Living Mexico’s Abortion Revolution: A Memoir

For more than 20 years, Dr. Estela Kempis and her colleagues risked their lives, their freedom, and their careers to provide abortion care and other reproductive health services to women in Mexico, when doing so was against the law. More recently, in November 2022, Estela was forced to take an unexpected hiatus from her medical practice to receive ongoing treatment for a rare form of cancer called Adenoid Cystic Carcinoma. Despite her serious health challenges, Estela is using her time in recovery to begin work on a book about the lessons she learned from her many years of strategically defying abortion prohibition. She hopes that, in addition to providing readers with an unforgettable and inspiring story of her journey from extreme poverty to the front lines of the battle for reproductive justice in Mexico, it will offer practical tools for people who fight to maintain abortion access in the U.S. and other countries where reproductive rights are currently in jeopardy. Moreover, funding Estela's book project will help her compensate for lost income during her leave from her medical practice. She has asked me to write to you today to request your support for her intensive efforts to write this book over the next twelve months.

(En español abajo)

ABOUT ESTELA AND “NUESTROS CUERPOS, NUESTRAS VIDAS”

I remember well the night I met Estela and heard about her dream. It was in a warm, dimly lit apartment in Cuernavaca, Mexico in September of 1998. A moment after we were introduced, she told me about her plans to become an abortion doctor and to build a practice that honored the autonomy of women’s bodies. The room was filled with conservative male law students, and I marveled as Estela shut down their disapproving anti-abortion arguments, one by one. Then, over the decades, I watched her follow her dream. She sought training abroad for the abortion techniques her school wouldn’t teach her, found like-minded colleagues throughout Latin America, and built the “Nuestros Cuerpos, Nuestras Vidas” clinic in Cuernavaca, Mexico, which has provided thousands of women with abortion services, access to contraception, and home births. Women who receive a medical consultation from Estela don’t just receive a service; they leave her clinic more empowered and with better information to make decisions about their own bodies.

This work demanded meticulous attention to detail, and required creative protocols to shield her and her patients from prison. There were many close calls. It took a toll on Estela. She didn’t know how much of a toll it was until the Mexican Supreme Court decriminalized abortion across the nation in September 2021. The initial wave of shock and joy gave way to stress and trauma; emotions she had carried beneath the surface were emerging now that the threat of imminent danger was gone. It was the price of the invaluable work she did. I had known, though, from the moment I met her, that nothing could have stood in her way.

What took me much longer to understand and appreciate were the uncommon circumstances that allowed a daughter of campesinos to become the only girl in her community to go to medical school. This is also part of the story that Estela will share with the world.

It is the story of a movement of women and allies with the ethical fortitude to defy their society’s social norms, until the rest of society came around to their way of thinking. Estela was by no means alone on that journey. It required brave mentors and sisters, each one with their own unique story, beginning with her mother, who did what it took to make sure her girls went to school; her father, the grandson of a revolutionary farmer killed in an ambush alongside Emiliano Zapata; Estela’s aunt, who lived out of the closet as a lesbian, which was at the time unheard of in her rural community; Sergio Mendez Arceo, the “red bishop” of Cuernavaca whose reorganization of the local church organization sowed the seeds of community organizing and a passion for justice in Estela’s heart; her friend Oliva, whose brother gave his life defending the community control of the local water supply; the physician in Rochester, New York, who sacrificed their own career to train physicians from outside the United States with no access to abortion training; and dozens of doctors and midwives from throughout Mexico and Latin America whose stories are each as important as Estela’s. And of course, none of what Estela and her colleagues did would have been possible without the green wave made up of millions of women and allies throughout the country and the continent who gradually lost their fear and became a viable political force in their own right. This is their story too.

HEALTH CHALLENGES

Adenoid Cystic Carcinoma is a rare form of cancer originating in the salivary glands. Estela was diagnosed in October 2022. For multiple reasons, treatment in Mexico was not possible. Taking leave to deal with her cancer has also left her temporarily without income. Through a miraculous turn of events, Estela has been able to receive treatment in New York City, where she underwent a complex partial maxillectomy and a reconstruction of her upper palate. The surgery was a success and she is now in the thick of seven weeks of radiation and chemotherapy. She has also been the beneficiary of countless acts of immense kindness, both big and small, including from many of you. She is filled with gratitude for all of the love and support she has received.

