AMERICA’S GREAT ABORTION SCANDAL Why Trump could ban terminations

Having a termination isn’t illegal in the US. But with Donald Trump now in power, many fear that’s about to change. Cosmopolitan investigates the alarming backslide on reproductive rights that has a growing number of women taking matters into their own ha

She was exhausted and nauseous, her breasts aching at even the slightest jostle. With a few years as a sexual health educator under her belt from her college days, Kelly Lane* looked down at the little white stick to confirm what she already knew.

Kelly also knew she was not interested in having a child. She was 25 years old, unemployed, and about to move in with her family, because she could no longer afford to pay her own rent. Parenting, even if she wanted to, would be impossible.

Determined to quietly end the pregnancy without telling anyone, she called her local sexual healthcare clinic, Planned Parenthood. Located in Jacksonville, Florida, it’s in one of the many conservative states in the US, where abortion clinics are rapidly closing. The woman who answered the call was sympathetic, but couldn’t help. They didn’t do abortions, she said. Not all of them do.

Panicking, Kelly shakily dialled the number for a private clinic Planned Parenthood had suggested. They could see her, but the procedure would cost $500. She hung up, and cried for the second time that day.

A few hours later, her face dry, she took a deep breath and pulled her laptop towards her. If the doctors couldn’t help her, she would have to help herself…

America is hailed as the great democracy of the free world. One of the richest, most developed and scientifically advanced countries on earth. Yet it is also greatly divided on one fundamental issue: abortion. Currently, abortion is legal in all 50 states of America, after a 1973 landmark Supreme Court case known as Roe vs Wade recognised the right of any woman, along with her doctor, to choose abortion in the early stages of pregnancy. However, the anti-abortion movement is a powerful force in the US, and over the past 44 years, law-makers in various states across the country have been passing bills that chip away at the freedom women have to choose – making abortion, though legal, sometimes impossible to access. And now, the Pro-Life and Pro-Choice power struggle is reaching a very dangerous tipping point.

Why? Well, last year, President Trump was elected with more political power than any Republican President since 1928. Republicans, the more conservative (and Pro-Life) of America’s two main parties, won control of both the House of Representatives and the Senate, as well as most of the country’s governorships. This majority gives Trump the power to make and change laws in a way Obama could only dream about. Trump was also in a position to appoint his choice of judge for the Supreme Court, and as he has nominated conservative judge Neil Gorsuch for the role, there’s every chance Roe vs Wade will be overturned and abortion will become illegal. But in 22 states, the rules are already so hostile that medically supervised, safe and affordable abortion is available in theory but not in practice. That’s why hordes of women are taking drastic action themselves.

KNOWING YOUR RIGHTS

To put this in context, women in the UK can have an abortion for free on the NHS, or in a private clinic anywhere in the country. Our health service funds 90% of abortions. Meanwhile, women in Texas alone have seen half of their abortion clinics close in the past four years. There are now just 20 clinics for a population of more than 5 million women (of reproductive age). In the states of North Dakota, South Dakota, Wyoming, Missouri, Kentucky, West Virginia and Mississippi, there is just one single clinic remaining in each state, due to hostile environments. Another dozen states have just two or three. As a result those seeking abortions may find themselves travelling 100 miles, or even further, to find help. Some even go across the Mexican border, where misoprostol (the ulcer drug commonly given for medical abortions) is available over the counter.

This is why researchers estimate that between 100,000 and 240,000 women, just in Texas alone, have attempted to end their pregnancies on their own. What’s more, this, according to other state laws, is also an offence punishable by time in prison. Since 2011, women in Idaho, New York, Indiana, Georgia and Tennessee have been arrested for attempting to induce their own abortions. In most cases, they used medication, although in Tennessee one woman was so distressed that she inserted a wire coat hanger into her vagina. Even those in New York, where access to abortion clinics is much easier (and,

“In the UK, our health service funds 90% of abortions”

mostly, covered by health insurance) still lose sleep at night – for fear of what the future holds.

