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Potential family planning cuts in Texas would reduce access to reproductive care for undocumented women

Later this month, the Texas Senate is expected to vote on the 2012-13 $164.5 billion budget that passed the House earlier this month.The House version includes $60 million cuts to family planning services.

On an organized conference call focusing on the impacts of state and federal legislation on the Hispanic community, several Planned Parenthood clinic directors and advocates for Hispanic women described how the Latina population — because of its size, income and health status — would be disproportionately affected by proposed federal and state funding cuts to family planning services.

Patricio Gonzalez, president and CEO of Planned Parenthood Association of Hidalgo County, said the average patient who accesses his Planned Parenthood clinics in Hidalgo and Starr Counties is between the ages of 20 to 25, has at least two kids (and no desire for a third) and is trying to put herself through school; she also has no health insurance. Gonzalez said approximately 23,000 people use services at his Planned Parenthood affiliate; of those, 20 percent do not have a Social Security number, but they are still able to access services through the state’s Title XX Social Services Block Grant, which is threatened by the budget cuts.

He said he predicts that without access to affordable pregnancy preventative measures, there will be an increase in pregnancy rates among illegal immigrant women in Texas, as well as an increase in women crossing the border into Mexico to obtain abortion-inducing drugs. The proposed funding cuts, he said, would reduce the amount of services his clinics would be able to provide by approximately 60 percent, and the majority of them would likely have to close down.

Gonzalez said that two years ago, two community health care workers at one of his clinics went into Mexico and posed as “mystery shoppers” at local pharmacies to find out how easy it would be to obtain abortion-inducing drugs.

Dora Alicia Proa, 57, was one of the promotoras de salud (community health care worker) who participated in the experiment.

In a call that was translated by an interpreter, Proa told TAI that she was able to obtain pills without a prescription from 10 different pharmacies she visited in Tamaulipas, Mexico, which borders Progreso, Texas. The way it works, she said, is a woman goes into a pharmacy and tells the pharmacist she has not gotten her period. Then the pharmacist sells her pills at a low cost (she couldn’t remember the exact price) and tells her if they do not work, she can return for stronger pills. Women can also obtain hormonal birth control injections at a cheap cost, she said.

The last time she crossed the border on one of these mystery shopping sprees, Proa said the streets were deserted due to increased violence — a drastic change from the previous year, when she said pharmacies were clamoring with women trying to buy abortion drugs.

Proa said she thinks cuts to family planning will have a significant impact on her community, because a lot of the funding is used to support education programs. In her 17 years working for Planned Parenthood, she said she has noticed that education efforts have resonated with many Hispanic families, who have opted to have fewer children in an effort to better support them. She said she is not sure if the clinics will be able to continue doing outreach work in these communities, particularly if more than half of them have to close, as Gonzalez predicts.

According to a Planned Parenthood report (PDF) based on statistics from the U.S. Centers for Disease Control and Prevention, in 2007, the pregnancy rate among women 15 to 44 in Hidalgo County was 114.8 per 1,000 females and 103.2 per 1,000 females in Starr County — compared to a rate of 93.3/1,000 in Texas. Reported legal abortions in these counties made up 2.27 percent of the 77,089 abortions in the whole state. From 2007 to 2008, incidents of Chlamydia increased by 765 cases throughout the Rio Grande Valley, with the largest increase in Hidalgo County, which saw about 600 more cases than were reported the previous year.

In August 2010, The Nation reported on this trend for poor pregnant women who cross the border to obtain abortifacients in Mexico, noting that the abortion-inducing drug of choice in many border town pharmacies is misoprostol, which can be purchased over the counter because it is also used to treat ulcers — and makes up half of the two-drug combination prescribed for medical abortions in the United States (the other half is mifepristone). The National Institutes of Health warns pregnant women not to take misoprostol to prevent ulcers because it may cause miscarriages, premature labor or birth defects.

José Camacho, executive director at the Texas Association of Community Health Centers told TAI that the proposed federal and state budget cuts will likely lead to several center closures, impacting approximately 230,000 women in Texas. (Due to the $600 million cut from funding to the federal Community Health Centers program, 5 million Americans without insurance will lose health care access, according the National Association of Community Health Centers.)

“The problem is, given the cuts at the federal level, we’re not given new capacity,” Camacho said. “We will not be able to pick up all of these women. We will try very hard.”

“It’s an effective death sentence,” he added, noting that many people will go without cancer and STD screenings and treatment.

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