Over brunch in the spring of 2016, Jennifer Conti, MD, clinical assistant professor in obstetrics and gynecology at Stanford University, and Gillian Schivone, MD, an Ob/Gyn in the Midwest, began to talk about wanting to get tattoos. Even though they had been close friends since their fellowship days, and had spent hours talking about patients and their personal lives, this conversation felt different. “It was pretty spontaneous,” Schivone says. Conti, who is also cohost of the V Word Podcast adds, “neither of us had tattoos or had really even considered getting one, but on that morning it seemed right.”
This sudden urge for permanent ink was sparked by being in Texas at a time when TRAP laws (Targeted Regulation of Abortion Providers) had closed about half of the abortion clinics in the state; both women are abortion providers, and they happened to be in Austin for the National Abortion Federation’s annual conference. With less access to safe care, women throughout the state had begun to take matters into their own hands. There was a rise in self-induced abortions as a result of clinic closures. Just as they have throughout history when access to abortion was outlawed or restricted, women found other often dangerous ways to obtain the same results. In that moment, in a conference full of abortion providers, the anger and frustration over this kind of policy, and fears for women’s safety, were palpable and powerful.
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These feelings are seeping into the collective consciousness again now that Brett Kavanaugh has been confirmed to the Supreme Court, where he can have a massive impact on the strength of Roe V. Wade to keep abortion safe and legal.
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Soon the women's “should we?" turned into a “let’s do it tonight,” which was solidified when they ran into Diane Horvath-Cosper, MD MPH, the medical director of Whole Women’s Health in Baltimore, and a mutual friend. “When you get your first tattoo, you need a wing woman — enter Diane,” Conti says. “Diane is no-nonsense and already had a tattoo, so we knew she'd hold us to it.” And Horvath-Cosper was up for the task: “Jenn said, ‘We're going to go get tattoos; want to come get one?’ and I heard myself say, ‘Sure!’”
Elsewhere at the conference, Emma Slachta, a registered nurse, and her friend, Daniela Diaz, a We Testify abortion storyteller who works at a national reproductive health organization, were having the same discussion. “There is a huge bond and strength that comes out of those who work in abortion care,” Slachta says. “They are my tribe, and some of my biggest ‘sheroes.’” Diaz remembers feeling like, “this is something I could have with me for life,” adding that she’s originally from Venezuela, where abortion is illegal, and “care is a back-alley abortion for the majority.”
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By dinnertime, the groups had joined together, six women in total (including one who we will call Jane Smith, who asked to remain anonymous due to the political nature of her work). “It seemed like the right moment, the right time, the right people,” Slachta says. Though none of them remember who had the idea or where it originated, they all agreed on the one and only tattoo they wanted to get: a coat hanger.
What a Coat-Hanger Tattoo Means
A google search of the words “coat-hanger” and “abortion” will lead you to the historical significance of this concept. The short story is that prior to the Roe v. Wade decision, many women used dangerous methods to induce their own abortions, and twisted-up wire hangers were one of the more macabre (and life-threatening) ones. The fear of this image becoming reality once again was very much in the forefront of these women’s minds. So, too, was the image from Wendy Davis’s historic filibuster in Texas during 2013, when Representative Senfronia Thompson hung a coat hanger from her microphone to voice her dissent over a Senate bill that would ban terminating pregnancies in the state after 20 weeks.
To Conti, “The coat hanger seemed the natural choice, like a 'no going back' symbol. It symbolizes the thing about which I am most passionate in my work and for my patients. It's badass, chic, and a reminder that we will not go back to a time when women were left with this option — not if I can help it.” To Horvath-Cosper, it served as a “visible reminder of why I do this work. I feel like to some degree, abortion providers are freedom fighters. The coat hanger tattoo is about the fight to be free from having to endanger our own health and lives to be able to determine if, when, and how to have a family. Nobody should ever again feel desperate enough to risk self-harm to end a pregnancy.”
Schivone agreed, explaining that to her, “it represents the idea that we can never go back to pre-Roe times, where people were dying due to unsafe abortions. It reminds me why I do the work I do when things are difficult, and it reminds me of what’s at stake, which are the very lives of people who can get pregnant.” Slachta added, “it recognizes the historical and present opposition to abortion access, and that I want better for those seeking care.” Their final companion, Smith said: “I work in policy, so when I see my tattoo, it's a reminder of all that we're fighting for and all that we have to lose.”
Diaz and Conti each described an additional, personal meaning. “I'd had an abortion a few years prior and had the privilege to have safe access to care. [The tattoo] also reminds me of the privilege I've had to have safe access,” Diaz says. For Conti, the tattoo represents another kind of personal transformation. “I was anti-choice up until college and grew up in a very conservative household...It's also a symbol of how far I've come in terms of being able to empathize with women and understand that I am in no place to judge others for their life decisions.”
