A Handy Guide to UTM Codes: Know Which of Your Campaigns Really Work


Our traffic bounces all over the place.

We have social. We have email. We have paid ads. There’s more sites, platforms, and networks than we could possibly hope to run our campaigns on.

How do we keep track of it all?

How do we know what’s working and what’s not?

We use UTM codes!!

What’s a UTM?

UTM stands for Urchin tracking parameters. They’re little pieces of data that we add to our URLs in order to see where different traffic comes from. They were introduced way back with an analytics tool called Urchin, the tool that was bought by Google and evolved into Google Analytics. Somewhere along the way, they became the industry standard for tracking marketing campaigns across tools.

These days, most analytics tools, marketing apps, marketing automation tools, and CRMs look for these parameters automatically.

There are five standard parameters.

UTM Medium: Think of this as a channel. Social, Organic, Paid, Email, Affiliates, are all core marketing channels that include multiple traffic sources.

UTM Source: The individual site within that channel. For example, Facebook would be one of the sources within your Social medium for any unpaid links that you post to Facebook. If you’re running a Facebook ad or spending money to promote a link, you’d want to label Facebook as a source within Paid. If you’re building a link for email, define which list that you’re sending the email to.

UTM Campaign: The specific campaign that you’re running. Feel free to fill this in however it makes sense to you. Names that allow you to easily identify product launches, promotional campaigns, individual emails or posts, etc. are all good.

UTM Content: This is an optional field. If you have multiple links in the same campaign, like two links in the same email, you can fill in this value so you can differentiate them. For most marketers, this data is more detailed than they really need.

UTM Term: Marketers rarely use this field these days. It’s so you can track specific keywords for paid organic campaigns. Since AdWords has it’s own tracking methodology and a deep integration with Google Analytics, you’ll rarely need to use this field.

Whenever you put a link on an external site (not your own site, more on this below), you add these parameters to your URL. Then when traffic lands on your site, you know where the visitor came from and that data appears in all your marketing and analytics tools.

Here’s a normal URL without any tracking:


And here’s the same URL with four UTM parameters added:


In this hypothetical example, we have a set of active users for a product that are going to receive an email. The campaign isn’t set to every email subscriber on file, only users that are defined as “active.”

Let’s break down each individual element of this URL to really understand it.

  • http://www.yoursite.com/pricing – Same page as the normal URL
  • ? – this tells your browser that everything after this point is just data
  • utm_source=active%20users – we’ve defined “active users” as our UTM Source. Since spaces can’t be used in a URL, the space is replaced with “%20”
  • & – this tells our marketing tools that we’ve finished defining the previous UTM and we’re about to start a new one
  • utm_medium=email – we’ve defined the UTM Medium as “email”
  • utm_campaign=feature%20launch – we’ve defined the UTM Campaign as “feature launch”
  • utm_content=bottom%20cta%20button – we’ve defined the UTM Content has “bottom cta button” so we can track traffic down to the individual link of the campaign

Feel free to skip Content and Term if you don’t have a need for them. But definitely get in the habit of always using Medium, Source, and Campaign consistently. Many analytics tools assume that all three are used together. And by skipping one, you can create data gaps in your reporting.

Google has a UTM Builder to help you put together these trackable URLs whenever you need them.

Email UTM Examples

Here’s an email sent by CreativeLive:

The button uses this URL and UTM parameters:

This email is from Rover:

The button uses this URL with these UTMs:

Note: a lot of email tools auto populate UTMs on every link which is why you’ll see some email links using the UTM Term parameter. This data is rarely, if ever, looked at by the marketing team.

Another example from the hotel chain, 1 Hotels:

The URL and UTMs that the button uses:

Paid UTM Examples

A paid ad from The Information on Facebook:

Note: They’re using a custom “offer” parameter along with the normal URM parameters.

An ad from uBiome on Facebook:

The URL:

An ad from Electronic Arts on Twitter:

The URL:

Note: you can see that they’re using “social” for the medium. Since this is a paid ad, I’d use a medium of “paid” instead. This will keep all the paid traffic sources under the same “paid” channel in your reporting.

Social UTM Examples

A tweet from Tomasz Tunguz:

The URL:


A tweet from Shane Barker:

The URL:

A Facebook post from The Points Guy:

The URL:

The Key to UTMs: Clean Data

I’ve worked with hundreds of teams and different analytics implementations. By far, the biggest problem with UTMs is getting a team to use them consistently.

UTMs are pretty flexible, you can add whatever values to each parameter you want. Want to segment your marketing channels into your “fluffy bunny” medium, your “rainbows” medium, and your “pink unicorns” medium? Go for it! Completely up to you.

