While the Supreme Court upholding the Fifth Circuit Court’s decision to allow Texas to keep enforcing its unconstitutional abortions restrictions does not mean they will eventually not strike down the law, it’s also not a good sign. The reason district court judge initially put a block on enforcing the law is that it’s quite obviously an undue burden on abortion access, due to the fact that it closed down abortion services at a third of the clinics offering them. So they had to reject that argument. So I’m worried. I won’t lie.
Even if things go the pro-choice way in the end, this will strike a permanent blow to access, especially in rural areas. Some clinics, like Planned Parenthood, mostly do other stuff, so they will stay open to offer contraception and well woman services. However, some abortion clinics exist only as abortion clinics—the demand is so high and supply is so lean elsewhere that they pretty much have to exist. So, those clinics that can’t comply are closing and rural areas. That said, one doctor, who is the only abortion provider in Harlingen, was interviewed by Slate and he explained how he intends to stay open and help women who need to terminate anyway.
Slate: What do you tell them?
Minto: That I do not do abortions. I cannot do them legally. And I tell them that I know that there are other things that people do.
Slate: What do other people “do?”
Minto: If they have a passport and enough money, they go over the border to Mexico and go to a pharmacy and buy misoprostol at a pharmacy. It is an ulcer drug, but it works as an abortifacient. It is not as effective mifepristone, which is the on-label medicine used in the U.S. But in these ladies’ situations, misoprostol can be a good choice. It is proper medicine in a blister pack from a proper pharmacy. Someone might even know how to dose it. But it can be an expensive choice. In the U.S., misoprostol costs 10 to 12 cents a pill. I have had ladies charged $80 a pill at Mexican pharmacies. Also passports are expensive and can take too long to get if you don’t have one already. Misoprostol only works up to about seven weeks after your last menstrual period. You need a passport now just to walk over the bridge into Mexico and back. Of course if you are undocumented this isn’t an option at all.
So after pointing them in the right direction, what other kind of help does he offer?
Slate: So the women take the drug and …
Minto: They stay close to home, and sometimes it all works fine. But if it doesn’t—or it works part-way, that is what often happens— they can come to me, and I can do “miscarriage management.”
Slate: That’s legal in Texas?
Minto: Yes, in Texas once a woman is vaginally hemorrhaging, it is legal for me to help her.
Slate: What does that involve?
Minto: The same thing as an abortion. It’s just a change in words. It’s double talk. It’s bullshit.
I feel like a broken record, but this is a point I cannot hammer home hard enough: The difference between “abortion” and “miscarriage” is a social construct and not a biological reality. Which isn’t to say it isn’t real, but it’s nonetheless important to understand that what makes an abortion different from a miscarriage is what part of a woman’s body rejects the pregnancy, her conscious mind or her uterus itself. (To simplify things. Obviously, spontaneous abortion has a myriad of causes, most unknown.) What this means is that you can’t tell if someone who presents to a doctor with symptoms of miscarriage had a hand in it. There’s no blood test you can take, and frankly, a lot of doctors would not want to. The first time abortion was criminalized, getting an illegal abortion meant having to have someone physically perform it. Now there are pills. That’s a game changer.
Of course, one thing that majorly sucks is that a lot of people want it to be just this way. A lot of people, even ones who claim to be “pro-life”, think of it this way: They don’t really want you to never have your abortion, but they think you need to work harder for it. To quote Dr. Minto, “Women are forced to crawl around like goddamn criminals,” and that’s roughly what many people think they should have to do in order to get an abortion. The idea that it’s a major hassle but that you get to have one anyway is the point—a sort of state-mandated penance and shaming period for you. This is the reality of how things play out. We know this because of how many anti-choice policies amount to telling women to work harder and endure more shaming: Ultrasounds, waiting periods, etc. And we know this because this is the logic underpinning clinic protest. They pretend it’s to talk women out of it, but it’s mostly to make sure women can’t go in without assholes trying to shame them first.
And ultimately, this is about well-off people using poor women as objects to express their sexual shame. They believe sex is naughty, but they don’t want to be the ones who are expected to suffer for that belief. Poor women are required to suffer and the rich hypocrites pat themselves on the back for their “moral values” while getting expensive and discreet abortions by traveling or having a private family doctor who doesn’t advertise that service.