A recent article in The Nation, “Crossing the Line,” tells the story of Diana, a single mother of two living in Brownsville near the Texas-Mexico border who needed an abortion. But she faced a few obstacles: The nearest abortion clinic was 30 miles away. Since Texas believes women on Medicaid should have to pay for an abortion out of pocket, the procedure could have cost her almost $1,000. And, perhaps worst of all, the stigma of being seen at an abortion clinic in her conservative community seemed too much for her to bear.
So instead Diana bought Misoprostol, an ulcer medication that is 80-85% effective at causing a process identical to a miscarriage, at a pharmacy across the border for a fraction of the price and self-induced an abortion at home.
Use of Misoprostol as an alternative abortion method, particularly by low-income and immigrant women, is hardly a new phenomenon but has popped up in the news a lot lately. Last month, Nicholas Kristof hailed Misoprostol as a drug that could revolutionize abortion around the world. And as far as do-it-yourself abortion goes, Misoprostol certainly has a lot going for it: It’s relatively safe—much safer than other methods the Planned Parenthood in Brownsville has seen over the years: “women who have used syringes, taken cocktails of prescription drugs, douched with battery acid and beaten themselves in the abdomen.” It’s cheap: $87 to $167 per bottle in a Mexican pharmacy, just pennies per pill in India. Since its primary use isn’t as an abortifacient, it’s hard for governments to restrict—and is likely to become even more widely accessible. Since it causes a miscarriage that looks indistinguishable from a natural one, in places where abortion is illegal, if there’s a complication or it doesn’t work completely, a woman can seek help at a hospital instead of risking either arrest or death. It’s taken in the privacy of her own home, so in conservative communities like Diana’s, she can avoid the stigma of the clinic, the harassment of anti-choice protesters, the “feeling of being judged by the strangers around her.”
In short, Misoprostol could do a lot of good around the world and save the lives of some of the up to 70,000 women worldwide who die from complications of unsafe (usually illegal) abortions each year. And I’m happy Diana could get it and that it worked for her.
But I’m not happy that abortion is so stigmatized in the Rio Grande Valley that many women don’t even realize it is legal. I’m not happy that because of the Hyde Amendment, those women who are least able to afford it are forced to pay between $450 and more than $900 for an abortion in a clinic. I’m not happy that the nearest abortion clinic to Diana is 30 miles away and 35% of women in the U.S. live in counties that lack an abortion provider. I’m not happy that the clinic is so embattled that the doctor wears a bulletproof vest to work and says that many of his clients first find out about the facility when they are brought there by church groups to protest. I’m not happy that he says that about 20% of his patients have tried Misoprostol first before coming to the clinic. I’m not happy that due to cost, inconvenience, and shame, women in the U.S., where abortion is legal, are turning to Mexico, where it is largely illegal, to find alternative ways to end their pregnancies.