman, a big
belly and a warning crossing the belly, and also.
Speaker 3 (22:07):
With call there was a skull.
Speaker 8 (22:09):
There was his call.
Speaker 13 (22:11):
Wow.
Speaker 7 (22:12):
I'm one hundred percent sure of that.
Speaker 3 (22:17):
We haven't been able to confirm this call, but we
have seen the image of a pregnant woman in a
circle with a slash through it.
Speaker 6 (22:27):
When the pharma company developed Cida Tech, it discovered that
the drug had the significant side effect on women, a
serious side effect. It caused bleeding and contractions that could
induce a miscarriage.
Speaker 3 (22:39):
So for people who were pregnant and wanted to stay
that way, it was a very dangerous pill to take.
Speaker 6 (22:46):
But for people who were pregnant and did not want
to be SATEA Tech's side effect wasn't a problem. It
was a solution, a new tool to self manage an abortion.
But unlike the teas and crochet needles women had been using,
set Attack was overwhelmingly safe and effective.
Speaker 3 (23:04):
And somebody somewhere, somehow figured that out.
Speaker 4 (23:13):
I don't think we ever identified where it started.
Speaker 2 (23:17):
No, it's impossible to know this. Don't forget. We didn't
have social media. Then there's no records.
Speaker 6 (23:23):
It wasn't like there was a lot of incentive to
take credit. Whoever did this was likely breaking the law.
Speaker 2 (23:30):
They wouldn't give their name.
Speaker 11 (23:31):
I am Mary Smith, and listen, you can use this
to induce an abortion.
Speaker 3 (23:37):
Some speculate that it was a pharmacist or a midwife.
Speaker 4 (23:42):
We certainly knew that pharmacists were involved.
Speaker 11 (23:46):
I went to the pharmacy and I bought this.
Speaker 6 (23:49):
But even if we can't know the original source, we
do know how the knowledge spread far and white.
Speaker 4 (23:56):
The women themselves.
Speaker 7 (23:57):
Women said hah, I have no question and of saying
that it was from women, Brazilian women. Women continue taking
it because it was another woman from her family.
Speaker 4 (24:09):
Who shared with her. It certainly wasn't advertised.
Speaker 2 (24:12):
Was in the air.
Speaker 11 (24:14):
I can't tell you when something is in the air
among women's talks.
Speaker 2 (24:18):
I mean it was in the air.
Speaker 8 (24:26):
Sayra was spreading by word of mouth.
Speaker 3 (24:30):
This is a woman. We're calling by her initial r
to protect her safety because what she did was and
still is illegal in Brazil. Process.
Speaker 8 (24:42):
A woman who went through the process would tell another
hey by that by that.
Speaker 3 (24:47):
The whispers about side attack reached Dart in nineteen eighty six,
the same year it came on the market in Brazil,
and she thought it sounded a lot better than the
first abortion she had been through, the type of dangerous
abortion Rivaldo had seen time and time again in the
emergency room in the early eighties.
Speaker 6 (25:05):
The first time ar needed an abortion, she was a minor,
thirteen or fourteen years old, living in Pacific. She was
dating someone a lot older than her and ars even
though she was in a relationship, she understood almost nothing
about sex or her body because of how she grew up.
Speaker 8 (25:23):
Oh, my mother raised us like potatoes in the ground.
Speaker 6 (25:27):
Our was one of twelve kids.
Speaker 2 (25:29):
What did you cons I had us on sex so well.
Speaker 8 (25:33):
We didn't have the talk about what sex was. I
just knew that I was going to get kissed. I
didn't know that the thing was going to create a child,
so I didn't know that a partner shouldn't cross certain boundaries.
Speaker 6 (25:46):
When Our started feeling funny and her period stopped, she
confided in her older sister.
Speaker 8 (25:53):
She sat me down and said, look, you're pregnant. There's
going to be a baby, and we have to find
a solution. Because Dad is going to kick you out
of the house, or he's going to kill you.
Speaker 6 (26:05):
Her sister didn't mean it as an exaggeration. She thought
her dad would literally kill r if he found out
she was pregnant. He nearly done just that a few
years earlier.
Speaker 8 (26:15):
To our sister, Eileen Lavish, he once took out his
gun and tried to kill my sister, the same sister
who helped me. Because my sister lost her virginity.
Speaker 6 (26:26):
So it was dangerous for ar to stay pregnant, but
it was also risky to get an abortion, both physically
and legally. Our sister took her to a midwife, and
our remembers the midwife inserted a catheter into her cervix
to induce an abortion. When she returned to her parents' house,
she had very heavy bleeding and then passed out.
Speaker 8 (26:48):
Okay, Daddy, I actually fell on the bathroom floor. My
sister picked me up, showered me, and told my mother,
I'm going to take her because she's having her period.
It's very strong and she's weak. She didn't tell my father.
Speaker 6 (27:06):
Our sister took her to the hospital. While she was there,
doctors questioned her. They wanted to know if she'd done
anything to cause an abortion. Ar kept denying she had,
even when they threatened her with jail.
Speaker 8 (27:17):
Is he no? I said, no, of course I had
to deny it. I was told to deny it. It
was a crime that involved a lot of people.
Speaker 6 (27:25):
Right Ur was given a DNC to complete her abortion.
The doctors told her she nearly perforated her uterus and
had been at risk of losing it. R stayed in
the hospital for several days to recover in a maternity
room with other women who'd attempted an abortion.
Speaker 8 (27:42):
All of them had done something, and the one next
to me.
Speaker 6 (27:46):
She died, died. I asked why, Yes.
Speaker 8 (27:50):
I had a curatage right then I was fine, but
the one next to me, she never came back.
Speaker 3 (28:03):
A few years later, when I was nineteen years old,
she got pregnant a second time.
Speaker 5 (28:09):
She says.
Speaker 3 (28:09):
The guy she had seen just a couple of times
forced himself on her. I decided to have another abortion,
but this time it was a very different experience because
of cytotech aparash trity.
Speaker 8 (28:22):
It was for gastritis. So they sold it at the pharmacy.
Like water, you just go in and say, hey, give
me a box of cyitotech. Anyone could buy it.
Speaker 3 (28:32):
The pharmacy she bought it from told her to swallow
two pills, wait a couple of hours, then take two
more pills until she finished six pills. He also gave
her an instruction that was very common at the time.
Speaker 8 (28:44):
Oh, look, you were going to expel. When you expel,
when you're bleeding a lot, go to the hospital.
Speaker 3 (28:53):
I went home and took the pills.
Speaker 8 (28:56):
So the contraction started and I had some leading, she says.
Speaker 3 (29:01):
The pain was strong, but not like with the first abortion.