DESPERATE TIMES

On the surface, Florida shouldn’t have been a difficult state for Kelly to obtain an abortion in. Unlike most states, there was no waiting period, and more than one clinic available. However, Florida, like 32 other states, doesn’t allow Medicaid insurance – the plans used by low-income and no-income residents without private insurance coverage – to pay for an abortion unless the patient had been raped or was in danger of dying. Kelly had no insurance. Now that she was pregnant she could qualify for Medicaid, but it wouldn’t cover an abortion (although it would pay for prenatal care and delivery). How was she supposed to be able to afford a $500 abortion?

That’s how, late one night, she found herself researching ‘natural’ ways she could force a miscarriage. Finally, after reading about it on a few websites, Kelly took massive amounts of vitamin C, then chased it with dong quai root – a Chinese herb thought to bring on menstruation by affecting oestrogen levels. Her nausea got increasingly worse and she began compulsively checking for signs of the blood she so desperately wanted to see.

Then a sharp, constant pain in her abdomen began to frighten her. “I started to feel more sick. My stomach started cramping all the time. That’s when I stopped. I was worried I was doing damage to my health.”

Kelly’s story is just one of many. According to an analysis for The New

York Times by journalist Seth Stephens-Davidowitz, there were more than 700,000 Google searches performed on some variant of self-induced abortions just in 2015, the year that clinic closures hit their highest. Of those searches, 160,000 were looking for how to buy abortion pills, tens of thousands looking for methods like vitamin-C dosing, and, most alarming of all, 1,300 searches for the phrase ‘how to do a coat hanger abortion.’

The risks of any of these methods go way beyond the staggering physical costs to the women involved. They also carry a legal cost, too. Purvi Patel, an Indiana woman accused of murder for inducing her own abortion later in her pregnancy, faced 20 years in prison for feticide – and served 18 months for ‘child neglect’ when the original charge was finally overturned. Anna Yocca, the Tennessee woman who used a coat hanger, was charged with attempted murder, and served 13 months before she was allowed to have her plea reduced to ‘attempted procurement of a miscarriage’ instead.

Those crossing the Mexican border to get abortion drugs now also face an additional risk, in light of Trump’s vow to deport three million undocumented immigrants once elected. According to a 2012 study by the Texas Policy Evaluation Project, 12% of women living near the Mexican border reported trying to induce their own abortions – the Texas population of undocumented immigrants is projected to be around 1.75 million people. Their choice? Carry an unwanted pregnancy to term, or lose access to their own children in the US.

NOWHERE TO TURN

Sarah* sat huddled on the bathroom floor, wrapped in the pain of her own self-induced abortion. It was Sunday, and everyone else was at church. She lived in the Bible Belt – a stretch of the US known for its ultra-conservative political views and Christian religious practices – and although she and her husband were very liberal, the people around her, who she worked with, lived near, spoke to at the shops, were not.

This baby was a mistake. She was 36, and during a rough patch in her marriage, had had an affair with an old friend – a doctor at her local hospital. Her husband had had a vasectomy. There’s no way it could have been his.

The minute her period was late, she knew. All of the secrets came out. Both men agreed with Sarah that abortion was the right decision, so she made an appointment at a Nashville clinic right away, hoping to be given RU-486, the combination mifepristone and misoprostol medication protocol that would make this all go away.

At the clinic, aggressive older protesters shouted at them and teenage abortion opponents ran up and down the line, trying to speak to them and thrust pamphlets about the horrors of abortion into their hands. Once Sarah was inside the clinic, staff rushed her into a room for an exam, abruptly telling her that they didn’t see anything on the ultrasound. They did a pregnancy test, but didn’t leave it for long enough. They told her she’d have to come back again in a month. Not knowing how far along she was, she was worried this might leave her outside the seven- to nine-week window in which you’re allowed to have a medical abortion, before you have to have surgery.

