Money matters: Abortion care and socio-economic class

Added to the physical inaccessibility is the economical restriction imposed on women, due to the increasing cost of the procedure. This is particularly problematic for African-American, Latinas and low-income women because of their difficulties in obtaining the resources needed to pay for the procedure and associated costs. Indeed, hi addition to the fees directly relating to the medical intervention - which range from $300 to $700 during the first trimester and $800 to $1,000 in the second trimester - women must pay for all travel costs (transportation and accommodation). Costs of abortion can represent more than a month of salary for some women, in addition to taking time off to obtain the procedure. This situation forces women to seek outside help to cover the expenses or care for their children while they undergo the procedure, often implying that they must disclose their plan (Fuentes et al., 2016). The economic burden of abortion is further increased by the lack of coverage by public insurance, as Medicaid cannot cover abortion due to the enactment of the Hyde Amendment in 1977, under which federal funds cannot be used to provide an elective abortion (H.R. 14232, 1977). Some insurance companies, both private and public, do not cover abortions due to state laws prohibiting insurance companies from offering abortion coverage (Guttmacher Institute, 2019). While others do cover insurance, a study found that two-thirds of participants did not use their insurance to cover the procedure (Jones et al., 2013). This can be explained by a lack of knowledge of insurance coverage or a desire to keep the procedure private (Jones et al., 2013). Therefore, the existence of abortion funds - an organization whose main goal is to fundraise money to help low-income women access their right to abortion - is central to lessen the economic burden of abortion restrictions on women. In McAllen, 80% of all abortions provided at the Whole Woman’s Health clinic are funded by one of the abortion funds available to women living in the region. In El Paso, at the local Planned Parenthood clinic, all abortions provided are paid out of pocket, making abortion funds an important help for low income women. Thus, access to abortion is increasingly linked to the economic situation of women. However, undocumented women often are in precarious economic situations and these costs are not simple obstacles, but rather insurmountable barriers. While abortion funds are available to help with the costs, not everyone knows of them, and questions regarding address, and other information that can be perceived as sensible by migrants, might be a tangible obstacle. Clinic workers become vital help for women, as they help with applying for help with local abortion funds. While not a monetary help, underground networks of “aunts” have been created by women wanting to help other women. These networks offer accommodation, food and comfort to women traveling out of town or out of state to access the procedure, helping in both reducing the costs and psychological care.

Self-abortion and medical abortion: Taking care outside of the clinic

While impeded access to abortion might have direct impacts on the number of abortions performed in a clinic, it does not necessarily lead to a decrease in the number of women wanting to terminate a pregnancy. A direct impact of more restrictive laws is an increase in self-induced abortion - or attempted selfinducement. Indeed, a New York Times study of 700,000 Google searches of terms identical or related to “self-induced abortion” concluded that there is a correlation between states enacting more restrictive laws and states where the number of searches is higher than the national mean (Stephens-Davidowitz, 2016). Economic accessibility of the procedure is cited as the main obstacle preventing women from seeking professional care, particularly for women of color and of low income (Grossman et al., 2010). A 2015 study in Texas concluded that between 100,000 and 240,000 women tried, successfully or not, to provoke a self-induced abortion (Grossman et al., 2015). The study highlights that Latina women are more likely to know about the methods and to attempt a self-induced abortion (Grossman et al., 2015: 2). While self-abortion is often represented in negative terms and pictured through the lens of pre-legalization means, studies of self-abortion highlight that for some women, it is a choice, rather than something forced on them due to restrictive policies. Indeed, for some women, self-abortion allows them to decrease the perception of a medical intervention, transform the abortion into something more natural and a way to be at peace with the decision and lessen the impression of having "killed a baby” as they compare self-abortion to menstruations (Grossman et al., 2010; Lindgren, 2017). Beyond the physical and psychological impacts of a self-induced abortion, there are also legal considerations in a plurality of states. Indeed, as shown by Tania Bakic Hayden’s research (2011), there have been cases where women who decided to terminate their pregnancy outside of authorized abortion clinics face criminal charges for what is deemed an illegal abortion. Such is the case of Gerardo Flores, who is currently imprisoned on two counts of murder, with two concurrent sentences. His underage pregnant girlfriend. Erica Basoria, unable to obtain a legal abortion without parental consent - and because she was beyond the 20-week limit imposed by the state of Texas - asked for his help in provoking a miscarriage, which resulted in prosecuting for murder of two fetuses (Malisow, 2005). Under a 2003 Texas law, she could not be prosecuted, as it is a mother's right to end the pregnancy (SB319, 2003). This criminalization of abortion increased since the 1980: While the charges used to be based on the illegality of the procedure, more and more states prosecute women - and other actors of self-induced abortion - with charges of murder. However, banning abortion does not decrease the need for it, it just increases the risks that women will be forced to take - seeking care in potentially unsafe conditions. The return to self-abortion, and the criminalization of it, offers a clear insight into the precarious state of the right to abortion in several US states.

Cultural experiences and migration realities: Abortion laws and Latinos

Latinas' experience of abortion care is lived through their cultural identity, hi 2014, Latinas accounted for 24.8% of all abortions in the US, while they represent

Reproductive care in US-Mexico borderlands 161 around 9.3% of the overall US population. However, foreign-born Latinas were less likely than US-born Latinas to opt for abortion, with an estimated rate 40% lower than that of US-born (Lara et al., 2015). Nonetheless, Latinas are often excluded from studies on abortion access, due to the perceived lack of desire to access the service in regard to their religiosity and the valorization of family inherent to Latinx culture (Mann et al., 2015; Bermudez and Mancini, 2013). While those factors certainly impact a woman’s decision and/or her experience of post-abortion feelings, as well as the amount of support received, it cannot be generalized to all Latinas, and studies must take into consideration their experience receiving care as well as the specific burdens they experience in seeking care.

Furthermore, multiple barriers to undocumented migrants’ access to abortion keep (un)documented migrant women in a subordinated position, contributing to the oppression they experience and constituting a succession of violences (Gomez, 2015). These policies also increase fear among migrant communities: “Such legislatives acts appear to be creating a ‘chilling effets’ that prevents Latinos from using community services, including those dedicated to health care because of the threat of deportation that immigrants face with hardened enforcement measures or shear humiliation” (Ochoa O’Leary and Valdez-Gardea, 2013: 80). Migration status pushes women towards some choices regarding their reproductive health that might not be their preferred one, depriving them of their agency. The attempt to control migrant women’s access to abortion is multifaceted and perpetuated through direct and indirect channels: There is a desire to control the racialized body, the reproductive body by limiting access to healthcare and a tendency to restrict socio-economic well-being towards a previously impoverished population.