Southern Border Brings Easy Access to Abortion-Inducing Drug

By Laura Tillman, The Brownsville Herald. Posted March 25, 2008.

There is no “abortion clinic” in Brownsville, but women here commonly and quietly undergo the procedure.

In Texas, abortion is legal during the first two trimesters of pregnancy. At the nearest provider in Harlingen, medical and surgical abortions are offered at reduced or no cost to women who cannot afford to pay.

But based on data about the number of self-induced abortions seen by local clinics and social workers, it is likely that many of the abortions undergone by women in this area are done using drugs purchased at Mexican pharmacies, without accurate information about the safest amount or method for inducing miscarriage.

Many Brownsville women and a significant number of men know the vague details of a little white pill called misoprostol, known by its brand name Cytotec and hesitantly referred to as a “wonder drug” by those who study it.

On the bottle a small icon of a pregnant woman encircled and crossed out in red illustrates the product warning: “Cytotec may endanger pregnancy (may cause abortion) and thereby cause harm to the fetus when administered to a pregnant woman.”

Anecdotally, stories of a friend or neighbor who has used it are passed along.

According to Harlingen Reproductive Services, the nearest clinic to offer abortion procedures, about half of the women they see have already attempted to use misoprostol or another prescription drug to attempt abortion. At Women’s Whole Health in McAllen, this comprises 30 to 40 percent of their clients.

If used properly, misoprostol is about 85 percent effective in inducing abortion, and most women will not need to seek medical assistance, according to one of the drug’s pioneering researchers for abortion usage, Dr. John K. Jain.

Misoprostol has been a popular option for women in countries where abortion is either illegal or inaccessible since the late 1980s.

In Texas, abortion is legal in the first 25 weeks of pregnancy. Cameron County is one of the 7 percent of Texas counties with a clinic. Still, for local women the cultural pressure and economic barriers to abortion often outweigh the risks of swallowing an unprescribed pill.

Even a conservative estimate would double and possibly triple the number of abortions occurring in the area.

Unknown Underground

Information on abortion statistics is easy to find, in part because of the stringent surveillance enforced by pro-life lobbying groups. But facts on self-induced abortion require significant investigation, beyond the scope of the average woman in the poorest city of its size in the United States.

Misoprostol hasn’t been extensively tested in this country for use as an independent abortion drug. Even the country’s foremost researcher of sexual and reproductive health, the Guttmacher Institute, has virtually no data on underground usage of the drug for self-induced abortion, because the practice is so secretive.

Research groups like the Population Council, Ibis Reproductive Health, and the National Latina Institute for Reproductive Health have begun gathering data on the accessibility and safety of misoprostol in the past few years.

But there is a reticence to disseminate the information, for fear governments could crack down on the distribution of this relatively safe alternative to informal surgical abortion.

In some countries where abortion is illegal, misoprostol availability has been reduced. Once the drug was widely publicized in Brazil, it became illegal to prescribe outside of a hospital setting.

Dr. Mitchell Creinin, the director of gynecological specialties and family planning at the University of Pittsburgh Medical Center, and one of the drug’s foremost researchers says that there’s no chance this will happen here.

“You have to remember it’s already part of the FDA approved regimen,” he added, referring to the mifepristone-misoprostol regimen available in the first nine weeks of pregnancy, which gives women the option of a medical abortion experienced at home.

The drug also remains useful for its labeled purpose, ulcer treatment, and in the treatment of arthritis and for gynecological purposes, like softening the cervix and inducing labor.

Long Drives, Legal Options

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