She was bleeding, but she didn't faint. She didn't have
her sister by her side, but she was able to
get herself to the emergency room. One thing was the same.
The doctors again questioned her and again are denied that
she had done anything to cause an abortion, and this
(29:23):
time arsas she didn't have to stay in the hospital.
She had a DNC and left. Her parents never found
out about it. Art went on with her life. She
moved in with her sister, who supported her going.
Speaker 8 (29:39):
To school in form so I graduated as a social worker.
Speaker 3 (29:45):
The two experiences were very difficult for r but one
thing was clear.
Speaker 8 (29:50):
The second time, I didn't have a lot of side effects.
I didn't have a lot of bleeding, so it was
safer for me. I felt more comfortable Festal.
Speaker 6 (30:11):
Still, she wishes she'd had more support because r and
women like her who took side attech to cause an
abortion in those early years, they were experimenting on themselves.
It's not like the pills came with a slip of
paper explaining how to have an abortion.
Speaker 3 (30:28):
In fact, if you remember, the instruction said don't take
this pill if you're pregnant.
Speaker 6 (30:34):
In nineteen ninety three, researchers from a public university in
the country published a study called side Attack in Brazil
at Least it doesn't kill. In it, most women reported
taking between four and sixteen pills, but some reported taking dozens.
It's likely that ar didn't take the right dose to
have a complete abortion.
Speaker 3 (30:54):
But over time, Brazilian women again figured out something by themselves.
Speaker 4 (31:00):
One of the interesting things that I noted in my
research is that women got much better at using cytotech.
Speaker 3 (31:07):
This is Sarah Costa again, the researcher in Rio de Janeiro.
While she conducted the study in the early nineties, several
years after cytotech became available, she heard about how women
were taking the bills, put.
Speaker 4 (31:19):
The manto your tongue or in set the menual vagina.
Speaker 3 (31:23):
Eventually they started getting better results.
Speaker 4 (31:25):
At the beginning, I would say that a lot of
women needed cureitage, but it turned out once they got
better at using it, they were actually having complete abortions.
Speaker 3 (31:37):
In other words, they no longer needed a DNC. How
long was your data collection period?
Speaker 2 (31:44):
I think it was about.
Speaker 4 (31:45):
Six to nine months.
Speaker 2 (31:46):
First it's fast.
Speaker 4 (31:48):
Yeah, so you know, we were able to observe change.
Speaker 6 (31:53):
Of the women who went to a hospital after having
an abortion, Sarah found that nearly sixty percent reported using
Sida tech to self manage it. She wrote that this
represented quote only the tip of the iceberg, because many
more women could have taken side attech and not needed
medical help. According to our research, the median dose the
(32:14):
women were taking was eight hundred micrograms four pills, which
is the same dose the World Health Organization now recommends
for pregnancies up to twelve weeks.
Speaker 3 (32:25):
And how are they getting this information? Sarah found that
the overwhelming majority of women who used Sido tech eighty
four percent had learned about it from friends, relatives, or colleagues.
It was the network starting to form women loosely connected
by whispers. Just by sharing their experiences what worked and
(32:45):
what didn't work, they began to build knowledge.
Speaker 7 (32:49):
Women know how to be scientists at home when science
is not offering what they need.
Speaker 6 (32:56):
This is Devorah Denis Agan, the Brazilian anthropologist law professor
who remembers the skull on the side attack box.
Speaker 7 (33:03):
So basically, it's about observation, it's about taking experiments in
our own bodies, and it's about sharing with others.
Speaker 6 (33:14):
She calls it domestic science, and she saw the results
of this domestic science for herself. By the time she
learned about side attack, it was no good deal.
Speaker 7 (33:23):
So I was at school in the eighties when I
saw for the first time a classmate with the pills,
telling us I'm going to take them today.
Speaker 6 (33:35):
Her classmate got the pills through a family member and
they worked.
Speaker 7 (33:40):
Can you believe that the day after she was in school.
Speaker 3 (33:45):
I'm wondering why you think cito tech became so popular
so quickly.
Speaker 7 (33:51):
Let me try five reasons. One, it was discovered by women,
It was shared from women to women. It proved to
walk and to be safe. It was used for an
essential need to women's lives, and it was available at
(34:11):
the community level, and it was cheap, very cheap.
Speaker 3 (34:16):
Pharmacists in Brazil told us they sold it for about
five bucks in the early nineties, compared to five hundred
dollars for an abortion at a private clinic. At the time,
cide Attech sales exploded. Researchers tracked that in the late
eighties and early nineties, more than fifty thousand boxes of
the pill were being sold in Brazil every month.
Speaker 6 (34:43):
Actually, there are more reasons women chose cide attack. In
that same report from nineteen ninety three, CEDA Tech in Brazil,
at least it doesn't kill. The researchers interviewed women who
had used it. In their testimonies, they described lots of
reasons for liking it. We had voice actors read some
of their quotes aloud.
Speaker 3 (35:03):
Since it wasn't a procedure requiring a doctor's expertise, it
didn't exactly feel like an abortion to some of these women.
Speaker 8 (35:09):
It's less traumatic, a lot less. You know what the
sensation is. The sensation is that your period is late,
and so you take medicine for it to come.
Speaker 6 (35:19):
As a result, some women describe feeling less guilty taking
the pill.
Speaker 3 (35:25):
If I have gone to a clinic, I would never
have forgiven myself, and women felt it put them, not
their partners or doctors in control.
Speaker 14 (35:35):
Using side attack is something that is yours. Nobody has
to know what you did or you didn't do. No
one invades your privacy. Even the gynecologists that I went
to later didn't know that I had had an abortion.
Speaker 6 (35:51):
Women who wanted abortions weren't the only ones who appreciated
side attack. Many doctors did too, because they didn't have
to deal with so many gruesome cases or do such
serious procedures like having to remove a uterus. One doctor
in sel Paulo told the researchers that he seemed hasterectomsdropped
from two a week to one every six months.
Speaker 3 (36:14):
When we asked Rivaldo the Ovigian receive how he remembers
feeling at the time, he used one word.
Speaker 5 (36:21):
I'll leave you relief. I leave the.
Speaker 3 (36:26):
Relief of mind and of conscience, simpme.
Speaker 5 (36:29):
We to peel it.
Speaker 12 (36:30):
I was happy because I saw that what we couldn't do,
which was to help women, the network was doing it,
and that's what I wanted.
Speaker 13 (36:41):
I wanted women to be healthy.
Speaker 12 (36:44):
So if I couldn't do it effectively, the network was
doing it.
Speaker 6 (36:56):
Rivaldo told us that feminists and health providers coined the nickname.
