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 So she did what an estimated 100,000 women or more in Texas have
done - had a self-induced abortion.
With the help of a friend, some online instructions and quick dash
across the Mexican border for some pills, she addressed the issue of
unwanted pregnancy in a state where women are finding abortion
services too expensive and too far away.
Restrictive laws took hold in Texas in 2013, forcing so many clinic
closings that fewer than 20 remain to serve 5.4 million women of
reproductive age.
Supporters of the laws say they protect women's health. The
regulations require clinics to upgrade to hospital standards and
doctors performing abortions to have formal agreements to admit
patients to local hospitals.
But experts say that if the U.S. Supreme Court upholds Texas'
restrictive abortion laws, the numbers of self-induced abortions
will escalate.
So far, the number of Texas women who have taken that option could
be as high as 100,000 to 240,000, depending on how it is calculated,
experts say.
 "We certainly hypothesize that if there is a bad ruling from the
Supreme Court that leads to more clinic closures, yes, this will
only become more common," said Dr. Daniel Grossman of Ibis
Reproductive Health in California and researcher with the Texas
Policy Evaluation Project at the University of Texas at Austin.
Susanna, a musician in Texas' Rio Grande Valley who chose to use an
alias to protect her identity, described her self-induced abortion
two years ago at age 23 as "almost primal."
"It was like we were back in the days of the Wild West, like we have
to figure this out by ourselves and just grit our teeth and get
through it," she said.
Research shows U.S. women opt to self-induce due to the closing of
their local clinic, the expense of a clinical procedure or the costs
of traveling to a distant facility.
Most commonly they take misoprostol, available in Mexico without a
prescription, at home.
Educating themselves on the procedure, women like Susanna's friend
Selena, also not her real name, have stepped in to teach other women
to do what clinics can no longer provide.
DO-IT-YOURSELF
Selena said she and a handful of friends decided to learn the
do-it-yourself method after their local clinic, Whole Woman's Health
in McAllen, shut down in the midst of its legal fight.
Whole Woman's Health is challenging the Texas abortion law before
the U.S. Supreme Court.
 With that clinic closed, the closest option was four hours away in
San Antonio, Selena said.
But how-to instructions are easily found online on websites
belonging to Women on Waves and Women on Web, Dutch reproductive
rights groups, and the World Health Organization, said the
28-year-old social worker.
"Our objective was to share this knowledge with our friends and hope
that from there, they will take that information and branch out and
help other people," she said.
For Susanna, a surgical abortion at a clinic, if it were even open,
would have cost nearly $600.
"I wouldn't be able to afford it," she said. She earned money
cleaning houses and at night played trombone in a band.
So Susanna drove across the border to the small town of Nuevo
Progresso in Mexico to buy misoprostol over the counter at a
pharmacy for US$19.
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"This is a trend we only anticipate growing in light of many
factors, including this spate of state-level provisions on access
that are resulting in clinic closures," said Jill Adams, a legal
expert on self-induced abortions and executive director of the
Center on Reproductive Rights and Justice at the University of
California, Berkeley Law School.
INSTRUCTIONS
Misoprostol, originally prescribed to treat ulcers and arthritis,
induces abortions with contractions and heavy bleeding.
The process lasted about 12 hours, said Susanna.
"It sucked," she said.
Self-inducing is not risky so long as women have the right
information and follow medical instructions carefully, experts say.
"This is not the coat hanger abortion of the days of yore," said
Adams.
But Grossman added: "We also hear of women using ineffective methods
like herbs or doing things that are potentially dangerous like
getting punched in the stomach."
Whether self-induced abortions are legal or not depends
on an array of factors, Adams said.
While seven states not including Texas explicitly ban self-induced
abortions, others may have pertinent laws on the books such as the
unauthorized practice of medicine or drug charges, she said.
Susanna keeps her story secret from her family but said she has
helped other women undergo the same process, directing them to
websites or helping obtain misoprostol.
"A child is a very important, precious thing, and to just bring it
into the world willy-nilly is I think a preposterous idea," she
said.
The paucity of clinics in Texas is especially hard in the poor and
largely Hispanic Rio Grande Valley, which stretches along the river
separating the United States from Mexico.
"They're trying to make us jump through all these hoops," Susanna
said. "It's like a war on the poor people."
Selena says she sees self-induced abortions as a good solution if
the Texas abortion laws remain in place.
"Some people may feel more secure because they get to be in the
comfort of their own home, and it's more affordable," she said.
"And it's something they do more on their own terms."
(Reporting by Ellen Wulfhorst, Editing by Ros Russell; Please credit
the Thomson Reuters Foundation, the charitable arm of Thomson
Reuters, that covers humanitarian news, women's rights, trafficking,
property rights and climate change. Visit http://news.trust.org)
[© 2016 Thomson Reuters. All rights
reserved.]
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