What went wrong crossing the Texas-Mexico border to buy abortion pills

From Texas Public Radio:

Texas has one of the most restrictive abortion laws in the country. Many who have an unwanted pregnancy have little choice than to go out of state to access a legal abortion. It’s expensive and difficult, especially for those living in South Texas.

New Mexico is one of the states that saw an increase in patients from Texas after the passing of SB8.

Now with the overturning of Roe v. Wade, Texans are finding that states like New Mexico are too far, but Mexico is not. So what are the options for getting an abortion across the South Texas border in Mexico?

Texas Public Radio’s Kayla Padilla and David Martin Davies went to find out.

They traveled to the border city of Nuevo Progreso, Tamaulipas.

This is their Reporters’ Notebook.

DAVIES: It cost a dollar to walk across the border bridge from Weslaco, Texas into Nuevo Progreso. And every day lots of Americans make that crossing to buy low cost pharmaceuticals from unregulated pharmacies.

The main street was crowded with American day-trippers looking for bargains on everything from dental care to booze to tchotchkes. One of the main things they look to buy are over-the-counter medicine.

PADILLA: We met a woman named Dana who came from Louisiana to stock up on medications. She wouldn’t tell us her last name.

“You can get meds here,” she said. “I don’t need any this time, but I’ve gotten them here before, a lot cheaper. Like antibiotics and stuff liraglutides, injectable weight loss [medication is] a lot cheaper here.”

DAVIES: I ask her if she feels safe here–and safe buying–and taking–medication from Mexico.” She replies: “Yes, 100 percent.”

PADILLA: When we were there, we were immediately approached by a man who asked if we were looking for a dentist. The main street was lined with dental offices. We said no, but that we wanted to inquire about abortion pills. Without missing a beat he called over another guy who led us through an alley to get to a small pharmacy. The clerk said that yes, they did have the abortion drug. But when we told him we were reporters and had some questions, he stopped being quite so solicitous. He changed his story and said he didn’t have the drug.

That same kind of exchange happened at the next pharmacy. That is, once we told them we were reporters, their demeanor changed, they seemed less helpful and friendly and much more nervous. And suddenly, they claimed they didn’t have the abortion drug.

DAVIES: The thing is, we have to be totally transparent and share with them that we are reporters. There is no getting around that candor.

And then, at the third place we went to, the person behind the counter didn’t seem to believe the fact that we are reporters. He seemed to think we were using that as a cover to actually buy the abortion pill. As odd as that might seem, the idea that we were journalists was just too incredible. I think he thought we really wanted to buy the abortion pill for our own use.

PADILLA: Right. He didn’t believe we were reporters. He believed we really wanted to buy the abortion medication. We got some weird looks. But he sold us a box of the drug Cyrux a brand name for misoprostol.

DAVIES: This medication is approved to prevent stomach ulcers. But it also causes a miscarriage.

PADILLA: Misoprostol is used in combination with another drug — Mifepristone — for a medical abortion. Together, they’re supposed to provide a more effective abortion than Misoprostol alone.

So we asked about buying Mifepristone. We were told they didn’t have it. Then I asked the clerk for the instructions for taking Misoprostol. At first, he said to take one pill every hour for up to ten hours. Then he said that actually, I could take as few or as many pills as I wanted. He said the prescription itself was totally up to me. He offered the alarming directive in such a matter-of-fact way–as if he were instructing me on how eating candy.

I asked him when I should stop taking it. I asked if I should take it until there was some effect.

In Spanish, the pharmacist said, “Sí. Puede tomarse 10, 3, 4, dependiendo. O más o menos” This means, “Yes, you can take 10, 3, 4, depending. More or less.”

In Spanish we also say, “mil a dos mil” to signify the limitless range. This is what this pharmacist was recommending–an unregulated and wild range.

DAVIES: So lots of problems here. The pharmacist obviously didn’t recommend the proper dosage and protocol. No one said anything about medication abortion meds shouldn’t be after 10 weeks of pregnancy. No one offered any recommendations or specifications about anything else at all, including after-care.

