‘Routine, Ordinary Care’

The nearly seven hundred photographs in Carmen Winant’s book The Last Safe Abortion, and the more than 2,700 4×6-inch prints that were displayed in her wall-sized installation of the same name in the 2024 Whitney Biennial, might be fairly described as poorly composed, grainy, out of focus, underexposed or overexposed, mundane. There are snapshots of wall clocks, of desks covered in paperwork, of women answering the phone or sitting in meetings, of medical equipment and various types of contraception. Some pictures, showing just a blurred hand or a grainy rectangle of gray, look like they might have been mistakes. These are unlikely images to appear in an art museum, or in a book that won an award at the prestigious Arles photography festival in France, as Winant’s did last July. 

But their commonplace quality is precisely the point. Together the photographs in The Last Safe Abortion document day-to-day and person-to-person abortion care between 1973, when the Supreme Court ruled in Roe v. Wade that the Constitution protects a woman’s right to an abortion, and 2022, when that decision was overturned. The words of the title—printed in purple letters on the pinkish front of the spiral-bound, soft-cover book—are widely spaced and capitalized. Inside, each brightly colored page includes a grid of four photographs. The pages’ look and feel evoke construction paper, bringing to mind arts and crafts, announcements on community notice boards, Post-It notes: modest tools for organizing and sharing information.

Winant, who teaches at Ohio State University in Columbus, collected most of the images from the archives of more than a dozen universities and reproductive health clinics in the Midwest and South, including states like Iowa, Kentucky, and Nebraska, where abortion is now banned or severely restricted. The Emma Goldman Clinic in Iowa City, founded in 1973 and represented in many of the photographs, was named for the anarchist activist who was twice arrested for violating the 1873 Comstock Law while campaigning for access to birth control. Winant integrated some of her own photographs as well, though it’s not apparent which are hers except for a few self-portraits. This feels intentional, as though she’s situating herself within the movement rather than documenting it from a distance. 

She used a similar strategy in her 2018 book My Birth, which consists of some two hundred images of women in labor—most of them anonymous, with a few of Winant’s mother giving birth to her three children woven in. In that project Winant aimed at “making birth and birth work visible,” she said, “and worthy of creative and intellectual inquiry.” Collected from books and magazines as well as garage and estate sales, the photographs showed women in baths, on floors, in beds, alone or with their partners present, or with doctors or midwives assisting. 

When My Birth was exhibited at the Museum of Modern Art in 2018, the two thousand–plus images of various shapes and sizes—some in color, some black-and-white—were stuck to the wall with pieces of blue painter’s tape, filling the opposing sides of a passageway from floor to ceiling. In these photographs of women bearing down, babies crowning, blood and sweat, there was joy, certainly, but also pain and effort. I visited on a crowded day, and my response was more visceral than intellectual: the passageway felt narrow and the flood of images overwhelming. Giving birth, in Winant’s installation, was a marvel but also a feat of considerable labor, and not without risk. “The right to be pregnant has everything to do with the right to be unpregnant,” Winant has written. “Like 60 percent of the women who get abortions in this country, I am also a mother, and was already a mother when I got an abortion between the births of my two children.”

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Last year in Aperture magazine, Casey Riley—a curator at the Minneapolis Institute of Art, where the project was first shown—argued that the snapshots in The Last Safe Abortion showing women going about their everyday activities in communal purpose amount to “a deliberate de-escalation of the visuals associated with abortion care by its opponents.” To protect the privacy of actual patients, some of the women depicted are clinic staff modeling what patients would be doing during a visit (having blood drawn, making an appointment, meeting with a doctor). 

In images used by anti-abortion forces, fetuses often seem to exist apart from a female body, or take priority over that female body. In October 2024, when the attorney generals of Idaho, Kansas, and Missouri filed a challenge to the Food and Drug Administration’s repeal of the requirement that women receive mifepristone, known as the abortion pill, in person under the supervision of a doctor (despite the fact that the Supreme Court had thrown out a similar suit four months earlier), the complaint was “larded with provocative and irrelevant photographs,” wrote Linda Greenhouse in The New York Times, including “a picture of an embryo, in reality not more than an inch long, blown up to huge, baby-like proportions.” That policy change had made it possible for women to terminate pregnancies at home after obtaining the medication by mail rather than requiring them to take the medication at a clinic or hospital—an onerous, sometimes impossible burden for anyone who lives in an area where such services are unavailable. 

