‘ Please, I am out of options ‘: inside the murky world of DIY abortions
As Donald Trump promises new restrictions on abortion, emails reveal the desperation of women who have no place to go to end unwanted pregnancies
Hello. I simply found out that I am four weeks pregnant.
I cannot carry on with this pregnancy for numerous reasons and I want to have an abortion. Though it is an option for me in the United States, in reality, it is not really an option because the $600 – $700 to have it done is simply out of the question.
Im hoping you can advise me and are able to help. I am absolutely desperate.
Martina read through her email is again and hovered her thumb over the send button. The message was addressed half a world away to Women on Web, a Dutch not-for-profit group that mails abortion medications to pregnant women who live in countries where abortion is outlawed.
Martina lives in Texas, where abortion is limited but legal attaining it one of the places where Women on Web refuses to mail the drugs. Still, Martina guessed she would try her luck. She had lost her job to downsizing, and in its place she had found only part-time work. Her rent had gone up. Lately, she was borrowing fund for gas.
There was no question that she couldnt afford to have a child. The question was whether she could even afford an abortion.
Martina had an inkling that what she was asking for help performing her own abortion might not be fully legal. But she was out of answers. She reached send. Then she began to suit the internet for other styles she could cause her own abortion.
If this scene feels out of place in 2016, that may be because there was a time in this countrys history when thousands of back-alley and coat-hanger abortions prompted calls for the procedure to be legal. After the US supreme court established a right to a legal abortion, in the 1973 decision Roe v Wade, self-induced abortions were supposed to become a thing of the past.
But almost as soon as the court legalized abortion, opponents of abortion rights began to whittle them away. Congress began proscribing poor women from employing Medicaid to cover abortions in September 1976. Obamacare, the largest healthcare expansion in decades, allowed insurers to continue to pick and choose the circumstances under which they would cover abortion and allowed states to ban the coverage wholly. The two decisions have ensured that millions of women who have sought an abortion have had to pay for it out of pocket. And a sweeping wave of anti-abortion statutes has shut clinics in many nations, cresting with an awesome force-out over the last five years.
In such a hostile climate, it is no wonder that self-induced abortions are still a significant, if largely concealed phenomenon one that even pro-abortion rights groups are only just beginning to comprehend. One analyse of abortion patients found that 2.2% has endeavoured to, at some point in “peoples lives”, induce their own abortions without professional medical assistance. Another estimated that potentially 4.1% of Texas females have tried to self-induce or at least 100,000 women.
There is no concrete data on how many women in the US have tried to self-induce, But there is some evidence although it is inconclusive to suggest that self-abortion endeavors are on the rise. From 2008 to 2011, as the economy worsened and a wave of new restrictions choked abortion access around the country, online queries about self-induced abortion almost doubled, according to Seth Stephens-Davidowitz, an economist who analyzes Google searches.
Into this crisis of reproductive rights now stroll Donald Trump. As chairperson, Trump has promised to restrict abortion even further. He has vowed to nominate justices to the supreme court who might overturn Roe v Wade. Roe, because the court is loath to reverse itself, has survived such menaces before. But Trump has explicitly promised to nominate justices who might put Roe in their crosshairs.
In his first major interview after winning office, Trump described truthfully what might happen to some females if Roe v Wade were overruled. Theyll perhaps have to go, theyll have to go to another state, he said. And thats OK? he was asked. Trump responded, Well, well see what happens.
But we dont have to wait and see what happens. History has already shown us what happens when women in the US cant access abortion. So has the present day.
In 2015 alone, Women on Web, the Dutch not-for-profit, received more than 600 emails from US girls looking for a way to objective their own pregnancies.( The group does not send abortion drugs to the US, because the US does not outright ban abortion .) Women on Web agreed to share ratings of these emails with the Guardian, an unprecedented window into the lives of women who feel they have no other option but to aim their pregnancies themselves.
Among the hundreds who wrote to Women on Web was Martina. She contacted the Guardian shortly after she found out about her unwanted pregnancy and shared every step of her journey, which eventually took her across an international border.( As corroboration, she provided photographs, including of her travel documents. Her name has been changed for her privacy .) She wasnt sure if she faced a potential legal danger. And in fact, self-induction is in a legal grey area, and many enterprising attorneys have charged women who carried out their own abortions with crimes. Nevertheless, Martina felt compelled to speak.
