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    "text": " Hello, my name is Maggie Mahan. I'm a former sex worker, currently a full-spectrum doula and birth worker, and I'm a deaf worker in training. Today I want to show you something. I think it's pretty cool. Come check it out. What I'm holding in my hands right now is a manual vacuum aspirator. This is a device that can make an abortion possible. It's a tool that's used around the world. It's safe. It's recognized by the World Health Organization as an essential tool. It's one that protects the lives of human beings. Abortion is something that impacts more than just women. And this is not something that we say just to be nice or to remember to be inclusive. It is important to remember that all of our freedoms, especially our reproductive freedoms and our bodily autonomy, are tied in together. As I talk about abortion, I want you to remember that this is something that affects people with gestational capacity. Some women, but not all, have the capacity for pregnancy. Some people who are transgender have the capacity for pregnancy. All of us right now are facing a very, very severe curtailing of our rights and our freedoms. All of our bodies are in jeopardy. We cannot move forward if we don't recognize the way that all of us have our fates intertwined together. That there is no way to fight for abortion fully without also making sure to fight for the rights of people who are transgender to access the gender-affirming care that they deserve. And to remember that we all have a right to the health care that we need. The MVA is easily mass-produced and shipped, but it is a tool that not everyone may have full access to. It's possible to reproduce this tool using some things that you might find at home or at a nearby grocery store or hardware store. I'm going to show you how it works. This long piece of plastic that you see here is a cannula. This is the piece that enters the cervix, and this barrel here is what helps produce a suction that is capable of evacuating the contents of the uterus. As a vacuum, it's actually very, very simple to make on your own. Prior to the legalization of Roe v. Wade, abortion could only be accessed by a certain number of people who were willing to take the risk to provide them. Many of these people did so in the best of faith and the highest of competence, but not everybody did. There were people who took advantage of those who needed to access abortion. They either charged exorbitant rates or entered into abusive, violent, or unfair quid pro quo arrangements where people were expected to exchange sexual favors for access to health care or any other number of goods and services that someone might want. There was a group of activists who helped people find providers and doctors who would be willing to provide abortion, but they also had to acknowledge that some of those people they were working with were not engaging with the best of faith. They felt perhaps powerless or outnumbered or outgunned because they didn't have that knowledge or that capacity or those tools. Abortion seemed like something that only people with years and years and years and years of education or specialized knowledge could handle. When they watched the process, though, they realized that this might not be the case. Abortion might be something that could be safe and accessible and performed by people in community. They looked at what the actual technology and the tool was. They understood its purpose and they understood the components that made it possible and they began to build what was called the Dell M. In this case, the suction of the MVA is provided by a syringe. The jar is capable of holding the contents that are removed from the uterus and the cannula is used the same way to enter the cervix and the uterus to make this all possible. Most of the time when we think about abortion, we're left with an abstraction. Rather than being a tool or a form of health care, we think about it in terms of morality morality or fear. When our mind goes to abortion, oftentimes we're thinking about all of the baggage and all of the anxiety and all of the fear. The people who don't want there to be reproductive freedoms want to be in place to get what they want and to maintain the control that they have. We've rarely been given an opportunity to understand sexuality, let alone pregnancy or the end of one. Taking the time to learn about these things in and of themselves without moralizing, without the fundamentalist religion, without anyone else interpreting what the science is in and of itself really lets us know what is at stake and what kind of tools health care providers are being told that they can or cannot use. In order to fully criminalize abortion, it becomes necessary to surveil and scrutinize the actions of health care providers who are capable of providing one. This will have a impact on reproductive health care as a whole. It will make people less willing or able to step into the role of becoming a reproductive health care provider. It will come with more government people looking over their shoulder, questioning what they're doing, putting their careers in peril. It becomes a pain. It becomes a struggle that a lot of people simply don't have the space in their life to take on. When we criminalize abortion, we take away the options of our knowledge and our health care as a whole. It will have a degrading effect, whether or not someone is coming to see a health care provider to end a pregnancy or not. When we remember what those tools are, though, and we remember what they do, we can see the futility of these laws and their quest. We don't need anyone's permission to make abortion possible. Whether or not an abortion is right for you is something that is up to you to decide, not negotiate. Many people want