For decades, the Pregnancy Control Clinic, tucked away in a squat beige building around the corner from a bowling alley, handled the majority of abortions in Guam, a tiny U.S. territory 1,600 miles south of Japan.
But the doctor who ran it retired seven years ago and the clinic now looks abandoned. An old medical exam table sits near a dressing table with a displaced faucet, and a letter from Dr. Edmund A. Griley is taped to the front door: « My last day of seeing patients is November 18, 2016, » he said. written. « I recommend you start looking for a new doctor as soon as possible. »
Dr. Griley has since died, and his deserted clinic is a dusty snapshot of Guam’s past and, according to some, its future.
Although abortion is legal in Guam up until 13 weeks of pregnancy, and thereafter in some cases, the last doctor who performed abortions left Guam in 2018. The closest abortion clinic on US soil is in Hawaii, an eight-hour flight away. And an ongoing court case could soon cut off access to abortion pills, the latest way for most Guam women to get legal abortions.
As anti-abortion activists across the country build on the momentum of the Roe v. Wade, Guam, a speck of land in the Pacific, stands out.
Forces on both sides of the abortion debate say the island of 154,000 people is on track to become the purest example of what life would be like under a near-total ban. More than a dozen states have banned most abortions, forcing women seeking abortions to travel elsewhere, sometimes at great expense and risking their health. But none are as isolated as Guam.
« Guam is a litmus test, » said the territory’s attorney general, Douglas Moylan, a Republican who opposes abortion. « If anti-abortion forces were to be successful anywhere in the United States, I would say Guam would be one of them. »
There are two doctors licensed in Guam and willing to provide abortions, and both are based in Hawaii, where they can see patients via video calls and prescribe abortion pills. That could change if the Ninth Circuit Court of Appeals reinstates a territorial law that would require women to see a doctor in person to obtain pills.
Anti-abortion sentiment is rife in Guam, and there are other attempts to further restrict the procedure. Mr. Moylan, the Attorney General, is fighting Federal Court to try to revive a 1990 law that banned nearly all abortions, but was blocked by a federal judge. Meanwhile, lawmakers passed a bill last year that would ban most abortions after six weeks of pregnancy. It was vetoed by Governor Lou Leon Guerrero, a Democrat, a nurse, and the island’s first female governor.
She recalled that as a student in California prior to the Roe v. Wade, she cared for women who were « bleeding because they either had abortions themselves or they’d gone to clandestine abortion clinics and it didn’t get it right. »
As head of the Guam Nurses Association, Ms. Leon Guerrero testified in opposition to the 1990 banthat it would have made it a crime to perform, undergo, or seek an abortion, except in certain medical emergencies, or to encourage women to abort. A federal court ruled that the law was unconstitutional and prevented the territorial government from enforcing it, but it remains valid.
« Everything that’s happening impacts Guam and our women here, because we’re so much more isolated in terms of access to health care, » the governor said.
Where America Day begins
Guam is located so west of the continental United States that its clocks are 15 hours ahead of Eastern Standard Time, in the same time zone as Vladivostok, Russia, and the east coast of Australia. The island promotes itself as « where America’s day begins. »
But although they are American citizens, Guam residents, who mostly identify ethnically as Chamorro, the indigenous people of the Mariana Islands, or as Filipino, cannot vote for president or send voting representatives to Congress.
About a third of the island is controlled by the Department of Defense, whose presence is expanding. Although abortions are not available at military bases on the island except in emergencies, the Pentagon will pay for abortion-related travel for troops serving in places where the procedure is illegal.
Abortion has long been a taboo topic in Pacific Island communities; about 80% of Guam’s inhabitants are Catholic, reflecting the island’s Spanish colonial past.
Dr. William Freeman, the last doctor who performed abortions in Guam, left the island in 2018. Dr. Freeman, now 78 and living in Manila, said when he first arrived in Guam 39 years ago, the seven doctors who performed the abortions often received « phone calls threatening to kill us or blow us up. »
When he retired, a partner who opposed an abortion refused to continue that part of their practice. Dr. Freeman suggested that doctors visit Guam for six-week periods to deliver the procedure, but « no group was willing to make their clinic available, » he said.