This flexibility has a downside though, flexibility also means a lack of consistency.

Let’s use an example, say you want to tag all your links from paid channels with the same medium parameter.

What do you define that medium as?

Well, you have a LOT of options:

  • Paid
  • paid (yes, these are case sensitive in some tools)
  • CPA (cost per acquisition)
  • cpa
  • PPC (pay per click)
  • ppc
  • CPC (cost per click)
  • cpc

It’s incredibly common for different people on the same team to use different terms for the same medium, source, or campaign. It’s even pretty easy to use different terms yourself! We all get busy, forget what we used in the past, and tweak something accidentally. I catch myself doing this regularly.

Whenever this happens, your data fragments.

Now, some tools will attempt to group some of the more common variants for you. Google Analytics has a range of parameters that it groups into particular mediums.

But many tools don’t, they take the data exactly as it comes.

Messy data means that you’ll have a terrible type trying to see what’s going on. The problem can range from constantly having to manually massage a few rows yourself to having reports so messy that it’s impossible to see where anything is coming from.

How do we fix this?

Whenever working with a new team or site, I always start with a basic Google Spreadsheet. Then I build a few columns that have dropdown selections, especially for medium and source. I’m paranoid about forcing consistency for those two values. And then I let folks fill in the campaign and name parameters however they like. If you keep medium and source clean, the majority of your reporting problems will go away.

With a quick formula, you can even get the spreadsheet to build the final tracking URL for you.

The workflow goes like this for the whole team:

  1. For all external links, go to the team’s UTM spreadsheet
  2. Add your destination URL in the first column
  3. Pick the medium from a dropdown of only 5-10 options
  4. Pick the source from a dropdown of 20-30 options (this list will be longer since each channel has a few sources within it)
  5. Fill out the campaign field
  6. Fill out the content field if you want (optional)
  7. Final URL is automatically populated in the last column

Quick and easy for the entire team to follow. It also gives you an ongoing record of every single trackable URL your team has built. Good to have if something breaks later and you have to diagnose the problem.

There’s a few UTM tracking templates out there like this one. Feel free to Google around until you find one you like. I usually find a free template from Google, create a copy, and then add dropdowns for the Medium and Source columns. Finally, I force the team to use that same spreadsheet every time they create a new URL. Once I’ve done that, I’ve never had an issue with getting a team to use the same values consistently.

What about internal tracking? Can we use UTMs?

How do we track links on our own site? What if we put a banner on our blog for a purchase, demo, or free trial, how do we tell if the banner drives conversions?

I strongly recommend that UTMs never get used for your own internal links.

How come? It’ll break your analytics tracking.

You see, Google Analytics and other tracking tools typically start a brand new visitor session whenever a visitor arrives on a page with UTMs. They assume that UTMs are only being used on external links and then reset all session-level data.

That means that the session resets and the visitor now looks like they’ve visited your site multiple times.

All of these metrics will start to get skewed:

  • Session totals
  • Time on site
  • Pages/visit
  • Page entrances and exits
  • Traffic sources and channels

Just about every metric in Google Analytics will change.

If this happens to a few visitors, it’s not a big deal. You won’t even notice it.

But if you have a steady flow of visitors that go through that campaign, you’re permanently skewing your analytics data from reality. Analytics data is already hard enough to keep accurate, the last thing you want to do is make it worse intentionally.

What do we do instead?

There’s two options that typically get used.

Event Tracking

Every analytics tool has a way to fire a JavaScript event. Any front-end engineer can do this easily, it’s a way to tell the analytics tool that an action occurred.

When an analytics tool sees an event, it knows that the action occurred during the same session. None of the other analytics metrics will get reset. And there’s plenty of reports built into these tools to see which events lead to conversions, how many events are happening, and which traffic sources trigger events.

For Google Analytics, there’s a bunch of documentation on events work here.

A Custom Parameter

UTMs are one set of URL parameters that are broadly recognized by the marketing community. But we can set any of our own parameters that we want on our own site.

For example, we could add ?unicorn=purple to all of the links. Analytics tools will just ignore these parameters since they don’t recognize them but we have the freedom define any parameter of our choosing.

Many engineering teams will use their own internal parameters to track extra internal data in a custom way. One of the more popular parameters is “ref” which is short for reference. It’s just a quick short-hand parameter that people tend to use when they want to track something.

Again, analytics tools won’t pay any attention to the ref parameter or any other custom parameter that you build. If you have a user database (you’re building a SaaS or consumer tech app) or have a CRM (most B2B companies), your engineers can use a few of these internal parameters to collect any extra data that you want to record.