Although Estela is on leave from her clinic, the work continues. A wonderful young doctor - Andrea - is attending to patients during Estela’s absence. Andrea is dedicated to the cause of reproductive rights and is among the first of a new generation of abortion providers in Mexico who have not had to work with fear of arrest on their minds, as Estela did for so many years. They are continuing the work that Estela and her colleagues began.

THE BOOK:

Before Estela started writing, she wanted a good reason to dedicate her time to such a daunting task. A few good ones immediately came to mind. As she told me, “I want doctors, and all healthcare providers, to know that they have a place in a social movement. All the patients that came through my door were on a road to freeing themselves and their bodies, and the sum total of all of them created an unstoppable wave of liberated territory. I want doctors working under unjust laws to see how we did it. I want doctors to know that their job goes beyond clinical diagnosis and treatment. Their circumstances might be different, but we can give them ideas about how to continue providing abortion services in a way which simultaneously helps to chip away at abortion prohibition.” She continued: “I also want everyone, doctors and people who aren’t doctors, to understand how important it is for girls, especially girls living in tough situations like I was, to have mentors and role models. We need more girls to have the courage to be free.”

Your support for this project, at an extremely difficult time for Estela, is much appreciated. To show her gratitude, Estela would like to send the first completed draft copy of the book to all those who contribute $200 or more; all those who contribute $500 or more will receive a printed copy.

And if you know someone making change in the field of reproductive rights in your community, please let us know! Estela would like to send a finished copy to that person for free.

For those who are interested, here below is the proposed outline for the book. Estela knows the contents of the first nine chapters. The final chapter has yet to be written. With your help, Estela will write that chapter, and with any luck, she may help an inspired young organizer to write the next chapter of history as well.

With love and gratitude,

Greg Berger, Estela’s partner and husband,

On behalf of Dr. Estela Kempis, “Nuestros Cuerpos, Nuestra Vidas.”

Here below is the draft outline of her book:

Intro: The day Roe Vs. Wade was overturned in the United States.

Dr. Estela Kempis delivers a speech remotely via video to the floor of the Morelos state congress advocating for what was unthinkable just a few short years ago: Free and universal abortion access for women and girls in a state known as the cradle of the Mexican Revolution. Many legislators give her a standing ovation. Some walk out. And it is announced that a bill guaranteeing public abortion access in Morelos will be put to debate. Estela cannot believe this is happening.

Just a few short months earlier, Estela stood in New York City’s Washington Square Park in disbelief, watching women whose struggle had inspired her now rallying and mourning the loss of a fundamental right. As the United States faces a setback in abortion access, Estela reflects on her journey as an abortion provider offering quality, clandestine sexual and reproductive health services, including abortion, in Morelos. As abortion is decriminalized in Mexico, it is increasingly prohibited in the U.S. How could this be? Estela realizes that her experiences over decades as a provider operating under abortion prohibition can now help outline a road map for women and providers in the U.S. and elsewhere. And so she reflects on the lessons learned on her journey…

Chapter One: ”A Little Girl In The Land of Zapata and Other Men.”

Estela describes her childhood in Morelos and Mexico State and the legacy of her campesino family, including her great-grandfather's participation in Emiliano Zapata’s revolutionary struggle for land and autonomy. But her past has a dark side: the violence of extreme poverty in which her family has lived, and the gender-based violence and abuse she faced as a girl on a daily basis in many spheres of public life. The chapter ends with the story of a simple gift that changed her life: a toy doctor’s toolkit gifted to her by her Aunt Ignacia.

Chapter Two:” A Different Kind of God.”

To escape the drudgery of housework expected of all girls in her household, Estela finds hope in an unlikely place: The Catholic Church. Cuernavaca’s Bishop, Sergio Méndez Arceo, becomes a champion for social justice as he embraces Liberation Theology - a radical religious trend transforming Latin America. Estela gains a global perspective on local politics, while suffering discrimination from some members of the local upper class. As a girl living in poverty, she is faced with greater difficulties than her male peers. She participates in an important local social movement with the support of the Church. As adulthood approaches, she becomes the first person in her family to go to Medical School.