Speaker 5 (36:59):
For some attack ashin Shamavady, Santo Techi, Sondy, Santo Santo Techi.
Speaker 6 (37:07):
They called it Santo.
Speaker 3 (37:09):
Tech, cyto tech, Santa tech. It has many names. You
might know it as miso prosto aka miso like the
(37:29):
soup or misto.
Speaker 6 (37:31):
There's no agreement on how to pronounce it. Experts believe
it's now the most commonly used abortion pill in the world,
and the World Health Organization says it's safe to self
manage with pills through twelve weeks of pregnancy.
Speaker 3 (37:47):
Later in the series, we follow the network as it
spreads this pill across Latin America.
Speaker 6 (37:53):
I was like, what, no way, and into the US. Oh,
there's a whole of you, and you're all like underground
and secret squirrel and using different names.
Speaker 2 (38:05):
It was just mind blowing.
Speaker 10 (38:08):
Up.
Speaker 3 (38:08):
Next, women create an entirely new support system around me.
So that challenges the medical establishment and the law al
e sib.
Speaker 11 (38:22):
Someone was going to do what we didn't dare to
because we had a license and we were afraid of
the law.
Speaker 6 (38:44):
If you want to hear the rest of the series
right now before everyone else, go sign up for Embedded Plus.
Embedded is a home for ambitious storytelling at MPR, and
signing up for Embedded Plus is a great way to
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dot org slash embedded to find out more.
Speaker 3 (39:08):
The network from Embedded is a collaboration with Latino Usa,
a production of Futuro Media. This episode was produced by
Monica Moreles Garcia and Abby Wendel. Re Rena Cohen edited
the series. Additional reporting by Abby Wendel, fact checking by
Cecil Davis Basquez, nicolet Kahn, and Johanna Romano Sanchez. Robert
(39:31):
Rodriguez mastered the episode.
Speaker 6 (39:33):
Voice overs by Mariana de la Varva, Julia Carneo, Marcellos Darobinaz,
and Susi Valerio. Leanna Simpstrom is our supervising Senior producer,
Katie Simon is our supervising senior editor, Irena Gucci is
our executive producer, and Colin Campbell is the Senior Vice
President for Podcasting at MPR. The Embedded team also includes
(39:57):
Luis Trejes, Dan Germa, Adelina Lancianie and Ariana Garablee from
Latino USA. Our executive producers are Marlon Bishop and Penilee Ramidez,
and our production managers are Jessica Ellis and Nancy Trujuillo.
Speaker 3 (40:12):
Thanks to our managing editor of Standards and Practices, Tony Kevin,
and Tojohannes Urghi and Michael Ratner for legal support and
Tommy Evans, MPR's managing editor Editorial Review. Our visuals editor
is Emily Bogol. Original tail art by Luke Medina.
Speaker 6 (40:29):
Special thanks to Alissa nat Warney, Selina Simons, Steffen, Mariana
de la Barba, Maria Matta Bruno, Julia Carno, Roberta Fortuna,
Dina Ortega, Kelly Blanchard, Maureen Paul Lure, Rivera, Abigail Aiken, Gisell,
carinod red Wine and Jefferson Drest And a big thanks
(40:51):
to our embedded plus supporters.
Speaker 3 (40:54):
I'm Marta MARTINEV.
Speaker 6 (40:55):
I'm Victoria Strada.
Speaker 3 (40:57):
This is embedded from MPR.
Speaker 6 (40:59):
Thanks for listening.
Speaker 3 (41:00):
We taknakias for the scutard.
Speaker 7 (41:05):
Latino USA is brought to you in part by the
Levi Strauss Foundation outfitting movements and leaders fighting for a
more just and abundant world, with the support from the
International Women's Media Foundation
Speaker 8 (41:18):
As part of its Reproductive Health, Rights and Justice in
the America's initiative, and the v Day Foundation
Dear listener, It's Maria no Josa and before we start,
I want to give you a heads up because this
is not a regular Latino USA episode. Today representing the
first episode of the network, which is a new series
that let You Know USA co produced with NPR's Embedded podcast.
Speaker 2 (00:20):
Now.
Speaker 1 (00:20):
This series is about something that is really relevant in
the United States right now, and that is abortion. But
it's not the story you might be expecting. Our series
follows women across the Americas who discovered a method to
have safe abortions without doctors in countries where abortion was
(00:42):
pretty much banned, and these women changed how people access
abortion not only in their countries but around the world,
including right here in the United States today. For over
a year, Latin Know USA producers Victoria Estrada and Marta
Martinez have been reporting on this story and now they're
(01:04):
going to take us all over the Americas to follow
this movement made up of women's networks. Here now are
Martha and Victoria with the first episode of the network.
Speaker 3 (01:17):
It was one of those moments when people understand their
witnessing history, they remember where they were.
Speaker 4 (01:24):
I was standing at my standing desk in my house,
waiting and.
Speaker 5 (01:30):
I just started crying at my desk.
Speaker 2 (01:35):
It was totally surreal.
Speaker 6 (01:37):
They remember where they were when Roe versus Wade fell.
Speaker 3 (01:41):
The biggest change to abortion rights in the United States
and nearly half a century is here.
Speaker 6 (01:48):
The Supreme Court had made its decision.
Speaker 3 (01:51):
Ruling that ends the constitutional right to an abortion. While
abortion rights opponents celebrated the news that Rowe had been overturned,
many abortion rights supporters feared the US was going backwards,
back to the nineteen hundred.
Speaker 7 (02:08):
It's like, what are they going to take from us next?
Speaker 6 (02:12):
Back to a more dangerous time.
Speaker 4 (02:14):
This is an emergency, This is an extreme crisis.
Speaker 3 (02:17):
People will die across the country.
Speaker 6 (02:20):
Protesters gathered on the steps of the Supreme Court in Washington,
d c. Holding images of code hangers over their heads
right by by.
Speaker 3 (02:32):
The day after the fall of Row, thirteen states immediately
banned or severely limited abortion. Eventually nearly half of old
states did, and within a month of the ruling, dozens
of clinics stopped performing abortions, forcing many Americans to trouble
hundreds of miles to get one. Other laws targeted abortion providers.
Speaker 8 (02:53):
Are you scared?
Speaker 9 (02:54):
I am scared, and I think a lot of us
are because there's nowhere else in medicine that is policed
and regulated and now criminalized to such a degree.
Speaker 6 (03:13):
But not all abortion rights supporters felt this way.
Speaker 2 (03:17):
Everybody was so calm in the network.
Speaker 6 (03:20):
The network, it's what we're calling the diffuse set of
people who are expanding abortion access in an unconventional way.
