As state anti-choice legislation shutters abortion clinics, abortion rights advocates say the country is beginning to see the impact on access to safe care. The last remaining abortion clinics in Mississippi and Alabama are just a court decision away from being closed. In parts of Mississippi, Black women’s maternal mortality rate is on par with countries in sub-Saharan Africa. Abortion rights advocates say unfettered abortion access is critical to the health and safety of Black women. But it is becoming challenging in states with large African American populations.
According to new Texas Policy Evaluation Project (TxPEP) surveys, researchers estimate between 100,000 and 240,000 Texas women between the ages of 18 and 49 have attempted to terminate their pregnancies without the assistance of an abortion provider. The first of its kind study surveyed 779 women and conducted 18 in-depth interviews to explore the experiences of the 4 percent of women attempted to abort their pregnancies. Nationally, less than two percent of women attempt to self-induce an abortion before traveling to a clinic. But in Texas, the amount is significant in comparison to the population because the Black female population there is 1.8 million, more than 51 percent of the 3.5 million Blacks in the state, according to the U.S. Census Bureau.
In addition, Black Texans, make up 12.5 percent of the population there, but 30 percent of people obtaining abortions, although the study found that self-induction was actually more prevalent among Hispanic Texas women.
Although she lives in Georgia, stories like that of Kenlissia Jones are similar. Jones, 23, was arrested in June after self-inducing her own abortion using Cytotec, an abortion which she purchased over the Internet from a Canadian seller. According to a police report, Jones went into labor while in a car and delivered en route to the hospital. The fetus was pronounced dead 30 minutes after arrival. Jones’ brother told the Washington Post she was unable to afford an abortion in a clinic, and took matters into her own hands.
Like Jones, the women surveyed in Texas said they attempted to self induce because they did not have the financial resources to pay for their abortion or travel to a clinic, the clinic closest to them had closed, a friend or family member suggested self-induction, and they wanted to avoid the shame and stigma of going to an abortion clinic. “I didn’t have any money to go to San Antonio or Corpus,” said a 24-year-old survey respondent. “I didn’t even have any money to get across town. Like I was just dirt broke. I was poor.”
Researchers noted that poverty, in addition to legislative and social barriers, created challenges that left women with self-inducing as their only option. An overwhelming majority of women obtaining abortions cite financial barriers as a need to terminate their pregnancy, and women denied abortions are three times as likely to live in poverty two years later. Barriers to public health insurance coverage, including Medicaid, make abortion unaffordable and force 1 in 4 women to carry an unwanted pregnancy to term.
Women surveyed used a variety of methods to self-induce their abortions including largely ineffective herbal and tea remedies recommended by friends or family members, as well as Cytotec, purchased in Mexico where it is available without a prescription. “…I took black cohosh so that’s when I did some research and they said black cohosh with vitamin C would work. And then a special root pill,” described a 20-year-old woman from Houston. “I can’t remember the name. And after a while taking all the pills was very nauseating and I didn’t want to do it anymore. So, it was just a lot to take in and I wasn’t taking it well, but I kept doing it anyway.” Her abortion was not complete and she later had a surgical abortion.
This study comes on the heels of the Supreme Court agreeing to hear the Whole Woman’s Health v. Cole case, a challenge to HB 2, Texas’ omnibus abortion legislation, passed in 2013 which closed a majority of the state’s abortion clinics. Should the Supreme Court uphold the law, Texas, which has over five million women of reproductive age, will be left with fewer than ten abortion clinics, and could clear the way for states across the country to close more abortion clinics.
“As clinic-based care becomes harder to access in Texas, we can expect more women to feel that they have no other option and take matters into their own hands,” explained Dr. Daniel Grossman, TxPEP co-investigator and Professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Francisco. “This is the latest body of evidence demonstrating the negative implications of laws like HB 2 that pretend to protect women but in reality place them, and particularly women of color and economically disadvantaged women, at significant risk.”
Renee Bracey Sherman is a writer, reproductive justice activist, and a member of Echoing Ida, a project of Forward Together that amplifies the voices of Black women around critical social justice issues. Follow her on Twitter at @RBraceySherman.