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How Mexico ensures access to safe abortion without legalizing it

Abortion rights activists take part in a demonstration in Mexico City
Reuters/Edgard Garrido
No outcomes of pregnancy are a crime in Mexico
  • Annalisa Merelli
By Annalisa Merelli

Senior reporter based in New York City

Published Last updated

When it comes to abortion, Mexico offers a glimpse of a possible future for the US.

Like its northern neighbor, the country is a federal republic of 32 states in which the legality of abortion varies. It does not have a federal law, or Roe v Wade-like constitutional decision legalizing abortion—a position the US is likely to find itself in by the end of June, when the Supreme Court is expected to officially announce its decision on Dobbs v Jackson Women’s Health OrganizationThe decision, a draft of which was leaked last month, might overturn the precedent stating that a woman has a right to obtain abortion as part of her right to privacy. If the leak is confirmed, it would end the federal protection of abortion, and making its legality dependent on the individual state.

This would open the way to restrictive laws in Republican-majority states, many of which have trigger laws ready to go into effect as soon as the Supreme Court ruling is out, including ones that could lead to the arrest of women experiencing miscarriages. But in Mexico, the situation is different in a small, but very significant way: Abortion is not legal, but has been decriminalized federally. On Sept. 7, 2021, Mexico’s Supreme Court unanimously ruled that it was unconstitutional to punish abortion as a crime.

The effects of decriminalization

The 2021 Mexican supreme court decision was propelled by the so-called marea verde, or green wave, a Latin American transnational movement promoting abortion rights, which pushed for the approval of abortion laws in countries including Argentina and Columbia, and in Mexican states. While it stops short of full legalization, its effects are significant in effectively giving women, including those who don’t qualify for an abortion in their home state, broader access to safe abortion.

In Mexico no outcome of a pregnancy is criminalized—including miscarriages, no matter how they occur—so women who get abortions outside of the medical infrastructure, for instance by inducing an abortion with medication at home, can seek medical attention at any time without putting themselves in danger of being reported to the authorities.

Medical abortion in Mexico is offered in medical settings via two medications, mifepristone and misoprostol. But women who choose to have a medical abortion at home, because they don’t qualify for legal abortion in their state, or prefer to deal with it independently, typically take misoprostol only, following World Health Organization protocol (pdf). Abortions done with misoprostol alone are just as safe as those with the combination of drugs, but easier to obtain without a prescription as it’s sold over the counter as a medication to treat ulcers in every state.

The right to support women who have abortions

Veronica Cruz, a leading pro-abortion activist who founded Las Libres, an organization that provides accompaniment to women who wish to terminate unwanted pregnancies in the state of Guanajuato, says things have changed since the decision even in very anti-abortion states like her own. Las Libres has been operating for 22 years, and has developed a so-called “escuela de acompañamento“—a training for women who want to offer physical assistance as well as medical and legal information to others seeking a termination of a pregnancy.

Even prior to the 2021 decision, Las Libres didn’t shy away from providing abortion accompaniment and information despite the legal risks. “When the law restricts a right, it isn’t right, and if the law isn’t right we have to reject it,” says Cruz. The goal of the abortion movements remains to legalize abortion in all states, she says, but decriminalization has helped reduce some of the stigma around abortion and has allowed activist networks to move more freely and safely.

This includes facing fewer risks in organizing and facilitating travel for women in anti-abortion states—in both Mexico and, increasingly, from the US—end their unwanted pregnancies. Women who face significant cultural and social obstacles to abortion in their home state—for instance Guanajuato, where the stigma against abortion is strong—can seek financial, logistical, and emotional support from pro-abortion networks to travel to another state to terminate the pregnancy through surgical abortion, even after the first trimester, when misoprostol is most effective.

Believe women, by law

This works alongside an instrumental legal provision, introduced in 2013 to actualize the right to abortion for victims of rape, who have a right to end their pregnancy in every state in the country.

The decision states that in order to obtain an abortion under the rape exception a woman doesn’t need to provide a police report of the assault—as was the case in several states prior to the decision. Instead, her word that it happened is sufficient.

A linked provision, upheld by the supreme court late this past May, confirmed that for minor victims of rape, defined as those between the ages of 12 and 18, there is no need of for parental consent to obtain an abortion, freeing many teenagers to seek abortions despite familial opposition or incest.

“Sometimes the patient doesn’t want to present the report to the police, and we respect that,” says José Luis Flores Madrigal, a doctor and director of the maternal and infant health hospital Esperanza López Mateos, in Guadalajara, in the state of Jalisco. “I simply have to believe her.”

“That really struck me in the hospital, when we were learning about the rape exception, when […] I asked if [women] needed to prove anything and [the doctor] just said, ‘no, we just believe women,'” says Julie von Haefen, a North Carolina state representative who was present at a meeting with Mateos. “I will remember that forever probably, just the matter-of-factness of that statement was just so revealing, because not everyone in the United States believes women.”

📬 A periodic dispatch from the annual session of the United Nations General Assembly in NYC.

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