Abortion on the border: The institutionalization of stigma and shame
By Victoria Rossi/El Paso Matters and Veronica Martinez/La Verdad
This story is the second installment of a three-part series that explores the exchange of abortion services between El Paso and Ciudad Juárez. As a consequence of the stigma and shame surrounding abortion, fronterizas have endured trauma and suffering in order to access the services and medication they need.
Some of the sources that agreed to interviews with La Verdad and El Paso Matters have not spoken openly about their abortions with their families and friends; because of this some of the names have been changed. The last names of acompañantes have been omitted in order to protect their identities and prevent any legal action against them.
The series includes deeply personal stories about abortion that could be upsetting to some readers. This story includes language that may be offensive to some readers.
The heartbeat gave Ana nightmares for years. She stared at the sonogram of her fetus as a woman at El Paso’s Hill Top Women’s Reproductive Clinic, who wore scrubs but had not introduced herself, described the image on the TV screen before them.
Earlier, the woman had explained that Texas state law required this narration. If Ana wanted her abortion, the woman said, she was not allowed to look away.
It was 2015 and Ana had just started dental school at the Universidad Autónoma de Ciudad Juárez. At 19, she knew she wasn’t ready to be a parent. But despite the confidence that her decision was the right one for her, its aftermath lingered for years.
“This is your baby’s face,” Ana recalled the woman saying. “This is your baby’s size.”
Then without warning, the woman turned up the volume and suddenly a heartbeat pulsed through the dark room. “I have to go get something,” the woman said, and left Ana alone in the dark with the sound.
That sound, she imagined, must have convinced some women to continue their pregnancies.
“It didn’t convince me,” she said. “But I can tell you that it did affect me. It stayed with me for a long time.”
What came afterward was a “horrible depression,” she said. She didn’t leave the house for two weeks. When she wasn’t having nightmares, she couldn’t sleep. “For a long time, I felt very alone. For a long time, I felt very isolated. For a long time, I felt like I’d done something wrong,” she said.
Part three: Activists stay resilient
Texas continues to limit access to abortion services through legislation that imposes strict regulations on abortion providers. Among them is the state’s 2011 law that requires clinics to make any cardiac activity audible and display sonogram images, verbally describing the results, before performing an abortion. (Contrary to the staff member’s assertion, however, the American Civil Liberties Union states patients may choose not to look at sonogram images or listen to audio.)
And earlier this year, the Texas Legislature passed a law banning abortion as soon as cardiac activity can be detected in an embryo — which can be as early as six weeks. Under the new law, set to go into effect Sept. 1, Ana would have been unable to receive an abortion at all.
In most states in Mexico, including Chihuahua, it is a crime to terminate a pregnancy except under extreme circumstances such as cases of sexual violence, if the woman’s health is at risk, if the woman has been forcibly inseminated, or if the abortion was accidental.
A study by the Latin American Consortium Against Unsafe Abortions concluded that criminalization and prohibition of abortion reinforces and magnifies feelings of shame and guilt for those who get the procedure. The criminalization of abortion in Chihuahua, along with access restrictions in Texas, have also brought to the forefront discussions about the physical and mental trauma women may endure after the procedure.
Elia Orrantia, director of SinViolencia AC, an organization that aids survivors of family and sexual violence, said that even in a legal context, having an abortion can cause psychological effects. But, she noted, it is “not the procedure itself; it is the social stigma and the stress of the criminalization of the interruption of pregnancy.”
Eva Moya, an associate professor at the College of Health Sciences at the University of Texas at El Paso, said doing any research related to abortion and access to reproductive services is challenging because stigma prevents people from talking about the topic.
Moya said stigmatization often leads to discrimination against those who seek abortions, particularly marginalized people. This is linked to obstacles that prevent access to safe reproductive services, including birth control, accurate information on sex education, and medication.
“Stigma will always impede or pose an obstacle to access,” she said. “It will compromise the ways in which we can educate others about health issues.”
