Historically, it has not been easy to access abortions on Guam despite them being legal, due to stigma and past restrictive laws Photograph: dbimages/Alamy

It’s been impossible to get an abortion on the island since 2018, and the closest legal clinic is in Hawaiʻi

Guam has taken a significant step toward restoring abortion access, after the ACLU scored a victory in a lawsuit that seeks to ensure residents of the US territory can turn to remote healthcare providers for abortion medication.

Telemedicine medication abortions, which allow doctors to remotely prescribe the abortion drugs mifepristone and misoprostol to patients up to 10 weeks pregnant, would be an obvious solution, if it were not for a 1978 Guam law that says abortions must be “performed” in a “medical clinic or hospital”. The ACLU lawsuit is fighting, in part, to block that law from being enforced.Advertisement

“We know that many people have reached out to physicians in Hawaiʻi about accessing abortions and that not all of them have been able to overcome the enormous financial and logistical obstacles to traveling several thousand miles,” said Vanessa Williams, a Guam lawyer working with the ACLU.

Historically, it has not been easy to access abortions on Guam despite them being legal, due to stigma and past restrictive laws. In the 1990s, the mostly Catholic US territory, where 165,000 people live, passed a law that prohibited abortion except when the mother’s life was endangered. Eventually, the US ninth district court of appeals struck down the law, citing Roe v Wade.

“There are very polarizing points of view within our small community on this emotionally charged issue,” said Williams.

Along with the 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 include Guam. The island was colonized by Spain in the 17th century, when Catholicism was introduced, and was ceded to the US in 1899.

Dr Michael Lujan Bevacqua, a CHamoru scholar and the son of Rita Lujan Bevacqua, a nurse who fought for abortion access in the 1990s, says abortion rights align with ancient CHamoru values and that CHamoru women were empowered to make choices for themselves.

TelAbortion, a pilot project in Hawaiʻi and 12 other states, allows certified doctors to provide abortion consultations via videochat and mail the medications directly to patients. But two ambiguous laws in Guam, one of which is the 1978 law, have made medical professionals unsure how to proceed, prompting the ACLU and two Hawaiʻi doctors who are licensed to practice in Guam to file the recent lawsuit in January.

On 5 March the ACLU reached an agreement with Guam’s attorney general and Board of Medical Examiners that means the 1978 will not be enforced. While that amounts to a major win in the case, Alexa Kolbi-Molinas, a senior staff attorney at the ACLU Reproductive Freedom Project, says that in practice “things will not change overnight”.

A key challenge still remains in overturning the second law, which requires patients to attend an in-person visit with a physician on the island at least 24 hours before an abortion to share mandated information. The ACLU says this creates undue logistical hurdles as well as privacy concerns. It also puts a physician in a tenuous situation, since punishment for violating the law includes loss of a medical license.

“The settlement clears any legal obstacles to using telemedicine to prescribe medication abortion,” said Kolbi-Molinas. “It is still an open question in the case whether patients will be required to visit a different healthcare provider in Guam to obtain the mandated information.”

The ACLU will challenge the second law on 18 March in Guam’s district court.

Source: https://www.theguardian.com/world/2021/mar/10/guam-abortion-access-aclu-lawsuit?fbclid=IwAR3XCDTvMFy5rumBdRCgXbHVEe7ErUGranAswD8jNFoVRBggmKv3hOvW5w8