to know, is this dangerous? Does this device pose a danger to people? And it is important for us to remember that pregnancy is already dangerous, enough as it is, especially pregnancy at a time when people cannot access health care, especially at a time when people are facing the types of conditions that can lead to adverse health outcomes of all kinds. Pregnancy is dangerous enough as it is. Abortion, however, despite what we might see with the wire hanger, is not in and of itself dangerous. To know how to build this, however, does not necessarily mean that one is ready to get up and take this role. Building this is a reminder of the simple object that has now been declared illegal and a type of knowledge that has been designated as off-limits or not an option. Building it allows us to have a greater awareness and imagination for how we can respond to bad laws that get in the way of people and to know what it is we're fighting for. We are not trying to keep weapons out of the hands of health care professionals. We are fighting to keep knowledge and very basic tools, the kinds of tools that you find all over the world every day being used to save lives and to help affirm them, taking them away or making them harder to access or attaching criminal penalties, however, are the real risks. When one gets an abortion, especially when it is criminal, the biggest risk that one will face is their confrontation with the law, not the actual act of abortion itself. One of the reasons that I like to teach people how to build a DLN is not to create an entire field or resource of people ready to use jars with tubes to actually perform abortions, but to help create people who remember that these tools and this knowledge is theirs. When you build it and it's in your own hands, then you remember what is being taken away from you in a very real way that is not abstract. However, right now, I think it is more important for everybody to know that medication abortion doesn't require any construction. It's something that you can access, that you can keep in your medicine cabinet, that you can help direct somebody towards, that is very safe and very effective to use. Only a minority of people right now are even aware that medication abortion exists. If you know that and you tell people you are helping to make abortion accessible for somebody, by virtue of sharing that information and its possibility, knowing where one can go to access this care, knowing how to help connect someone in a place that doesn't have it, helps make abortion accessible. And the more we know about abortion, the more we can help get around the bad laws that are being established. When it comes to medication abortion, there is no test that anyone can administer that can prove definitively what caused that pregnancy to come to a conclusion. If someone has accessed abortion and they are concerned about their health outcomes, and there is something going on in their body that doesn't feel right, they are not on their own. If this is you or someone you care about, you can report to an emergency room and let the people there know that you suspect a possible miscarriage, because the treatment for miscarriage or abortion is the same. It doesn't matter whether it was endogenous circumstances or exogenous circumstances like medication. What matters is addressing a potential hemorrhage or an infection. Letting people know that they don't have to disclose everything about how their pregnancy came to an end will help them feel safer in accessing the care that they need, and will help prevent negative outcomes from occurring. When health care providers who do not provide abortion are aware of this as well, they can act as a support figure. It is not necessary to scrutinize a patient to see if they are in violation of the law. That is not the job of a health care provider. The job of a health care provider is to reduce human suffering and address issues that are causing problems, disease, or illness in someone's body. When we look at laws about potential bounties or trying to go after people who aid and abet abortion, it's important to remember what you do or do not have to disclose. And the answer is you don't have to disclose very much. Although right now what we're faced with as a pressing issue is helping people obtain access to abortion, it is important that we continue to ensure that we are engaging in a fight to limit those legal repercussions by decriminalizing or legalizing abortion everywhere. Medication works among those who can take it. A manual vacuum aspirator works for those who are able to meet a health care provider or knowledgeable person who can operate one. Our nation has the largest prison population in the world. Without securing legal or decriminalized abortion, we are unable to make sure that that resource can reach the people who are inside our jails and prisons. It is already difficult enough for someone who is incarcerated to access any form of health care whatsoever. If it is a form of criminal or optional or designated optional health care, then it will not be available to the people who are inside our jails and prisons. As I teach the people in this audience how to build these tools or learn how to access them, I am also doing everything in my power to make sure that these tools and resources are available to the people who cannot be in rooms like these or the people who do not have the freedom to travel or the access of safe passage to get where they need to be. It is also important to remember that we are the best resources and not always technology, because it can be misapplied. The other day, as I was cruising my Twitter feed, I saw a press release for a startup company that was answering the problem of Roe v. Wade by establishing a startup company that would sell and provide abortion medication. Of