I feel like theres such a negative stigma to this, she said. Its kind of kept under the radar, hushed, so it needs to be talked about. People needed to know, she added, that abortion restrictions had real victims. Youre not really helping anyone. Youre not really protecting anyone. Youre just causing women who are in these situations who feel desperate to take desperate measures.
The letters to Women on Webform a uniform chorus of desperation. Please and afford and help and dread appear in dozens of places, signaling the nature of how these women became stranded.
now he is threatening me, saying I can never leave.
I am afraid of what he is capable of.
For a variety of reasons, an abortion must look like a miscarriage.
this has to look like a miscarriage.
I dont have $600.
Planned Parenthood wants $650. My bf and I live in our car.
I cant afford an abortion.
I simply cannot afford an abortion.
A teenager in a state where minors require parental consent for an abortion said her parents were forcing her to have her baby.
A woman in Missouri wrote to say that she had gone to her countries merely abortion clinic, but the protestors shamed me into going back. Im not a citizen and its a little scary coz I feel very lonely.
I am beside myself, read another womans email. One month before she wrote her email, she was raped. She received her coverage through Tricare, insurance policies plan for military personnel and their families. Tricares policy is to cover abortion in cases of rape as long as a doctor has a good faith belief that the rape occurred, according to a spokesman. But this woman wrote that Tricare refused to pay for her abortion on the basis that she never reported the rape.
To end this nightmare, she wrote, it would expense me one-third of my familys monthly income. She continued, I have seen a doctor. I have had a sonogram. Tricare covers that. I can give birth to my rapists baby for free.
Please I am out of options, the letters read.
Can u please.
please please please.
I cry and pray every night that the Lord take this child from me somehow.
I will maintain searching online for help.
What is striking about reading these emails one after another after another is the diversity of experiences that result all these women down the same track. There are homeless women and middle-class women and marriage women and single women, women living in cities and women separated from the nearest abortion provider by an ocean: two wrote in from the big island of Hawaii, where the last clinic, a Schemed Parenthood in Kailua-Kona, closed in 2014.
When people think about low-income women trying abortion, they have this stereotypical vision of a single woman on welfare, said Laurie Bertram Roberts, head of the Mississippi Reproductive Freedom Fund. Her group provides financial assistance for abortions. But its also people who have two jobs. Six hundred dollars is a lot of fucking money. For a lot of the people who call us not a majority, but many those obstacles are just too high. Even with our help.
Women on Web wrote back to Martina a few hours after she sent her message. Were sorry, the reply came, Women on Web cannot provide the service in any country with safe abortion services. The email listed a few not-for-profit abortion funds Martina could call for financial assistance. Then it recommended other options: If you live close to Mexico you can also travel to Mexico to buy misoprostol, a drug that they are able induce a miscarriage early in a pregnancy.
It sounded like a gamble. Martina felt a jolt of dread. What if its incomplete? What if I do it wrong? What if I fuck up my organs somehow? She pushed these thinks aside. At least it was an option.
Martina learned that her insurance would not encompass her abortion and left messages with two abortion monies. She also procured a world of websites describing ways to induce abortions with herbs or vitamins. Following advice from the sources that appeared the most reputable, she began taking cinnamon capsules and several thousand milligrams of vitamin C per day.
Its not unheard of for women to turn to herbal concoctions, reproductive rights proponents said. Its considered an OK thing to do this is just how theyve managed it for years, said Esther Priegue, the director of counseling at Choices Womens Medical Center, an abortion clinic in Queens. Her patients occasionally use an herbal brew to try to induce a miscarriage.
The internet echoes with such recipes. What you probably have, in reality, is hundreds of people doing it hundreds of different ways, said Beverly Winikoff, the president of Gynuity Health Projects, a reproductive rights research group. The way its always been.
Of course, there werent is expected to be hundreds of different ways.
Self-induced abortion was supposed to have all but disappeared after the supreme court established the human rights of an abortion throughout the country. In the run-up to Roe v Wade, in the late 1960 s and early 1970 s, abortion was restricted to a handful of major cities and the women with the means to travel there. Roughly 100,000 females intersected nation lines for a legal abortion in New York state; in a single year, the number of women going to illegal providers or trying to self-induce was up to 12 times that. Some years, up to 200 women would die of complications from illegal or self-induced abortions. And compared with the number of women who survived horrific complications, the above figures seems small. In 1968 alone, a single Los Angeles County hospital treated 701 females suffered by septic abortions.