They were not panicking.
Speaker 8 (03:30):
Everybody was like, we've been doing this work, We're going
to continue doing this work.
Speaker 2 (03:33):
Nothing is changing. Who cares.
Speaker 8 (03:36):
I'm actually energized.
Speaker 3 (03:41):
This network it's hard to even describe because it's not
formal or centralized. There's no ceo, no headquarters.
Speaker 6 (03:51):
Some people work together, but plenty don't know each other.
They're midwives and nurses, grandmothers and friends.
Speaker 3 (03:59):
This network cross borders and reaches people throughout the world,
from South Africa to Mian March to Mexico and all
over the United States. What unites the network is how
they are expanding abortion access by helping women have safe
abortions on their own without a doctor involved.
Speaker 6 (04:20):
Their method grew out of a very small thing. It
actually fits in the palm of your hand.
Speaker 3 (04:25):
But despite being physically tiny, when it comes to reproactive health,
doctors researchers and people working in this field say it's
been monumental, extraordinarily important.
Speaker 8 (04:39):
It's a lifesaver in so many ways.
Speaker 3 (04:41):
Is the equivalent to the discovery of penicillin, because it's
a before and.
Speaker 6 (04:45):
After, But unlike penicillin, this discovery has not been universally embraced. Instead,
it's the latest target of abortion restrictions that continue to
make the news.
Speaker 7 (04:57):
The future of abortion access could be impacted by a
new lawsuit just filed by the Attorney General of Texas.
Long dormant federal law prohibits the nailing of any supplies
used for abortions.
Speaker 6 (05:08):
Possession could be punishable by up to five years in prison.
Speaker 3 (05:17):
From NPR's Embedded and Futuro Media's Latino Usa, This Is
the Network.
Speaker 6 (05:22):
A series about the DIY method that tooks safe abortions
out of the clinic and the women who made it happen.
Speaker 3 (05:30):
Episode one, Santo Tech.
Speaker 6 (05:35):
I'm Victoria Estrada.
Speaker 3 (05:37):
And I'm Marta Martine. We're both producers at the public
radio show Latino USA. We've been covering reproductive rights in
the Americas for years now.
Speaker 6 (05:47):
And when we started to see more and more challenges
to abortion access in the US. We immediately thought about
Latin America because historically Latin America has had strict abortion bands,
not so different from what we're seeing now in parts
of the US.
Speaker 3 (06:02):
But as research from around the world shows, bands don't
stop people from getting abortions. They just lead them to
take more risks to end their pregnancies. That's where the
phrase bacali abortion comes from and where we get the
image of a woman using a code hanger self managing
her abortion.
Speaker 6 (06:21):
But nearly forty years ago, in Latin America, women developed
an abortion method that was medically safe and effective, no
doctor needed, and this new type of self managed abortion
transformed how abortions happened across the world today.
Speaker 3 (06:36):
It all started in Brazil, where this method was born
in the late nineteen eighties. Victoria and I took a
trip there last year in twenty twenty four, and one
of the people we interviewed was Jacqueline pe Tanki Hi.
Speaker 10 (06:50):
Jacqueline.
Speaker 3 (06:51):
Jacqueline is a longtime feminist advocate how was Your Day?
And she lived through Brazil's military dictatorship, which lasted for
more than two decades. When the dictatorship fell in nineteen
eighty five, she thought to get women's rights into Brazil's
new constitution, because women at the time had so little
say in their workplaces, marriages, or over their bodies.
Speaker 2 (07:17):
So here in front.
Speaker 11 (07:18):
You have the Christ.
Speaker 2 (07:20):
Oh, it's here, right here.
Speaker 3 (07:22):
From Jacqueline's falcony in Rio de Janeiro, we could see
what's probably the most iconic image of Brazil, the statue
of Christ the Redeemer. So you see it every day
in the morning when you wake up, like hello and yeah,
I say hello, Christ, how are you be good?
Speaker 2 (07:41):
Be good, Jesus Christ.
Speaker 3 (07:44):
Maybe you've seen it in a movie or photos. It's
this huge sculpture overlooking the whole city of Rio de
Janeiro on top of this spectacular cliff. It's interesting because
I was actually talking about this with Victoria this morning,
that religion is very resent in this city in a
very visual way, because you have the Christ up there
(08:04):
in the mountain looking at you all from everywhere.
Speaker 2 (08:08):
Yeah, everywhere, everywhere.
Speaker 3 (08:15):
It's this constant reminder of the influenced Catholicism has had
on Brazil for much of its history.
Speaker 11 (08:21):
For the careful of church contraception has always been a
key issue.
Speaker 3 (08:28):
Until the eighties, many Brazilian women didn't have great access
to birth control before then. In the Burhish region of
the country, women had an average almost six children.
Speaker 6 (08:39):
We heard that some women just didn't know much about
their own bodies. For example, some women were afraid of
using tampons because they thought they might get lost inside
of their vaginas. We also heard that some women thought
that their vagina was connected to their mouth.
Speaker 3 (08:55):
This lack of knowledge had serious consequences.
Speaker 11 (09:00):
Significant let's call punishment. It was on women's bodies, death
or morbidity.
Speaker 5 (09:15):
Okay, could you just count to ten whom doyce.
Speaker 3 (09:22):
In the nineteen eighties, Brazil's maternal mortality rate was higher
than most of the rest of the world.
Speaker 5 (09:28):
UVV my, do we see you in Mohel?
Speaker 12 (09:33):
I lived through a time when women got sick and died,
died of infection, died of bleeding, young women, extremely young women.
Speaker 6 (09:43):
This is doctor Rivaldo Albuquerque so medicotetra.
Speaker 12 (09:50):
I am a gynecologist, I am a practicing Catholic and
I have been working with women's health since I was
a medical student.
Speaker 6 (10:00):
I visited Rivaldo in the coastal city of Recife in
northeast Brazil. It's the poorest region in the country. When
he started working in a public hospital in nineteen eighty five,
the state that Recife is in had the highest maternal
mortality rate in all of Brazil. Rivaldo saw it every
day in the emergency room, a lot of pregnant women
coming into a r with complications from a lack of
(10:22):
prenatal care, like chronically high blood pressure, and also complications
from abortion.
Speaker 3 (10:28):
Abortion was and still is illegal in most cases in Brazil,
and it was often seen as a sin, but that
doesn't mean women were not getting abortions. Research from that
time estimated there were between one and four million abortions
happening in the country every year.
Speaker 5 (10:46):
I spasushkity on.
Speaker 12 (10:47):
People who had the money could look for doctors who
did abortions in clinics in hospitals with every safety precaution,
using sterilized materials.
