By Victoria Rossi/El Paso Matters and Veronica Martinez/La Verdad
This story is the final installment of a three-part series that explores the exchange of abortion services between El Paso and Ciudad Juárez. The fight against restrictions in Texas and criminalization in Chihuahua relies on a complex network between the two border cities. Activist efforts have sprouted from the healing that abortion stigma has created, and a resilience to preserve the right of autonomy over one’s body.
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 box of misoprostol sits in CC’s medicine cabinet above the bathroom sink. It’s been there for a year now. Sometimes she’ll open the mirrored door and feel relieved to see the abortion pills sitting alongside her eye drops and antacids, her Vicks Vaporub, Plan B and Benadryl — all just “general health stuff,” she said.
Other times, she looks at the box of misoprostol and worries. “Who might be the one who needs this? When am I going to cross again?”
Though she’s never been pregnant herself, CC has crossed the U.S.-Mexico border four times to buy misoprostol for friends, or friends of friends, who wanted to end their pregnancies. While abortion is illegal in most of Mexico, misoprostol is also used as an ulcer treatment and is sold over the counter for as low as $20.
“I just feel so bad for people who might be in that situation, of not being able to get (an abortion) if they want to get it. I can’t even imagine the worry,” she said.
CC, who has asked to be identified by her initials, buys misoprostol informally, offering help through word of mouth. She is joined by a growing number of advocacy organizations, online pharmacies, telemedicine services and online resources that seek to help people safely take abortion pills outside the clinic setting.
Different forms of reproductive justice advocacy have sprouted on both sides of the border.
In Texas, groups like the El Paso-based West Fund provide financial and logistical support to people seeking in-clinic abortions, and strive to counter the stigma that can surround abortion, casting it as a normal medical procedure that can save lives. Recent state legislation has moved to impose civil and criminal penalties not only on abortion providers but also on support networks, including groups like West Fund, that would help women access abortion services in a shrinking legal timeframe.
Meanwhile, feminist groups advocating for the decriminalization of abortion in Mexico have gained momentum in the profoundly conservative state of Chihuahua.
These efforts do not end at the border; they cross international lines and intertwine in a complex network of support for people that seek access to abortions. Challenges like the pandemic, the border closure and new Texas legislative developments have strained this network, but advocates continue their push to ensure women can continue to have abortions — even if underground.
“Activists and advocates are finding ways to continue to provide for people in very creative, unique ways so that we don’t go back to the era of people dying (from underground abortions),” said Lina-Maria Murillo, an assistant professor at the University of Iowa who studies reproductive health services on the border. “I am moved by this mutual aid response to these draconian laws. It’s powerful work that people are doing to support each other.”
Pandemic abortion barriers on both sides of the border
CC last bought a box of misoprostol in Mexico a year ago, after she moved back to El Paso from Brownsville. Since March 2020, border crossings have been restricted between the two countries to only U.S. citizens and essential workers, which has limited access to non-urgent healthcare services, including abortions.
“There’s so much uncertainty with the pandemic here on the border, with who can cross or when you can cross,” she said. CC was born in El Paso, but has worried throughout the pandemic that the border might close even to U.S. citizens. “I need to at least have one (box) here because what if they don’t let us cross tomorrow?”
Studies have found that when barriers to in-clinic abortion care mount, people are more likely to attempt to manage their own abortions — particularly as the distance to a clinic increases, and for those with lower incomes. This is especially true in places like El Paso, which has high poverty rates, no abortion services and where Juárez pharmacies lie just across the bridge.
A statewide survey of Texas abortion clinics found that self-managed abortions were more common along the Texas-Mexico border, where 12% of Borderland patients had previously tried to end their own pregnancies compared to 7% of Texas patients and 2.6% nationwide.
During the pandemic, demand for abortion medication spiked on both sides of the border. When Texas Gov. Greg Abbott imposed a four-week ban on abortion in late March 2020, citing COVID safety concerns, a study by University of Texas researchers found that Texans’ requests for telemedicine abortion services rose by nearly 94% from the previous year, the highest increase in the country.