Your blog banner URL would then look something like this:


Then when the demo request gets submitted, the value “blog_banner” would be stored however you want in your user database or CRM. And you’ll get that data without accidentally resetting all your analytics metrics for that visitor session.

Use Crazy Egg

If you install Crazy Egg, you can visually see all the clicks coming from internal links, buttons and forms from any page on your website. It’s the easiest way to see what clickable elements are hot and which ones are not.

Other Methods to Track Marketing Campaigns

While UTMs are the method for tracking marketing campaigns between marketing tools, you have a few other options.

Conversion Pixels

Just about every paid ad platform will give you a snippet of JavaScript that you can use to track conversions within their tool. This includes Facebook, AdWords, and all the retargeting tools like Adroll and Perfect Audience.

The process is pretty simple:

  • Go into your account on that tool
  • Find the JavaScript snippet for tracking conversions
  • Place the snippet on the page of your site that means a conversion event has occurred (usually a thank-you page of some kind)

Since the paid platform can now see when visitors convert on your site, they’ll track the conversion for you. When you see conversion data in Facebook or Analytics, this is usually where the conversion data is coming from.

While this does make managing your paid campaigns much more efficient since you can do everything within the tool itself, I do recommend that you also set up your own UTM tracking for these campaigns. You’ll want your own set of data to validate against when it’s time to calculate the true ROI of a channel or campaign. By nature, there is a conflict of interest with these tools, they want to take credit for as many conversions as they possible can in order to demonstrate their value. If you have your own data, it’ll be easy to double-check and make sure everything is accurate.

Separate Landing Pages

When all else fails, there’s always the option to build unique landing pages for every single campaign. It’s labor intensive but it’s also fool-proof.

Instead of worrying about UTMs and analytics integrations, sign up for a landing page tool like Leadpages or Unbounce. Then create a few basic landing page templates that you can re-use over and over again. Then every time you appear on a podcast, write a blog post, run a new paid campaign, or anything else, whip up a quick landing page and send the traffic to that specific page.

Simple and effective.

These tools will give you reporting on how much traffic and how many conversions happen on each page. Since every campaign got a unique page, it’s easy to see which campaigns give you conversions. This is a great option when your marketing team only needs to collect email subscribers or get prospects to fill out a simple form to become a lead. If you’re trying to drive free trials or more complicated conversion types, this may not be an option.

It also won’t work if you’re promoting pages that don’t have a strong CTA and visitors are likely to bounce around your site to other pages. Promoting blog posts on social is a good example where unique landing pages wouldn’t work.

The Quick Recap

UTMs are the most popular method for tracking our traffic across different sites. All the analytics tools and many marketing tools recognize them automatically. When you set them up, make sure you use the Medium, Source, and Campaign parameters every time. Only use Term and Content if they’re valuable to you.

Remember that the key to having useful campaign data is to use values for Medium and Source consistently. Otherwise, your data will get fragmented in your reports which makes it much more difficult to figure out what’s going on.

However you implement UTMs, don’t ever use them for internal links. They’ll break your analytics data, triggering an event for your analytics tool or using a custom parameter are much better options.

While UTMs are the standard, there are a few other ways to set up your tracking. For paid platforms, using the tracking pixel that they provide can make things much easier. And you can always keep things keep by building a unique landing page for each campaign.

5 Expert Steps For Building Outcome-Based Customer Success Playbooks


Customer success playbooks are an invaluable component of a strong customer success  strategy…as long as the playbooks are laser-focused on enabling measurable value to be realized by customers. 

Most CS teams have playbooks built for ‘customer management’, i.e. playbooks that guide the CSM on completing activities and milestones important to their company – the software vendor. While customer success playbooks that get the customer to launch the software, attend QBRs, identify risk, engage in renewal planning, and provide access to leadership to enable expansion selling are certainly important, these types of playbooks do not create any value for the customers themselves.  

CS leaders at the top of their game understand that customer success playbooks focused on driving the achievement of value-based outcomes for their customers are critical to a successful customer success strategy. At Valuize, we call these outcome-based customer success playbooks, Outcome Delivery Playbooks.

These customer success playbooks are focused on achieving and sustaining customer adoption of the right parts of your product(s) at the right time so outcomes that create measurable value are achieved. 

Here is our 5 step framework for building outcome-based customer success playbooks.