But just a few years after Roe, the country seemed to vanquish the coat-hanger abortion. In 1976, the Centre for Disease Control announced that only three women had died the previous year from abortion complications a stunning reduced by deaths. When anti-abortion activists accused the centers of undercounting, the CDC, according to the book Inside the Outbreaks, put up a $100 bounty for proof of any abortion demise the centers had failed to report. We paid out zero money, one official remembered proudly.
But others realized that, even though women were no longer succumbing in scandalous numbers, illegal and self-induced abortions were still a serious problem.
The CDC announcement came out the same year Dr Jason Doe began to do his medical residency. In the remote north-west corner of Louisiana, he rotated through an obstetrics ward that received many of the areas most impoverished residents. The nations only abortion clinic stand in the opposite corner of the state. So even though abortion technically was legal for those women, it wasnt available, Doe said.
One of his first patients had unraveled a wire coat hanger and used it to break her water. Another transgressed her water with a red rubber catheter her friend had stolen from a hospital.
Does memory of another patient is dominated by her screams. As she seized in pain, physicians removed an intact cotton boll the husk was still attached from her vagina. She had soaked the cotton fibers in turpentine and honey.
In three years, I suppose I watched a dozen examples, said Doe.( Doe agreed to speak only under a pseudonym. He runs as an abortion provider in Shreveport and has kept his identity hide from the public .) He treated women who had gone to back-alley abortion providers and a woman who had shot herself in the stomach. Turpentine became a kind of harrowing motif. One girl employed a syringe to inject it into her abdomen. The tide only ceased in 1980, when two abortion clinics opened a few months apart in nearby Bossier City and Shreveport. Roe v Wade was seven years old.
Just constructing it legal is not enough, Doe said. If its not available, if a woman actually does feel that she needs to terminate her pregnancy, she may be willing to try just about anything.
His were not isolated experiences. In 1977, Rosie Jimenez became one of the first females to die from an illicit abortion after Roe v Wade. Jimenez has hitherto had one legal abortion, paid for using Medicaid. But in 1976, Congress passed the Hyde amendment, which banned the use of federal Medicaid funds to pay for abortion and which many proponents still consider the countrys biggest barrier to abortion access today. The next time Jimenez became pregnant, she sought out an unlicensed midwife in McAllen, Texas. She died of a bacterial infection.
In fact, nearly every year after Roe v Wade brought isolated reports of a woman taking drastic steps to terminate her pregnancy. 1978: Three young women in Colorado poisoned their livers by drinking tiny amounts of aromatherapy oil to try to induce an abortion. 1984: A teenager injected herself with a local anaesthetic and attempted to cut out her fetus. 1994: A Florida teenager placed a pillow over her abdomen and shoot herself in the side.
Earlier this month, a woman in Tennessee was charged with exacerbated assault for trying to give herself an abortion with a coat hanger. She was found out after profuse bleed sent her to the emergency room.
It is against this backdrop of misfortunes that some reproductive rights activists have argued for attaining the same abortion medications used routinely in clinics available to women in their homes. It would be phenomenal if people could receive this drug in the mail with all the instructions and the right security measure, said Yamani Hernandez, the executive director of the National Network of Abortion Funds. Already, she added, the internet is permitting untold number of to find and use the medication without medical supervision. Among the 700,000 searches on self-abortion Stephens-Davidowitz identified in 2015, some 160,000 were searches for a style to obtain the abortion pill through back channels.
Is there a chance those searches could increase under a Trump presidency? Yes, said Hernandez. That is something that one could reasonably predict in an environment where abortion becomes even illegal, or even more inaccessible than it has been. We will do anything in our power to get people the information and the care that they need. Even now, her group posts instructions for self-administering misoprostol on its website For safetys sake.
Not all proponents feel good about disseminating this information. But they consider it better than the alternatives.
Recently, Roberts answered one of the scariest calls of her advocacy career. A young lady was on the line, saying her friend “ve been given” her a home remedy. Her friend claimed to have used this method to aim four separate pregnancies, even though each time it sent her to the hospital.
Ultimately, we helped this woman go to a clinic before she could do something dangerous, Roberts said. Her friend had told her to drink turpentine with sugar.
At a crisis pregnancy centre, an ultrasound confirmed that Martinas home remedies hadnt run. She was still pregnant. The distress must have shown on her face, because the technician offered a flurry of reassurances. They watch a lot of single moms who do it on their own. They have a store that sells baby clothes at a markdown. They help with discounts on daycare. Martina fumed. A baby is more than merely buying clothes and food, she thought.
