Ruth runs through a checklist as she packs. There’s ginger chews for nausea, chamomile tea for calm, two thick pads for bleeding. Inside seed packets of cantaloupes, cucumbers, tomatoes and peppers, she slips two smaller plastic baggies containing abortion pills, which she’s labeled by hand. 

A few months earlier, Ruth would feel her heart pound as she assembled the kits, a rush of adrenaline as she drove to mail them, wondering if she’d get stopped – and if stopped, arrested. Now, she said, “The fear is gone. And I’m just at righteous indignation.” 

She adds lollipops to counter the bitter taste of the medicine and a pamphlet titled “Feminist Care for Safe Abortion” with detailed instructions for ending pregnancies privately, outside of clinic settings – which, except in medical emergencies, is no longer an option in Texas.

Within hours of the Supreme Court decision that overturned Roe v. Wade in late June, Texas clinics stopped providing abortions. Texas is now among 13 states that have banned most abortions. 

“If it is possible, plan for a friend, loved one, or another person you trust to stay with you through your abortion process,” the pamphlet advises. “It can help you feel more comfortable and supported.”

Most state anti-abortion laws do not punish the people who end their own pregnancies. For anyone who helps them, however, the penalties can be steep: In Texas, that could include prison time.

Though some of Texas’ larger cities have moved to deprioritize criminal investigations or prosecutions of abortion-related crimes, that hasn’t happened in El Paso. Greg Allen, the city’s police chief, has said publicly that he would not support deprioritizing investigations of such cases. El Paso District Attorney Yvonne Rosales, who will leave office this week, would not sign onto a letter submitted to her by abortion rights activists that would have pledged to make abortion prosecutions the office’s lowest priority. Her two-year replacement will be appointed by Gov. Greg Abbott, a vocal opponent of abortion rights.  

Ruth talks over a crackling cell phone line on her way out of El Paso, where she’ll be mailing two packages that could put her at risk of violating any number of state laws – including prohibitions against mailing medications without prescriptions, she said.

Since Roe fell, she’s sent packages all over the country, with most going to Texans. She tries to send the care kits, as she calls them, within 48 hours of receiving a name and address through an encrypted messaging app.

This is a new sort of risk for Ruth, who asked not to use her real name for this story. A mother and educator in her 40s, Ruth’s support for abortion rights strengthened after she underwent a high risk – but very wanted – pregnancy, she said. So far in her life, she’s accrued no more than a few speeding tickets. 

But she contacted El Paso Matters to describe how she came to volunteer her time subverting abortion restrictions because she wants other El Pasoans to know: “There are those of us who are willing to risk breaking the law to make sure women still can exercise their rights as human beings.”

An envelope is stuffed with pads, medicine and candy. (Corrie Boudreaux/El Paso Matters)

Ruth thinks of herself as “a cog in a wheel,” and has a deliberately vague understanding of where she fits. She knows that other volunteers have bought the abortion medications mifepristone and misoprostol at Mexican pharmacies, while others bring them into the United States. Other volunteers stash large quantities of those pills in states all over the country until it’s time to send them to volunteers like herself, who prep and mail the packages directly to the people requesting them.

And she knows that whoever receives the packages she’s mailed will communicate with yet another volunteer who will support them through their abortion.

Adopting a Mexican approach

This model was developed in Mexico over the course of two decades by organizations like the Guanajuato-based reproductive justice group Las Libres, with whom Ruth volunteers. Las Libres – the Free Ones – works to advance “women’s rights to live free of violence,” said the group’s founder, Verónica Cruz Sanchez, speaking by Zoom from her Guanajuato office in Mexico.

Cruz formed Las Libres in 2000 to ensure that sexual assault survivors could access abortion after Mexican lawmakers revoked the right to end pregnancies resulting from rape. The group’s cause soon expanded to include anyone who wanted to end a pregnancy, whatever their reason.

Since its founding, Las Libres has gone to court to free women imprisoned for ending their pregnancies and has pushed to decriminalize abortion throughout Mexico. They also operated in a legal gray zone by creating networks of acompañamiento – accompaniment, in the form of emotional and medical support – to people as they ended their own pregnancies. 

They do so openly, Cruz said. “We’ve always been very public about defying our government, saying ‘You don’t have the right to criminalize, you don’t have the right to make it a crime.”

Abortion pills were an essential part of their strategy, Cruz said. “A lot of times it’s the beliefs of medical providers that are the obstacle – if they don’t want to perform (an abortion), if they don’t think it’s good.”

In the United States, for example, more than 40 states allow health care providers or institutions to refuse to participate in an abortion, according to the Guttmacher Institute, which tracks U.S. reproductive health policy.     

“And so for us,” Cruz continued, “realizing that you could have an abortion at home using medication was a fantastic tool.”

Those who oppose abortion rights have targeted medication abortions as their new battleground. In mid-November, abortion opponents filed a lawsuit in Texas seeking to reverse the Food and Drug Administration’s decades-long approval of mifepristone, arguing that the FDA had not thoroughly studied the drug and that it is not safe.

In assisting with self-managed abortions, Las Libres follows medical protocols outlined by the World Health Organization, which describes such abortions as a form of “self-care intervention” that is both safe and effective. When taken in combination, according to studies, mifepristone and misoprostol are up to 95% effective in ending early pregnancies.   