Chapter Three: “What They Don’t Teach You In School.”

Estela marches to a different drummer at the University, dreaming of revolution instead of amassing a fortune. As her graduation nears, a classroom exercise suddenly brings to bear Estela’s experiences with Liberation Theology and places her firmly on the side of abortion rights, citing Mendez Arceo’s church teachings as the basis of her pro-choice beliefs. She decides to try and learn techniques for ending unwanted pregnancies that weren’t taught to her in school. The historic EZLN uprising in 1994 sharpens her focus. But even as she sets her mind to becoming an abortion practitioner, she finds her personal life driven into a dead end as she enters a mistaken marriage.

Chapter Four: “Changes in Latitude.”

Despite a lack of training, Estela performs her first medical abortions. As she breaks taboos by being the first in her family to seek a divorce, Estela meets Greg. Searching for personal freedom, she takes a job in an indigenous community in the Sierra Tarahumara in Chihuahua, where she learns that “reproductive freedom” means more than just the right to abortion. After marrying Greg, Estela approaches the “sacred cows” of Mexico’s abortion rights movement and has doors shut in her face, recalling the class-based discrimination of her youth. Through a series of connections facilitated by allies affiliated with Hampshire College in Massachusetts, Estela is trained by a courageous abortion provider in Rochester, New York, who risks their medical license to make sure she can bring her newfound skills back to Mexico. With the backing of her U.S. based friends, those in Mexico who had closed their doors to her, suddenly embrace her with open arms.

Chapter Five: “Nuestros Cuerpos, Nuestras Vidas.”

Step by step, Estela learns what it means to practice abortion in a state in which it is illegal and where social stigma surrounding it remains. Through a process of trial and error, Estela searches for a viable way to operate her clinic. Little by little, through word of mouth, women and girls in Morelos learn that “La Doctora Kempis” is there to help. But the stakes are high. Estela can face prison and lose her license at any moment. In 2007, a glimmer of hope emerges as Mexico City becomes the first territory in Mexico to legalize abortion. Estela realizes that she is not alone. A growing movement of women forms a “green wave” in Mexico and Latin America.

Chapter Six: “The joy of sisterhood.”

Estela builds her permanent clinic in the suburban pueblo of Ocotepec, in an unusual, ecologically sustainable house she builds with the help of her family. She joins the Colombia-based ESAR Network, which for years has been quietly revolutionizing access to abortion in Latin America. Her reputation grows, and Estela develops her own consultation protocols, departing from some established conventions of medical practice, and applying feminist techniques and sensibilities to the doctor-patient relationship. Estela and Greg’s marriage face growing pains as parenthood forces them to confront antiquated patriarchal arrangements and habits. Meanwhile, old relationships die and Estela develops her deepest professional bonds to date with a new and younger generation of women from the ESAR network.

Chapter Seven: “Two steps forward, one step back…”

Movements to legalize abortion begin to proliferate and find success throughout Latin America, and Mexico is no exception. Estela reflects on the strategic importance of abortion access as a tactic leading to legal abortion in the best of cases, and as justified civil disobedience when legalization is impossible. The Mexican Supreme Court unexpectedly decriminalizes abortion throughout Mexico, unleashing a new era in reproductive freedom, but also triggering Estela’s latent trauma and PTSD, now that her guard is suddenly let down. When Roe Vs. Wade is overturned and women and providers face a new era of abortion prohibition in the United States, the experiences of Estela and her colleagues suddenly hold new importance for their sisters abroad.

Chapter Eight: “Physician, heal thyself.”

Estela is diagnosed with a rare form of cancer, coming face to face with her own limits and mortality. But her health crisis provides an opportunity to pass the torch to a new generation of providers. It also gives her time to reflect on the lessons of her life and her commitment to anti-patriarchal organizing. Old friends and allies rally to her aid. She reflects on the importance of diversity and inclusion in feminist movements. As she receives treatment at one of the world’s premiere cancer centers, Estela’s dedication to a unique, women-led, patient-centered form of healthcare is affirmed.