PADILLA: The pharmacy clerk told us he sells a lot of these pills and the buyers are women from the United States.

We talked to Dr. Josie Urbina. She’s an OBGYN based in California. She said she wasn’t surprised about the experiences we described in Nuevo Progreso.

“The pharmacy tech is not privy to knowing the dosage of Misoprostol for medication abortion,” she said. “That’s not something that they treat in Mexico. Pharmacists don’t learn how misoprostol works for abortion.”

PADIlLLA: Misoprostol is used in combination with another drug — Mifepristone — for a medical abortion.

So we asked about buying Mifepristone in the pharmacies we went to – but they didn’t have it. Mifepristone isn’t as available in Mexico as it is in the United States. But it’s still safe to take Misoprostol alone for a self-managed abortion so long as you have a plan and some form of support.

“I just wanna clarify the medication is very safe to do,” said Dr. Urbina. “There’s two protocols, one with Mifepristone and Misoprostol. And then the other one with just Misoprostol only. But since Mifepristone — the more expensive one — isn’t available in a lot of third world countries, a lot of people just use the Miso.”

PADILLA: Dr. Urbina said that it is important for anyone who is going to cross the border for abortion pills to have a plan. She said that websites like MAHotline.ORG provide factual information in both English and Spanish. She added that going to a chain pharmacy in Mexico will ensure you’re buying safe medication.

“There’s not the same threshold for safety with independent pharmacies,” she said.

DAVIES: So while at the pharmacy, where the clerk gave such questionable instructions, we did buy the box of pills. One box contains 28 doses at a cost of $55 dollars.

PADIlLLA: Next we went to a supermarket called El Disco Super Center. There was a big pharmacy in the center of the store with just about any medication you can think of.

DAVIES: We went to the counter and asked the clerk for the abortion drug and he grabbed a box from a large stack next to him. He said the price was $25 dollars. That’s half the price we’d just paid earlier with the pharmacist with the liberal prescription.

PADILLA: This other pharmacist said they were selling a lot of this medication to young women from the United States. He also didn’t have the companion medication Mifepristone. In fact, he didn’t know any instructions on how to take it. He just shrugged his shoulders when we asked him for those recommendations.

DAVIES: We wanted to talk to a doctor in Nuevo Progreso and again we went and sought out the help of these ubiquitous street corner recruiters and fixers. One of them led us to a small office about half a block away.

PADILLA: The doctor was young, clean cut — he had a stethoscope draped around his neck. In front of him was a prescription pad.

DAVIES: We asked him if he’d seen American women in his practice–American women who had come across the border to get the abortion procedure. He offered an emphatic no. He said abortion procedures are illegal in the state of Tamaulipas. But, he said, people just go directly to the pharmacy.

PADILLA: However, in September, Mexico’s Supreme Court ruled to federally decriminalize abortion.

DAVIES: But it’s still illegal in most Mexican states – like Tamaulipas which shares a 230-mile border with Texas from Brownsville to Laredo.

PADILLA: When we told the doctor about the pills we bought he said that those medications are illegal, too. However, obviously, they are so widely available and openly bought and sold. But the reason is that they are supposed to be sold only as a stomach medication–for ulcers. However, the medication is not indicated for anything other than stomach ailments, not for abortions. This could explain why the first couple of clerks didn’t sell it to us.

DAVIES: When we crossed back into Texas and declared to the U.S. Customs officer that we bought the abortion pills, he merely waved me through.

PADILLA: So what did we find out? Is crossing the border to access an abortion an option for someone looking to get around the Texas prohibition?

DAVIES: Well, no and yes. It would be safer to go online and get the correct pills with telemedicine and have medical supervision in the process. But many in South Texas don’t have access to broadband internet. According to Pew Research, over 60 percent of households in the Rio Grande Valley don’t have broadband. And telemedicine is not an option for them.

PADILLA: So for many, going across the border for the Miso pills is an option. And an abortion procedure is completely out of the question – at least in the states of Tamaulipas and Texas.

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