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The Unique Obstacles to Abortion Access in Guam

Flag of Guam.
Despite centuries of colonization, our pre-colonial matriarchal traditions and culture of respect endure. That includes our right to decide when and whether to have a family.
Flag of Guam.
Vanessa L. Williams,
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January 28, 2021

Yesterday, I joined the ACLU in filing a lawsuit to restore abortion access to Guam. More than two years ago, the last known abortion provider in Guam retired, and thanks to outdated and medically unnecessary restrictions, island residents cannot use telemedicine — which over a decade of evidence and experience has shown to be a safe and effective means of providing medication abortion — to access legal abortion. In effect, these laws are operating as an abortion ban.

Unfortunately, this is not the first time advocates, like myself, have had to turn to the courts to defend access to safe and legal abortion in Guam. In 1990, Guam took the national stage when its governor, Joseph Ada, signed into law a bill banning abortions on Guam. The law was a frontal assault on our constitutional rights — in fact, the government of Guam argued that the right to abortion did not even apply to Guam at all — and was the most restrictive ban enacted in the United States since the Supreme Court had decided Roe v. Wade. The law was challenged, the government of Guam lost, and the suit cost the people of Guam millions. Guam legislators stayed away from the issue for a while but — just as we have seen throughout the United States — over the last decade they have steadily introduced laws to make abortion more and more difficult to access.

Since 2008, politicians in Guam have introduced nearly a dozen medically unnecessary and politically motivated restrictions on safe and legal abortion care. The majority of these legislative efforts were signed into law, creating a web of barriers that have pushed safe and affordable abortion care out of reach for island residents. Among other harmful and stigmatizing effects, these laws delayed access to care and forced patients to make multiple, unnecessary visits to their doctor.

These barriers are exacerbated by a unique problem that sets Guam apart from other U.S. citizens. Guam sits about 5,800 miles (12 flight hours) from the U.S. mainland, and 3,800 miles (7 flight hours) southwest of our closest U.S. neighbor, Hawai’i. Guam has also been a federally designated a Health Professional Shortage Area (HPSA) and a Medically Underserved Area (MUA) — meaning that specialized and tertiary medical services are thousands of miles away.

These barriers hurt those who are already hurting most. The most vulnerable make up a larger part of our community than anyone would like to admit. Our rates of poverty, poor health, and domestic violence and sexual assault already are among the highest in the United States. And the current lack of access to abortion only exacerbates this crisis: Research shows that women who are forced to carry a pregnancy to term after being denied a wanted abortion are four times more likely to experience subsequent poverty; are more likely to experience serious complications from the end of pregnancy; and are more likely to remain in abusive relationships.

People who are already struggling should not be denied the ability to get an abortion, continue a pregnancy, or have a safe place to raise their children — yet that is exactly what is happening in Guam. No politician should deny us our freedom to make decisions about our own health, our bodies, and our families — especially not one who claims to serve the people of Guam. It is impossible to separate our choice of whether and when to have children from every other choice in our lives. From housing to schools to jobs, virtually every major decision that influences our lives is irrevocably impacted by our decision to have a child. Any denial of the right to choose whether to have a child is a denial of all of our other choices.

It is painful to see my island’s distinction among the U.S. is yet again based on the denial of a fundamental right to our women. However, as a Chamorro woman, carrying the legacy of Chamorro activism for reproductive freedom, I know we do not take for granted our inherent right to determine our own destiny — it is something we are still fighting for collectively. As a mother, I have to believe that we will trust and respect that our women should not be individually restrained from determining what is right for our futures. Despite centuries of colonization, our pre-colonial matriarchal traditions and culture of respect endure. I hope we continue this legacy by respecting that people in Guam are capable enough to make their reproductive health choices themselves, free from unnecessary interference from the government. If we don’t, it will cost us much more than money this time.

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