In her head, she was already reviewing her scheme. She had heard back from merely one abortion money, which had turned her down for assistance because she had a task. And so, for a quarter of what a US abortion clinic would charge, she had bought a flight to Mexico City. The flight left the next day. She would stay with a friend. Abortion pills would expense about $20 at a pharmacy if she could find a pharmacy that carried the drug and would sell it to a young woman.
Then, she would take the medications at her friends house. Im gonna say like, Oh man, Im on my period, Im so sorry, I hate that this is ruining the trip, I feel so sick, she said, voicing perfectly unrehearsed.
Martina had relied on this kind of subterfuge for the past several weeks. Friends had noticed she was distracted. Her boss had noticed she was nauseous. This whole day that Ive been pregnant, and that Ive known Ive been pregnant, thats all Ive thought about, she said. Ive almost exclaimed like five times today. But you have to push that aside and act like youre penalty, she said: Oh yeah, Im sorry, I was zoned out for a sec. Oh yeah, sorry, just not feeling great.
The more difficult challenge was concealing her pregnancy from her boyfriend. She knew he would want to start a family. At home, she was taking so much anti-nausea medication to keep from vomiting in front of him that she no longer had enough to sustain her through the work day.
You feel alone, but you cant do anything about it, she said. I merely kind of have to set my feeling outside of it. You need to focus. What do you need to do in order to move forward?
Its kind of like when youre drowning. If you just flap around, youre just going to drown. But if you focus on what the goal is, on what you need to do, stay calm, thats how youre going to survive.
It was the sixth pharmacy Martina went to in Mexico that sold her the misoprostol. The first five, a mix of big national chains and mommy and pop stores, claimed they didnt carry it. She felt at least one pharmacist was lying to her. Eventually, she returned to the first store to ask, if not here, where could she buy it?
A little while afterwards, she paid $26 for a blue carton about the size of her hand. Misoprostol, it said. Caja con 28 tabletas.
It wasnt an exciting impression, holding the box. It was scary, Martina said. Its just like a God-I-just-want-to-get-this-over-with feeling. She was still too nauseous to take the pills while she was in Mexico City, so she would have to take them in the United States. It was a panicky moment, bringing pills back through customs. But there was a larger anxiety.
My biggest fear is, what happens if someone procures out? What happens if something is wrong with you? Martina had said a few days earlier. What happens if my body doesnt entirely rid itself? In most abortion clinics, she knew, a drug abortion was induced with two medications: one drug to discontinue the pregnancy, and misoprostol to expel the pregnancy. She would only be taking the misoprostol. So basically, youre half-assing the job.
She knew what symptoms would tell her something had gone wrong. But still. Theres just so many questions. I would so much instead have a health professional help me in this and various kinds of guide me through it versus DIY. Theres some things arent mean for that, and this is definitely one of them.
It is impossible to know what happened to all the other women who reached out to Women on Web. But a study of women who were rejected because they were past the clinics gestational restriction found that most of them carried their pregnancies to term.
Roberts, the Mississippi activist, said that many women who struggle to pay for an abortion eventually get creative. Not long ago, she spoke to a mother who was weighing whether to raid her diaper fund to pay for her abortion. It was unlikely her mothers would give her money for an abortion, she reasoned, but they would probably help her buy more diapers.
There are no more creative problem solvers, and I entail this, than women with no money, she said. And Im went on to say that with the utmost respect, because there are people who will think of all this as shady. And Im not. Ive watched people fighting, and being brilliant, brilliant, in coming up with ways to survive. Its a skill she dreads more women might need in the future.
Martinas trip had cost a fraction of the money she needed to raise for an abortion in a US clinic something her intellect was still trying to grasp. The whole time I was traveling, I couldnt believe it was happening, she said.
We were speaking a few days after she returned from Mexico. An ultrasound had just confirmed that she was no longer pregnant, and her voice was sunny. I am so relieved, to be honest. She hadnt realise, until she was no longer pregnant, how much stress she had placed on herself. Now, she felt like she could exhale, she said. Like she could step back on the road of her life and figure out where she had been when she diverged.
Martina had taken the pills on a Saturday. She took the first dosage. She set a timer on her telephone. Then she took the second dose.
The pills worked just like they were supposed to. She bled, but not too much. She felt the pregnancy pass. She felt exhausted.
And then it was done.
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