Stigma and shame
Sophie was convinced she would do anything to keep her parents from learning she was pregnant. She knew about misoprostol, an ulcer medication that is also used to medically terminate a pregnancy. But in 2013, when she became pregnant, she said information about how to take the medication was scarce.
She read online that oregano tea was a homemade remedy, but later learned that herbal teas could cause kidney and liver damage when taken in high doses. She wanted to have an abortion, but she didn’t want to die for it.
She decided to tell her mother, who asked what she wanted to do: Have the baby? Give it up for adoption? Have an abortion? “I don’t know,” Sophie, then 17, said. “But I don’t want to be a mom.”
That week, the Juarense crossed the border into El Paso to have an abortion, which only she and her parents knew about.
To pay for the procedure at Hill Top Women’s Reproductive Clinic, the family tapped into her college fund. Earlier that year, she had been notified via email that she’d been accepted to a university in Houston with a partial scholarship.
The procedure cost $400, more than half of what the family had just begun to save to grant Sophie a safety net to go to college. Sophie ended her pregnancy to follow her dreams, but even after her abortion she didn’t attend her dream college.
“It wasn’t as much about the money,” Sophie said. “It was everything that happened around the situation. The way things developed really affected me. Everything came crashing down.”
Nadia Meza, one of the founders of Juárez Feminista, an activist group in Ciudad Juárez that speaks against the criminalization of abortion, said there is a need to show that abortion is not a rare occurrence, and that blocking access to information is harmful for women’s health.
“Something what we’re taught since we’re very young is that having an abortion is a sin,” Meza said. “This is the strongest stigma that makes women afraid to search for the information that they need.”
For Sophie, the biggest obstacle to her recovery was keeping her abortion a secret.
“I think that, if I would’ve been able to do it openly and with no secrecy around it, it would have been very different,” she said.
More than anything, she felt ashamed. When she told her female friends she was pregnant, they advised her not to have an abortion because that decision “would make (her) go to hell.”
“Decidí mejor no decir nada,” dijo Sophie. “¿Por qué no cerraste las piernas? ¿Por qué no usaste condón? De pendeja no me iban a bajar.”
(“I decided not to say a thing,” Sophie said. “Why didn’t you close your legs? How come you didn’t use a condom? I would always be that stupid girl.”)
To avoid judgment, Sophie told her friends she lost the baby. It took her more than two years to speak about her abortion.
‘Sister, we’re here with you’
It has taken Sophie more than six years to finish college, but she also had many opportunities like studying abroad, she’d made new friends and has entered into healthier and happier relationships.
Abortion has been legal in Mexico City since 2007 and since then it’s been permitted in three additional states: Oaxaca became the second state to decriminalize abortion in 2019, followed by Hidalgo and Veracruz in 2021.
Sophie, now 25 years old, thinks the country has come a long way since 2013. She thinks about women today who have spaces to obtain their abortions safely. When she reads about abortion rights marches happening in Mexico City — now, in Ciudad Juárez as well — her eyes fill with tears.
“Que chingón habría sido haber tenido esas porras en el momento. How awesome it would have been to have that support,” Sophie said. “Or to have been able to go with a colectiva (feminist collective) and tell them what I went through and to be told, ‘Sister, we’re here with you.’”
Ana is still not sure why she had to hear the heartbeat before her abortion. “That process isn’t medical. It doesn’t serve women at all,” she said. “A lot of times I feel like I had a certain amount of post-traumatic stress even though it was totally controlled, in a clinic with professionals.”
Two events helped Ana heal from the experience. The first was the birth of her son. She hadn’t planned that pregnancy either, but by 2019, she and her partner were more financially stable and living in El Paso. This time, the moment she learned she was pregnant, she thought to herself, “That’s my baby.”
The second event began with her second abortion. With her son barely a year old, she was exhausted, still breastfeeding around the clock, and now hit with morning sickness.
“I was already extremely busy being the mother of the baby that was in my arms,” she said. “He needed me so much. I was extremely concerned about having to change his life or having to take attention away from him.”
