Immigrant women face barriers

(WOMENSENEWS)–Legal and reproductive rights advocates are rushing to the defense of an 18-year-old Dominican immigrant living in Lawrence, Mass., who faces possible murder charges for undertaking a do-it-yourself abortion.

Local lawyers with the American Civil Liberties Union are monitoring the case and have spoken with the family about available services and support.

Susan Yanow, longtime Massachusetts reproductive rights activist and founder of the Cambridge-based Abortion Access Project, has helped the young woman, Amber Abreu, identify medical and legal experts to support her public defender.

“This is a travesty on every level,” says Yanow. “When we don’t provide access, people are left to make decisions as best they can, which may not be congruent with best health practices.”

As of now, the teen faces the charge of procuring an illegal miscarriage–which carries a maximum sentence of seven years–based on a relatively obscure 1840s statute. Possible homicide charges mean the teen could face an even higher maximum sentence of life in prison if she is found to have acted with malice aforethought or premeditation. The teen’s legal status hinges on the outcome of an autopsy that will determine the length of her pregnancy.

Prosecutors state that Abreu was between 23 and 25 weeks pregnant. Abortion is legal in Massachusetts up to the 24th week, nevertheless, the teen is charged with procuring a miscarriage. If in fact the autopsy indicates she was 24 weeks or more pregnant, prosecutors could decide to bring homicide charges.

Abreu will be back in court Feb. 25 for a pretrial hearing.

Yanow from the state’s abortion access project argues that the “procuring the illegal miscarriage” charge is a legal anomaly. “No other medical procedure, aside from assisted suicide, carries criminal charges,” she said.

Defense attorneys could challenge any charges against Abreu in a number of ways, says ACLU Massachusetts spokesperson Sarah Wunsch.

Most basic, however, is the argument that Abreu did not understand she was committing a crime and legal due process requires fair notice from the government of what constitutes a criminal act.

“She is a young, scared, poor immigrant who couldn’t possibly be reasonably expected to understand the intricacies of the legal system,” Wunsch says. “We hope the prosecutor will rethink levying charges and decide against prosecuting her because one possible effect of this case could see women driven away from the public health system out of fear, and that is not beneficial to women or babies.”

First Court Appearance in January

Abreu made an initial court appearance on Jan. 24 in the Lawrence District Court on charges of unlawfully procuring a miscarriage that resulted in the death of her premature baby. She had previously admitted to taking three pills of Cytotec, the brand name for misoprostol, an anti-ulcer medicine known to induce abortion.

Abreu gave birth to a 1 and 1/4 pound baby girl named Ashley on Jan. 6 in the Lawrence General Hospital emergency room, two days after taking the medication. She left the hospital almost immediately afterward against the advice of doctors.

The infant was rushed to Tufts-New England Medical Center in Boston where she clung to life for four days before dying on Jan 10. Doctors discovered traces of Cytotec in the baby’s urine.

Under police questioning, Abreu–who speaks some English and has lived in the United States for 18 months–said the baby’s father had abandoned her and she was afraid of burdening her immigrant mother with the unwanted pregnancy.

Abreu is described by family and friends in press reports as a well-behaved, studious teen.

Drug Bought in Dominican Republic

Saying she was unaware of the potential legal implications of her actions or other options for health care services, Abreu told police that she turned to Cytotec, procured by a friend in her native Dominican Republic, where the drug is sold over-the-counter for about $1. In the United States the drug is only available by prescription, but it is not illegal to import it or possess it.

A 2000 study by the New York-based National Latina Institute of Reproductive Health of Dominican immigrants found 37 percent of subjects were familiar with the Cytotec technique.

Abortion is illegal in the Dominican Republic under all circumstances.

Most Latin American countries have extremely rigid rules governing abortions. Often they are only legal in cases of rape, incest, or cases where the mother’s life is endangered. In some countries, such as Chile and El Salvador, they are illegal under all circumstances. Colombia liberalized its abortion law in May 2006 by allowing exceptions, including to save the health of the woman.

Authorities prosecute hundreds of women for illegal abortions and an estimated 5,000 women die every year as a result of clandestine abortions, according to the International Planned Parenthood Federation.

In only one other case has a woman’s use of Cytotec for an induced abortion in the United States resulted in a criminal prosecution. A South Carolina court sentenced Mexican immigrant Gabriela Flores to four months in prison in 2002 for taking the drug during the 16th week of her pregnancy and miscarrying.

Case Casts Shadow on Latinas

The Abreu case casts a long shadow over other female immigrants from Latin America, says Aishia Glasford, a policy analyst for the National Latina Institute for Reproductive Health.

“Here you’ve got a sizable group facing linguistic and cultural barriers in how reproductive health is dealt with,” says Glasford. “In most Latin American countries sex education is not given in the home or in public arenas like schools.”

Even for Latinas who speak English the health care system is often difficult to navigate. High costs are one barrier. In 2002, 32 percent of Latinos were without health insurance, according to the U.S. Census Bureau, compared to 20 percent of blacks and 14 percent of whites.

Advocates for Latina health say the Abreu case dramatizes the need for better, more accessible health services.

Screenings for breast and cervical cancer, treatments for sexually transmitted diseases and access to contraception are among their priorities. Bilingual counselors are also high on their list.

Breast cancer is the No. 1 cause of cancer deaths among the Latina population; only 38 percent of Hispanic women age 40 and older have regular screening mammograms. Hispanics suffer the highest invasive cervical cancer incidence rates (16.2 per 100,000) of any group other than Vietnamese, and twice the incidence rates of non-Hispanic white women, the American Cancer Institute reports. Also, incidences of cervical cancers are twice as high for Latinas than non-Latina white women and Latinas tend to be diagnosed later than other women.

“We need a culturally and linguistically competent way to address the issue and help jump start meaningful dialogue within immigrant communities,” says Glasford.

Juliette Terzieff is a freelance journalist based in Buffalo, N.Y. She has worked for the San Francisco Chronicle, Newsweek, CNN International and the London Sunday Times during time spent in the Balkans, the Middle East and South Asia.

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For more information:

National Latina Institute for Reproductive Health:

Fact Sheet on Latino Youth: Health Care Access

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