Inside the Underground: Rebecca Grant Chronicles the Past, Present, and Global Future of Abortion Access
In her new book Access, journalist Rebecca Grant explores the legacy of underground networks, the modern-day resurgence of self-managed care, and the global forces shaping abortion.
In Access: Inside the Abortion Underground and the Sixty-Year Battle for Reproductive Freedom, journalist Rebecca Grant traces the long arc of reproductive rights activism, from pre-Roe resistance networks to today’s digital-age accompaniment models. Based on years of investigative reporting and historical research, the book draws connections across decades, movements, and borders—showing that abortion access has always been both a deeply local and radically global struggle.
Grant didn’t originally plan to write such a historically rooted book. Her focus, at first, was on post-2020 developments, particularly the fallout from the Dobbs decision. But as she immersed herself in interviews and archives, the connections between past and present became impossible to ignore. Activist networks from the 1960s and 70s—like the Jane Collective and the West Coast sisters—offered striking parallels to today's movements, not just in tactics, but in spirit.
“Even though the technology has changed, I think a lot of the kind of philosophical underpinnings or what's motivating the activists, or some of the strategies or tactics that they use, certainly feel aligned,” Grant said.
Groups like the Army of Three and their successors on the West Coast focused not just on legal reforms, but on providing direct aid. That model of practical, peer-to-peer support has reemerged in today’s digital underground. Instead of secret phone numbers and whispered referrals, people now access abortion pills through encrypted emails, overseas telemedicine networks, and online directories. According to Grant, the ethos is the same: meet people where they are, trust them to make their own choices, and resist systems that delay or deny care.
The story is not solely American. Grant expands her narrative across borders, highlighting activists such as Dr. Rebecca Gomperts of the Netherlands and Verónica Cruz of Mexico, who have reshaped access to healthcare globally. Organizations such as Aid Access and Las Libres have stepped in to provide medication abortion across hostile legal landscapes, including in the U.S. Gomperts, for example, was the first to mail abortion pills to Americans outside of a clinical trial setting. Cruz openly offered cross-border aid in the wake of Texas’s SB8 law, building on years of organizing in Latin America.
For Grant, the global view isn’t just about geography—it’s about strategy. She highlights how international movements have developed tools and philosophies that are now shaping the American reproductive justice movement. From Poland to Argentina, she traces both setbacks and victories, with the case of a criminally charged Polish activist serving as a cautionary tale of where the U.S. might be headed.
“With the internet now, the global feminist movement is truly global, and it transcends borders,” Grant said. “And those activists talk and they know each other, and they share strategies, and you can see strategies that are popping up in Poland then pop up in the US.”
The book also examines why the mainstream abortion rights movement in the U.S. faltered, particularly in addressing the needs of low-income women and women of color. After Roe v. Wade, much of the pro-choice establishment focused on protecting the legal right to abortion rather than expanding access. This defensive posture—hardened by decades of anti-abortion violence—led to compromises like the Hyde Amendment, which denied Medicaid coverage for abortion and disproportionately harmed the most vulnerable.
Grant highlights how that failure is now being reckoned with. Activists today aren’t just trying to restore Roe, but to move beyond it—to create systems that center equity, community care, and self-determination. She sees signs of hope in the rising number of people able to access abortion via telehealth and mutual aid networks, despite state bans.
Though the political climate is bleak, Access offers a story of resistance as much as repression. It is, at its core, a testament to the activists—past and present—who have refused to wait for permission and who have built a decentralized, often invisible infrastructure to ensure that reproductive care endures.
“I really wanted to write the book with the spirit of like resistance and kind of empowerment,” Grant said. “And to tell the story of activists who are just relentlessly fighting, because I think that that is also a story that deserves just as much attention as all the bad things that are happening.”