Speaker 6 (11:00):
In other words, people who had the money could go
see a doctor who was willing to break the law
for the right price. Those were not the women who
ended up in the emergency room where Rivaldo worked. His
patients had often gone to places that were less reputable
and unsafe.
Speaker 3 (11:18):
Others just tried to self manage their abortion.
Speaker 10 (11:21):
We heard about lots of ways, herbs, teas or drinks,
shahs beb in, session of foreign objects, the rods of
an umbrella, needles, and whatever medicines they could buy at
the pharmacy.
Speaker 4 (11:39):
You know all the horror stories that you read about.
Speaker 3 (11:44):
By the time women got to Rivaldo, they often had
perforations in their uterus, hemorrhages, and serious infections.
Speaker 6 (11:53):
Rivaldo told us about a specific case that has stayed
with him. It was a patient who was only a
few years younger, and he was at the time.
Speaker 5 (12:01):
Romomili Diziandois Feelius.
Speaker 12 (12:05):
She was a nineteen year old woman who had already
had two children.
Speaker 13 (12:10):
She came in with a generalized infection.
Speaker 12 (12:13):
It was a desperate condition and we didn't have any
background information about this woman. She wouldn't speak, She was
in no position to explain what had happened to her,
and the person who brought her in didn't want to
talk either.
Speaker 6 (12:31):
Rivaldo and the other doctors suspected she had an unsafe abortion,
and so they decided to do an exploratory operation.
Speaker 12 (12:38):
So that we could evaluate the abdomen what was happening
with this infection. And when we opened the abdominal cavity,
we found the uterus that smelled part of the word rotten.
Speaker 6 (12:52):
Rivaldo still remembers it.
Speaker 12 (12:54):
A terrible smell with several perforations. It was a classic
picture of an unsafe abortion. Since it's an illegal procedure.
The women must have stayed home for a few days
or didn't receive proper medication.
Speaker 6 (13:13):
Who knows how long she waited to go to the
hospital after signs that something was wrong, and now there
was nothing the doctors could do.
Speaker 12 (13:22):
Why did this woman die? I can't tell you without hesitation.
Because she was black and because she was poor.
Speaker 6 (13:31):
Poqueraigre Rivaldo told us he really felt for these women.
Speaker 12 (13:38):
They are in a situation of suffering, of vulnerability.
Speaker 13 (13:43):
Their health and their life are at risk.
Speaker 12 (13:47):
I know these women, many are Christians, Evangelical, Catholic, but
they are going through a specific moment in their life.
Speaker 13 (13:56):
They are in need.
Speaker 3 (14:01):
But Rivaldo was an exception. Many doctors did not treat
these patients well.
Speaker 12 (14:06):
Women who had tried to have an abortion were the
last ones to be treated during our shifts.
Speaker 3 (14:13):
So these women they would be in the emergency room
all day long without food or anything to drink.
Speaker 12 (14:21):
They spent the whole day fasting waiting for their procedure
on an empty stomach, and they are being punished because
they were the last ones to be taken care of.
Speaker 3 (14:33):
He remembers that some doctors wouldn't give the women enough
anesthesia before their diletion and curtash or DNC, so the
women would feel the pain of their cervix being dilated
and the walls of their urs being scraped.
Speaker 12 (14:49):
And the women cried out because of the pain of
their suffering. Unfortunately, I heard medical staff say, when you
did it, it was a lot of joy, a lot
of pleasure, and now you're crying.
Speaker 13 (15:06):
You don't know what you did. You killed the baby.
Speaker 6 (15:15):
One doctor told researchers at the time that his hospital
was doing two hysterectomies a week because of so many
botched abortions. Another doctor called working with these patients a
quote revolting process because she was presenting us with a
disgusting mess unquote.
Speaker 3 (15:35):
Some doctors went even further than insulting the women. In
some cases they called the police.
Speaker 12 (15:41):
And the police would come all the way to the
hospital and handcuff the women.
Speaker 13 (15:47):
They would chain them to the bed. Women were arrested.
Speaker 3 (15:52):
Rivaldo says his hospital never let this happen, but he
knew it happened elsewhere.
Speaker 13 (15:59):
The standard for these women.
Speaker 12 (16:02):
So these are things that I will never forget some causes.
Speaker 6 (16:09):
At the end of the shift, Rivaldo would make notes
about his patients, who lived, who died.
Speaker 12 (16:15):
How many birds, how many sea sections, how many surgeries,
how many abortions, how many infected abortions.
Speaker 6 (16:24):
And around the year nineteen eighty seven, he noticed a change,
a big change.
Speaker 12 (16:31):
Severe cases of infections, severe cases of hemorrhage.
Speaker 13 (16:35):
They disappeared.
Speaker 3 (16:37):
Women were still coming into the er, but they were
showing up with new symptoms, much less serious, ones.
Speaker 12 (16:44):
Like an increasing body temperature hyperthermia. And it didn't make
sense because you couldn't find an infections condition. Some women
also had astro intestinal symptoms. We realized that there was
something different, and this made us a little confused.
Speaker 5 (17:03):
So the show took Kofuzu.
Speaker 6 (17:06):
Around the same time, a researcher named Sara Costa was
working for Brazil's School of Public Health in Rio de Janeiro,
more than a thousand miles south from Recife, and she
noticed another big change.
Speaker 4 (17:18):
We were seeing this incredible decline in fertility.
Speaker 3 (17:22):
Suddenly women were having fewer children but.
Speaker 6 (17:26):
Why it was strange because there were no big policy
changes to account for it.
Speaker 4 (17:32):
The government wasn't providing much information about how to control fertility,
and the borshin was still illegal. So something just wasn't
adding up. Was its spontaneous use of oral contraception. How
were they getting it?
Speaker 3 (17:50):
So in the early nineties, Sarah began talking directly to
the women and we conducted.
Speaker 4 (17:56):
Those interviews over a period of several months and analyzed
the results.
Speaker 3 (18:02):
She and her team interviewed more than eight hundred pregnant
women in seven hospitals in Rio de Janeiro. Many of
those women had come into the hospital bleeding. Hospitals in
Rio and in other parts of the country had been
seeing more cases like this in the past few years,
of women who seemed like they had attempted an abortion.
Speaker 4 (18:22):
We thought we would actually discover a lot more complications,
serious complications, but most of the women went into hospital
with bleeding, had a cure tage and left left.
Speaker 3 (18:38):
They didn't get stuck in the hospital with infections or
other complications.
Speaker 4 (18:43):
It was a bit of a surprise.
Speaker 6 (18:47):
In Recife, Rivaldo had noticed a similar pattern.