« Hope Is Growing »
Guam’s law requiring women seeking an abortion to receive government-mandated information from a doctor — and only in person — has been blocked by a court order while a legal appeal proceeds. The two doctors based in Hawaii argue in their cause that if the injunction is lifted, it will become virtually impossible for them to assist women in Guam through telehealth.
It would be a victory, as far as the island’s Catholic officials are concerned. In an interview with the chancellery of the archdiocese of Agana, where Pope John Paul II stayed overnight in 1981, Father Romeo Convocar, the apostolic administrator, said that abortion pills obtained with telemedicine are now one of his major concerns.
Last summer, anticipating that the Supreme Court would soon overturn its Roe v. Wade, the archdiocese has distributed a pastoral letter to be read aloud in its two dozen churches: .”
Catholic officials pushed for the territory to adopt a six-week ban. They resumed conduct a ceremony for the burial of unclaimed fetuses from miscarriages or miscarriages. They applauded Mr. Moylan’s legal efforts to reinstate the 1990 abortion ban.
Sharon O’Mallan, president of the Guam Catholic Pro-Life Committeecalled Dobbs’ decision that overturned Roe v. Wade « fantastic – now he hands it over to us and now we decide what we want as our laws. »
In late April, she and Agnes White, a nurse, pointed to a billboard they had helped create: « Healing Abortion Pain, One Weekend at a Time. »
The goal, they said, was to recruit women who had had abortions to attend a confidential counseling retreat sponsored by an international religious group that opposes abortion.
« I’d gladly go to jail »
Abortion rights advocates fear what will happen in Guam, which has happened high rates of sexual assault AND maternal mortality — whether access to abortion pills is actually blocked. The lawsuit filed by doctors in Hawaii, for example, argues that women in Guam would face greater medical risks, as well as daunting financial and logistical burdens. (Second census datamedian annual household income, excluding military families, was $58,000 in 2019, or about 20% below the national average.)
Famalao’an Rights, a reproductive rights nonprofit founded in 2019, stepped up its organization in 2022 as the proposed six-week ban was gaining traction. The 2,200 pages of a legislative committee relationship anguished emails and handwritten letters from the public, mostly opposing the ban, sputtered about the bill.
Then came the Dobbs decision and its aftermath. “It just felt like we were at the top of the hill, so close to the finish, and then the finish line moved,” said peloton leader Kiana Joy Yabut.
Dobbs’ decision was demoralizing for activists, who are gearing up for more anti-abortion laws and preparing to help women get abortions, even if it means breaking the law.
« I would gladly go to jail, » Ms Yabut said.
Guam women said they have already faced the difficulty and stigma of abortion for years.
Happy Tingson was working as a hotel housekeeper in 2015 when she became pregnant. She only told two people: her best friend, Rhea Patino, and her boyfriend at the time.
« Not a single smile on her face, » said Ms Tingson, who was comforted by Ms Patino and another friend when she cried during an interview at her sister’s home. « She was basically saying, ‘It’s not the right time for us to have it, we’re not financially stable,' » Ms. Tingson said.
Ms. Patino took Ms. Tingson to the pregnancy control clinic, which has since closed, to receive the procedure, which cost $500 in 2015. pieces,” Ms. Tingson said.
He never told his parents, who are now dead, he said. She hasn’t told her older brother yet.
When asked if any of her friends had also suffered a miscarriage, Mrs. Patino interrupted: « Me. »
When Ms. Patino, a waitress, became pregnant in the fall of 2020, she and her boyfriend at the time agreed they couldn’t afford to raise a child.
“I felt helpless,” she said. “Try talking to a doctor, and they’re like, ‘I’m sorry, we don’t support that.’ «
Ms. Patino, who was seven weeks pregnant at that point, decided the more reliable option was to fly to Florida. Planned Parenthood unexpectedly gave up her $500 fee for her.
“They said you came from Guam and you had to fly here – it’s so sad, because you don’t have a clinic out there,” recalled Ms Pitino, now 32. “It’s so dangerous. How can they do this to you guys? »