--------------------------------------------------------------------------------

Durante más de 20 años, la Dra. Estela Kempis y sus colegas arriesgaron sus vidas, su libertad y sus carreras para proporcionar servicios de aborto y otros servicios de salud reproductiva a mujeres en México, cuando hacerlo era ilegal. Más recientemente, en noviembre de 2022, Estela se vio obligada a hacer una pausa inesperada en su práctica médica para recibir tratamiento (aún en curso) para una forma rara de cáncer llamada carcinoma adenoide quístico. A pesar de sus serios problemas de salud, Estela está utilizando su tiempo en recuperación para comenzar a trabajar en un libro sobre las lecciones que ha aprendido a lo largo de sus muchos años de desafiar estratégicamente la prohibición del aborto. Es su esperanza que, además de brindar a los lectores una historia inolvidable e inspiradora de su viaje desde la extrema pobreza hasta la primera línea de la batalla por la justicia reproductiva en México, ofrezca herramientas prácticas para las personas que luchan por mantener el acceso al aborto en los Estados Unidos y en otros países donde los derechos reproductivos están actualmente en peligro. Además, financiar este proyecto ayudará a Estela a compensar los ingresos perdidos durante su licencia laboral. A pedido de ella, les escribo hoy para solicitar que apoyen sus intensos esfuerzos para escribir este libro durante los próximos doce meses mientras se recupera.

SOBRE ESTELA Y “NUESTROS CUERPOS, NUESTRAS VIDAS”

Recuerdo bien la noche en que conocí a Estela y me contó su sueño. Fue en un departamento cálido y poco iluminado en Cuernavaca, México, en septiembre de 1998. Un momento después de que nos presentaran, me contó sobre sus planes de convertirse en médica abortista y construir una práctica que honrara la autonomía de los cuerpos de las mujeres. La sala estaba llena de varones estudiantes de derecho conservadores, y me maravillé cuando Estela descartó sus argumentos antiabortistas, uno por uno. Luego, durante décadas, la vi perseguir su sueño. Buscó capacitación en el extranjero para las técnicas de aborto que su escuela no le enseñaría, encontró colegas con ideas afines en toda América Latina y construyó la clínica "Nuestros Cuerpos, Nuestras Vidas" en Cuernavaca, México, que ha proporcionado servicios de aborto, acceso a anticonceptivos y partos en el hogar a miles de personas. Las mujeres que reciben una consulta médica de Estela no solo reciben un servicio, sino que salen de su clínica más empoderadas y con mejor información para tomar decisiones sobre sus propios cuerpos.

Este trabajo exigió una meticulosa atención al detalle y requirió de protocolos creativos para proteger a Estela y a sus pacientes de la prisión. Hubo varias situaciones de riesgo. Todo esto le pasó factura a Estela. Ni ella sabía cuánto la había afectado hasta que la Suprema Corte de México despenalizó el aborto en todo el país en septiembre de 2021. La oleada inicial de sorpresa y alegría dio paso a emociones de estrés y trauma; sentimientos que había reprimido y que ahora emergían al haber desaparecido la amenaza de peligro inminente. Ese era el precio del invaluable trabajo que hacía. Sin embargo, desde el momento en que la conocí, supe que nada podría detenerla.

Lo que me llevó mucho más tiempo entender y apreciar fueron las circunstancias únicas que permitieron que una hija de campesinos se convirtiera en la única niña de su comunidad en asistir a la escuela de medicina. Esta es también parte de la historia que Estela compartirá con el mundo.

Es la historia de un movimiento de mujeres y aliados con la fortaleza ética para desafiar las normas sociales de su sociedad, hasta que el resto de la sociedad aceptó su forma de pensar. Estela no estuvo sola en ese camino. Requirió mentores valientes, cada uno con su propia historia, comenzando por su propia madre, que hizo lo que fuera necesario para asegurarse de que sus hijas fueran a la escuela; su padre, nieto de un campesino revolucionario asesinado en una emboscada junto a Emiliano Zapata; la tía de Estela, que vivió abiertamente como lesbiana, algo que en ese momento era inusitado en su comunidad rural; Sergio Méndez Arceo, el "obispo rojo" de Cuernavaca, cuya reorganización de la iglesia local sembró la semilla de la organización comunitaria y la pasión por la justicia en el corazón de Estela; su amiga, Oliva, cuyo hermano dio su vida defendiendo el control comunitario del suministro de agua local; el médico de Rochester, Nueva York, que sacrificó su propia carrera para entrenar a médicos de fuera de los Estados Unidos sin acceso a capacitación sobre el aborto; y docenas de médicos y parteras de todo México y América Latina cuyas historias son tan importantes como la de Estela.

