While gestures of support from U.S. neighbors and allies are appreciated, outsourcing abortion care is not a solution to the problems overturning Roe v. Wade will exacerbate.
On Wednesday, May 25, Oklahoma Governor Kevin Stitt (R) signed into law a total ban on abortion—continuing the nationwide assault on access to reproductive healthcare. As millions of patients face abortion prohibitions in their home states and the potential end of protections afforded by Roe v. Wade, proposed solutions to the prospect of forced pregnancy in the U.S. are inadequate.
Karina Gould, Canada’s minister of families, children and social development, has previously assured American women that they can obtain safe abortions in Canada. Since last fall, activists in Mexico have been working feverishly to establish networks that supply abortion pills to women in the U.S. And, while the gestures of support from neighbors and allies are appreciated, outsourcing abortion care is not a solution to the problems overturning Roe v. Wade will exacerbate.
International medical travel creates new forms of suffering, even as it may alleviate others.
Medical travel is a form of class-based privilege, where the relatively wealthy are enabled to receive health services unavailable to others. Research shows that, as middle-class individuals in developed countries, such as the U.S., experience a retrenchment of healthcare entitlements and declining healthcare access, they have begun to seek 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 share in common their tendency to worsen healthcare inequalities. Necessitating international travel for abortions is poised to continue this harmful trend.
Studies show that, when the distance to a clinic exceeds more than 25 miles, there is a significant drop in people of color and lower-income people being able to access medical services. Necessitating international medical travel will certainly worsen these existing racialized class inequalities.
For example, key barriers to abortion access include financial and geographic resources. The six-week abortion ban in Texas means that pregnant people must travel an average of 247 miles—one way—to obtain an abortion. Pregnant people struggling to make ends meet must scrape together the money, transportation and time to access life-saving healthcare. What’s worse, 26 states have mandatory waiting periods, adding to the overall time and money needed to see a procedure through to completion.
Considering that low-income women of color are already less likely to be able to afford time off of work and access to childcare needed to accommodate inter-state abortion travel, the prospect of them realizing international abortion care access seems far-fetched. This barrier becomes insurmountable when one considers it takes approximately eight to 11 weeks to obtain the needed passport that only about one-third of Americans currently hold.
Healthcare seekers desperate for 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 what they are accustomed to in the U.S. and, in some cases, may find themselves suffering the effects of inadequate blood screening, outdated medications, and poor infection control.
Additionally, having to travel internationally for an abortion leaves people without clear access to post-operative care. Thus, where an abortion procedure performed elsewhere may have been safe, a critical lack of recovery services at home, or lack of insurance coverage for recovery care, will leave individuals who have terminated a pregnancy abroad vulnerable to infection, sepsis and even death.
Broader research on international medical travel also clarifies the potential for international abortion care markets to exacerbate the inequalities that pregnant and birthing people experience in their own communities.
In the Indian surrogacy market, for example, policy failures deny local women access to the pro-natal technologies and services that have been built for international clientele. For many Indian surrogates, their first experience with medicalized birth is for their surrogate pregnancies, not their own. Cutting-edge technology and expertise exist for the benefit of medical travelers rather than the Indian citizenry, a trend likely to expand to prospective international abortion care markets.
More broadly, international medical travel undermines global health equity efforts to extend life-saving expertise where it is most needed, as opposed to where it is most afforded. The creation of medical travel markets facilitates “brain drain” in developing countries, as skilled care providers leave in search of higher incomes in countries where demand and ability to pay are high. This thwarts healthcare provision in under-resourced communities already overburdened by conditions of ill-health and disease. In Thailand, for example, medical tourism has resulted in brain drain and higher medical costs to Thai citizens.
Increased healthcare inequality and poor international healthcare infrastructure are threats to political stability and global security. As the COVID-19 pandemic has made painfully clear, gaps in public health systems anywhere can create suffering and turmoil everywhere. Thus while some developing countries, such as the Philippines and Thailand, view medical tourism as a potential pathway to economic growth, this is a wealth-building strategy with potentially dire costs.
International medical travel is thus not a viable solution to abortion bans in the U.S.. A worldwide increase in healthcare inequality is a steep cost we simply cannot afford.
Americans must be wise to the perils of outsourcing abortion care and urge our international neighbors and allies to join the fight to uphold Roe v. Wade.
Sign and share Ms.’s relaunched “We Have Had Abortions” petition—whether you yourself have had an abortion, or simply stand in solidarity with those who have—to let the Supreme Court, Congress and the White House know: We will not give up the right to safe, legal, accessible abortion.
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