‘Abortion: Add to Cart’ Envisions a Future for Safe Self-Managed Abortion Post-Roe

Abortion pills are used in over half of abortions performed in the U.S. right now—but remain relatively unknown. These filmmakers are putting them in the spotlight.

(Instagram / Wikimedia commons)

A new film about self-managed abortion with pills explains how people in the U.S. are finding abortion pills online and using them safely on their own. Accessible, informative and engaging, Abortion: Add to Cart provides a roadmap for how people can have safe abortions post-Roe—even in states that ban abortion.

The film is directed by Los Angeles-based filmmaker Jessica Sarah Flaum and produced by Geneva Faye, who released it shortly after the Supreme Court draft opinion overruling constitutional abortion rights established close to fifty years ago in Roe v. Wade.

“With the recent leak from SCOTUS, we decided to release our film publicly to be a resource in preparation for an upcoming post-Roe world,” says Flaum.

The 35-minute film recently won Best Documentary Short at the Manchester Film Festival in the U.K., and is currently available on You Tube.

“We want to create a conversation and we want to get it out of the shadows,” says Faye.

‘Abortion: Add to Cart’ features two abortion storytellers: Alice, who used the Austria-based telehealth abortion provider Aid Access; and Ari, a trans-masculine non-binary person who self-managed their abortion before abortion pills were widely available. The filmmakers also interview activists from the organizations Plan C and If/When/How, who provide information and legal support to people seeking to self-manage abortion, as well as medical providers from Planned Parenthood, Aid Access and Physicians for Reproductive Health.

Abortion pills are effective, safe, easy to use and increasingly available online. Doctors prescribe two FDA-approved oral medications to end a pregnancy: mifepristone and misoprostol. Mifepristone interrupts the flow of the hormone progesterone that sustains the pregnancy, and misoprostol causes contractions to expel the contents of the uterus — abortion seekers can use the pills in combination, or take misoprostol alone. Abortion pills are safer than Tylenol.

Ms. sat down with Flaum to talk to her about the film.

Carrie Baker: What made you want to create a film about self-managed abortion?

Jessica Sarah Flaum: I had always been really interested in reproductive rights, and specifically abortion rights. It was something I was always really passionate about. However, one time I came across an article about self-managed abortion and I had no idea it was even an option. I realized that if someone like me, who really kept up with the news and kept up with abortion politics had no idea about this option, that meant a lot of other people probably didn’t know either, people who may need it at some point in their lives. And so that really motivated me to want to do a documentary to educate people about self-managed abortion as an option.

I also wanted to change the conversation around what it means to be pro-choice. I think a lot of times we think about pro-choice being the decision to either have or not have an abortion. But through this film, I’ve learned that it also means what that abortion looks like. Self-managed abortion is an important option that people need to be aware of.

Baker: Why is this film so important right now?

Flaum: With the potential overturning of Roe v. Wade, we know that self-managed abortions will be on the rise. And that’s why we believe that this information is so vital so that people understand their options and have resources to turn to if this is an option that works for them. When I started this project two years ago, it felt very urgent. It’s so much more urgent now.

Many people don’t even know about the abortion pill, which accounts for over half of all abortions in the United States. We know this information is vital, but it’s even more vital now. And we wanted to get the information out there so people can understand it and make decisions for their own lives.

We have always seen this story as one of hope. Working in abortion rights and reproductive rights doesn’t always feel very hopeful. Sometimes it can feel like a losing battle, especially now. For us, the power of abortion pills and the internet really feels unstoppable. We know that there are going to be many hurdles that are going to come if there’s an overturning of Roe v. Wade, but we are hopeful that by spreading the word we can help alleviate some of that by allowing people to understand this option that they probably have never heard of.

Baker: Why did you include stories of people who self-managed abortions themselves?

Flaum: Activists and providers are amazing, but I felt like it was important to include people who had actually lived these experiences, especially if someone is watching who may be considering a self-managed abortion. They get to see people maybe like them, and be able to understand if it’s the right choice for them and be able to connect on a personal level with someone who they know has chosen that option.

Baker: Who do you hope watches the film?

Flaum: Honestly, someone like me two years ago. I had always considered myself really supportive of reproductive rights and abortion rights. It was something I was really passionate about. I was so shocked that there was this method out there that I had no idea about.

When I first learned about self-managed two years ago, it was very scary and confusing, especially the coat hanger imagery. Self-managed abortions are often demonized, intentionally or unintentionally. This process has reframed that in my mind to help me understand better what’s changed and how there are different methods now, and why they’re safe, how they can be effective and how we should really be allowing people the freedom to be able to choose the best method for themselves.

Baker: What do you most want your viewers to know?

Flaum: It feels like a really dark time right now. It’s often easy to feel like there’s nothing you can do to stop what’s happening—the overturning of Roe v. Wade, the numerous restrictions, especially in conservative states that make it really difficult for people to access abortion. But there are resources out there, things that activists are doing around self-managed abortion, but also in other ways that can really improve people’s lives and get them access to abortion. We need to be hopeful and try to find options and workarounds and keep fighting because this is definitely not over. We’ve got to keep working for the people who need it most.

Baker: What do you find hopeful about abortion pills?

Flaum: The power of abortion pills is really centering the individual in their own care. Misoprostol was discovered by Brazilian activists who realized looking at the box that it could cause miscarriages, and realized that they could use it to terminate their pregnancies. It’s always been something that’s rooted in fighting back, that’s rooted in revolution, that’s rooted in individuals taking control of their own bodies and their own lives, against government, against lawmakers, against anyone who’s trying to gate-keep abortion. The power that abortion pills have is really unstoppable.

I don’t think people realize how it’s used in other countries, how accessible it can be, how easy it can be to use. It’s certainly not the right method for everyone. In-clinic abortion and aspiration abortion are absolutely necessary and vital to have. But we really need to uplift this method to spread the word to allow people to understand it better and provide them more options for their own lives.

Baker: What’s your hope for the film?

Flaum: Self-managed abortion has a lot of stigma around it, not just in the general public, but also in the reproductive rights community. We’re hopeful that this film can provide an educational experience for providers, for students, for educators, for activists and for the everyday person that just wants to know more.

View the trailer here, or watch the full film:


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Carrie N. Baker, J.D., Ph.D., is the Sylvia Dlugasch Bauman professor of American Studies and the chair of the Program for the Study of Women and Gender at Smith College. She is a contributing editor at Ms. magazine. You can contact Dr. Baker at cbaker@msmagazine.com or follow her on Twitter @CarrieNBaker.