The 5 Ws of Designing Outcome-based Customer Success Playbooks

Outcome-based customer success playbooks explain what needs to be done when, where, and by who to ensure the achievement of value-based outcomes prescribed to customers (the why). Building your customer success strategy with these 5Ws in mind will help you create strong, customer-centric playbooks.

Establish Why You Need To Design Outcome-based Playbooks

Simon Sinek gets it right! Always start with the why. This is especially true when designing your customer success playbooks. 

Don’t make the mistake of starting with the who when designing your playbooks. Many companies start by looking at the teams they have inside the company tasked with ‘customer success’ and build playbooks that align with the role definitions and capabilities within those teams. 

Instead, start by clearly defining the why behind the customer success playbook i.e. the objective of the playbook. For Outcome Delivery Playbooks, there is a single common why driving them: the achievement of value-based outcomes. 

“achievement of value-based outcomes”

Definition: Users are using your product’s feature/functions to do their ‘jobs’ in such a way that the measurable value prescribed to the customer is realized.

So the first step in building an Outcome Deliver Playbook is to identify the value-based outcome you want the playbook to consistently, efficiently and scalably achieve with customers. To do this, you need to have already designed the value-based outcomes that your company will be prescribing to and agreeing with your customers in their Success Plan

Determine What Actions Need To Be Taken To Make Your Playbooks Successful

With the why of the outcome-based customer success playbook clear, next you can tackle the what. What tasks and milestones must be completed to achieve and sustain user adoption of the product feature/functions required by the target value-based outcome?  

Leveraging the product, domain, industry and customer knowledge in your company, you must define the tasks and milestones that must be completed by you, the vendor, and the customer themselves to achieve the target adoption state. Below, are some examples of task types that might make up an Outcome Delivery Playbook. Note that you must define the tasks and milestones that need to be completed outside your product as well as inside your product. 

Identify Who Needs To Deliver Your Playbooks

Now, it’s time to identify who must be responsible/accountable /consulted/informed (RACI) for each task and milestone outlined in the playbook. The goal is to determine who has the skills required (e.g. technical, strategic, leadership, etc.), the access required (i.e. to the necessary people, technology, and processes), and the authority required (i.e. status, role, etc.) to be successful.

By thinking about the what, why, and who of your customer success playbooks, it’s clear to see that the delivery of these outcomes extends far beyond your customer success organization. For this reason, customer success playbooks need to be cross-functional. While your customer success organization can lead the delivery of these playbooks, all of your customer-facing teams and their leaders should be involved in this process. For related insights on this topic, consider this article on how to align sales and customer success

Indicate Where You Need To Operationalize Your Playbooks

Ultimately, your customer success playbooks need to be data-driven and scalable in order to drive recurring measurable value to your customers. Thus, you need to determine where each task in your customer success playbook should be executed to ensure maximum scale, efficiency, and impact. The first step in doing so is to proactively evaluate whether or not the technology you’re using now will help your team deliver your customer success playbooks in the future.

Ask yourself whether the task can be executed so that:

  1. It can be automated? 
  2. The duration, progress, and results can be measured? 
  3. It will minimize application/window switching for the task executioner? 

While workarounds like Google Docs or SFDC might be an adequate solution for the time being, the most successful customer success organizations use customer success technology like Gainsight. If you’re currently considering an investment in customer success technology, here are 6 evaluation criteria to help you determine which provider is right for your organization. 

In addition to determining the technology that will be used to operationalize the playbooks in the hands of your own teams, think about how the playbook tasks can be operationalized directly in the hands of the customer. Analyze where customers are using your product most frequently relative to the outcome they need to achieve. By mapping out the customer’s usage of your software product, you can easily identify the best place to trigger, enable and measure the customer’s completion of the task you need them to next complete per the design of your playbook. 

Specify When To Execute Your Playbooks

Last but not least, you need to decide when each outcome-based customer success playbook should be executed to ensure maximum customer retention and expansion. In other words, a successful customer success strategy requires an in-depth understanding of how value-based outcomes and therefore Outcome Delivery Playbooks map out across the entire customer success journey. 

Identify the interdependencies within your value-based outcomes and their associated delivery playbooks. Can outcome Y be achieved in outcome X hasn’t already been achieved? Or can either come first? 

These relationships between the outcomes and therefore between the playbooks must be reflected in the customer expectations of when each outcome will be achieved. Leverage Success Plans to capture the sequencing of the outcomes prescribed to and agreed to by a customer and the associated playbooks that must also be prescribed and agreed to by the customer. 

Success plans are mapped directly to your pre-existing customer success journey, which automatically integrate the sequencing of your playbook delivery. If you’re looking to develop a success plan for your organization, we recommend using this prescriptive success plan template to get started.

