A recent New York Times article about self-induced abortions in the Latina community provoked much debate within the reproductive health world.
The January 4th article, “For Privacy’s Sake, Taking Risks to End Pregnancy,” examined two studies on do-it-yourself abortions among Latinas in New York, San Francisco, and Boston and featured interviews with community leaders in the Dominican community in Washington Heights. The article focused on the use of misoprostol, a prescription ulcer drug, to self-induce abortion. Misoprostol is one of two drugs used together to induce non-surgical abortion, but it is not approved by the FDA to be used alone for abortion. The article cites misoprostol as one of a number of unconventional, and potentially risky, at-home methods “frequently employed in attempts to end pregnancies by women from fervently anti-abortion cultures despite the widespread availability of safe, legal and inexpensive abortions in clinics and hospitals.”
This article highlights both the barriers that many women, especially those in immigrant communities, face in accessing professional reproductive health care services and the lengths that women will go to end their pregnancies, with or without professional medical care.
But a few experts have criticized the article on “sensationalist” grounds. In a response on RH Reality Check, researchers from Ibis Reproductive Health and Gynuity Health Projects— the organizations that conducted one of the cited studies—said the article overstated both the prevalence of misoprostol use and the dangers associated with it. While clearly not the best abortion option, a Gynuity study attests that misoprostal is effective in 85-90% of cases. Critics also call the article’s assertion that self-induced abortions in New York are “illegal” and “illicit” misleading. Although many states do have laws outlawing self abortion, New York is not one of them.
Still other critics have criticized the myth that “safe, legal, and inexpensive” abortions are readily available. Jessica Gonzalez-Rojas, director of policy and advocacy at New York-based National Latina Institute for Reproductive Health, was interviewed for the Times story, and says she is disturbed by the resulting article. “We dispute the Times‘ implication that accessing clinics is very easy,” she said. “There’s the idea among undocumented women that they’ll be deported if they go to a clinic, and the Times is wrong about the price of an abortion being cheap for many women.”
Indeed, the article glosses over the very real and damaging barriers to abortion access faced by many low-income and immigrant women. The Hyde Amendment, passed by Congress in 1976, exempts abortion from the medical procedures covered by federal Medicare funds except in the most extreme cases. With 19 million women who rely on Medicaid for their health care coverage—not to mention the additional 17 million women who are uninsured—many low-income women must pay out of pocket for abortion procedures. As the average cost of an abortion at 10 weeks’ gestation is $370 dollars according to the Guttmacher Institute, this represents a huge barrier to access. The National Institute for Reproductive Health’s Low Income Access Program addresses these very difficulties that all too often prevent low-income women from accessing abortion, contraception, and other important family planning services
Besides cost, cultural obstacles also often plague immigrant women—including fear of telling family members, mistrust of the health-care system, fear of surgery, worry about deportation, and concern about clinic protesters. All of these factors can combine to drive women to taking their abortions into their own hands.
Whatever the problems with the article, the reality of self-induced abortions is a stark reminder that many low-income and immigrant women do not have access to the reproductive health services they need. And a reminder that in the face of restricted access and an anti-choice environment, women will always do what they have to do to end unwanted pregnancies.
For more responses to the article see here.
By Maya Dusenbery