In Mexico, Sofia Garduño of Fondo MARIA, an organization that offers financial assistance to women seeking abortions, said the influx of people coming to Mexico City, where abortion is legal, diminished as some feared traveling and contracting COVID-19. As many lost their jobs, they also lost the disposable income that made traveling to Mexico City possible; abortions became even more unaccessible.
“With the pandemic, we saw an increase in the use of medication to induce abortions,” Garduño said. “We saw a big boom since (the medication) represents an option for all of these women who couldn’t access services in Mexico City.”
Even as the need for misoprostol rose, the pandemic exacerbated socioeconomic inequities, making the medication more difficult to come by for some.
“There’s a lot of marginalized women (in Juárez), especially now with the pandemic,” said Nadia Meza, founder of Juárez Feminista, a feminist collective, or colectiva. “They don’t have the money to pay for misoprostol, even less to travel to Mexico City or the United States where they can have a safe abortion.”
And on both sides of the border, new legal and political challenges to abortion access lie just ahead.
Chihuaha’s incoming governor, Maria Eugenia Campos, has said she opposes decriminalizing abortion and will take office on Sept. 8.
On Sept. 1, a Texas law took effect that dramatically shrinks the legal timeframe for abortions. Abortion providers and advocacy groups had sued to block the law, with a court hearing scheduled for Monday to argue the case. When the Fifth Circuit Court of Appeals canceled that hearing, the groups filed an emergency request asking the U.S. Supreme Court to block the law. The Supreme Court took no action on the request, and on Wednesday, the law went into effect. It comes on the heels of an August court ruling restricting Texas providers’ use of the most common procedure for second-trimester abortions.
The impact of these developments could cross the international border, permanently limiting abortion options for Juarenses once able to cross into El Paso to obtain legal in-clinic abortions. El Paso’s Planned Parenthood, which remains open but has stopped offering abortions during the pandemic, said that previously, about 3% of its abortion patients were from Mexico.
Aiding and abetting
The new Texas law, known as Senate Bill 8, bans abortions as soon as cardiac activity can be detected in an embryo — which can be as early as six weeks after conception, before many learn they are pregnant.
The law, authored by state Sen. Bryan Hughes, R-Mineola, also allows U.S. residents to sue anyone who “aids and abets” those seeking an abortion past this window.
The law’s language centers on abortions occurring at Texas clinics — not self-managed abortions. But CC worries she could fall into the category of someone who “aids and abets” people ending a pregnancy past the new legal time limit. “What if they use that against us?” she asked.
Groups working to offset the financial and logistical hurdles to Texas abortion care hold similar concerns. SB 8 specifically lists “paying for or reimbursing the costs of an abortion through insurance or otherwise” — or even intending to do so — as grounds for a lawsuit.
Alexis is the helpline manager for West Fund, the El Paso-based reproductive justice organization that provides funding for those seeking clinical abortions in the region — including Juarenses who need help accessing U.S. abortions. Alexis, who uses they/them pronouns and asked to withhold their name due to safety concerns, said the group’s small staff is unsure who at the organization would be held liable in a lawsuit. They are especially worried for the young volunteers at West Fund.
In Chihuahua, feminist colectivas foresee that SB 8 could spur even more demand for misoprostol in Ciudad Juárez.
Mariela Castro is a spokesperson for Marea Verde Chihuahua, the state affiliate of a feminist movement that advocates for the decriminalization of abortion in Latin America. She said the organization already knows of at least 10 cases within the last year where people have requested that the medication be sent to an address in the United States.
As Texas’s SB 8 opens the door to civil lawsuits, another bill is on its way to the governor’s desk that could put people like CC at risk of jail time.
Senate Bill 4 would, among other provisions, make providing abortion medication to people outside a health care setting a criminal offense, said Farah Diaz-Tello, senior counsel and legal director for If/When/How, a national reproductive justice nonprofit.
Under the bill’s language, “any act of giving, selling, dispensing, administering, transferring possession, or otherwise providing or prescribing an abortion-inducing drug” would be punishable with a state jail felony — which hold sentences ranging from six months to two years and fines of up to $10,000.
To date, Texas lawmakers have largely focused their restrictive measures on physicians and clinics in the name of improving health safety for abortion patients. Taken together, SB 4 and SB 8 “represent a privatization of abortion politics,” Diaz-Tello said.