Y por supuesto, nada de lo que hicieron Estela y sus colegas hubiera sido posible sin la ola verde conformada por millones de mujeres y aliados en todo el país y el continente que poco a poco fueron perdiendo el miedo y se convirtieron en una fuerza política viable por derecho propio. Ésta es su historia también.

DESAFÍOS DE SALUD

El Carcinoma Adenoideo Quístico es una forma rara de cáncer que se origina en las glándulas salivales. Estela fue diagnosticada en octubre de 2022. Por varias razones, no fue posible realizar el tratamiento en México. La licencia para hacerle frente a su cáncer también la ha dejado temporalmente sin ingresos. A través de un giro milagroso de los acontecimientos, Estela ha podido recibir tratamiento en la ciudad de Nueva York, donde se sometió a una compleja maxilectomía parcial y una reconstrucción de su paladar superior. La cirugía fue un éxito y ahora se encuentra en medio de siete intensas semanas de radioterapia y quimioterapia. También ha sido beneficiaria de innumerables actos de inmensa amabilidad, tanto grandes como pequeños, incluso de muchos de ustedes. Está llena de gratitud por todo el amor y apoyo que ha recibido.

Aunque Estela se encuentra en licencia de su clínica, el trabajo continúa. Una maravillosa joven médica, Andrea, atiende a los pacientes en ausencia de Estela. Andrea está dedicada a la causa de los derechos reproductivos y es una de las primeras de una nueva generación de proveedores de servicios de aborto en México que no han tenido que trabajar con el temor de ser arrestados, como lo ha hecho Estela durante tantos años. Continúan el trabajo que Estela y sus colegas iniciaron.

EL LIBRO:

Antes de que Estela comenzara a escribir, quería una buena razón para dedicar su tiempo a una tarea tan abrumadora. Algunas vinieron a su mente de inmediato. Como me dijo: "Quiero que los médicos, y todos los proveedores de atención médica, sepan que tienen un lugar en un movimiento social. Cada paciente que entró por mi puerta estaba en un camino hacia su liberación y la de su cuerpo, y la suma total de todos estos pacientes creó una ola imparable de territorio liberado. Quiero que los médicos que trabajan bajo leyes injustas vean cómo lo hicimos. Quiero que los médicos sepan que su trabajo va más allá del diagnóstico y tratamiento clínicos. Sus circunstancias pueden ser diferentes, pero podemos darles ideas pero podemos darles ideas sobre cómo continuar brindando servicios de aborto de una manera que al mismo tiempo ayude a socavar la prohibición del aborto". Continuó: "También quiero que todos, médicos y personas que no son médicos, entiendan lo importante que es para las niñas, especialmente las niñas que viven en situaciones difíciles, como yo, saber lo importante que es tener mentores y modelos a seguir. Necesitamos que más niñas tengan el coraje de ser libres".

Su apoyo a este proyecto, en un momento extremadamente difícil para Estela, es muy apreciado. Para mostrar su gratitud, Estela desea enviar una copia del borrador del libro a todos aquellos que contribuyan con $200 o más; aquellos que contribuyan con $500 o más recibirán una copia impresa.

Y si conocen a alguien que esté haciendo cambios en el campo de los derechos reproductivos en tu comunidad, ¡hágannoslo saber! Estela desea enviar una copia a esa persona de forma gratuita.

Estela conoce el contenido de los primeros nueve capítulos. El capítulo final aún no ha sido escrito. Con su ayuda, Estela escribirá ese capítulo y, con un poco de suerte, también podrá ayudar a jóvenes organizadores inspirados a escribir el próximo capítulo de la historia.

Con amor y gratitud,

Greg Berger

En nombre de la Dra. Estela Kempis, "Nuestros Cuerpos, Nuestras Vidas".