Crossing the Line
Diana moved to Brownsville at 4, but her parents maintained strong ties to their home country. They never discussed sex with her. "It was implied that you wouldn't have sex until marriage," she says. "It was still a taboo subject." Jackie Christensen, a Brownsville teacher who taught high school health classes for more than two decades, says this is typical. "I would always start the class by asking if the students had ever talked with their parents about sex," she says. "I'd be lucky if one or two raised their hands." It wasn't until Planned Parenthood came to Diana's high school to give a presentation about sex and contraception that Diana became informed on the subject. These days, Planned Parenthood is no longer permitted to make such presentations in the district, and contraception is prohibited in the classroom. Christensen says she tried to fill in the gaps for her students but that many health teachers felt too uncomfortable. "A lot of health teachers didn't want to teach that topic," she says. "They wouldn't go into detail." Stories of underground abortions were so common that she took to warning against them during health class. "I'd tell my students, 'If you do things your own way, there could be damage to the uterus,'" she says.
Manipulating information women who are seeking abortion receive is a staple of antichoice politics. A recent episode of Friday Night Lights reveals how damaging that strategy is.
The familiar history of botched abortions has made Misoprostol increasingly popular among women seeking out a less dangerous private alternative to abortion, particularly in places where abortion is illegal. The Planned Parenthood in Brownsville reports visits by women who have used syringes, taken cocktails of prescription drugs, douched with battery acid and beaten themselves in the abdomen to attempt abortion. "These pills are beginning to revolutionize abortion around the world, especially in poor countries," New York Times columnist Nicholas Kristof wrote this summer, noting that the drug would be difficult to ban because of its other uses, which include stopping postpartum hemorrhages. Rebecca Gomperts, founder of the organization Women on Waves, which provides reproductive health services around the world, agrees. "It creates autonomy," she says. "The fact that [women] can just take a medication is huge, because they don't have to depend on someone else doing something to their bodies."
Gomperts believes that using Misoprostol can actually be preferable to going to a clinic, particularly if a woman has access to information on how to use it correctly, knows how long she has been pregnant and can get medical help if something goes wrong. Still, there are significant risks: if used incorrectly, Misoprostol can cause the uterus to rupture and bring about internal bleeding. "In one of the most extreme cases, the girl took over a hundred pills," Dr. Minto, of the Harlingen clinic, says. "It's amazing that she survived." Diana, too, was lucky. She now knows that taking the pills that far into her pregnancy was dangerous. She could have caused her child to have birth defects, had the drug not worked and had she carried to term. Or the pills could have caused her to hemorrhage or prevented her from having children in the future. That, she says, scares her.
A number of recent studies looking at self-induced abortions in the United States suggest that women across the country continue to seek out alternatives to clinics that are embattled, increasingly costly and geographically inaccessible. Dr. Dan Grossman, of Ibis Reproductive Health, whose research on the topic has focused on various US cities as well as the Rio Grande Valley, says the group of women attempting self-induced abortion is fairly diverse. An ongoing study by the Guttmacher Institute corroborates this: 79 percent of women who tried self-induced abortion were from the United States, and that number was spread across twenty states.
"I think our findings suggest that there are still significant barriers to abortion care in the United States," Grossman says. "Those include the high cost of abortion care—and in most states Medicaid cannot be used to cover abortion care." Low-income women feel these barriers more acutely. Three-fourths of women who have an abortion say that, like Diana, they cannot afford a child, according to the Guttmacher Institute. Forty-two percent of women having abortions are below the federal poverty line.
Brownsville, located in one of the poorest counties in the country, illustrates this economic divide. Driving through one of the new subdivisions, you could easily assume the city is middle-class. The adobe and brick homes look alike, with tall palm trees punctuating the wide lawns. Lakes where ibises, anhingas and ducks dive for food provide a scenic backdrop for the city's wealthier families. But Brownsville's poor neighborhoods resemble those across the snaking Rio Grande and the eighteen-foot border fence along its northern bank. Houses here are cobbled together from cheap wood and scrap metal, dogs run wild and the smell of sewage wafts through the streets. There is no medical school or law school for hundreds of miles, and while many soldiers in the military come from this area, there's no veterans' hospital either. As in many poor areas in the United States, health services are often acquired at the emergency room, with little preventive medicine being sought. Here, women don't often have a consistent relationship with a physician they trust. Instead, care is delivered at times of emergency. In such an environment, a mission like Ferrigno's at Whole Woman's Health remains incredibly challenging. Without better healthcare education, affordable coverage and information for women about their reproductive rights, risky, self-induced abortions will continue. A drug like Misoprostol may be proving to be a safer alternative, but it is no substitute for reproductive care that happens out in the open, with the expertise of a medical professional.
For her part, Diana understands this. Now that time has passed, she has reflected on her experience. She knows she took a risk and admits she would have had regrets had things turned out differently. But when asked what she would tell another woman who is seeking an abortion and weighing her options, Diana takes a moment to reply. "Logically, you should go to a clinic," she says. "If you have the money, you should. It's safer. But the whole thing of being in a clinic like that is, it traumatizes people too. Really, the more private thing and the more convenient thing to do would be to just take the pill."