While gestures of support from US neighbors and allies are appreciated, outsourcing abortion care is not a solution to coup problems. Raw vs. Wade will aggravate.
On Wednesday, May 25, Oklahoma Governor Kevin State (right) signed into law a comprehensive abortion ban — a continuation of the national attack on access to reproductive health care. Millions of patients face the ban on abortion in their countries of origin and the potential end of the protection it offers Raw vs. WadeSuggested solutions to the possibility of forced pregnancy in the United States are insufficient.
Karina Gould, Canada’s Minister of Family, Children and Social Development, previously assured American women that they can have safe abortions in Canada. Since last fall, activists in Mexico have worked frantically to create networks providing abortion pills to women in the United States, and while gestures of support from neighbors and allies are appreciated, outsourcing abortion care is not a solution to the coup problems. Raw vs. Wade will aggravate.
International medical travel creates new forms of suffering, even if it may alleviate the suffering of others.
Medical travel is a form of class privilege, in which the relatively wealthy are empowered to receive health services unavailable to others. Research shows that as middle-class people in developed countries, such as the United States, experience curtailment of health care benefits and diminished access to health care, they are beginning to seek care in international settings. This includes travel for life-saving surgeries, such as organ transplants, as well as elective procedures such as plastic surgery. These different types of international medical travel share a tendency to exacerbate healthcare inequalities. The requirement for international travel to perform abortions is set to continue this harmful trend.
Studies show that when the distance to a clinic exceeds 25 miles, the ability of people of color and low incomes to access medical services is significantly reduced. The necessity of international medical travel is sure to exacerbate class inequality based on race.
For example, major barriers to accessing abortion include financial and geographic resources. A six-week abortion ban in Texas means pregnant women must travel 247 miles — one way — to get an abortion. Pregnant women who are struggling to make ends meet must muster the money, transportation, and time to get life-saving health care. Even worse, 26 states have mandatory waiting periods, increasing the total time and money needed to see the procedure through to completion.
Given that low-income women are already less likely to be able to afford time off work and access to the child care needed to accommodate intercountry abortion travel, the likelihood of them achieving access to international abortion care seems far-fetched. This barrier becomes insurmountable when one considers that it takes approximately eight to 11 weeks to obtain the required passport that only about a third of Americans currently hold.
Healthcare seekers in dire need of assistance may be looking for unregulated, cheaper and riskier international medical travel options. These patients may be less protected under local policies and laws than they are used to in the United States, and in some cases, they may find themselves suffering from the effects of inadequate blood testing, outdated medications, and poor infection control.
Additionally, having to travel internationally for an abortion leaves people without clear access to postoperative care. Thus, when an abortion performed elsewhere is safe to perform, a severe lack of recovery services at home, or a lack of insurance coverage for recovery care, will leave individuals who terminated their pregnancies abroad vulnerable to infection, sepsis, and even death.
Extensive research on international medical travel also demonstrates the potential for international abortion-care markets to exacerbate the inequalities experienced by pregnant women and childbirth in their communities.
In the Indian surrogacy market, for example, policy failures deny local women access to pro-birth technologies and services created for international clients. For many Indian agents, their first experience with a medical birth is their surrogate pregnancy, not theirs. The latest technology and expertise exists for the benefit of medical travelers rather than Indian nationals, a trend that is likely to expand to potential international abortion care markets.
More broadly, international medical travel undermines global health equity efforts to extend life-saving expertise where it is most needed, rather than where it is most provided. The creation of medical travel markets facilitates a “brain drain” in developing countries, as skilled caregivers leave in search of higher incomes in countries with high demand and ability to pay. This frustrates the provision of health care in under-resourced communities already burdened with conditions of ill health and disease. In Thailand, for example, medical tourism has led to brain drain and higher medical costs for Thai citizens.
Increasing inequality in health care and weak international health care infrastructure pose threats to political stability and global security. As the COVID-19 pandemic has painfully demonstrated, gaps in public health systems anywhere can cause suffering and disruption everywhere. Thus, while some developing countries, such as the Philippines and Thailand, view medical tourism as a potential path for economic growth, this is a wealth-building strategy with potentially high costs.
Thus, international medical travel is not a viable solution to the prohibition of abortion in the United States. A global increase in inequality in health care is a huge cost that we simply cannot afford.
Americans must be wise in facing the dangers of outsourcing abortion care and urging our neighbors and international allies to join the fight to support Raw vs. Wade.
Signing and sharing Ms. Re-launched the “We Had Abortions” petitionWhether you have an abortion, or simply solidarity with those who have had an abortion, inform the Supreme Court, Congress and the White House: We will not compromise the right to safe, legal, and accessible abortion.