She called up the old friend she’d had the affair with and begged him to write her a prescription for misoprostol. Used on its own, misoprostol is 90% effective at causing an abortion itself, although it is more effective when used in conjunction with mifepristone, which suppresses the hormones that allow a pregnancy to continue. He agreed, and she picked up the pills on a break at work and took the first dose immediately on her way back. It didn’t work.

“I bled a little bit,” says Sarah. “I thought, ‘Wow. OK, this wasn’t so bad.’ I mean, I was ready for it

“It’s Nashville, Tennessee. You don’t talk about abortions here”

like I would be ready for a period.”

The bleeding stopped but the morning sickness didn’t, and Sarah was still gaining weight. A month later, she took a new pregnancy test. Still positive.

Sarah was at least nine weeks pregnant now, close to the end of the window where a medication abortion is recommended, and everyone involved was increasingly desperate. So she tripled the dose, and this time it worked.

“The hard part was when the contractions started,” Sarah says. “It was cramping, like having my period only worse. It went on for two hours. Then, finally, I could tell something was coming out. We just wanted it done and we wanted it done quietly because it’s Nashville, Tennessee. You don’t talk about abortions here.”

UPPING THE ANTE

Sarah was lucky to be able to access a prescription, but other women have to resort to increasingly more drastic measures. The most popular route is to search for websites that sell the medicine, hoping that the pills that arrive aren’t counterfeit and dangerous. Others are contacting international women’s rights groups hoping to get pills through them, not realising that these organisations can’t ship them medication as long as abortion is still technically legal.

“Since Trump has ascended, we’ve seen more women asking us to provide drugs to the United States,” says Leticia Zenevich, a spokesperson for Women On Waves, an international organisation that ships medication abortion pills into countries where abortion is illegal. “We’ve had heartbreaking letters from people who could have gone to Mexico, but couldn’t cross the border because they didn’t know if they’d be let back in.”

Things have got so bad that, in April, another international women’s health organisation, Women Help Women – which already provides counselling and support in over a dozen countries across the globe – announced a new online portal for US-specific information regarding abortions using medication. This includes a secure contact form to safely and privately ask questions about the protocol without fear of arrest.

US civil rights groups are upping their own efforts, too. The SIA (Self-Induced Abortion) Legal Team based out of The University of California, Berkeley School of Law, has begun an effort to inform people of their legal rights when it comes to ending a pregnancy outside the clinic setting. There are even underground training groups explaining World Health Organization protocols for inducing abortions with misoprostol, or explaining how ‘menstrual extractions’ can be performed if the right equipment is used.

This support network can’t come soon enough. If one more pro-life anti-abortion Republican Supreme Court appointment is made, there will be enough votes to overturn Roe vs

Wade, allowing each state to decide if it wants abortion to be legal or not. At this point, 22 states have laws to make abortion immediately illegal if that occurs, and another 11 states are likely to follow suit. That would leave abortion legal in just 17 states in the country – and illegal in most of the middle US and South. Things could be about to get a whole lot worse.

ONWARDS AND UPWARDS

Kelly eventually got financial support from her parents and boyfriend (today her fiancé) to make an appointment with the clinic and pay for the termination. After making her way through the protesters outside the doors, she eventually ended her pregnancy legally in a safe, clean medical setting. Now, Kelly volunteers at a North Carolina charity that helps others get funding for their own abortion, so they don’t risk their own health and future fertility trying to induce on their own like she did.

“We have patients that call us and say, ‘I’m pregnant and I can’t afford it. How much bleach can I drink?’” says Kelly .“We get lots of those kinds of questions, from people saying, ‘I don’t even know if abortion is legal now,’ or ‘Do you know how I can get those pills [misoprostol]?’” Kelly estimates that at least one caller every month asks about how to end a pregnancy on her own. “I get that question about bleach at least a few times a year,” she admits.

If this many people ask, she wonders, how many are trying it on their own without telling anyone at all?

“We have patients that call us and say, ‘How much bleach can I drink?’”