“This really broadens out the scope of control and punishment, so that it’s no longer something restricted to targeting clinic hallways. This is actual people’s lives,” she said.
Similar to SB 8, SB 4 would not criminally punish anyone who has an abortion. But the proposed bill would “cut people off from systems of care by criminalizing other people who might support them,” Diaz-Tello said.
For Diaz-Tello, “the people who end up getting swept up in criminalization are loved ones. It’s somebody’s mother, it’s somebody’s sister, it’s somebody’s friends who have provided them with the means to end their pregnancy. … They’re right in the crosshairs of this law.”
If signed into law, SB 4 could create fear and isolation among fronterizas seeking abortion services, she said. “That’s not a bug, that’s a feature — making people afraid to seek help from loved ones, because they think that their loved ones might be susceptible to criminalization. Isn’t that exactly what this law is intended to do?”
Border communities like El Paso may be especially vulnerable to these provisions, she noted, given “how frequently people find ways to meet their health care needs by going over borders, or seeking other ways to get (abortion) medications.”
Although still a threat in Texas, criminalization is already a reality in Chihuahua, where helping women obtain abortions — which are largely illegal in the conservative Mexican border state — is a jailable offense. Despite this risk, an underground network has formed of feminist colectivas and abortion companions known as acompañantes, who work to help women access abortion medication, information and the emotional support needed to end their pregnancies safely.
Acompañantes fear stigmatization and possible criminalization if they’re accused of forcing someone to terminate a pregnancy or, in cases like Puebla and Nuevo León, accused of encouraging abortions by spreading information.
Samantha, who asked to use only her first name for this series, has been an acompañante for almost three years. What she is willing to do for other women can potentially put her in jail.
“I’ve met some (acompañantes) that, when they go to urgent care helping someone with a hemorrhage, get a lot of questions asked that lead to blaming them or seek to depict them as criminals,” she said.
Because of that, she has learned to take precautions.
Before committing to an acompañamiento, she asks women multiple questions to make sure she’s not risking the chance of being accused of forcing them have an abortion. A resentful partner who doesn’t agree with the procedure, a conservative mother or a disloyal friend can put Samantha and the women she’s helping at risk.
Mexican organizations similar to West Fund, the El Paso-based group that helps finance abortions, offer funding assistance to help people obtain abortions in the parts of Mexico where abortion is legal: Mexico City, as well as the states of Oaxaca, Hidalgo and Veracruz. Among those groups is Fondo MARIA, which is also part of the United States National Network of Abortion Funds.
According to the group’s co-coordinator, Sofia Garduño, it is mostly women from Central Mexico who seek out Fondo MARIA’s help. Still, the organization has aided more than 700 women on the northern border since its founding in 2009, including 159 women from the state of Chihuahua.
But for those living on the northern border about 1,000 miles away from the Mexico’s capital, reaching abortion clinics is a major challenge, especially during the pandemic. To close the gap in access, feminist groups and colectivas have increasingly relied on misoprostol. The colectivas openly provide the information on self-managed abortions so that women can have the procedures safely at home.
Some groups also work underground to ensure women have access to the medication by creating misoprostol “banks.” The “bancos de miso,” as they’re commonly known, can be places where the medication is kept safely or shared accounts with funds to buy the medication. In a more abstract sense, they can also be the network of women and colectivas that connect other women to trustworthy providers.
The banks also accept monetary donations and act as a safety net to make misoprostol affordable for people that can’t afford it. In some cases women have the money to purchase the medication but they can’t go to the pharmacy without their partners or parents finding out.
For some, not having a reliable form of transportation to go to a pharmacy far from their neighborhood, where they won’t be recognized, makes it more difficult to buy misoprostol.
Samantha has identified some pharmacies where women won’t be questioned. She refers women to these locations and tells them how much the medication is supposed to cost.
Not all of these locations are close to every acompañante or woman who wants to have an abortion at home, so they have to find different options. Samantha has often found that when a trusted male partner is available, it is better to ask them to buy the medication.
“They won’t be questioned in the same way we are for being women,” Samantha said.