The most famous images to be coopted by the anti-abortion movement originally appeared in a 1965 issue of Life magazine. The astonishingly detailed cover photograph, by the Swedish photographer Lennart Nilsson, showed an eighteen-week-old fetus floating in its amniotic sac. The images that made up Nilsson’s story, “Drama of Life Before Birth,” seemed to show the development of a single embryo from fertilization to twenty-eight weeks, though they were in fact from different pregnancies. In order to get clearer images than were possible when photographing in utero, and so that he could act quickly, Nilsson had set up a studio at the Sabbatsberg hospital in Stockholm, where over a period of seven years he photographed fetuses that had been miscarried or had been terminated because they were ectopic pregnancies—nonviable and threatening to the life of the mother. Nilsson’s motivations, as Charlotte Jansen noted in The Guardian, were scientific rather than political. To his dismay, anti-abortion activists in the 1970s and 1980s began enlarging the photographs, pasting them on posterboards, and wielding them outside clinics that offered abortions.

The pro-choice movement has used photography for its purposes as well. In 1973, shortly after the Roe decision, Ms. magazine printed a police photograph of the naked body of an unidentified woman who had died alone on a motel room floor after a botched abortion, accompanied by the words “Never Again.” The anonymous image quickly became a symbol representing all women who had died without safe abortion care. It was reproduced in every edition of Our Bodies, Ourselves—the influential book known as the “women’s health bible”—for decades. Winant came across it there as a teenager in the mid-1990s. The picture, she told Riley, “has been burned into my mind since I first saw it.” 

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But the anonymous woman in the photograph had a name—Gerri Santoro—and one of her sisters, Leona Gordon, recognized her in the issue of Ms. The photograph had been taken by police in Norwich, Connecticut, in 1964, and had not been shared with the family; it was later obtained by the journalist Roberta Brandes Gratz, who was writing a cover story about abortion access for the magazine. In the moving 1995 documentary Leona’s Sister Gerri, Gratz is asked if she recalls how Ms. came to publish it. “We had no knowledge of any of the personal details around it,” she says. “I don’t even remember knowing…the location of the site. None of that seemed relevant. I don’t know that any of us asked…. It was so gruesome, I don’t think any of us wanted to know. And anonymity at that time was the rule of the day.”

In her 2018 book On Abortion, the artist Laia Abril includes the photograph of Santoro, but in a reproduction that is faded almost into illegibility and hidden behind another image: glued to the page along its top edge is a photograph of a fetus from an anti-abortion website, pixelated out of recognition, which the reader has to lift to reveal the image beneath. The pairing suggests that the outcome of banning abortion—of prioritizing the fetus over the woman—is more suffering and death. Abril likewise blurs the photographs of other women who died from botched abortions (and who, like Santoro, could not give consent for their images to be used) but includes straightforward portraits of those who have survived illegal abortions in places like Poland or Peru, where the procedure is banned, and who agreed to be photographed.

Abril’s book is a powerful, complementary counternarrative to Winant’s portrayal of routine, ordinary care. On Abortion builds a clear and devastating picture of what happens to women, globally, when abortion is banned. Photographs and informational texts describe historical methods of abortion—poisonous plants and herbs, throwing oneself down the stairs, an eighth-century Sanskrit recommendation to squat over a boiling pot of onions—to demonstrate how women have attempted to take control over their own fertility.

Abril’s book was published during the first Trump administration, before it became clear just how significantly women’s rights in the US are under threat. According to the Guttmacher Institute, which tracks state legislation regarding abortion, twelve states have banned the procedure outright, and another seven have bans that commence in the first eighteen weeks of pregnancy. The Supreme Court has thus far upheld access to mifepristone, but the ability to get the drug varies by state. In May 2024 Louisiana became the first state to classify mifepristone and its companion medication, misoprostol, as “controlled dangerous substances,” making it a crime to possess them without a prescription; it recently indicted a doctor in New York on criminal charges for sending abortion pills across state lines. Five other states—Idaho, Indiana, Oklahoma, North Dakota, and South Carolina—have introduced bills allowing criminal charges to be filed against women seeking abortions.

In the face of this post-Roe surge of attempts to deprive women of bodily autonomy and basic access to health care, the snapshots in Winant’s book show us how unsensational abortion care is, how quotidian and necessary. Again and again they remind us what’s possible, and what is at stake. As Winant herself noted in a Washington Post opinion piece in January, the many clocks pictured in The Last Safe Abortion read as a warning—the clock is ticking, time is running out.