Long before the Dobbs v. Jackson decision, women in the Pacific territories of the U.S – Guam, American Samoa and the Northern Mariana Islands – have and continue to face unique obstacles that affect their access to abortion and other forms of reproductive health care.
In the case of Guam especially, where 85% of the island is Catholic, anti-abortion advocacy and legislation persist. Guam captured national attention in 1990 when the government passed one of the most restrictive abortion bans in the country, Public Law 20-134.
The bill barred abortion in just about every case, including those involving rape, incest and fetal abnormalities. The only exception was if the pregnancy were to jeopardize the mother’s health. Even then, she would need to seek out the approval of two independent physicians, who would then have to send their decisions to a
separate medical committee for review. In an attempt to prosecute all parties involved, the law stated that abortion providers could be charged with felonies and people seeking abortions with misdemeanors.
Thankfully, Roe v. Wade granted federal protection for abortion, so the courts deemed the bill unconstitutional, rendering it void by November of that year. But three decades later in the wake of the reversal of Roe, anti-abortion advocates and some legislators are reconsidering PL 20-134.
But whether the right to an abortion is protected, there remains one critical issue: In 2018, the island’s last abortion doctor retired, leaving more than 170,000 people without immediate access to this critical and lifesaving medical procedure.
Yet, this total absence of reproductive resources is only one part of the island’s health care crisis. The federal government has designated Guam as a Medically Underserved Area and a Health Professional Shortage Area, meaning that people have to seek more specialized medical procedures off-island. For reference, Guam is about 6,000 miles away from the U.S. mainland and 4,000 miles away from the nearest domestic clinic in Hawai’i. With a one-way ticket to Hawai’i costing more than $1,000, and accounting for additional expenses for accommodations, childcare or unpaid leave, medical services are inaccessible for those who need them most.
Before 2018, at least 200 people were getting surgical abortions each year. Today, that number is close to zero. While it affects both Chamorus (indigenous people of Guam) and Guamanians (non-native residents), the absence of abortion clinics and reproductive health care disproportionately affects Chamorus. Despite making up about 20% of the island’s population, they accounted for about 60% of all abortions. This means that an overwhelming amount of Chamoru women lack other alternatives but to carry out an unwanted pregnancy. When women are denied abortion access, they suffer on all fronts.
An ongoing study by the University of California-San Francisco examines the mental, physical and socio-economic consequences of women that have abortion access versus those that don’t. Women forced into childbirth are four times more likely to live below the federal poverty line. Moreover, it puts them at risk of remaining tethered in abusive relationships, and they have fewer resources to pursue further education and career opportunities. For Guam especially, where poverty, sexual assault and domestic violence rates are among the highest in the country, this total inaccessibility does nothing but exacerbate pre-existing issues. It becomes easier to fall through the cracks and much harder to climb out of them.
Despite this, with the majority of the island being Catholic, anti-choice sentiments remain in popular opinion. Anti-abortion rallies are well attended, even when there are no facilities offering abortions to begin with. Speaking from experience in attending Catholic schools my entire life, many teachers would require that the students attend these rallies for academic credit, no matter our personal beliefs.
Outside one of the island’s main birthing clinics, picketers congregate with “Stop Abortion Now” signs in hand. William Freeman, Guam’s last abortion doctor, said that many landlords would not rent him office space; he also received death threats for his work.
But when we look into the island’s pre-colonial history, the Chamoru culture empowered women to exercise their autonomy. Unlike their European colonizers, societal power resided with women, instilling within them the authority to make decisions for themselves, their families and their communities. Evidence dating back to the 18th century shows that women throughout the Pacific have long used natural contraceptives and other methods to induce miscarriages and end pregnancies.
Once Spain colonized the island in the 17th century, Christian missionaries vilified these practices. Branding the culture as sinful substantiated the violence, cultural assimilation and genocide that was inflicted on the indigenous people. In Guam, the outspokenness in denying women their bodily autonomy is a nasty byproduct of colonialism. Today, many swear by anti-choice ideology not because they believe in it but because it is the only perspective they had been raised to believe is good and true.
Ensuring safe and legal abortion access for Guam is an act of cultural preservation. In essence, the discourse about abortion access and reproductive health care is part of a much larger conversation. Within this conversation, we have to acknowledge how the absence of these resources both deepen and widen the cracks within an already vulnerable community.
As a Chamoru woman born and raised in Guam, I mourn for the women whose lives were changed because they were not given the opportunity to choose for themselves. Yet I remain optimistic in continuing my advocacy work for reproductive justice, especially in Guam, alongside others who wish to see the same.