Mexico’s medical underground

MEXICO CITY —  Every day, young women come to this city’s market of witchcraft and herbal remedies, seeking a way out of unwanted pregnancies in a country where abortion is illegal.

They leave with plants or elaborately concocted teas sold by women who decorate their stands with statues of “Holy Death.” The remedies very often work, according to scientists and doctors, though they can also cause serious physical harm.

Much more reliable, and sometimes just as dangerous, are the unlabeled black-market drugs guaranteed to make “the product” disappear with nothing more than the inconvenience of some light bleeding.

“Of course it works,” one female vendor said. “A lot of girls come here. They take the tea and the holy remedy, and they forget about being pregnant.”

The vendors at the Sonora Market are part of a large and illegal industry catering to women seeking abortions here. Pharmacists selling abortion-inducing drugs and doctors performing surgical abortions at some of the nation’s premier hospitals are also part of the trade.

Mexico City’s Legislative Assembly is scheduled to vote today on a measure that would legalize abortion in this city of more than 8 million people. The legislation, which is expected to win approval, could signal the demise of a subculture that profits from the desperation of thousands of women.

Although Cuba, Puerto Rico and Guyana are the only places in Latin America where abortion on demand is legal, most countries in the region have a flourishing abortion underground.

Abortion rights advocates in Mexico City portray the legalization bill, proposed by the city’s left-leaning legislature and mayor, as a health issue. Thousands of Mexican women are said to die each year from botched abortions performed by poorly trained providers, or from the side effects of potent herbs and other remedies.

At the same time, getting a safe abortion has never been a problem for women of means: Most private hospitals quietly flout the law and routinely perform surgical abortions, according to women’s groups.

For the poor, there is the self-medication of the markets and pills sold by whispering pharmacists.

A Times reporter this month spent a day at the Sonora Market, then traveled to several pharmacies. In all, she purchased six potential “abortions” for less than $250 total.

“Put it inside, as far as you can,” said a market vendor after selling four pills of a prescription drug for the equivalent of $37. “Then wait 20 minutes and start to do exercise. If you can run, that’s better. But if you can’t ... go do the laundry, anything that requires a lot of effort.”

Like market women everywhere, the remedy vendors at the Sonora Market pester potential customers and haggle over prices.

“Need help with your problem?” asked one woman, looking a 25-year-old reporter directly in the eye. “Tell me. Trust me. I can help you.”

*

Herb vendors

The market sells remedies for all types of medical problems, including diabetes and prostate troubles.

It’s also the place to put a hex on your enemies, or to make your spouse fall in love with you all over again. Dried herbs and minerals fill burlap bags, and skunk and snake skins hang from hooks.

Many herb vendors tell their customers that when taking their potions, they should also recite a prayer to Holy Death, a statue of a skeleton holding a scythe.

“This tea is yours for 500 pesos,” one vendor said. “But it guarantees an abortion.”

When the potential buyer expresses shock at the price, equivalent to about $46, the vendor quickly adds: “Give me 300. Take it, and you won’t regret it.”

The plant most commonly sold to women seeking abortions here is zoapatle, a shrub that grows wild throughout central Mexico, said Erick Estrada, head of an institute that studies medicinal plants. The institute is at the Autonomous University of Chapingo, in Texcoco, just outside Mexico City.

Indigenous healers have prescribed the herb for centuries as an aid in childbirth. Its widespread use for inducing abortions is relatively new.

Some scientific studies in the U.S. have shown the plant, known by the scientific name of Montanoa tomentosa, causes uterine contractions and dilation of the cervix. But measuring the proper dosage is tricky, Estrada said.

An undetermined number of women have died from hemorrhaging caused by herbs.

“Dozens of young women have arrived at the hospital with hemorrhages and contractions and sometimes their mother, boyfriend or friend brings what’s left of the plant and it’s been identified as zoapatle,” Estrada said.

Because sale of the plant is prohibited, Estrada said, many herbalists sell it mixed with other plants in “compounds.” Vendors at the Sonora Market offered teas with up to 40 different herbs.

Many pharmacies in Mexico City sell, at a significant markup, a prescription medicine that has been approved in the United States for the treatment of gastric ulcers, but which is also known to terminate pregnancies, doctors here said.

The pills are almost always sold without packaging or labeling.

“Insert these pills ... and wait,” said one pharmacist, a man of about 50. “In less than half an hour you’ll have a reaction. You’re going to start to bleed.... The bleeding shouldn’t last more than two days.”

The pharmacist warned the buyer to go to the hospital in case of heavy bleeding. He then gave one last piece of advice.

“I recommend that you not be alone when you do this,” he said. “Do it in the house of a friend, or with someone who knows what you’re doing. Just in case.”

The drug, misoprostol, is approved in some European countries for use in abortions, but only in conjunction with the drug RU-486. A 2003 report by the World Health Organization said more studies were needed on the effectiveness of misoprostol when used alone to induce abortions.

*

Black-market drug

But misoprostol is sold on the black market in nearly every Latin American country where abortion remains illegal, said Dr. Raffaela Schiavon, executive director of the Mexico office of Ipas, an international reproductive rights group.

Women who use the medicine face certain risks, she said.

“The danger is not the medicine itself, but rather what a woman does when faced with complications,” Schiavon said. “And she can suffer a hemorrhage if the drug isn’t applied at a correct dosage.... When you self-medicate, you don’t have all the information you need.”

At the Sonora Market, women who are too far along in their pregnancies might get different advice.

Injections are available of a drug used in the United States to induce labor.

One vendor directed a Times reporter to a secret clinic, located next to a busy Metro subway station, where a surgical abortion could be had for slightly more than $400.

“Go there alone,” an herb vendor said. “What they’ll do will just take a few minutes, but you’ll need some hours to recuperate.... You’ll go in walking, and you’ll walk out.”

*

hector.tobar@latimes.com