What should I do if I'm pregnant where abortion isn't legal?

Dear Reader, 

Missing a period can be nerve-wracking, especially in a situation where your options for an unintended pregnancy are limited. While pregnancy may be one cause of a missed or late period, there could be a number of other causes. If you’re pregnant, accessing abortion care in a place where it’s illegal, restricted, or just plain inaccessible may involve some effort and expense, but you don't have to go it alone. Your trip leaders and friends at home can provide information and support to help you get the care you need, and there may be ways to receive financial, medical, and emotional support from organizations in the United States (US) and abroad. You also mention having a partner; they can be a great resource to help you find support and solutions. 

As you mentioned, pregnancy isn't the only possible cause of a late or missed period. For example, the stress of traveling and adjusting to life in a different country may have disrupted your menstrual cycle. Eating new foods, adjusting to a different daily pattern, or going through a change in physical activity levels can also alter your cycle. A pregnancy test will give you information so you can decide what steps to take next. Sometimes pregnancy tests are kept off the shelves in stores; you could try asking a pharmacist to help you locate one. Your trip leader may also know how to get an in-home or office pregnancy test. Health clinics or urgent cares may be more likely to have pregnancy tests, depending on your region. You may wish to do some research on the closest health clinics to you; sometimes clinics have deceiving names and offer pregnancy support but won’t provide facts on all options to you if you’re pregnant (including abortion). If you're unable to find or access a clinic or urgent care, you may also be able to order pregnancy tests online that can be delivered to your door. 

If you’re pregnant, it sounds like you want to get an abortion. In certain countries including Egypt, cultural beliefs and legal barriers make it difficult for individuals to access reproductive health services, including abortion. While there, your health care provider in the United States, insurance provider, or study abroad program may be able to help you find a reputable women's health care provider in your country, or one nearby. Traveling to another country nearby may be an option for you. Your trip leaders might be familiar with accessing health care abroad as they may have encountered a similar situation with another student. Organizations such as Abortion Without Borders and the Abortion Support Network are also useful resources for international abortion needs. For the most part, these networks serve European countries, but also might be able to connect those in other countries to financial aid for travel. 

If you're unable to access an abortion abroad, you may decide to find a way to travel back to the US. Given these additional costs, you may reach out to groups such as the Women's Reproductive Rights Access Project that have more information about finding financial assistance for abortion procedures, while some organizations such as the Brigid Alliance also fund travel costs. They may also be able to provide some funding that could be used to pay for some of your travel back to the US if that’s a priority for you. All of this said, with the changing landscape of abortion in the United States, there’s also a patchwork of laws that ban or restrict abortion in certain states. If the state that you live in bans or heavily restricts abortion access, you may need to travel to another state where abortion is legal. For now, in the United States, you're also legally allowed to travel to another state where abortion is legal; driving across state lines might be less costly than flying out to another country. Some states are looking into ways to prohibit or limit this type of travel, so it's wise to check any local laws if you return to the United States and need to travel between states for the purpose of seeking an abortion. 

Whether you're abroad or find yourself back in the US, if you're unable to get to a health care provider that could provide abortion care, you may also be able to access medication abortion pills, mifepristone and misoprostol, through telehealth or online pharmacies. It’s important to note that the legality of mifepristone and mailing of these pills is being challenged in the courts, so it’s good to check whether the state you’re from allows for use of mifepristone. Those who choose to self-manage their abortion take these pills at home with the guidance of a health care professional. For more information on self-managed abortion, you can check out the Self-Managed Abortion; Safe & Supported website. Additionally, there may be legal repercussions for managing an abortion on their own. Nonetheless, using United States Food and Drug Administration-approved medication is lower risk than other methods that are often used to self-inflict an abortion. These methods can often lead to hemorrhaging, sepsis, and infertility. 

Figuring out how to pay for medical services while abroad can add to an already overwhelming experience. Connecting with friends or family at home, when possible, may be useful for emotional and financial support if needed. Even though it may be difficult to bring up your pregnancy worries or abortion concerns, a trusted friend may provide reassurance with any emotions you may experience. If you have internet access, you may choose to get in touch with friends via email, instant messenger, text message, or video chat. Your partner may also be a source of support, either emotionally or financially. Your trip leader might be another resource for you, but if you're not comfortable speaking with them, it may be worth contacting the study abroad coordinator at your home institution for guidance. You may also want to contact the academic advisor who helped you coordinate the trip, personal insurance provider, or your university's study abroad office for advice on how to navigate the health care system where you’re located. 

Studying abroad can be exciting, but scary when you're faced with a stressful situation in an unfamiliar environment. Even though you're far from home, you don't have to confront your pregnancy concerns alone. While abortion care across the world, especially in the United States, has changed dramatically in recent years, there are still options available to get the care you want and deserve, no matter where you live, even if you can’t afford it. You should also take advantage of the support systems around you if you're feeling stressed, whether that means leaning on your partner, friends, family, or even reaching out to a mental health professional through your school or community.