With these 5 Ws answered, you’re now ready to build outcome-based customer success playbooks. By launching this customer-centric initiative, your organization will be empowered to drive exceptional customer adoption, retention, and expansion results. 

This post was adapted from a Valuize webinar. Watch the full webinar recording here

Need guidance on implementing and automating your outcome-based customer success playbooks?

Shoot me a message: jtwb768b@gmail.com


How Access and Attitudes Towards Abortion Have Changed Through The Centuries



Considering the fraught and deeply political ways in which abortion is discussed and legislated in the U.S. today, it’s easy to forget the issue was not always a partisan, or even a moral, one. Rather, attitudes toward abortion have changed over the centuries, often evolving alongside political and historical moments that reflect shifts in power and privilege. In Colonial times, abortion was not a matter of federal or ethical significance, but a common decision made and acted upon by pregnant people and their midwives. Two centuries later, abortions were outlawed in every state. The matter of who gets to make decisions about abortion—whether it be the federal government, state legislators, or individuals—has historically been tied up in changing philosophies about bodily autonomy, the legacy of slavery and Jim Crow, the advent of the medical industry, and, eventually, the merging of religion and politics to form the party system we know today. The question of who has access to abortion is also closely connected with race, socioeconomic status, and proximity to power. Because history has shown that the legal status of abortions does not deter people from having them, the criminalization of abortion most directly impacts those without access to financial resources; in other words, wealthy Americans have always had better and safer access to abortions, regardless of whether abortions are legal or not. In order to trace the history of attitudes and policies around abortion in the U.S.—starting in colonial times and ending in the present—I consulted historical records, scholarly research, court documents, medical journals, news reports, and data from the Guttmacher Institute, a reproductive rights research and advocacy organization.

Pre-1850: Abortions in early America are commonplace

British common law followed the colonists to North America and formed the basis of the original laws and customs in the American Colonies. Abortion, like birth, pregnancy, and other processes involving women’s bodies, fell largely in the domain of communities of women. Knowledgeable midwives were responsible for guiding women through birth and did so with the participation of the woman’s female family and friends. This communal form of birthing, now referred to as “social childbirth,” benefitted the woman giving birth both psychologically and in terms of safety, according to the book “Lying-In: The History of Childbirth in America.” Since the group of attending women usually included those who had either given birth themselves or witnessed several births, they could provide a wealth of knowledge, experience, and comfort to the birthing woman. Abortions in early America were ubiquitous—some historians estimate between 20% and 35% of pregnancies in the 19th century were aborted. They were also uncontroversial from a moral and legal perspective, up until the quickening, which was when a pregnant woman could first feel the fetus move or kick in the womb, usually around 20 weeks into the pregnancy. Although quickening was the point at which many considered a fetus to be viable, even the abortion of a “quick fetus” was never “firmly established as a common-law crime,” Justice Harry Blackmun would later write in the Supreme Court’s majority opinion on Roe v. Wade. Abortions were most often seen as a decision to be made by a pregnant woman and her midwife, and were most often induced using herbs known for “restoring the menses,” historian Leslie Reagan wrote in her 1997 book “When Abortion Was a Crime. ”There was no real legislation regarding abortion until the early 1800s. The legal right to an abortion prior to quickening was reaffirmed in the 1812 Massachusetts court case Commonwealth v. Bangs. This pre- and post-quickening distinction would set a precedent for a series of laws passed in the 1820s and 1830s, starting with an 1821 Connecticut abortion law. This law was the first to officially criminalize medicinal abortion after quickening. However, it only penalized the provider of the abortifacient, not the pregnant woman, and was largely seen at the time as a means of protecting women from often-lethal abortion medicines.

Mid-1800s: Birth of the American Medical Association shifts abortion, pregnancy oversight from midwives to doctors

