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Flea-market abortion remedies thrive ahead of possible closure of Texas clinics

At an open-air flea market outside McAllen, Texas, near the Mexican border, shoppers can buy a goat and get their car windows tinted. Tables with handwritten signs touting Viagra are stocked with herbal remedies promising to burn fat and boost breast size. You can also find pills to end a pregnancy.

Bazaars like this have become home to a thriving black market, where women too poor to afford an abortion at a clinic or deterred by state mandates such as a 24-hour waiting period can buy drugs to induce a miscarriage on their own, a dozen area residents and doctors said in interviews.

Hundreds of miles north in Austin, the capital, lawmakers may inadvertently increase this illegal trade. Rules set to pass as soon as this week might result in the closing of most, if not all, abortion facilities in the state. If the law – promoted as a way to improve women’s health – makes legal abortion unavailable in Texas, more women may turn to markets such as the one near McAllen and risk their lives.

“You’d be amazed at how many people, young people, are taking those pills,” said Erlinda Dasquez, 29, a mother of four who has done so herself. “I probably know 12 to 20 people who have done this. My cousin just went to the flea market a few months ago.”

Women in the Lower Rio Grande Valley, along the southeastern border with Mexico, said it’s already harder for them to control their reproductive lives since the state cut funding for birth control in 2011.

In the past few years, health care providers in the valley, one of the state and nation’s poorest regions, have seen an increasing number of women suffering from incomplete abortions and bleeding after taking drugs unsupervised, they said.

The pills, which are known by the brand name Cytotec and require a prescription in the United States, are designed to prevent stomach ulcers. They can also induce abortion. Until recently, obtaining them meant a trip across the border to Mexican towns such as Nuevo Progreso, where pharmacies can legally sell them without a prescription.

Underground imports have brought the trade stateside. Whether it’s the actual Pfizer Inc. medication or a generic, side effects include premature birth and uterine rupture. The drug isn’t typically on display at flea markets. All you need to do is ask, residents said.

Pfizer is working with law enforcement to support efforts to prevent illegal sale of the drug, said Chris Loder, a spokesman for the New York-based company.

When Dasquez needed the pills, they weren’t yet available at flea markets. Instead, on a September day in 2010 while her mother was baby-sitting, Dasquez got behind the wheel of her gold Chevrolet Malibu to go see a woman who’d smuggled the drugs across the border to sell out of her living room.

The woman handed Dasquez four octagonal pills in a clear plastic bag, she said. They cost $40. At the nearest legal provider, a pharmaceutical abortion costs $550.

Dasquez said she turned down another option: injections that the woman was offering to administer on the spot.

“I was scared, but I thought I didn’t have any other choice – I had to do it whatever happens,” she said. “I told my mom, so if anything goes wrong, she could bring me to the hospital or get help.”

Texas became a flashpoint last month in the debate over abortion after Republican leaders championed a law to make the state the largest and most populous to mandate that clinics meet structural standards similar to those required of hospitals. It would also ban the procedure past 20 weeks of pregnancy. Abortion rights advocates say it might force the state’s 42 providers to close by making compliance too expensive or logistically impossible.

Backers of the bill have described the proposal as a way to promote women’s health by improving the safety of clinics, as well as a tipping point in the fight to ensure all pregnancies are carried to term.

“This is a human rights issue,” Republican Gov. Rick Perry said in a June 27 speech to anti-abortion activists. “The ideal world, of course, is a world without abortion.”

In Texas, 72,332 abortions were performed in 2011, the latest year for which data is available, according to the Texas Department of State Health Services.

A drug called Mifeprex, used in conjunction with Cytotec, is approved by the Food and Drug Administration as an alternative to surgical abortion within the first seven weeks of pregnancy. When taken as directed, it’s effective 92 percent to 95 percent of the time and complications are rare, according to the manufacturer of Mifeprex, Danco Laboratories LLC, based in New York.

That’s not the regimen followed by women getting the drugs on the black market, who can be as ill informed as those selling them. During a recent visit to the Almost Free Pharmacy in the Mexican state of Tamaulipas, a man behind the counter instructed an initial dose of two pills orally and one vaginally, followed by two pills every hour “until something happens.”

William West, a physician at Whole Women’s Health in McAllen, said he sees patients daily who have taken black-market abortion drugs. Many are bleeding or still pregnant, he said.

“It’s hard to know how successful it really is. We just see the failures,” said West, 77, who has been performing abortions for 31 years.

That’s what happened to Dasquez, who took a second dose after the first didn’t work. She bled for at least a month, she said.

Locals have a word to describe abortions like this: clandestino. It’s often poor and undocumented immigrants who seek them, unable to afford having more children or legal yet pricier options, said Paula Saldana, a community health instructor who volunteers to educate Hispanics about contraception.

“Only people with money go to clinics,” said Saldana, 36.

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