Speaker 13 (18:51):
We had a downward curve.
Speaker 12 (18:55):
Downward curve in abortion completion, and then there was a
moment when you almost didn't see any complications of abortion
at all.
Speaker 5 (19:05):
Praticamuniting now via complicate.
Speaker 6 (19:11):
Fewer complications from abortion meant one thing.
Speaker 13 (19:16):
Women stopped dying.
Speaker 3 (19:22):
Or at least far fewer were dying. From nineteen eighty
six to nineteen ninety one, the time Sarah and Rivaldo
were observing, the World Health Organization recorded a twenty one
percent drop in Brazil's maternal mortality rate.
Speaker 12 (19:39):
It seemed like magic, or a better word, familiari.
Speaker 6 (19:43):
A miracle, the cause of what Rivaldo calls a miracle.
After the break.
Speaker 3 (19:57):
In nineteen seventy three, the same year that Wade was
decided in the United States, something else happened that transformed
reproactive healthcare, but in a much more roundabout way. An
American pharmaceutical company called CERL developed a new drug to
gastric ulcers, kind of like TOMS or pepto bismo or
(20:18):
milk of magnesia. It was a small, white hexagon shaped
bill with a tiny figure of a stomach edged on
one side.
Speaker 6 (20:27):
Not a belly, the actual organ.
Speaker 3 (20:30):
It's actually the stomach that makes me remember this bill.
Speaker 6 (20:33):
It's called Cytotech and.
Speaker 3 (20:36):
Even though it was created by an American pharmaceutical company,
the Food and Drug Administration was slow to approve it,
several years before being available in the US. Cideattech first
made its way to Europe and then Brazil in nineteen
eighty six.
Speaker 6 (20:54):
And here's where it's hard to know what is fact
and what is part of the myth of side attech,
because in Brazil this ulcer pill took on a new
life for starters. We know that the original side attack
box came with a warning, but because it's been forty years,
people remember that warning differently.
Speaker 3 (21:13):
Jacqueline Petangi, the sociologist who says hello to the Christ
statue every morning in Rio de Janeiro, remembers that the
warning was written out.
Speaker 11 (21:22):
It's that little paper that comes with the medicine that
says you should avoid to take it if you were
pregnant because it could cause contractions.
Speaker 6 (21:33):
Doctor Rivaldo Albuquerque remembers the fine priner more specifically, there was.
Speaker 12 (21:38):
A very clear paragraph that said that it should not
be usually in pregnant women because it could cause uterinin
contractions and lead to miscarriage.
Speaker 3 (21:49):
Debra Denis, a Brazilian anthropologist and law professor who grew
up in the eighties remembers the warning as an image
on the box.
Speaker 7 (21:58):
It was a profile of a pregnant woman, a big
belly and a warning crossing the belly, and also.
Speaker 3 (22:07):
With call there was a skull.
Speaker 8 (22:09):
There was his call.
Speaker 13 (22:11):
Wow.
Speaker 7 (22:12):
I'm one hundred percent sure of that.
Speaker 3 (22:17):
We haven't been able to confirm this call, but we
have seen the image of a pregnant woman in a
circle with a slash through it.
Speaker 6 (22:27):
When the pharma company developed Cida Tech, it discovered that
the drug had the significant side effect on women, a
serious side effect. It caused bleeding and contractions that could
induce a miscarriage.
Speaker 3 (22:39):
So for people who were pregnant and wanted to stay
that way, it was a very dangerous pill to take.
Speaker 6 (22:46):
But for people who were pregnant and did not want
to be SATEA Tech's side effect wasn't a problem. It
was a solution, a new tool to self manage an abortion.
But unlike the teas and crochet needles women had been using,
set Attack was overwhelmingly safe and effective.
Speaker 3 (23:04):
And somebody somewhere, somehow figured that out.
Speaker 4 (23:13):
I don't think we ever identified where it started.
Speaker 2 (23:17):
No, it's impossible to know this. Don't forget. We didn't
have social media. Then there's no records.
Speaker 6 (23:23):
It wasn't like there was a lot of incentive to
take credit. Whoever did this was likely breaking the law.
Speaker 2 (23:30):
They wouldn't give their name.
Speaker 11 (23:31):
I am Mary Smith, and listen, you can use this
to induce an abortion.
Speaker 3 (23:37):
Some speculate that it was a pharmacist or a midwife.
Speaker 4 (23:42):
We certainly knew that pharmacists were involved.
Speaker 11 (23:46):
I went to the pharmacy and I bought this.
Speaker 6 (23:49):
But even if we can't know the original source, we
do know how the knowledge spread far and white.
Speaker 4 (23:56):
The women themselves.
Speaker 7 (23:57):
Women said hah, I have no question and of saying
that it was from women, Brazilian women. Women continue taking
it because it was another woman from her family.
Speaker 4 (24:09):
Who shared with her. It certainly wasn't advertised.
Speaker 2 (24:12):
Was in the air.
Speaker 11 (24:14):
I can't tell you when something is in the air
among women's talks.
Speaker 2 (24:18):
I mean it was in the air.
Speaker 8 (24:26):
Sayra was spreading by word of mouth.
Speaker 3 (24:30):
This is a woman. We're calling by her initial r
to protect her safety because what she did was and
still is illegal in Brazil. Process.
Speaker 8 (24:42):
A woman who went through the process would tell another
hey by that by that.
Speaker 3 (24:47):
The whispers about side attack reached Dart in nineteen eighty six,
the same year it came on the market in Brazil,
and she thought it sounded a lot better than the
first abortion she had been through, the type of dangerous
abortion Rivaldo had seen time and time again in the
emergency room in the early eighties.
Speaker 6 (25:05):
The first time ar needed an abortion, she was a minor,
thirteen or fourteen years old, living in Pacific. She was
dating someone a lot older than her and ars even
though she was in a relationship, she understood almost nothing
about sex or her body because of how she grew up.
Speaker 8 (25:23):
Oh, my mother raised us like potatoes in the ground.
Speaker 6 (25:27):
Our was one of twelve kids.
Speaker 2 (25:29):
What did you cons I had us on sex so well.
Speaker 8 (25:33):
We didn't have the talk about what sex was. I
just knew that I was going to get kissed. I
didn't know that the thing was going to create a child,
so I didn't know that a partner shouldn't cross certain boundaries.
Speaker 6 (25:46):
When Our started feeling funny and her period stopped, she
confided in her older sister.
Speaker 8 (25:53):
She sat me down and said, look, you're pregnant. There's
going to be a baby, and we have to find
a solution. Because Dad is going to kick you out
of the house, or he's going to kill you.
