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The Mexican abortion option

Get ready for it.

Misoprostol

At the Whole Woman’s Health center here, a young woman predicted what others would do if the state’s stringent new abortion bill approved late Friday forces clinics like this one to close: cross the border to Mexico to seek an “abortion pill.”

“This law will lead a lot more women to try self-abortion,” said Jackie F., a 24-year-old food server and student who was in the health center last week for a follow-up medical examination after getting a legal abortion.

The woman, who requested that her last name not be used to avoid stigma, was referring to a drug that can induce miscarriages and is openly available in Mexico and covertly at some flea markets in Texas.

In Nuevo Progreso, only yards past the Mexican border, pharmacists respond to requests for a pill to “bring back a woman’s period” by offering the drug, misoprostol, at discount prices: generic at $35 for a box of 28 pills, or the branded Cytotec for $175.

When asked how women should use the pills, some of the pharmacists said they did not know and others recommended wildly different regimes that doctors say could be unsafe.

“The women see it as “a pill to make my period come,’” said Andrea Ferrigno, a vice president of Whole Woman’s Health, which runs a network of abortion clinics. “Often in their minds, it’s not abortion.”

No question, if the new law is upheld you will see a large increase in border crossings for the purpose of acquiring abortion drugs. I predict that within six months of the law taking effect there will be a feature story about it in Texas Tribune. I also predict that if this happens there will be an even greater focus on “border security” by Republicans, in Congress and in Austin, to crack down on this practice. It’s just a question of who gets to author the bill that makes carrying misoprostol across the border a felony. Anyone disagree with me on this?

Lacking health insurance or fearing the stigma of being seen at an abortion clinic, thousands of Texas residents every year are already making covert use of this pill or trying other methods to induce abortions on their own, according to Dr. Dan Grossman, an obstetrician in the San Francisco Bay Area and vice president of Ibis Reproductive Health, a nonprofit research group.

When used properly in the early weeks of pregnancy, misoprostol, which causes uterine contractions and cervical dilation, induces a miscarriage about 85 percent of the time, according to Dr. Grossman. But many women receive incorrect advice on dosage and, especially later in pregnancy, the drug can cause serious bleeding or a partial abortion, he said.

The looming limits on legal abortion follow deep cuts in state support for family planning. Planned Parenthood clinics here in Hidalgo County do not perform abortions, but in 2010 provided subsidized contraception to 23,000 men and women at eight centers; as financing dried up, four of them have been closed. This year, the group will serve only 12,000 clients, and other organizations have not taken up the slack, said Patricio Gonzales, chief executive of the Hidalgo County chapter of Planned Parenthood.

If legal abortions become inaccessible in this part of the state, Mr. Gonzales said, “Planned Parenthood may have to step up” and try to raise $1.5 million or more to build a new surgery center that meets the requirements of the new law.

Lucy Felix, a community educator here with the National Latina Institute for Reproductive Health, said that many of the women she works with do not have legal residency and cannot drive north in Texas through Border Patrol checkpoints or even cross the southern border to buy the pill directly for fear that they may not be able to return to their families in Texas.

“The only option left for many women will be to go get those pills at a flea market,” Ms. Felix said. “Some of them will end up in the E.R.”

[…]

In a tour of the Whole Woman’s Health clinic here, Ms. Ferrigno noted some of the design and equipment requirements in the new law that would force the clinic to shut down. The clinic, part of a chain in Texas and other states, performs about 1,900 abortions a year using doctors that fly in from other states.

The clinic, like most in Texas, performs abortions only through the first 15 weeks of pregnancy, using medications or a suction method that takes 10 to 15 minutes and involves no incisions. The center uses donations to offer subsidies to many women, Ms. Ferrigno said.

The suite does not have the wide hallways required of a surgery center to facilitate the movement of stretchers in an emergency. In nine years and thousands of abortions, she said, the McAllen clinic has sent only two patients to the hospital, both for readily-treated bleeding.

Remember, this is all about the health and safety of women. Because Texas Republicans care so much about those things.

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