A stylized photo on Mifepristone, the abortion pill on a pink surface.
Image credit: Talia Dinwiddie on istock.com

These networks, led primarily by women, operate outside of the established medical world.As abortion access becomes increasingly restricted across the United States, underground activist networks, known as “companion networks,” in Mexico are providing women with abortion medications—not just in their own country but across the US border, too.

These networks, led primarily by women, operate outside of the established medical world and the law to create access to abortion even in states where abortions have become effectively, if not literally, illegal.

The existence of these networks has been reported by various news organizations. In 2020, the Guardian reported on such networks, describing a cross-border event in which activists from both the United States and Mexico vowed to continue and expand their collaboration in providing women with access to abortions:

Over the course of the long weekend, members of 30 different abortion rights groups, from across Mexico and the United States, formed what they call the Red Transfronteriza, or Cross-Border Network. Following a model that Mexican and other Latin American feminists had developed over the past two decades, the Red Transfronteriza would “accompany” Americans through their abortions, guiding them through the World Health Organization’s protocol for safely using abortion pills without the supervision of a doctor. They would also supply abortion pills to Americans for nothing, mailing donated medications to the United States.

More recently, writing for STAT this December, reporter Olivia Goldhill described the growth and expansion across the border of these companion networks as more or less a direct response to the 2022 US Supreme Court’s Dobbs decision, overturning the federal right to abortion access and leaving abortion laws to the states. That decision, notes Goldhill, came just as Mexico’s Supreme Court decriminalized abortions in that country.

Goldhill describes the groups as serving primarily women who face numerous hurdles to obtaining an abortion in the United States:

These volunteer groups…have been quietly sending abortion pills across the border, often to vulnerable people who lack funds or immigration papers, and training volunteers in the U.S. to establish their own companion networks.

With abortion access…increasingly hampered in the United States, “we’re migrating that mission into the U.S.”

Mexican national Crystal Pérez Lira, a leader of one such companion network provocatively named Bloodys Red Tijuana, tells Goldhill her group received its first cross-border request for aid, in the form of abortion pills, just a few years ago. They’ve assisted some 60 women in the years since.

Companion Networks Expand

Initially set up to help Mexican women access abortions, that mission is changing, Pérez Lira said. With abortion access increasing in Mexico while it becomes increasingly hampered in the United States, “we’re migrating that mission into the U.S.”

Goldhill traces the origin of such companion networks to another group, Las Libres, from Guanajuato, Mexico, founded by Verónica Cruz Sánchez, an abortion activist who has helped spread the model of companion networks throughout Mexico.

Since Dobbs, Goldhill reports, Las Libres has trained some 200 volunteers in the United States—often relying on Google Translate to communicate—to form and staff their own companion networks.

The work goes beyond supplying misoprostol and mifepristone, the two main pill medications used to induce abortion. It includes logistical and emotional support for the women being served. Volunteers learn to advise women undergoing abortions about what to expect, what signs of danger to look for, and what to do if things go awry (volunteers tell women who have to go to a hospital, for example, to report a miscarriage).

Goldhill describes companion networks as a social movement rooted in the belief in abortion as a personal choice and personal right—a right that exists regardless of what the law and medical establishment have to say about it.

That kind of understanding of abortion rights has long existed in Mexico, Goldhill notes, where until recently abortions were severely curtailed, but is in some ways underdeveloped in the United States, where, since Roe—and until Dobbs—abortion access was often taken for granted:

Companion networks are explicitly non-medical, framing abortion as a personal choice, rather than an act that needs to be governed and performed by doctors. “The U.S. is getting late into this type of abortion rights access because they thought they already had it,” said Pérez Lira. “They just had clinics and professionals and prescriptions at the center.”

Meanwhile, Goldhill reports that Mexican nonprofits—above-ground institutions, in other words—are also responding to the changing landscape of abortion access between the United States and Mexico. In some cases, those nonprofits set up clinics in Mexico with the expectation of receiving patients from the United States.

The work of such companion networks is, by definition, dangerous.

One nonprofit, MSI Reproductive Choices, has opened such a clinic in Cancun and is meanwhile setting up to be able to provide abortion medications “at any point along the U.S.-Mexico border.”

But as a nonprofit, those services, Goldhill notes, “will only be able to serve people with the documentation and freedom to cross over.”

The underground companion networks, by contrast, are prepared to help those who cannot travel, who may lack documentation, and who may lack the means to pay for medications: Bloodys Red Tijuana, for example, does not charge women for the pills, relying instead on donations.

The work of such companion networks is, by definition, dangerous. Volunteer groups risk detection and prosecution, as do, in some cases, the women seeking abortions.

But such risk is part of the mission. Rather than deter these networks, the recent barrage of US laws meant to restrict, outlaw, and even criminalize abortion has only served to inspire companion networks to expand their work, Goldhill reports.

The companion networks, Goldhill writes, are unafraid of these legal hurdles. As Bloodys Red Tijuana leader Pérez Lira told Goldhill, “For us, it doesn’t matter.”