International travel to access abortion is a global health problem, not a solution

While gestures of support from U.S. neighbors and allies are appreciated, outsourcing abortion care is not a solution to the staggering problems Roe vs. Wade will get worse.

Students protest the overthrow Roe vs. Wade in New York on May 19, 2022. Many participants in the American marches wear green, listening to the symbol of the struggle for reproductive rights originating in Latin America. (Alex Kent/AFP via Getty Images)

On Wednesday, May 25, Oklahoma Governor Kevin Stitt (right) signed into law a total ban on abortion, continuing the national assault on access to reproductive health care. As millions of patients face abortion bans in their home countries and the potential end of the protections offered by Roe vs. Wadethe solutions offered to the prospect of forced pregnancy in the United States are inadequate.

Karina Gould, Canada’s Minister of Families, Children and Social Development, has previously assured American women that they can get safe abortions in Canada. Since last fall, activists in Mexico have been working feverishly to establish networks that provide 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 overwhelming problems. Roe vs. Wade will get worse.

International medical travel creates new forms of suffering, although it may relieve others.

Medical travel is a form of class-based privilege, where relatively wealthy people are allowed to receive healthcare services inaccessible to others. Research shows that as middle-class individuals in developed countries, such as the United States, experience reduced health care entitlements and declining access to health care, they have begun to seeking care in international settings. This includes travel for life-saving surgeries, such as organ transfer, as well as elective procedures such as cosmetic surgery. These different types of international medical travel have in common their tendency to aggravate health inequalities. The need for international travel for abortions is poised to continue this harmful trend.

Studies show that when the distance to a clinic exceeds 25 miles, there is a significant drop in the number of people of color and low-income people who can access medical services. The need for international medical travel will certainly aggravate these existing racialized class inequalities.

For example, major barriers to abortion access include financial and geographic resources. Texas’ six-week abortion ban means pregnant women must travel an average of 247 miles (one way) to get an abortion. Pregnant women struggling to make ends meet must muster the money, transportation and time to access lifesaving healthcare. Worse still, 26 states have mandatory waiting periods, adding to the time and money needed to complete a procedure.

Considering that low-income women of color are already less likely to be able to afford time off work and access the childcare needed to accommodate interstate abortion travel, the prospect that they realize international access to abortion care seems far-fetched. This hurdle becomes insurmountable when you consider that it takes about eight to 11 weeks to obtain the necessary passport that only about a third of Americans currently hold.

Healthcare seekers in desperate need of help may seek out unregulated, cheaper, and potentially more dangerous international medical travel options. These patients may be less protected by local policy and laws than they are used to in the United States and, in some cases, may experience the effects of inadequate blood screening, expired medications, and poor monitoring. infections.

Additionally, having to travel abroad for an abortion leaves people without clear access to postoperative care. Thus, where an abortion procedure performed elsewhere may have been safe, a critical lack of in-home recovery services or a lack of insurance coverage for recovery care will make people who have terminated a pregnancy abroad vulnerable to infection, sepsis and even death.

Broader research on international medical travel also clarifies the potential of international markets for abortion care to exacerbate the inequalities experienced by pregnant women and women giving birth in their own communities.

In the Indian surrogacy market, for example, policy failures prevent local women from accessing pronatal technologies and services that have been designed for international clientele. For many Indian surrogates, their first experience of medical childbirth is with their surrogate pregnancies, not theirs. Cutting-edge technology and expertise exists to benefit medical travelers rather than Indian citizens, a trend likely to extend to future international abortion care markets.

More generally, international medical travel undermines global health equity efforts to extend vital expertise to where it is most needed, as opposed to where it is most affordable. The creation of medical travel markets facilitates the “brain drain” in developing countries, as skilled healthcare providers seek higher incomes in countries with high demand and ability to pay. This thwarts the delivery of health care in underresourced communities already overburdened by poor health and disease conditions. In Thailand, for example, medical tourism has led to a brain drain and increased medical costs for Thai citizens.

Rising health care inequalities and poor international health infrastructure threaten political stability and global security. As the COVID-19 pandemic has made painfully clear, shortcomings in public health systems anywhere can create suffering and turmoil everywhere. So while some developing countries, such as the Philippines and Thailand, see medical tourism as a potential route to economic growth, it is a wealth-creation strategy with potentially huge costs.

International medical travel is therefore not a viable solution to abortion bans in the United States. A global increase in health care inequalities is a high cost that we simply cannot afford.

Americans must be aware of the dangers of outsourcing abortion care and urge our international neighbors and allies to join the fight to defend Roe vs. Wade.

Sign and share Mrs. relaunched the “We had abortions” petition– whether you have had an abortion yourself or simply stand in solidarity with those who have – to let the Supreme Court, Congress and the White House know: we will not abandon the right to a safe abortion, legal and accessible.

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