Speaker 6 (26:05):
Her sister didn't mean it as an exaggeration. She thought
her dad would literally kill r if he found out
she was pregnant. He nearly done just that a few
years earlier.
Speaker 8 (26:15):
To our sister, Eileen Lavish, he once took out his
gun and tried to kill my sister, the same sister
who helped me. Because my sister lost her virginity.
Speaker 6 (26:26):
So it was dangerous for ar to stay pregnant, but
it was also risky to get an abortion, both physically
and legally. Our sister took her to a midwife, and
our remembers the midwife inserted a catheter into her cervix
to induce an abortion. When she returned to her parents' house,
she had very heavy bleeding and then passed out.
Speaker 8 (26:48):
Okay, Daddy, I actually fell on the bathroom floor. My
sister picked me up, showered me, and told my mother,
I'm going to take her because she's having her period.
It's very strong and she's weak. She didn't tell my father.
Speaker 6 (27:06):
Our sister took her to the hospital. While she was there,
doctors questioned her. They wanted to know if she'd done
anything to cause an abortion. Ar kept denying she had,
even when they threatened her with jail.
Speaker 8 (27:17):
Is he no? I said, no, of course I had
to deny it. I was told to deny it. It
was a crime that involved a lot of people.
Speaker 6 (27:25):
Right Ur was given a DNC to complete her abortion.
The doctors told her she nearly perforated her uterus and
had been at risk of losing it. R stayed in
the hospital for several days to recover in a maternity
room with other women who'd attempted an abortion.
Speaker 8 (27:42):
All of them had done something, and the one next
to me.
Speaker 6 (27:46):
She died, died. I asked why, Yes.
Speaker 8 (27:50):
I had a curatage right then I was fine, but
the one next to me, she never came back.
Speaker 3 (28:03):
A few years later, when I was nineteen years old,
she got pregnant a second time.
Speaker 5 (28:09):
She says.
Speaker 3 (28:09):
The guy she had seen just a couple of times
forced himself on her. I decided to have another abortion,
but this time it was a very different experience because
of cytotech aparash trity.
Speaker 8 (28:22):
It was for gastritis. So they sold it at the pharmacy.
Like water, you just go in and say, hey, give
me a box of cyitotech. Anyone could buy it.
Speaker 3 (28:32):
The pharmacy she bought it from told her to swallow
two pills, wait a couple of hours, then take two
more pills until she finished six pills. He also gave
her an instruction that was very common at the time.
Speaker 8 (28:44):
Oh, look, you were going to expel. When you expel,
when you're bleeding a lot, go to the hospital.
Speaker 3 (28:53):
I went home and took the pills.
Speaker 8 (28:56):
So the contraction started and I had some leading, she says.
Speaker 3 (29:01):
The pain was strong, but not like with the first abortion.
She was bleeding, but she didn't faint. She didn't have
her sister by her side, but she was able to
get herself to the emergency room. One thing was the same.
The doctors again questioned her and again are denied that
she had done anything to cause an abortion, and this
(29:23):
time arsas she didn't have to stay in the hospital.
She had a DNC and left. Her parents never found
out about it. Art went on with her life. She
moved in with her sister, who supported her going.
Speaker 8 (29:39):
To school in form so I graduated as a social worker.
Speaker 3 (29:45):
The two experiences were very difficult for r but one
thing was clear.
Speaker 8 (29:50):
The second time, I didn't have a lot of side effects.
I didn't have a lot of bleeding, so it was
safer for me. I felt more comfortable Festal.
Speaker 6 (30:11):
Still, she wishes she'd had more support because r and
women like her who took side attech to cause an
abortion in those early years, they were experimenting on themselves.
It's not like the pills came with a slip of
paper explaining how to have an abortion.
Speaker 3 (30:28):
In fact, if you remember, the instruction said don't take
this pill if you're pregnant.
Speaker 6 (30:34):
In nineteen ninety three, researchers from a public university in
the country published a study called side Attack in Brazil
at Least it doesn't kill. In it, most women reported
taking between four and sixteen pills, but some reported taking dozens.
It's likely that ar didn't take the right dose to
have a complete abortion.
Speaker 3 (30:54):
But over time, Brazilian women again figured out something by themselves.
Speaker 4 (31:00):
One of the interesting things that I noted in my
research is that women got much better at using cytotech.
Speaker 3 (31:07):
This is Sarah Costa again, the researcher in Rio de Janeiro.
While she conducted the study in the early nineties, several
years after cytotech became available, she heard about how women
were taking the bills, put.
Speaker 4 (31:19):
The manto your tongue or in set the menual vagina.
Speaker 3 (31:23):
Eventually they started getting better results.
Speaker 4 (31:25):
At the beginning, I would say that a lot of
women needed cureitage, but it turned out once they got
better at using it, they were actually having complete abortions.
Speaker 3 (31:37):
In other words, they no longer needed a DNC. How
long was your data collection period?
Speaker 2 (31:44):
I think it was about.
Speaker 4 (31:45):
Six to nine months.
Speaker 2 (31:46):
First it's fast.
Speaker 4 (31:48):
Yeah, so you know, we were able to observe change.
Speaker 6 (31:53):
Of the women who went to a hospital after having
an abortion, Sarah found that nearly sixty percent reported using
Sida tech to self manage it. She wrote that this
represented quote only the tip of the iceberg, because many
more women could have taken side attech and not needed
medical help. According to our research, the median dose the
(32:14):
women were taking was eight hundred micrograms four pills, which
is the same dose the World Health Organization now recommends
for pregnancies up to twelve weeks.
Speaker 3 (32:25):
And how are they getting this information? Sarah found that
the overwhelming majority of women who used Sido tech eighty
four percent had learned about it from friends, relatives, or colleagues.
It was the network starting to form women loosely connected
by whispers. Just by sharing their experiences what worked and
(32:45):
what didn't work, they began to build knowledge.
Speaker 7 (32:49):
Women know how to be scientists at home when science
is not offering what they need.
Speaker 6 (32:56):
This is Devorah Denis Agan, the Brazilian anthropologist law professor
who remembers the skull on the side attack box.
Speaker 7 (33:03):
So basically, it's about observation, it's about taking experiments in
our own bodies, and it's about sharing with others.
Speaker 6 (33:14):
She calls it domestic science, and she saw the results
of this domestic science for herself. By the time she
learned about side attack, it was no good deal.
Speaker 7 (33:23):
So I was at school in the eighties when I
saw for the first time a classmate with the pills,
telling us I'm going to take them today.
Speaker 6 (33:35):
Her classmate got the pills through a family member and
they worked.
Speaker 7 (33:40):
Can you believe that the day after she was in school.