Ana’s first birth had been difficult, and she worried a second might leave her in the hospital for weeks, unable to care for her son, or worse. “It was a difficult decision, but I did it for love,” she said. “For love of my family, for love of my son most of all.”
She asked for help from a friend who supported abortion rights and was pointed to the Facebook page, “Tú decides, nosotras te acompañamos.” You decide, we’re with you.
There, she found links to other online resources, including groups throughout Mexico that offered medical and emotional support to anyone seeking an abortion. Whether in person or remotely, they would serve as acompañantes — companions — to others through the long process of ending their pregnancies.
Acompañantes have emerged in response to the stigma surrounding abortion and its criminalization in Mexico. With most abortions prohibited in health-care settings, acompañantes strive to ensure that self-managed abortions are safe.
Though not always health workers, they provide dosage instructions for medication and help monitor symptoms. Perhaps most importantly, they offer emotional support through a painful and sometimes difficult experience.
Ana messaged as many acompañante groups as she could; the first to write back was an organization in Merida, Yucatán. She communicated with them through her phone’s Facebook app and texted a photo of her ultrasound for a doctor to determine her stage of pregnancy, and screen for conditions that would make a medication abortion less safe.
The group messaged back: She was early enough along to take misoprostol. They recommended she wait one more week, she said. “I didn’t listen to them of course, because I was extremely stressed.” She replied, saying she couldn’t wait.
Through the Facebook group discussions, she had learned how to buy misoprostol at a Mexican pharmacy without raising the pharmacist’s suspicions. Commenters said to go at night, to ask for brand names like Cyrux and not misoprostol itself, and to send a man.
She and her partner drove from El Paso to a Juárez pharmacy late at night. She waited in the car as he went inside to buy the medication.
Ana’s acompañantes checked in on her via Facebook throughout the abortion. “They were completely right,” she said. She had taken the pills too early. “It didn’t work. I just got terrible diarrhea and I had to redo everything. It’s really important that you do it correctly.”
Ana tried again, and again, the acompañantes checked in through Facebook. Finally, it worked.
A month later, a close friend found herself in the same situation as Ana. She had a 4-month-old child and wanted to end her new pregnancy. She couldn’t do so at home — her boyfriend was abusive, Ana said, and didn’t want her to have an abortion. Though living in El Paso, Ana kept a small apartment in Juárez and invited the friend to stay there for the weekend.
Her friend took the first round of medication at 9 p.m. Ana didn’t sleep. She stayed beside her friend, feeding her coconut water and repeating reassurances: “You’re going to be in a lot of pain. You’re going to be tired, exhausted. You’re going to think you made the wrong decision because it’s not what your boyfriend wants, it’s not what your mom wants. But it’s about what you want.”
She checked her friend’s symptoms and temperature throughout the night, reporting back to the Merida gynecologist by Facebook. She kept an eye on the time to administer a second round of medication, then a third.
By morning, it was over. “She was very ashamed,” Ana said.
Ana recognized the feeling. She’d weathered the same with her first abortion. “They raise us women to feel guilty,” she said. “It’s part of our personalities, guilt. It’s a way they control us.”
In the United States, national groups like Shout Your Abortion, along with Texas organizations like the El Paso-based West Fund, have begun to push against the atmosphere of stigma and silence surrounding in-clinic and self-managed abortions.
“For me, the self-managed abortion route was out of convenience,” said Nancy Cárdenas Peña, a board member of Frontera Fund, a Texas organization that provides financial assistance for abortions. “I had access to information, I had access to resources. …. Honestly, that’s as complicated as it got.”
On We Testify, a website where people share their abortion experiences online and with the media, Cárdenas Peña described abortion as a “normal and lifesaving medical procedure.” Nearly 54,000 Texans received abortions in 2020, according to the state Department of Health and Human Services. The department recorded more than 660 abortions in El Paso County in 2019.
“I consider my abortion to be a miracle and I am grateful for the ability to make that decision,” Cárdenas Peña wrote.
And for Ana, the night was transformative. It was as if she’d spent the night taking care of herself. “It was the help I wish I’d had,” she said. “I wish I’d had a friend to stay with me, to tell me that I was okay, that I wasn’t a bad person…that the decision I was making was out of love and inspired by love.”
