Since Texas passed a strict anti-abortion law in September, more and more women along the southern border have been going to unregulated pharmacies in Mexico to get abortion pills. Border health professionals fear the Mexican pharmacies have become a last resort for some women. Observers say it's a sign of what's to come if the Supreme Court overturns Roe v. Wade.
The main street of Nuevo Progreso, Mexico — just across the sluggish Rio Grande from Weslaco, Texas — is a chaotic border bazaar that caters to American day-trippers looking for bargains and exotica. The street is packed with businesses that sell prescription eyeglasses, dental care, switchblades, tequila shots, statues of ghoulish drug saints and over-the-counter medicine.
You can buy many medications in Mexican pharmacies without a prescription, including the pills that have transformed the way women are ending pregnancies. Today, more than half of all abortions in the United States are achieved by what's called a medication abortion, as opposed to a traditional surgical abortion.
One drug, Mifepristone, blocks the hormone needed for a pregnancy to continue; the other drug, Misoprostol, causes cramping and bleeding to empty the uterus. The FDA has approved them as safe and effective in the first 10 weeks of pregnancy.
Pharmacies in Nuevo Progreso have noticed a sharp increase in a certain clientele.
"You should see how many girls come and try to get an abortion," says Walter Garza, a counter clerk at Garcia's Pharmacy. "A lot. Like crazy."
Garza says the two-pill combination — along with his consultation about how to use them — is $400. "And I know they'll get more expensive with all the girls coming in to buy 'em," he says. But Gaza is not a doctor or a pharmacist. When asked where he gets his medical information, he says with a chuckle, "A doctor told me."
Misoprostol, which is also prescribed to prevent stomach ulcers, is freely sold over the counter. He sells Mifepristone, the exclusive abortion drug, under the counter. But Garza claims he doesn't actually like to sell either one.
"I'm a Catholic and it goes against my religion," he says. "But business is business. You know what I mean? I gotta eat."
A 9-month-old Texas law — considered the nation's most restrictive — all but outlaws abortion as soon as the fetal heartbeat is detected, usually at six weeks. There is no exception for rape or incest. Abortion rights advocates say this is especially relevant on the border where undocumented women are often sexually assaulted on their journey north. An undocumented woman who becomes pregnant cannot travel beyond the Border Patrol checkpoints on highways leading out of the Rio Grande Valley.
"They're stuck in the Valley with no access to abortion," says Carla Angulo-Pasel, a political scientist and assistant professor at the University of Texas Rio Grande Valley.
On the other hand, a documented woman in the Rio Grande Valley has more options. If she wants to visit an abortion clinic with the fewest restrictions, she must drive 14 hours to Las Cruces, New Mexico. She could order abortion pills from an overseas pharmacy — say, in India — that will mail them to her. Offshore pharmacies are beyond the reach of laws in Texas, where doctors are forbidden to prescribe medication abortion after the fetal heartbeat is detected.
Or she can drive a half-hour to the border and visit a Mexican pharmacy. This is no different than an American bringing Viagra or Xanax purchased in Mexico back across the border.
Planned Parenthood and other organizations have posted detailed information online about how to take abortion pills and what to expect. But some unsophisticated customers may rely on a Mexican pharmacy for their information.
"And the problem with that, of course, becomes the regulation aspect," says Angulo-Pasel. "We don't know if those drugs have been FDA approved. And then you have the problem of not even needing a prescription, so there is no actual medical attention given to these women. It's just out of desperation."
There can be serious complications, says Dr. Roberto Diaz-Gonzalez, an ob-gyn at the Brownsville Community Health Center.
"Probably the most common complication with the medication will be incomplete abortion," he says. "That means not all the tissue comes out. If the patient doesn't look for care, that can cause an infection."
Since Texas' anti-abortion law has been in force, some women in the Rio Grande Valley say they've gotten a foretaste of a post-Roe world.
"It's had a chilling effect on people trying to obtain abortion care," says Nancy Cardenas Pena, Texas state director for the National Latina Institute for Reproductive Justice.
But activists have resisted.
"People in red states still deserve access to abortion care and so we'll continue fighting every step of the way in areas like the Rio Grande Valley," she says.
She offers two examples of pushing back.
When the city of Edinburg tried to declare itself a "Sanctuary for the Unborn" last summer, after hours of public comments against the ordinance it went nowhere. And last month, when a 26-year-old woman was arrested and jailed for murder in Rio Grande City for having "a self-induced" abortion, the abortion rights community swung into action to win her release. Ultimately, the charges were dropped.
Says Cardenas Pena: "We had a very good victory that day."
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