English-speaking, Texan and from vulnerable backgrounds: The Americans still accessing abortion thanks to Mexican feminists

The year 2023 was pivotal for understanding the effects of abortion restrictions in the United States. A year earlier, in June 2022, the U.S. Supreme Court issued the decision known as Dobbs v. Jackson Women’s Health Organization (JWHO), which overturned the abortion-rights protection established by a previous ruling from 1973: Roe v. Wade. Since then, thousands of American women have ended pregnancies with help from Mexican feminist collectives. Several recent studies put a face to those seeking abortions: a large share come from states such as Texas, where abortion is banned, and live in neighborhoods with high levels of poverty.

These findings emerged from research by several women. Facing a surge in restrictions, Alexandra Wollum, a public health expert and researcher at the Ibis Reproductive Health institute, contacted Verónica Cruz Castro, director of Centro Las Libres, and Sandra Cardona Alanís, founder of the Red Necesito Abortar MX network, with whom she has collaborated for years on scientific studies of sexual and reproductive health. Together they designed a study to try to answer the question: who are the Americans seeking help from feminist collectives in Mexico to access abortion?

Their findings reinforce warnings about what would happen once abortion rights were restricted: the most marginalized women ended up being the most affected. The vast majority of people who sought help from these collectives live in states where abortion is banned. Abortion in places where it is prohibited is often a feasible option only for those who can afford it. For those who cannot buy the medications or travel to a state where abortion is legal, Mexican collectives are an alternative.

Likewise, many women began crossing the border into Mexico to access this health service. Some were even received by Alanís at her abortion clinic in the city of Monterrey, Nuevo León.

By the time they compiled their report, Castro and her colleagues at Centro Las Libres, a feminist organization based in Guanajuato, already had more than 20 years of experience helping women end pregnancies in Mexico — with or without government approval. Since September 2021, they have also been supporting self-managed abortions for women who sought them from Texas.

They did so soon after the conservative U.S. state published a law restricting access to abortion if a physician could detect a fetal heartbeat, claiming this was an indicator the pregnancy could be carried to term successfully — a myth debunked by studies showing, for example, that fetuses with anencephaly, in which the brain or skull do not fully develop, can exhibit cardiac activity despite being nonviable.

On the other hand, another study explains that the human heart is not fully formed until around the 20th week of pregnancy, so the cardiac activity detectable from the sixth week is not comparable to the heartbeat of a fully formed heart.

The consequence was that many women lost access to this right overnight, including those with conditions that made carrying a pregnancy to term unsafe.

Thus, Las Libres and Red Necesito Abortar MX began providing information and accompaniment for women to end pregnancies at home, sending misoprostol and mifepristone free of charge — two medications used for the process.

After Roe v. Wade was overturned, Castro and Alanís recall how requests for accompaniment increased significantly and began arriving from several states that quickly enacted restrictions and bans on abortion access. In 2023 alone, they received at least 2,850 requests, which they analyzed in the study conducted with Wollum. To do so, they designed a set of questions that, based on the collectives’ experience, people would be willing to answer and established secure channels to communicate with them.

They found that 82% of help requests came from states with complete abortion bans, such as Texas. Using zip code information, they were also able to identify that the rate of people requesting help increased in areas with higher poverty, lower insurance coverage, and a larger share of Spanish speakers. However, to the surprise of the organizers, most of the people who contacted them were English speakers.

In areas where only 5% of the population lives below the poverty line, the rate of requests for accompaniment to Mexican collectives was 0.35 per 100,000 women. In areas where up to 17% live in poverty, the rate rose to 1.63. The overall average in the study was 2.44 women per 100,000.

The findings of this study help reinforce the evidence regarding the already known effects of abortion restrictions. According to Wollum, “support groups are truly helping to bridge a gap in access to abortion for people in the U.S. who, at this time, face the greatest obstacles to receiving care, including cost, distance, and language barriers.”

The specialist is one of a long list of scientists who, from their own work, have contributed research to understand the consequences of abortion restrictions and how to make care safer. In just the past four months, the journal Obstetrics and Gynecology has published at least three studies on the subject. Tuyet Mai Hoang, a social work specialist focused on sexual and reproductive health, authored one of them.

Hoang, who did not participate in Wollum’s study, says one of its chief strengths is the collaboration between activists on the Mexican side and U.S.-based scientists, each an expert in their field. “It’s important that activists, researchers, patients, and other stakeholders take part in the research process and the generation of scientific evidence to inform laws,” she says.

Hoang also recently published a study to better understand the experiences of people who traveled from restrictive states to others where abortion is legal, such as Illinois, where she works. One of her main conclusions is that a key motivation for making that trip is trust. “They don’t travel only to receive abortion care. And not only because abortion is unavailable or banned in their state, but because they sought medical care that, for them, felt safe, reliable, respectful, and nonjudgmental,” the researcher explains.

Anna Fiastro, a public health expert, concurs. Her research reached a similar conclusion, describing how women who travel to obtain misoprostol and mifepristone do so because they distrust remote medicine options. That distrust is fueled by lack of information and fear of possible legal consequences.

For Alanís, activism has shown that collective action can fill the gaps left by governments. Castro adds that the studies conducted in collaboration with Ibis have helped her understand how that idea has spread from Mexican collectives into the United States. She welcomes how the women who have accessed accompanied abortions have even formed their own community networks across the border. That will be the subject of Castro’s future research. However, given the daily criminalization feminists face, she does not think now is the best time to pursue it.

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