Despite new restrictions around the sale of abortifacients, abortions became more commercialized by the 1840s, with doctors and pharmacists advertising their services—both medicinal and instrumental—in newspapers. The shift from abortions being performed at home, often using home-grown herbs, to being performed or accessed more publicly, was already underway. However, it wasn’t until halfway through the 19th century that matters of pregnancy, birth, and abortion shifted away from a social- and community-oriented model steered by midwives, and toward a male-dominated medical model controlled by doctors. The single most influential factor in this societal shift was the founding of the American Medical Association in 1847. In the years before the AMA began, more medical schools opened and white male physicians with medical training sought to distinguish themselves from the types of medical practitioners people were used to relying on—namely midwives, herbalists, and local healers—by dismissing their work. These alternative providers were seen as both a threat to the authority of the burgeoning medical establishment and, in a business sense, as competitors for potentially lucrative services. When the newly formed AMA was met with derision by the general public, who did not take the group seriously, the association tried a new tactic to boost its appearance of professional credibility: the criminalization of abortion. In 1857, the AMA established a Committee on Criminal Abortion, which launched a campaign to discredit midwives’ work and elevate the AMA’s practices to an “elite” status. To achieve this end, the AMA argued for making abortion a matter that should be decided and performed by physicians, not women and midwives. At around the same time, changes in the Catholic Church’s official position on abortion coincided with discussions amongst AMA members about whether the life of a fetus began at quickening or conception. While Pope Sixtus V, who came to power in 1585, decreed abortion to be considered homicide—a crime that warranted ex-communication from the Church—this stance only lasted about three years, as Sixtus’ papacy ended shortly thereafter. In 1591, Pope Gregory XIV reversed this decree, instead asserting that abortion was only homicide after “ensoulment,” which occurred at quickening, or what Pope Gregory XIV determined to be roughly 24 weeks. This remained the Church’s official stance on abortion for the next 278 years until it was forbidden once more in 1869 by Pope Pius IX—a stance that remains in force today.

1880: Every state has laws restricting or banning abortions

The Catholic Church’s reversal on abortion coincided with the AMA’s campaign to restrict abortion. The AMA’s Committee on Criminal Abortion quickly adopted a moral argument that sought to cast doubt upon women’s knowledge of their own bodies and pregnancies. It circulated a report that lampooned “a belief, even among mothers themselves, that the foetus is not alive till after the period of quickening. ”The campaign to place abortion and birth in the hands of white male doctors was bolstered by language that stoked racial fears about declining birth rates amongst white populations, an influx of immigrants to the U.S., and the recent emancipation of formerly enslaved Black people, according to historian Leslie Reagan. Horatio Storer, who orchestrated the AMA’s campaign to criminalize abortion, wrote that the settling of the American West and “the destiny of the nation” rested on “the loins” of wealthy white women—a mission being jeopardized by these women having too many abortions. This was not the only way in which the AMA’s white supremacist stance impacted reproductive rights. In 1876, James Marion Sims, who is generally regarded as the founder of modern gynecology, became president of the AMA. Sims became famous for surgically repairing certain complications from childbirth—innovations he made after doing unanesthetized forced experiments on several enslaved Black women in the mid-1800s. In 2021, the AMA acknowledged this legacy, writing that Sims’ experiments “reinforced essentially racist misconceptions in medical science, specifically regarding the biological differences of feeling pain between Blacks and whites that still persist to this date. ”By 1880, every state had passed legislation that made abortion a crime, except in cases where the mother’s life was at risk. This kicked off the “century of criminalization”—from 1880 to when Roe v. Wade was decided in 1973—forcing abortions underground.

Mid-1960s: ‘Back-alley butchers,’ underground network provide illegal, often unsafe, abortions to the desperate

With abortion outlawed in every state, people seeking to terminate their pregnancies were forced to do so in frequently unsafe conditions. People who resorted to self-inducing abortions using a notoriously grisly array of techniques—the infamous coat hanger among them—were often poor, and could not afford the steep fee of employing an “abortionist” to perform the procedure. A study of low-income women in 1960s New York City found that, of those who reported having an abortion, 77% had attempted to self-induce. The danger of illegal abortions disproportionately impacted people not just across class lines, but also along racial lines. The illegal abortion mortality rate for women of color was 12 times higher than for white women between 1972 and 1974. Even those who paid someone to perform their abortion were often injured in the process; the phenomenon was so common, in fact, that most big-city hospitals had septic abortion wards—sometimes referred to as “septic tanks”—specifically meant for people ailing from botched abortions. While the exact number of illegal abortions in the years leading up to Roe is unknown, due to underreporting, estimates from the Guttmacher Institute place the number anywhere between 200,000 and 1.2 million per year in the 1950s and ’60s. The plenitude of people seeking abortions can be attributed in large part to the fact that contraceptives were not accessible for most of the 20th century. In 1965, Griswold v. Connecticut made the use of birth control legal for married couples. And it wouldn’t be until 1972, one year before Roe v. Wade, that Eisenstadt v. Baird legalized contraceptives for unmarried people, removing penalties around pre-marital sex for the first time. A wide range of people performed underground abortions during the first half of the 20th century: both untrained providers and discreet physicians, with motivations ranging from greed and a desire to exploit vulnerable people, to compassion for those in need of assistance.B ut not all underground abortion providers fit the stereotype of the “back-alley butcher.” Some reproductive rights activists developed ways of helping people access safe and affordable abortion care. The Jane Collective of Chicago, group of pro-abortion activists, famously formed in the ’60s and set up a call line, which connected those seeking abortions with the group’s own provider. After a while, the women realized they could learn to perform the procedure themselves, allowing them to expand their services to more people at a much lower cost. In the years leading up to 1972, when members of the collective were arrested for administering abortion services, Jane provided roughly 11,000 abortions to people in the Chicago area.