Since helping her friend in 2019, Ana has become an acompañante herself. She’s accompanied six other women in both Juárez and El Paso. She’ll offer to go to their homes or invite them to her house, or simply check in through Facebook. As soon as they make contact — through Facebook groups or word of mouth — she thinks of them as friends.
The region’s network of acompañantes is large, Ana said, though she wouldn’t know many people by their faces or even their names. “We’re totally anonymous. But there are many of us, all over the place.”
This, to Ana, makes all the difference. “When there’s a woman there to support you, or a group of people making sure that no one is judging you and that no one thinks that what you’re doing makes you a bad person, it completely changes the experience,” Ana said. “More than anything, it changes how you live after.”
Acompañamiento. Being there.
The first time Samantha helped a friend go through a self-managed abortion, she relied only on information she’d found online. After almost three years of experience, she thinks this was irresponsible, but she said that back then there was no support system she could count on.
For Samantha, abortion was a topic that no feminist groups, or colectivas, were willing to address. People would discuss it only in whispers, but the issue would remain unseen and overlooked, she said.
“I feel like we take a lot of space with the issue of femicides,” Samantha said about feminist groups in Ciudad Juárez. She recognizes that the city for years has been tainted by violence against women. “But that has left the issue of (bodily) autonomy rights on the side,” she said.
As she became more involved with the abortion rights movement, Samantha encountered organizations, like Marea Verde, that often hosted workshops led by medical professionals to train acompañantes. Through these workshops, she learned the common effects of misoprostol, how to perform a self-induced abortion with the medication, adequate dosage and techniques on how to be emotionally supportive for the women going through the procedure.
Samantha explained that a self-managed abortion is a process that can take about 12 hours. She prefers to accompany people during the day, so they can get a full night’s sleep and rest.
The medication causes contractions in the uterus, which detach and expel the embryo or fetus. Pain can vary from person to person, so for those who are not used to strong menstrual cramps, Samantha warns they will likely have a more painful experience.
Diarrhea, vomiting, fever and heavy bleeding are normal symptoms, according to the World Health Organization. She is usually present during the entire process to keep an eye on the women who seek her help and to make sure that the fever doesn’t last more than seven hours, the point where they have developed an infection.
The acompañante experience
Samantha is not always alone. In some of her more than 15 companionships, she has witnessed a great sisterhood among friends, cousins and sisters. Sometimes partners are present, but what Samantha sees the least of are mothers.
As an acompañante, Samantha has helped women as young as 15, but she also remembers a girl who reached out to her to help a 14-year-old friend. The acompañante feels sorry for some of these women and the situations they have to go through.
“I cannot play the role of judge,” she said. “I don’t think this is a process that they should be going through, but sex education is very limited.”
There’s also the experience of accompanying women who have no one. When Samantha is working, she knows her role is to make sure that the woman she’s helping doesn’t feel vulnerable. She sees them as friends who need someone to hold them by the hand.
But on some occasions, Samantha has refused to act as companion because she knows she’s not in the right mindset to be there for other women.
“It’s not about being there just to be there,” she said, adding that she often refers these cases to other women who are part of the network of acompañantes.
There’s also the possibility that in a medical emergency, she might be asked to take the women to a hospital where they both face chances of getting caught and charged with a crime.
Deciding if they’re willing to take another woman to urgent care under these circumstances is a decision each acompañante has to make, Samantha said. But she has already decided that if she’s ever in that situation, she will be there. She won’t leave her fellow women alone.
“I do it so I can help other women who are feeling like their world is crashing down,” Samantha said. “I know in the past there wasn’t always someone (willing) to be there, but at least now, at this moment, I can help.”
Cover photo: The sister cities El Paso and Ciudad Juárez appear as a single urban sprawl known as Paso del Norte. Women in the region have frequently resorted to crossing the border to find abortion options that are not available in their home states. (Corrie Boudreaux/El Paso Matters)