Speaker 3 (33:45):
I'm wondering why you think cito tech became so popular
so quickly.
Speaker 7 (33:51):
Let me try five reasons. One, it was discovered by women,
It was shared from women to women. It proved to
walk and to be safe. It was used for an
essential need to women's lives, and it was available at
(34:11):
the community level, and it was cheap, very cheap.
Speaker 3 (34:16):
Pharmacists in Brazil told us they sold it for about
five bucks in the early nineties, compared to five hundred
dollars for an abortion at a private clinic. At the time,
cide Attech sales exploded. Researchers tracked that in the late
eighties and early nineties, more than fifty thousand boxes of
the pill were being sold in Brazil every month.
Speaker 6 (34:43):
Actually, there are more reasons women chose cide attack. In
that same report from nineteen ninety three, CEDA Tech in Brazil,
at least it doesn't kill. The researchers interviewed women who
had used it. In their testimonies, they described lots of
reasons for liking it. We had voice actors read some
of their quotes aloud.
Speaker 3 (35:03):
Since it wasn't a procedure requiring a doctor's expertise, it
didn't exactly feel like an abortion to some of these women.
Speaker 8 (35:09):
It's less traumatic, a lot less. You know what the
sensation is. The sensation is that your period is late,
and so you take medicine for it to come.
Speaker 6 (35:19):
As a result, some women describe feeling less guilty taking
the pill.
Speaker 3 (35:25):
If I have gone to a clinic, I would never
have forgiven myself, and women felt it put them, not
their partners or doctors in control.
Speaker 14 (35:35):
Using side attack is something that is yours. Nobody has
to know what you did or you didn't do. No
one invades your privacy. Even the gynecologists that I went
to later didn't know that I had had an abortion.
Speaker 6 (35:51):
Women who wanted abortions weren't the only ones who appreciated
side attack. Many doctors did too, because they didn't have
to deal with so many gruesome cases or do such
serious procedures like having to remove a uterus. One doctor
in sel Paulo told the researchers that he seemed hasterectomsdropped
from two a week to one every six months.
Speaker 3 (36:14):
When we asked Rivaldo the Ovigian receive how he remembers
feeling at the time, he used one word.
Speaker 5 (36:21):
I'll leave you relief. I leave the.
Speaker 3 (36:26):
Relief of mind and of conscience, simpme.
Speaker 5 (36:29):
We to peel it.
Speaker 12 (36:30):
I was happy because I saw that what we couldn't do,
which was to help women, the network was doing it,
and that's what I wanted.
Speaker 13 (36:41):
I wanted women to be healthy.
Speaker 12 (36:44):
So if I couldn't do it effectively, the network was
doing it.
Speaker 6 (36:56):
Rivaldo told us that feminists and health providers coined the nickname.
Speaker 5 (36:59):
For some attack ashin Shamavady, Santo Techi, Sondy, Santo Santo Techi.
Speaker 6 (37:07):
They called it Santo.
Speaker 3 (37:09):
Tech, cyto tech, Santa tech. It has many names. You
might know it as miso prosto aka miso like the
(37:29):
soup or misto.
Speaker 6 (37:31):
There's no agreement on how to pronounce it. Experts believe
it's now the most commonly used abortion pill in the world,
and the World Health Organization says it's safe to self
manage with pills through twelve weeks of pregnancy.
Speaker 3 (37:47):
Later in the series, we follow the network as it
spreads this pill across Latin America.
Speaker 6 (37:53):
I was like, what, no way, and into the US. Oh,
there's a whole of you, and you're all like underground
and secret squirrel and using different names.
Speaker 2 (38:05):
It was just mind blowing.
Speaker 10 (38:08):
Up.
Speaker 3 (38:08):
Next, women create an entirely new support system around me.
So that challenges the medical establishment and the law al
e sib.
Speaker 11 (38:22):
Someone was going to do what we didn't dare to
because we had a license and we were afraid of
the law.
Speaker 6 (38:44):
If you want to hear the rest of the series
right now before everyone else, go sign up for Embedded Plus.
Embedded is a home for ambitious storytelling at MPR, and
signing up for Embedded Plus is a great way to
support that work. You'll get early access to every Embedded
series and sponsor free listening. Go to Plus dot NPR
dot org slash embedded to find out more.
Speaker 3 (39:08):
The network from Embedded is a collaboration with Latino Usa,
a production of Futuro Media. This episode was produced by
Monica Moreles Garcia and Abby Wendel. Re Rena Cohen edited
the series. Additional reporting by Abby Wendel, fact checking by
Cecil Davis Basquez, nicolet Kahn, and Johanna Romano Sanchez. Robert
(39:31):
Rodriguez mastered the episode.
Speaker 6 (39:33):
Voice overs by Mariana de la Varva, Julia Carneo, Marcellos Darobinaz,
and Susi Valerio. Leanna Simpstrom is our supervising Senior producer,
Katie Simon is our supervising senior editor, Irena Gucci is
our executive producer, and Colin Campbell is the Senior Vice
President for Podcasting at MPR. The Embedded team also includes
(39:57):
Luis Trejes, Dan Germa, Adelina Lancianie and Ariana Garablee from
Latino USA. Our executive producers are Marlon Bishop and Penilee Ramidez,
and our production managers are Jessica Ellis and Nancy Trujuillo.
Speaker 3 (40:12):
Thanks to our managing editor of Standards and Practices, Tony Kevin,
and Tojohannes Urghi and Michael Ratner for legal support and
Tommy Evans, MPR's managing editor Editorial Review. Our visuals editor
is Emily Bogol. Original tail art by Luke Medina.
Speaker 6 (40:29):
Special thanks to Alissa nat Warney, Selina Simons, Steffen, Mariana
de la Barba, Maria Matta Bruno, Julia Carno, Roberta Fortuna,
Dina Ortega, Kelly Blanchard, Maureen Paul Lure, Rivera, Abigail Aiken, Gisell,
carinod red Wine and Jefferson Drest And a big thanks
(40:51):
to our embedded plus supporters.
Speaker 3 (40:54):
I'm Marta MARTINEV.
Speaker 6 (40:55):
I'm Victoria Strada.
Speaker 3 (40:57):
This is embedded from MPR.
Speaker 6 (40:59):
Thanks for listening.
Speaker 3 (41:00):
We taknakias for the scutard.
Speaker 7 (41:05):
Latino USA is brought to you in part by the
Levi Strauss Foundation outfitting movements and leaders fighting for a
more just and abundant world, with the support from the
International Women's Media Foundation
Speaker 8 (41:18):
As part of its Reproductive Health, Rights and Justice in
the America's initiative, and the v Day Foundation
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