course, I want there to be as many options as possible, but one of the things that took me back was the way that this startup company was able to access several million dollars in seed money immediately from venture capitalists in order to sell the product of medication for abortion at almost twice the cost that it was available through grassroots networks. This is an example of the way that our imagination can be limited by our workplaces. If you look at the criminalization of abortion and you see an opportunity to profit or to create a product for people, you might be missing the point. To make abortion accessible does not necessarily mean to bring it into the marketplace and to incentivize people with profit. Right now, there are groups who are doing what they can to provide these tools and these medications as close to cost as possible. They're not there to make a profit off of the problem. They're there to solve it. When we can remember all the possible ways to access this and ways to support those networks, we don't have to necessarily look to venture capital or to a startup to solve the problem for us. We can remember that we solve the problems for us. The more you can inform yourself about the various ways to access this abortion, the harder it will be for someone to shut it all down. In the weeks and the months and the years to come, we are going to see people who are going to be criminalized, who are going to be stopped, who are going to be prevented from providing this care. That is meeting reality on reality's terms. This is what we are going to face. If we put all of our eggs in one basket, in one person, in one provider, in one hero, then we are lost. The more that we know about our options, the more that we support them, the more that we make sure that there is not one place but rather many people who are ready to stand up. Well, it'll be a lot harder to stop us. One startup is easy to stop. Thousands if not millions of people who know another way or another tool. They can't be. This is the commercially produced manual vacuum aspirator and this is what we will be approximating and building. And so I'm going to demonstrate it right here so you know a little bit more about the point and purpose of what you're building. To create the vacuum, I'm going to lock the chamber and I'm going to draw back this plunger. And you can feel the resistance and it locks in place by holding these little prongs. This is the cannula end. This is what you would be inserting into the cervix. In this case, we're going to insert it into some water to see. And I then release. And as you can see, the chamber has filled. That is as simple as it is. This would be the contents of the uterus and any of the tissue that you are removing from the uterus. It's as simple as that and that's what we're going to go ahead and build. So in order to create this same type of a vacuum chamber, we are going to replace this area with our jar. And we are going to have a cannula which will be identical to the cannula that we use on the commercial. This tube is going to help pull the contents through. We'll have it on a stopper. And the vacuum is going to be created with a syringe. Some of the drawbacks of this are this device is going to have a way to prevent you from pushing any of the contents back into the body. And you can get a one-way filter from Aquarium Supply, a very cheap piece, and this is going to help protect somebody. As you can see, the tube goes into the jar to collect the contents of the uterus and I'll have the suction right here with the syringe. And instead of releasing, I'm going to have a gentle pull. If I needed to do a few rounds, it would be crucial to remove this piece and either get a new syringe to keep the field sterile, but I would definitely not want to push the contents back. And then I could replace and draw again. The way you can test if this is working... oh and see how my little guard here is even preventing me from doing that. And that's why that can be a helpful tool. But if you're mindful and you don't have access to a one-way valve, you can work without it. I just think it's a really good helpful piece to include. In order to keep everything in a completely sealed vacuum, I've used some aquarium sealant and I drilled the holes with a drill. A rubber stopper is going to be very easy to drill through. That should not take you more than 30 seconds. And the rubber stopper is going to make a good complete seal. So here I am. And as you can see, I have pulled water through. And that's your test as to whether or not it's functioning. Oftentimes I use some dye, but today I don't have any to work with. If you want to practice, it might be helpful to have some. And that is really as simple as this device is. It really is a cannula, a vacuum, and a place for the contents of the uterus to go. If you want to learn more about the history of this, this is a book about the people who invented the Dell M. It will give you detailed instructions and a little bit of the history of how these tools work. It can be difficult to find, but it is available on used book sites. And I think it's really one of the most helpful guides that you can have. There are many different books that you can buy on gestational health care in general, but few are going to tell you how to work with a DIY device the way this book will. And despite the title, A Woman's Book of Choices, I would like to reiterate that abortion and menstrual extraction extend beyond just women's concerns. This is more about more than just women's choices. This is about the choices of anyone with gestational capacity. And by remembering that, we can remember all different kinds of reproductive health care and bodily autonomy and keep that in the front of our mind."
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