Chihuahua’s abortion rights movement advances
Abortion has been legal in Mexico City since 2007. After the legalization, members of Marea Verde, or the Green Wave, the feminist movement that advocates for the decriminalization of abortion in Latin America, started to gain popularity in other states. But in Chihuahua, it took longer for the green wave to arrive, Samantha said.
It wasn’t until 2018 that the Marea Verde Chihuahua formed with the purpose of advancing the conversation about abortion and reproductive justice in the region.
The organization offers training and assistance for women and feminist groups that want to become acompañantes, said Castro, the spokesperson for Marea Verde Chihuahua and member of the National Network for the Right to Choose. The colectivas, in turn, disseminate information about self-inducing abortions using misoprostol.
Juarense Nadia Meza also started one of those colectivas. In 2018, she began with a Facebook page called Juárez Feminista.
“We couldn’t find a lot of colectivas that would openly speak about (abortion). So we found ourselves trying to fill that gap and open a space for (discussion of) the abortion issue,” Meza said. The colectiva has also embraced other topics including safe sex education and access to birth control.
With the help of Rosas-Rojas, a pro-choice group in Mexico City, Juárez Feminista organized the first pro-abortion march in favor of the decriminalization and legalization of abortion in Juarez in 2018.
At the first pro-abortion march, more than 50 women attended, Meza said. Most were between 16 to 18. Attendance for the second march in 2019 rose to more than 100 women and included supporters in their 20s. A year later, more than 200 people turned out. The crowd included women in their 40s and mothers, who went in support of their daughters.
The pandemic-era closure of the border has restricted Juarenses’ access to legal abortions in the United States — and with the September advent of new abortion restrictions in Texas and an anti-abortion governor in Chihuahua, Juárez’s pro-choice movement will soon face additional challenges.
“We’re facing a very difficult context,” Castro said. “We’ve always worked in an atmosphere of secrecy and illegality, and we foresee that these conditions will become even more hostile.”
But Marea Verde sees these developments as another opportunity to enhance the training and support network for acompañantes in Ciudad Juárez.
For Castro, proximity to El Paso’s abortion clinics was a factor that in a way delayed the rise of the pro-choice movement in Juárez. “Juárez didn’t really work that much on (abortion rights) since, in general, there was an easy and safe access (to abortion clinics) in El Paso. These services are still inaccessible for a lot of women who don’t have the economic resources,” Castro said.
Going virtual during the pandemic also changed the dynamics for many of the colectivas working in Mexico. But for Meza of Juárez Feminista, it showed that a virtual network can be extended across the border, even amid Texas legislation that keeps adding restrictions on abortion providers.
“Acompañamiento can be done from a distance since what these women mostly need is emotional support and fortunately providing information about abortion in Mexico is not illegal.” Meza said. “The need will always be there.”
On the other side of the border, CC is also expecting a more difficult time ahead. The El Pasoan had known for a while that SB 8, the Texas law that targets those who “aid and abet” others seeking abortions past six weeks, was coming in September.
But she hadn’t known about SB 4 — the bill that would make the help she’s offering a jailable offense. Hearing about it, she groaned and went silent. “It’s like we can’t catch our breaths,” she finally said.
“I am scared,” she added. “I mean, yes, for myself, but also for the people who are going to need the abortions. It’s going to get really, really hard.”
CC doesn’t plan to stop, though. Attending Catholic high school in Chihuahua, she watched the school expel girls who became pregnant while the boys who’d impregnated them stayed on without question. She’s had friends confess to her that while they loved their children, they wouldn’t have chosen motherhood so young — they wished abortion had been an option.
“It’s exhausting. It’s terrible. It’s draining. It’s taxing. It’s not what we want, but if we have to do it, we’re gonna do it.”
Like acompañantes working in Juárez, she’s taking precautions. She helps others on the condition that they post nothing online. She puts nothing in writing — not by text, Whatsapp or Facebook — and when she talks about helping others with their abortions, she speaks in hypotheticals: “What if someone were to go to Mexico for the pills?”
For now, the misoprostol continues to sit in CC’s medicine cabinet. No one has asked for it yet. But she keeps it for someone who needs it — just in case.
Cover photo: Ciudad Juárez, the international line, and Downtown El Paso seen from the Camino Real. Women in the Paso del Norte 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)