Ten months before the Supreme Court overturned Roe v. Wade, Texas enacted Senate Bill 8, banning abortions past roughly five to six weeks into pregnancy – what was then the nation’s strictest time limit on abortion. Nine days later, Mexico moved in the opposite direction, with its highest court issuing a decision that decriminalized the procedure.

By then, Cruz said Las Libres was well equipped to expand its model to Texas.

“For us, it wasn’t a problem; it wasn’t even a discussion,” she said.

Texas, with its ties to Mexico and the frequent movement of people and goods across borders, seemed like a natural fit. 

“Of course, we were also thinking of our undocumented women, of migrants, of Latinas,” she said. “There’s a big concentration of our people in Texas. So it was also like an extension, a way of continuing to help our own people.”

“So I called together all the organizations, all the networks that we’d already formed and I said to them, ‘Listen, what would you think of us helping people in Texas?’ And everybody said, ‘Yes, let’s do it.’”

Very quickly, requests began to come in from people who were not undocumented, migrants or Latinas – or even in Texas, Cruz said. And when Roe v. Wade fell, what had been about 10 requests for help a day spiked to 100.

“Are you all ready to help about 22 states in the U.S.? And we said, ‘We’re here.’” 

Today, Cruz said, Las Libres works with a network of roughly 200 U.S.-based volunteers; about half of those volunteers live in Texas. Cruz would not go into specifics about El Paso-based volunteers except to confirm one thing – Ruth is not alone. 

The path to civil disobedience

Ruth attended a school with a high teen pregnancy rate. As she saw other girls in her class become pregnant, she found herself gaming out the possibilities: What would she do in their situation? 

“I didn’t know, but it wasn’t my place to tell other people what to do,” she said.

She never found herself in that situation. The closest she came was in the late 1990s, when a condom broke and getting the morning-after pill required a doctor’s visit. When Ruth told the consulting nurse why she’d come, “the nurse looked at me dead in the eyes and was like, ‘You can’t murder a baby. I’m not going to let you murder a baby.’ And this was for Plan B. And so I’m in tears, blubbering, and the doctor comes in and asks what’s wrong.”

Ruth told her.

The doctor’s response, Ruth recalled, was very different: “She said, ‘What we discuss in here is nobody’s business. Nobody else has to know what your choice is. Here you go; this is how you take the pills.’ Having somebody there to say ‘it’s OK, what you’re doing is not wrong’ was so …” Ruth doesn’t finish her sentence.  

Years later, Ruth “had a horrific pregnancy – like, almost-died horrific pregnancy,” she said. “And that was for a wanted pregnancy. I couldn’t imagine forcing a woman to go through that.”

“I know what it’s like to have a pregnancy go drastically wrong,” she added. “And now you’re trying to impose that on women who didn’t even want to be pregnant in the first place? That is traumatic to force onto people.”

Misoprostol, a medication to treat ulcers, can be purchased as an over-the-counter medication in Mexican pharmacies. (Veronica Martinez/La Verdad)

Supporters of HB 1280, one of the Texas laws that bans most abortions, note that it allows the procedure when a pregnant person’s life or major bodily function is at risk. But forcing doctors to delay an abortion until a pregnancy reaches the point of emergency could endanger patients’ lives, medical experts counter.

When the Supreme Court ended federal protections for abortion rights this summer, Ruth’s kids were grown and out of the house. She had more time on her hands and wanted to help. At first, she imagined she’d drive abortion-seekers across borders – into Mexico or New Mexico, where abortion remains legal.

“But then I was like, ‘Wait a minute, step back. Think about it. I need to work with people who have an established infrastructure, who know what they’re doing.’” She thought right away of Mexican nonprofits.

“Living in El Paso and having that respect for Mexican culture, I think, helped me know who to reach out to when all this happened,” she said.

‘Community is the response to our problems’

Cruz said Latin America offers useful lessons to the U.S. abortion-rights movement, particularly a community-based approach to reproductive rights and abortion access.

“Society in the United States has the opportunity to learn how to build a collective framework for abortion rights … not just one woman who goes to a clinic and resolves it. Because what’s happened now is challenging that whole system,” she said.  

When asked what advice she has for people who are new to the legal atmosphere that she has operated under for two decades, Cruz said: “It’s these networks of solidarity that save us. Community is the response to our problems.”

In just over three months, Ruth has sent out 50 packages – to a few blue states but mostly red, she notes – and has no plans to stop. She has a cover story memorized for when she mails the packages; she keeps two attorneys on speed dial in case she’s arrested.

As the work grows more routine, there are still moments where “it hits me,” she said. Sometimes, it’s as she writes out the name and address of the person who requested Las Libre’s help.  

Other times, it’s as she writes that person a short note: “You are loved,” she’ll write in black marker.

“That’s always where it sinks in that there’s a reason why I’m doing this,” she said. “I am doing this for the women who have nowhere else to turn. As I said, I’m just kind of a cog in the wheel of this whole thing – but this is for a specific person.” 

Recently, she sent a package to someone in El Paso for the first time. Turning her thoughts toward the person she’s helping, she said, “makes it less heart pounding.”

Victoria Rossi is a women and gender issues reporter with El Paso Matters and a Report for America corps member. She has worked as a health and education journalist, an immigration paralegal, and a criminal...