Texas Republicans Can’t Stop All Medical Abortions

If you’re seeking an
abortion in Texas, despite the state’s recent ban, you still have options. You
can go to AidAccess.org, where an overseas doctor will prescribe the same
medications that you would get in a clinic and have the pills shipped from
India in a few weeks. You can buy the pills from online pharmacies. You can have a remote consultation with a legal abortion
provider in a less restrictive state, like New Mexico, and get the pills
shipped to your Texas address via mail forwarding. Or you can do what countless U.S. residents do to find
more affordable medications of all kinds: cross the border into Mexico. There
you can buy misoprostol, an ulcer pill used as part of the standard two-drug
medication abortion protocol that is about
80 percent effective on its
own in the first trimester. You can rest assured that the Mexican
Supreme Court last week declared that abortion is no longer a crime in that country. You
can take the pills at home, as you would after a clinic visit, and in the
rare event that you have a complication, your symptoms will be undetectable as
anything other than a miscarriage.Options like those listed
above do bring legal risks, but only a tiny fraction of the tens if not
hundreds of thousands of people who have managed their own abortions in the United
States have faced criminal consequences. The number of people arrested for ending a
pregnancy or helping someone else to do so is in the dozens, according to
unpublished data cited by Farah Diaz-Tello, senior counsel for the legal
advocacy group If/When/How. (The group’s last published report
put the number at 21 since 2000.) Senate
Bill 8, the law in Texas that
allows any private citizen to sue those who aid or abet in an abortion, does not apply to those who manage their own.While S.B. 8 has succeeded
in shutting down almost all abortions in Texas clinics, it has led to a surge in awareness
of strategies for
self-managing abortion that are all but imperceptible to anyone trying to
enforce the law. Aid Access saw a spike in requests for services for about a
week beginning on August 31, the day before the law took effect, a provider
told me. Plan C, a group that directs people to information about how to get abortion
pills, saw visits to its website increase about 50-fold, from about 500 a day
in early August to more than 25,000 on September 1, according to co-founder
Elisa Wells. When Instagram
shut down Plan C’s account, it only increased the group’s profile. Texas lawmakers are
trying to control the uncontrollable.Now Texas lawmakers are
trying to control the uncontrollable by imposing criminal penalties on the transfer of abortion pills. Senate
Bill 4, which is awaiting signature by Governor Greg Abbott, would
ban medication abortion after 49
days of pregnancy (about three weeks after a missed period). That would cut off access to medication abortion for many in Texas clinics even if the Biden
administration succeeds
in bringing a halt to the
near-total ban that remains in effect right now. Senate Bill 4 makes “any act
of giving, selling, dispensing, administering, transferring possession, or
otherwise providing” abortion-inducing drugs in violation of the law a felony
punishable by up to two years in jail. It is an effort to dismantle something
that is beyond the law’s reach—widespread and decentralized distribution of
pills largely originating in Mexico, where, as of last week, abortion is no
longer a crime. In other words, the law will fail.  “We have effective pills,
we have modern means of ordering them and transporting them that fall entirely
outside of the purview of this law,” Wells told me. These options include telemedicine
abortion services like Aid Access and Abortion on Demand, which are based in
countries and states beyond the legal reach of Texas.  “Access to abortion is necessary, and it’s
also inevitable.”Abortion seekers in Texas
have long crossed the border into Mexico, where misoprostol is sold on the
street and over the counter in pharmacies for a fraction of what a medication
abortion costs in a clinic. Texas-based abortion funds like Frontera Fund that help
people pay for abortion in a
state where Medicaid doesn’t cover it have always known that their services are
far from enough to meet everyone’s needs.“Even with our help,
people were unable to afford an abortion because it’s expensive and it’s much
easier to get the medication in Mexico and just do it yourself,” said Zaena
Zamora, executive director of Frontera Fund.Misoprostol’s potential as
a self-managed abortion drug was discovered not by doctors, but by women who needed
to end pregnancies in countries where abortion was illegal. When it came on the market as an
ulcer drug in the 1980s with the warning that it could cause a miscarriage, it
didn’t take long for Brazilian women to realize what that meant. Hundreds of
thousands of people used the pills to get around Brazil’s abortion ban before
the country restricted its sale in 1991. By then, misoprostol’s use had spread around the
world.In Mexico, dozens of
accompaniment groups guide people through the process of managing their own
abortions with misoprostol, as I wrote
for The New Republic last year. The largest and most high-profile of
these groups, Las Libres, has helped 20,000 women self-manage abortions since
it launched in 2000, about half of them during the pandemic alone, according to
founder Verónica Cruz. While Las Libres operates openly, protected by its high
profile, more than 3,600 people across Mexico were reported, and 172 people were imprisoned, for the crime of abortion from 2010 to 2020, according to data from the
Mexican reproductive rights group GIRE, first cited by Reuters. Many more have been accused of crimes like infanticide or homicide for miscarriages or
stillbirths—a possibility that remains, even after the Mexican Supreme Court
declared that abortion could no longer be prosecuted as a crime, Cruz said. “In those cases, normally
what is being criminalized is women’s sexuality or their infidelity, or their
lack of knowledge, or their poverty,” Cruz said. “They’re criminalizing the
conditions of their lives.”“They’re criminalizing the
conditions of their lives.”Or, as Mexican Supreme
Court President Arturo Zaldivar put it:
“Rich girls have always had abortions and never gone to prison.” If Mexico’s history is any
indication, lawmakers here will never be able to stop self-managed abortion;
its use will only spread as laws became stricter. What state and local
authorities will be able to do is ruin the lives of low-income people of
color who, as Cruz put it, will be criminalized for the “conditions of their
lives,” as much as anything else. S.B. 4 and S.B. 8 will cause enough confusion
and fear to prevent many more people from getting care. This confusion is one
of the laws’ most dangerous aspects. That’s why activists have turned their energy to distributing information about abortion pills. In the days before the
near-total abortion ban went into effect in Texas, Plan C drove
a billboard truck through
the streets with the message: “Missed period? There’s a pill for that.” Last
Thursday, outside the Supreme Court in Washington D.C., activists with the
group Reproaction gathered to shout the protocol
for medication abortion into a bullhorn. About 10 minutes into the event,
abortion opponents arrived and began blasting recordings and chanting, “Hey
hey, ho ho, the abortion pill has got to go!” The disruption created a certain
amount of confusion and chaos. It did not, in the end, stop the activists from
making the point that they had intended to make: That you can end a pregnancy
at home with pills, and the state will have a hard time stopping you. 
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