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In Texas, it can be very difficult and very costly to get a legal abortion. This is causing more and more young women to get do-it-yourself abortions. They walk across an international bridge to a Mexican pharmacy to buy the abortion pill. As NPR's John Burnett reports, without the supervision of a doctor, the results can be troublesome.
JOHN BURNETT, BYLINE: Nuevo Progreso, Mexico sits across the river from Progreso, Texas. In the crowded, chaotic sidewalks, it's all here for the asking - dental work, eyeglasses, pirate DVDs, tequila shots, prostitutes and cheap, plentiful prescription medicine. Highly restricted drugs like Xanax, Ritalin and Valium are sold like aspirin over here.
A big seller is the powerful abortion pill Misoprostol, not to be confused with the morning-after pill. A fleshy man with gold caps on his teeth named Roberto Gonzales sits on a park bench. He worked as a clerk in a Nuevo Progreso pharmacy until recently. He remembers the constant stream of customers asking for an abortion drug with the brand name Cytotec.
ROBERTO GONZALES: (Through interpreter) We sold it like hot bread. The girls in Texas came over to buy this treatment - eight to 10 tablets for a pregnancy of nine weeks. It works the fastest.
BURNETT: Roberto now makes a living washing cars and hustling on the streets of Matamoros. But for the eight years he worked in Nuevo Progreso, he says he learned a few things about the drugs he sold.
GONZALES: (Through interpreter) They'd ask me how to use it. And I tell them what I heard. Many times, the instructions inside the box tell them how to do it - how to induce an abortion. I'd warn them it's dangerous. Lots of time, there's heavy bleeding.
BURNETT: His advice to customers highlights the risks of improvised abortions. Instructions inside the box say nothing about how to take Cytotec to abort an embryo. Abortion is illegal in every state in Mexico. Cytotec is only sold as an ulcer medicine. So that leaves customers to pick up instructions from friends, off the internet or from untrained pharmacy employees like Roberto.
GONZALES: (Through interpreter) Now I'm looking for work again in a pharmacy. We'll see what happens.
BURNETT: Janet Crepps is senior counsel at the Center for Reproductive Rights in New York. Upon hearing Roberto Gonzales's comments, this was her reaction.
JANET CREPPS: That's just a terrifying state of affairs - that women would turn to someone like that to give them that advice. It's the 2016 version of the back-alley abortion. And it's a very sad state of affairs.
BURNETT: The regimen for abortion medication recommended by the World Health Organization consists of one dose of a drug called Mifepristone to stop the pregnancy, followed 24 to 48 hours later by four tablets of Misoprostol to induce a miscarriage. Taken together, the pills have a 95 percent success rate.
Misoprostol-only abortions, the kind offered in Mexico, are significantly less effective, according to a warning from the American College of Obstetricians and Gynecologists. Priscilla found this out the hard way. She's a law student in Matamoros who says she was 18 years old when she bought some Misoprostol to bring my period back.
PRISCILLA: (Speaking Spanish).
BURNETT: "I was at home when I took the pills. Then I started to hemorrhage," she remembers. "I felt awful. I thought the medicine was working. But it didn't."
In Mexico, women can be prosecuted for going to a public hospital showing signs of an attempted abortion. So Priscilla says she found a doctor in town who performs surgical abortions confidentially.
PRISCILLA: (Speaking Spanish).
BURNETT: "He took me into a room," she says. "He put me to sleep and terminated the embryo. I was so scared, so confused."
PRISCILLA: (Speaking Spanish).
BURNETT: Abortion is, of course, legal in the United States. In the border city of McAllen, the Whole Woman's Health clinic offers abortions. So why are Texas women going to pharmacies in Nuevo Progreso? It could be a matter of cost. A medical or surgical abortion in McAllen costs $500.
The Rio Grande Valley is one of the poorest regions in the country. In Mexico, a pack of abortion pills sells for under $50. It could be that abortions are just more trouble in Texas, with all the rules imposed by the legislature. A woman has to get an ultrasound and see the doctor three different times.
There's another possibility. Women seeking an abortion may not know the clinic is still open in McAllen. After the law went into effect, the clinic closed. Then a federal judge ordered it to reopen. The vice president of Whole Woman's Health is Andrea Ferrigno.
ANDREA FERRIGNO: The point is - if you're pregnant, you don't want to be - and what are the options available to you next? And the last thing you heard was that the clinic was closed and that there was some sort of case in the Supreme Court about it. It's confusing.
BURNETT: The GOP-dominated legislature passed the anti-abortion law with the stated goal of protecting the health and safety of Texas women. Abortion rights advocates contend it does the opposite - that it encourages do-it-yourself abortions. I put that question to Joe Pojman, executive director of Texas Alliance for Life, a strong supporter of the omnibus abortion bill.
Does it concern you that the harder it is to get an abortion in Texas, the more women are going to go across the border and buy their pills in Mexico and not be under the guidance of a physician?
JOE POJMAN: I just don't see a time when abortion is not readily available in Texas. And that is just not our goal. We have a goal of protecting innocent human life from conception through natural death using peaceful, legal means and by promoting compassionate alternatives to abortion.
BURNETT: Since Texas adopted its new abortion rules, more than 20 women's clinics have closed. The Supreme Court is expected to rule this month on the constitutionality of those restrictions. Supporters of abortion rights predict if the justices uphold the law, more clinics will close and the Mexican border pharmacies will get even more business. John Burnett, NPR News, Austin.
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