This dissertation traces the ways in which Mexican abortion advocates shape the changing landscape of abortion care in Mexico and the United States following contrasting Supreme Court rulings. Drawing on multi-scalar qualitative methods, I craft three papers that examine how the accompaniment model of abortion care in Mexico resists state violence, how shifting reproductive politics in the United States have had cascading effects across the border, and how abortion acompañantes engage their bodily selves to inform an alternative form of care. In the first paper, I outline the framework of insurgent reproductive citizenship to suggest how abortion accompaniment reconstructs forms of citizenship for pregnant people left at the margins of the state. The second paper uplifts the insurgent knowledges of acompañantes as they navigate the creeping effects of abortion criminalization and reshape our understanding of abortion care after the overturning of Roe v. Wade in the United States. In the third paper, I explore how acompañantes’ insurgent bodies are engaged to inform a praxis of bodily care work that specifically cares for those who have been alienated by the state. In weaving together these three papers, this dissertation reveals how abortion advocates in Mexico engage their insurgent knowledges and bodies to pursue an insurgent form of citizenship. In doing so, the advocates resist state violence, reshape the landscape of abortion care, and promote reproductive justice for women and pregnant people in Mexico, the United States, and beyond.