If You Have a Uterus, You Need to Read This Book

A Woman’s Book of Choices: Abortion, Menstrual Extraction, RU-486 by Rebecca Chalker and Carol Downer was recommended to me by a friend the day after the news broke that the US Supreme Court was voting to overturn Roe v. Wade and eliminate federal abortion protections. She knew that, like a lot of people, I was scared and wanted to prepare myself for a post-Roe future. She had found A Woman’s Book of Choices at a library and suggested I also give it a try.

I am so, so thankful to that friend, because I can honestly say that this is one of the most informative books I’ve ever read. There is some fantastic information in here, so I definitely want to put this resource on more people’s radar. This is, as the title of this post suggests, a book I think everyone with a uterus should read.

My biggest complaint isn’t actually about the book itself, but its publisher: they’ve allowed A Woman’s Book of Choices to go out of print. In fact, it’s so out of print it’s entered rare book territory.

I wasn’t even able to find used copies of this book online. Usually, even if a book is rare, I’m able to track down a few (very expensive) copies for resale on sites like Ebay, AbeBooks, ThriftBooks, etc. And I found this book so valuable, I might actually have been willing to cough up a couple hundred dollars for a physical copy. But there are no copies to be had. Literally. You can’t even pay $200+ for a beat-up paperback.

Luckily, I was able to find a digital version of A Woman’s Book of Choices on Scribd. That’s great for me, because I already pay for a Scribd subscription. It’s not so great for people who can’t afford or don’t want to pay the $10/month subscription fee. But I will say this — Scribd offers a free trial and allows you to download books and documents. Do with that information what you will.

My local library also didn’t have a copy. Neither did any of the colleges and universities in my area. However, I know some libraries have copies, and you can probably get it through an inter-library loan. You may also be able to electronically borrow a digital version. I know it’s on archive.org, for example.

(I’ve also posted my own notes on A Woman’s Book of Choices on this blog, sort of like my own personal CliffsNotes. Feel free to check that out.)

It may require a little bit of digging, but if you can get your hands on a copy, this is one of the most important books you’ll ever read. There is information in here that may literally save a life someday, especially as states start to ban and restrict access to abortion. (Could that be part of the reason it’s so hard to find now? Maybe.)

A Woman’s Book of Choices really does address ALL of the choices for terminating an unwanted pregnancy. There’s a chapter on how to find a good abortion provider if you live in a place where abortion is legal and a chapter on standards for abortion care. There’s a couple of chapters on menstrual extraction (ME), which is not technically an abortion procedure but which can prevent unwanted pregnancies. There’s a chapter on abortion with pills and a chapter on herbal remedies.

There’s even a few places where the authors talk about the history of the reproductive justice movement and about how unwanted pregnancies were handled before Roe v. Wade. There’s also multiple discussions of abortion law and of where different home-health methods like ME and herbs fall on the spectrum of probably-legal to almost-definitely-illegal.

It really is everything you’ve ever wanted to know (or didn’t necessarily want to know but felt like you should know) about abortion.

There is A LOT of information in here. While the authors are very clear that this is not a “how-to” guide, they do provide a lot of detailed descriptions, research, and anecdotes — including very clear and detailed descriptions of suction aspiration abortion, menstrual extraction, medication abortion, and even an herbal abortion (though this last comes with a lot of health warnings). They also provide resources where you could learn to do some of these things, like menstrual extraction, yourself. There’s even medical textbook-style diagrams!

My biggest complaint about the book itself is that the section on herbal abortions only lists herbs by their common name and doesn’t include a botanical name. This may seem like a nitpick, but when you’re talking about the medicinal uses of herbs, it’s really important to be as clear as possible. For example, “mistletoe” could refer to any of several plants in the Santalales order, some of which are poisonous. Botanical names would have made this section much more helpful.

Obviously, some of the information is bound to be outdated in a book published almost exactly 30 years ago, especially when that book is about medical procedures. For example, in 1992 RU-486 (now more commonly known as mifepristone) was a new technology that was only available in some European countries and hadn’t been around long enough to study long term side effects. As I write this in 2022, mifepristone is one of the most commonly used abortion methods, and is statistically safer than Tylenol. About 50% of the abortions performed in the United States use mifepristone and misoprostol. Because this method is so safe, the FDA has approved its use at home without medical supervision, which makes this one of the best options for people who need to keep their abortion private.

The resources listed in the book, which were probably very exhaustive and very helpful in the 90’s, are significantly less helpful now. Several of the groups mentioned in the “Information Networks” chapter are no longer active, and some of the books in the “Suggested Reading” section are out of print.

Another way this book shows its age is in the use of gendered language. The authors refer to abortion as a “women’s issue” and regularly use “woman” to refer to any person seeking an abortion. Even the title, “A Woman’s Book of Choices” implies that the issues discussed in this book only affect women.

In the early 1990s, abortion was very much seen as a (cisgender) women’s issue. However, nowadays we’re more aware of and comfortable talking about the reality that not everyone who wants or needs an abortion is a woman. A person seeking an abortion may be a cis woman, or they may be a trans man, nonbinary, genderfluid or genderqueer, or intersex. For this reason, pro-choice activists today tend to use more gender-neutral language, like saying “pregnant person” instead of “pregnant woman.”

I think this is less a case of intentional transphobia on the part of the authors and more a case of language changing over time. Maybe someday we’ll get an updated version of this book or one like it that talks about abortion through a specifically trans lens, but until then, a lot of this information is still relevant to people with uteruses who do not identify as women.

And finally, the authors of A Woman’s Book of Choices could never have predicted the level and type of technology we would have at our fingertips in 2022, or the danger that would come with it. They never could have predicted smart phones, webcams, or location tracking. These technologies have drastically changed the way we relate to our bodies, and they pose new risks to people living in anti-abortion states.

Period tracking apps are a great example of this. Today, a lot of people use smart phone apps to track their cycle — but those apps track your data, which could be used to prove you had an abortion. Add this to the fact that your smart phone continuously broadcasts your location through Wi-Fi, cellular data, and Bluetooth, and law enforcement can not only tell that you’ve had an abortion, but where and when you probably had it, all from your phone. If you live in a place where abortion is criminalized, as it is under new Texas laws, law enforcement can use data from a period tracking app like Flo (which has already been busted for selling data) to determine that you missed a period, then use location tracking to confirm that you visited a clinic in another state.

Obviously, the authors of A Woman’s Book of Choices couldn’t have warned against using period tracking apps or advised people not to bring their smart phones to abortion appointments, because those technologies didn’t exist when this book was written. (Seriously though, if you live in a state with anti-abortion laws, delete your period tracking apps. You can track your cycle fairly easily with a notebook or calendar. And please do not take your phone to an out-of-state abortion.)

My point here is that, although this book is a great resource, it shouldn’t be the end of your pro-choice education. Keep reading the news. Familiarize yourself with the law and its loopholes.

But A Woman’s Book of Choices is an excellent beginning to your pro-choice education. And for that, I really can’t recommend it highly enough.

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