Guam has taken a significant step toward restoring access to abortion, after the ACLU won a victory in a lawsuit that seeks to ensure that residents of the U.S. territory can turn to remote healthcare providers for medication. for abortion.
Abortion in Guam has been impossible since 2018, when the last abortion doctor retired and moved from the island. Before that date, at least 200 abortions occurred in Guam each year. Today, accessing the closest legal abortion clinic requires a flight to Hawaii, an expensive and difficult undertaking, especially during a pandemic.
Telemedicine medication abortions, which allow doctors to remotely prescribe the abortive medications mifepristone and misoprostol to patients up to 10 weeks pregnant, would be an obvious solution, if it weren’t for a 1978 Guam law that says Abortions must be “performed” at a “medical clinic or hospital.” The ACLU lawsuit is fighting, in part, to prevent that law from being enforced.
“We know that many people have approached doctors in Hawaii for abortions and that not all have been able to overcome the enormous financial and logistical obstacles to travel several thousand miles,” said Vanessa Williams, a Guam attorney who works with the ACLU. .
Historically, it has not been easy to access abortions in Guam despite the fact that they are legal, due to stigma and restrictive laws in the past. In the 1990s, the overwhelmingly Catholic territory of the United States, home to 165,000 people, passed a law banning abortion except when the mother’s life was in danger. Ultimately, the US Ninth District Court of Appeals struck down the law, citing Roe v Wade.
“There are very polarized views within our small community on this emotionally charged issue,” Williams said.
Along with vocal anti-abortionists, there has also been a local movement for abortion rights led by CHamoru women, the indigenous people of the Mariana Islands, which includes Guam. The island was colonized by Spain in the 17th century, when Catholicism was introduced, and was ceded to the United States in 1899.
Dr. Michael Lujan Bevacqua, a CHamoru academic and son of Rita Lujan Bevacqua, a nurse who fought for abortion access in the 1990s, says abortion rights align with long-standing CHamoru values and that CHamoru women were empowered to make decisions for themselves.
TelAbortion, a pilot project in Hawaii and 12 other states, allows certified physicians to provide abortion consultations via video chat and deliver medications directly to patients. But two ambiguous laws in Guam, one of which is the 1978 law, have made medical professionals unsure of how to proceed, prompting the ACLU and two Hawaiian doctors licensed to practice in Guam to file the recent lawsuit in January.
On March 5, the ACLU reached an agreement with the Guam attorney general and the Board of Medical Examiners that the 1978 agreement will not be enforced. While that amounts to a major victory in the case, Alexa Kolbi-Molinas, senior attorney for the ACLU’s Reproductive Freedom Project, says that in practice “things will not change overnight.”
A key challenge remains to repeal the second law, which requires patients to attend an in-person visit with a doctor on the island at least 24 hours before an abortion to share the required information. The ACLU says this creates undue logistical hurdles, as well as privacy concerns. It also puts the doctor in a delicate situation, as the punishment for breaking the law includes the loss of a medical license.
“The agreement removes any legal obstacles to the use of telemedicine to prescribe medical abortion,” said Kolbi-Molinas. “It remains an open question in the case whether patients will need to visit a different healthcare provider in Guam to obtain the required information.”
The ACLU will challenge the second law on March 18 in Guam’s district court.
George is Digismak’s reported cum editor with 13 years of experience in Journalism