Image by Vgrigas.
Dayana González decided to tell me her story only after we’d had two lattes at the small coffee shop where she had agreed to meet me. In the midst of talking about abortion legislation, her face shifted.
She began to tell me the story of a young woman who stood alone outside a lock shop in a rough neighborhood. Inside, surrounded by key-covered walls, the woman handed the clerk some money and said the right words. He led her to a back room, a bed covered in white sheets. Fifteen minutes later, the woman caught a bus home, wiped up the blood on the seat when her stop appeared. Instead of sleeping, she worried about infection; in the morning, she pulled herself out of bed and went to class—more afraid of raising suspicion than of dying from complications.
When González finished speaking, she cried a little. She told me how powerless she’d felt when she was forced to choose between her future and a life-threatening procedure.
González (a pseudonym used to protect her safety) had her abortion in Bogotá, Colombia, but her story is a cautionary tale for women in the United States, where our reproductive rights are under continuous attack.
The U.S. Supreme Court is expected to release its opinion on Whole Woman’s Health v. Hellerstedt this month. Its decision will determine if the TRAP (Targeted Regulation of Abortion Providers) laws that have closed down half of abortion clinics in Texas violate the “undue burden” standard established in Planned Parenthood v. Casey. In other words, it will decide if the Texas TRAP laws make it unconstitutionally difficult for a woman to assert her right to a legal abortion.
If the Supreme Court upholds the Fifth Circuit Court’s ruling that these TRAP laws are constitutional, not only will Texas clinics stay closed, clinics in other states where similar legislation is in play may close as well. Many U.S. women will find themselves in González’s situation.
As this threat to abortion rights hangs in the balance, it is essential that we remember legislation is important, but it is not enough. Unless the rights legally guaranteed to U.S. women are available in practice in every state, the Roe v. Wade decision becomes no more than a piece of paper.
The same sort of paper that, in theory, places reproductive rights in Colombia ahead of many other Latin American countries. As of 2006, abortion was decriminalized in Colombia in cases where the pregnancy endangers the health of the mother, is nonviable, or is the result of rape or incest.
But Catalina Martinez, a regional director at the Center for Reproductive Rights in Colombia, says despite the law, Colombian women face constant barriers to accessing abortion care. Respondents to a Guttmacher Institute survey reported providers stalling or refusing to provide legal abortions outright on moral grounds. Women often face moral judgment from family and community.
The barriers U.S. women must overcome when seeking abortion care are similar. Anti-choice doctors fail to perform prenatal testing for fear their patients might choose to terminate a pregnancy and pharmacists refuse to dispense the pills necessary for medical abortion. Families disown daughters and sisters. Protesters with gruesome signs block the paths of women seeking care.
And this is what women in the United States currently face. Many conservative U.S. politicians seek to implement additional abortion regulations that are far more restrictive than those on the books in Colombia, where—because of cultural and legal hurdles—the vast majority of women seeking an abortion still turn to illegal clinics. Of the over 400,000 abortions in Colombia each year, less than one percent are legal procedures.
If these politicians are allowed to have their way, the reality for U.S. women will worsen. Studies show that abortion rates in countries with legal restrictions do not fall. Instead, women simply are forced to seek more dangerous abortions. Already, between 100,000 and 240,000 women in Texas know someone who has or have themselves tried to end a pregnancy on their own. As clinics become sparser and more strictly regulated, that number can be expected to rise, and with it, the danger to women’s health.
González intimately understands the danger inherent in illegal abortion—she lost a friend to an unsafe, illegal procedure. According to a 2013 Guttmacher Institute report, roughly 70 women a year die in Colombia as a result of unsafe illegal abortions; thousands more end up in the hospital. Is the United States ready to confront these kinds of numbers among its own population?
In Colombia, the most common method of self-induced abortion is misoprostol–one of the two ingredients in RU486. Misoprostol is also used to reduce the risk of ulcers. Because of this, it is more easily attainable than other medical abortion drugs. It’s sold over the counter in many countries, as it is in Colombia, and is easily bought on the black market in others, including the United States. In fact, respondents to a Texas Policy Evaluation Project survey identified misoprostol as the most common method among women who reported knowing someone who had attempted to end their own pregnancy.
The problem is, used incorrectly, misoprostol can lead to serious side effects requiring medical attention. If abortion restrictions, like the Texas TRAP laws, are upheld in the United States, it is likely that more women will turn to misoprostol—as well as more extreme methods of ending their own pregnancies—and more health complications will ensue. The World Health Organizations has directly linked constraint of abortion care to health outcomes—the highest abortion-case-fatality rates are in countries with legal restrictions on abortion.
Organizations in Colombia, and activists like González, are working to move beyond an on-paper-only decriminalization to true freedom of access. If women are to have real access to legal abortions, says Martinez, Colombian society as a whole must recognize abortion as a decision that only women can make.
If we in the United States don’t come to the same conclusion, the trajectory of U.S. reproductive rights will take an even uglier turn than it already has. As Colombia fights to move forward, the United States will continue to move backward. And despite legal protections, U.S. women will have less and less power over their own bodies.
Alice Pettway is a poet and writer whose work has appeared in over 30 print and online journals. Currently, she teaches creative writing in Bogotá, Colombia.