On Tuesday the U.S. Supreme Court declined to block a new law in Texas that requires doctors who perform abortions to have admitting privileges at a local hospital, a measure that has caused at least a dozen clinics in the state to stop terminating pregnancies. Dr. Lester Minto owns and operates one of the affected clinics, Harlingen Reproductive Services. I spoke with him last week as he awaited the Supreme Court’s vote.
Slate: Are you closed?
Lester Minto: Of course not. I have nine ladies scheduled for tomorrow.
Slate: What do you tell them?
Minto: That I do not do abortions. I cannot do them legally. And I tell them that I know that there are other things that people do.
Slate: What do other people “do?”
Minto: If they have a passport and enough money, they go over the border to Mexico and go to a pharmacy and buy misoprostol at a pharmacy. It is an ulcer drug, but it works as an abortifacient. It is not as effective mifepristone, which is the on-label medicine used in the U.S. But in these ladies’ situations, misoprostol can be a good choice. It is proper medicine in a blister pack from a proper pharmacy. Someone might even know how to dose it. But it can be an expensive choice. In the U.S., misoprostol costs 10 to 12 cents a pill. I have had ladies charged $80 a pill at Mexican pharmacies. Also passports are expensive and can take too long to get if you don’t have one already. Misoprostol only works up to about seven weeks after your last menstrual period. You need a passport now just to walk over the bridge into Mexico and back. Of course if you are undocumented this isn’t an option at all.
Slate: What do women do if they don’t have a passport?
Minto: They buy the drug at a flea market. This is bad and sad and wrong. They are going to be buying things on the street. You don’t even know if you are getting the real thing. But these goddamn politicians ... Women are forced to crawl around like goddamn criminals. So I am here to help them.
Slate: How do you help them?
Minto: I give them a sonogram to make sure they are pregnant—and if they are pregnant, to make sure it is a uterine pregnancy—that they have no ectopic issues or anything. Then I give them vitamins. Because if they decide to keep the pregnancy, you want it be a healthy one. If they decide to do “something,” you don’t want them to hemorrhage excessively. That is a risk if a lady is anemic. A lot of my patients don’t have great health care, so a lot are anemic.
Slate: So the women take the drug and ...
Minto: They stay close to home, and sometimes it all works fine. But if it doesn’t—or it works part-way, that is what often happens— they can come to me, and I can do “miscarriage management.”
Slate: That’s legal in Texas?
Minto: Yes, in Texas once a woman is vaginally hemorrhaging, it is legal for me to help her.
Slate: What does that involve?
Minto: The same thing as an abortion. It’s just a change in words. It’s double talk. It’s bullshit.
Slate: Why don’t you just get admitting privileges at a local hospital and comply with the new law?
Minto: They won’t have me. They are religiously affiliated. So you know, Jesus.