1960s: Pressure from activists creates reform in some states ahead of Roe v. Wade

The 1960s ushered in a new era of social and political change—the civil rights, women’s liberation, and anti-Vietnam War movements converged to create a sense of optimism and energy, particularly among younger generations. The sexual revolution in particular began to shift conservative norms around what kinds of sexuality were acceptable, and questions about women’s sexual empowerment entered mainstream conversation. The advent of the birth control pill coincided with these new beliefs and allowed (married) people to control their fertility more effectively than ever before. By the late ’60s, the work of activists, changing attitudes around sex, and the impact of Griswold v. Connecticut were beginning to have an impact on how lawmakers and the general public viewed abortion. Over the course of that decade, abortion had gone from a taboo subject people whispered about, to something shouted about in protests. Activists argued the precedent set by Griswold, which protected married people’s right to contraception through their right to privacy, should, by the same token, extend to abortion. In 1967, Colorado reformed its abortion law, triggering a string of other states to do the same in the years leading up to 1973. In 1970, the AMA formally reversed its earlier stance when it voted in favor of legal abortion. New York repealed its abortion law altogether in 1970, allowing for abortions up to 24 weeks, or at any point in the pregnancy if the life of the mother was in danger. The state, and particularly New York City, quickly became a hub for out-of-state people seeking abortions. Estimates from health officials between 1970 and 1972 attribute roughly two-thirds of all abortions performed to non-New York residents. While this dramatically improved the safety outcomes for those who had the means to fly to New York, pay the cost of the procedure and lodging, and fly home—mainly wealthy white women—people with fewer resources in more restrictive states continued to suffer from unsafe and unregulated abortion services.

1973: Roe v. Wade makes abortion safe and legal in all 50 states

On Jan. 22, 1973, the Supreme Court handed down its 7-2 decision on Roe v. Wade, rendering restrictive abortion laws across the country unconstitutional. Despite the overarching implications of the ruling, public reaction was reportedly muted. This was, in part, due to the fact that abortion had not yet become a partisan or deeply politicized issue. In fact, many of the justices who voted in favor of Roe were conservatives and Richard Nixon appointees, including Justice Harry Blackmun, who delivered the majority opinion. The news of the Roe decision was largely overshadowed by the fact that Lyndon B. Johnson, who had served as president just four years earlier, died that same day. Then-President Nixon’s private reaction to the Roe v. Wade decision was infamously captured in a secret audio recording by one of his aides: “I know there are times when abortions are necessary. . .I know that—when you have a Black and a white, or a rape,” he said. Nixon didn’t make a public comment about the ruling. In the immediate aftermath of the decision, the majority of the criticism of Roe came from the Catholic Church. Abortion access improved quickly after Roe v. Wade. The septic abortion wards that had sprouted up in hospitals to treat complications from unsafe abortions were closed and replaced by clinics. Complication rates went down, and because of improved access to abortions early on in the pregnancy, the rate of abortions after the first trimester dropped from around 25% in 1970 to 10% in the first 10 years post-Roe.

Late-1970s: Racial fearmongering creates rise of the ‘Moral Majority’

The decade after Roe v. Wade saw the beginnings of a shift in political and social allegiances around the issue of abortion. Prior to Roe, and even in the few years after, evangelical Christians did not oppose abortion—in fact, many Southern Baptists supported legal abortion. Abortion was not a major political issue for the right at that time, and most Catholics, the most outspoken anti-abortion voter bloc, tended to vote Democratic prior to 1970.

A few key events changed the priorities and demographics of the political parties. The first, and perhaps most influential, was the elimination of tax exemptions for segregated private schools. Referred to as “segregation academies,” these schools cropped up in the aftermath of the Brown v. Board of Education decision, as white evangelical families pulled their children out of public—now integrated—schools. After Black Mississippi families sued in 1970, the IRS was pressured to crack down on segregation academies by removing their tax-exempt status in the late ’70s.