Together over dinner they googled tattoo parlors in Austin, read reviews on Yelp, and consulted a few friends, until they landed on All Saints Tattoo. “We had two requests: One, we needed a female tattoo artist — this was about female empowerment,” Conti says. “And two: She needed to be pro-choice (we literally asked, ‘How do you feel about abortion?’).”
When it was time for needle to hit skin, as medical professionals, they were prepared for some pain. Smith explains, “I remember when we were actually getting the tattoos, talking about how many women go without pain medications for their first [trimester] abortion procedures, because those meds [can be] another couple hundred dollars. So many women are piecing together enough funds for the procedure itself that anesthesia is out of the question.”
Each woman chose her own placement for the tattoo based on how comfortable she was being asked about it. “Gillian, Diane, and I all wanted it on our ankles so people could see them and so they wouldn't be hidden,” Conti says. “We weren't ashamed of our feelings about abortion, and we wanted them to be conversation-starters. A coat hanger is an odd enough tattoo that you at least have to stop and consider what it could mean, including abortion, if you see it from afar.” Horvath-Cosper added, “I wanted it to be visible, because I welcome the opportunity it gives me to talk about abortion care and why it's so important.”
Slachta, however, felt differently. “I was one of the few in the group who got it in a less public space. I have other tattoos that are much more visible, which can draw attention and questions. Because this issue is so personal to me, and because we are in such a period of anti-abortion legislation and restrictions to access, I did not want the possibility of some anti [choice person] chatting me up about their thoughts on abortion.”
While each woman described their job as their passion and as almost a “calling,” they also described feeling unsafe or misunderstood. When asked what was most often misconstrued about their job, Conti powerfully stated, “That we are good people. Not infrequently after caring for a woman, she will turn to me and say, ‘Thank you for being so nice to me,’ to which I'll reply, ‘Why wouldn't I be?’ People imagine that the men and women who perform abortions are a special breed of provider who only do this in a vacuum and don't see the whole person. The truth is, abortion providers also deliver babies, take out your ovarian cysts, and help with your menopause symptoms. We realize that caring for women means caring for them during every aspect of their reproductive life, and without judgment.”
It is these kinds of conversations that some of the women hoped the tattoo would prompt. Schivone recalls a woman asking what hers meant, while she rode the Metro in D.C. “I decided I felt safe to disclose to her and we had an interesting conversation about reproductive access. She admitted she hadn’t thought about these issues...and was surprised by how restricted abortion care is.” Diaz has had similar experiences all over the world. She remembered, “In an island off of the coast of Ibiza, Formentera, a woman knew what this was about. Not only did she like the tattoo but she talked to me about her abortion. Oftentimes, it's a conversation starter as some folks know the meaning of the hanger. It easily leads to storytelling.”
Though the women left the conference, some to opposite ends of the country, the experience united them. Horvath-Cosper said, “It was one of the most powerful bonding experiences I've had with a group of women. I think about our group often and I remain in contact with everyone because we are all still working in abortion care and advocacy and because they're all powerful, kind, badass people.”
It is without question that they thought about each other later that year when the Supreme Court voted to overturn the TRAP laws in Texas. For that brief moment in time, their tattoos symbolized a success in the fight for reproductive rights. But, as it has throughout their careers, the success was temporary, as abortion access is again under siege.
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“At the time I got the tattoo I didn’t think we would be so close to having multiple states with no abortion clinics at all. There is definitely more urgency now to the idea of keeping abortion safe and accessible,” Schivone says. Horvath-Cosper adds, “The fight feels so much more urgent, especially as we confront the possibility of the overturn of Roe. But the reality is that for many people, this has always been urgent. Rural women, people of color, adolescents, people with low incomes, immigrants, people with disabilities — the promise of Roe has never been fully realized for them. It's a struggle to get ANY healthcare, and especially reproductive healthcare.”
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Perhaps that is why the coat hanger tattoo has transcended the abortion provider community and entered the general public. “I'm not sure how many people have it now, but it's not insignificant," Conti says. "It's like a sign of the rebellion, and people want to join.” On Instagram at the time of publication, the hashtag #hangertattoo revealed 409 posts — not a wildfire of a trend, but it’s definitely out there beyond the six women who got theirs on a whim that day in Texas. Of course, we can't assume that every person with a hanger tattoo got theirs for reproductive-rights related reasons; there's also a clutch of fashion girls out there with hanger tattoos ostensibly representing their love of clothes. But in 2017, Planned Parenthood had a fundraiser where Brooklyn tattoo artists doled out “pre-designed, female empowerment-themed” tattoos, as the Huffington Post reported, and a simple black coat hanger was one of the options.
As for whether these six providers hope the trend takes off? Well, of course, they say it’s every individual’s choice. “One of the things about being pro-choice is I don't hold opinions about what other people do with their own bodies,” Smith says. None of the women regrets her tattoo now, two years later. Conti, for her part, feels held accountable by it: “It’s a daily reminder that we can never really let down our guard. We will always need to fight for women,” she says. “I can't be complacent with this symbol on me.”