Another Supreme Court case contributed to a growing backlash amongst white evangelical Christians: Engel v. Vitale, a 1962 ruling that prohibited public schools from sponsoring schoolwide prayer. As the Republican party increasingly became the socially conservative “party of family values,” the issue of abortion became a convenient—and more socially acceptable—proxy through which the right could channel its discontents around desegregation, growing sexual liberalness, and civil rights. Adopting an anti-abortion stance also helped the Republican Party convince more socially conservative Catholics to break with the Democrats.

By the end of the 1970s, these issues had converged to aid the rise of the Moral Majority, a right-wing movement headed by televangelist Jerry Falwell. The Moral Majority merged fundamentalist social and political conservatism and mobilized the Christian right, aiding in the election of Ronald Reagan in 1980 and ushering in a new era of American politics.

1980s-2000s: Legal challenges to Roe v. Wade introduce restrictions

Legal challenges to Roe began long before the Supreme Court decided to hear Dobbs v. Jackson Women’s Health Organization back in 2021, ultimately resulting in Roe’s fall. Starting in the 1980s, cases like Harris v. McRae and Webster v. Reproductive Health Services were already introducing restrictions to the access Roe initially promised.

Harris v. McRae restricted Medicaid funding for abortions to cases of rape, incest, and life endangerment, while Webster v. Reproductive Health Services upheld Missouri’s limitations on who could perform abortions, as well as where.

The 1992 ruling for Planned Parenthood v. Casey both reaffirmed Roe while also introducing a loophole through which states could restrict access to abortions: As long as state laws did not pose an “undue burden” on people seeking abortions before the point of fetal viability, those restrictions could be acceptable. This reworked the trimester framework established by Roe, which ensured access to abortion during the first two trimesters and allowed for states to decide on restrictions or bans on third-trimester abortions.

In 2000, the Supreme Court heard Stenberg v. Carhart, which challenged a Nebraska ban on a late-term abortion method called dilation and extraction—controversially referred to as “partial-birth abortion.” The Court ruled the ban was unconstitutional, because it posed an “undue burden” on those seeking an abortion, as defined in Planned Parenthood v. Casey. But only seven years later, this decision was contradicted by the Supreme Court’s Gonzales v. Carhart ruling, which upheld the passage of the Federal Partial Birth Abortion Ban Act. The act criminalized the dilation and extraction abortion method, the first time a specific technique was banned.

Since Planned Parenthood v. Casey and Gonzales v. Carhart, states have passed increasingly restrictive laws around abortion, including banning other specific abortion methods, and introducing mandatory waiting periods and counseling, gestational limits, parental consent for minors, and compulsory ultrasounds.

2022: Roe v. Wade is overturned

On May 2, 2022, a leaked Supreme Court initial draft majority opinion overturning Roe v. Wade inspired panic and protest amongst supporters of legal abortion and preliminary celebration for opponents of Roe. Then, on June 24, 2022, the Supreme Court released its ruling and Roe officially fell.

For many people living in states with restrictive abortion laws, the reality of getting an abortion over the past several years has already resembled a pre-Roe world: where having the means to drive or fly across state lines and pay for abortion services, as well as other associated travel costs, is often a dealbreaker.

Some things will change, however, now that the Supreme Court has overturned Roe v. Wade. The distances people will need to travel to receive abortion care will increase manifold. Current estimates from the Guttmacher Institute indicate that 26 states are likely or certain to ban abortion. These states are concentrated in the South and Midwest, and would effectively create hundreds of miles-long abortion deserts in parts of the U.S. Residents of Louisiana, Florida, and Texas in particular could see an increase of hundreds of miles to the nearest legal clinic.

But accessing an abortion in the event of a 26-state ban does not mean returning to the days of back-alley butchers and coat-hanger abortions. Abortion services have evolved significantly since the century of criminalization, and have become increasingly safe and simplified. Reliance on surgical abortion has decreased: as of 2020, over half of all U.S. abortions are medication-based. The most common medication for abortion is an FDA-approved combination of two drugs—mifepristone and misoprostol—which are usually administered during the first 10 weeks of pregnancy.

Self-managed abortions—abortions performed by the individual at home—using mifepristone and misoprostol are likely to become more popular. Through-the-mail abortion pill and telemedicine consultation services like Plan CHey JaneAidAccess, and Women on Web have emerged to improve access in abortion deserts.

The right to an abortion is codified in state laws or constitutions in 16 states, including New York, Illinois, California, Oregon, and Colorado, as well as Washington D.C. Many of these states are preparing for a surge in the number of out-of-state visitors seeking abortions, or have already seen an uptick in recent years as restrictions on abortions have tightened in neighboring states.

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