{{Short description|none}} '''Abortion in Guam''' is legal under territorial law, but the absence of [[abortion]] providers in the territory means that it is effectively impossible to receive abortion services.
== History ==
=== Early history === Abortion, also known as ''pokká,'' was first documented in Guam in the 1750s. [[Chamorro people|Chamorro]] women sought suicide, sterilization, or abortion as they did not wish to birth a child into the "[[History of Guam#Spanish era|subjugation of the Spaniards]]".<ref name=":2">{{Cite journal|last=Rubinstein|first=Donald|date=1992|title=Culture in court : notes and reflections on abortion in Guam|url=https://www.persee.fr/doc/jso_0300-953x_1992_num_94_1_2605|journal=Journal de la Société des Océanistes|volume=94|issue=1|pages=35–44|doi=10.3406/jso.1992.2605}}</ref> Early methods utilized by Chamorro women to [[Self-induced abortion|self-induce abortion]] included consuming drinks made from tree trunks, roots, and leaves.<ref name=":2" />
=== 20th century === There were no clinics or doctors providing abortion services during much of the 1990s. During this time, women who sought abortion services often traveled to the [[Philippines]] to get an [[Abortion in the Philippines|abortion]], though abortion was and continues to be illegal in the country.<ref name="Abor Guam">{{Cite web |last=Stole Weiss |first=Jasmine |title=No abortion providers on Guam |url=https://www.guampdn.com/story/news/2018/06/30/no-abortion-providers-guam/744847002/ |access-date=2019-05-29 |website=Pacific Daily News |date=30 June 2018 |language=en}}</ref> In 1990, the [[Legislature of Guam]] enacted a law prohibiting abortion in all cases except when there was "substantial risk" to the woman's life or continuing the pregnancy would "gravely impair" her health.<ref name=":32">{{Cite book |last1=Arndorfer |first1=Elizabeth |url=https://books.google.com/books?id=RDqXplZptaIC |title=A State-By-State Review of Abortion and Reproductive Rights |last2=Michael |first2=Jodi |last3=Moskowitz |first3=Laura |last4=Grant |first4=Juli A. |last5=Siebel |first5=Liza |date=December 1998 |publisher=DIANE Publishing |isbn=9780788174810 |language=en}}</ref><ref name="Abor Guam" />
This law was challenged by the [[American Civil Liberties Union]] (ACLU) and struck down by the ninth circuit court of Guam in a case called ''Guam Society of Obstetricians and Gynecologists v. Ada'' in 1997.<ref name=":32" /><ref>{{Cite news |last=Lewin |first=Tamar |date=1990-03-21 |title=Guam's Abortion Law Tested By A.C.L.U. Lawyer's Speech |language=en-US |work=The New York Times |url=https://www.nytimes.com/1990/03/21/us/guam-s-abortion-law-tested-by-aclu-lawyer-s-speech.html |access-date=2020-05-11 |issn=0362-4331}}</ref><ref>{{Cite news |last1=Lewis |first1=Neil A. |date=1990-08-24 |title=Judge in Guam Rejects Strict Law on Abortion |language=en-US |work=The New York Times |url=https://www.nytimes.com/1990/08/24/us/judge-in-guam-rejects-strict-law-on-abortion.html |access-date=2020-05-11 |issn=0362-4331}}</ref> Future governor [[Lou Leon Guerrero]], then serving as president of the Guam Nurses Association, testified in opposition to the ban.<ref>{{Cite news |last1=Chen |first1=David W. |last2=Hayashi |first2=Noriko |date=2023-06-26 |title=In Isolated Guam, Abortion Is Legal. And Nearly Impossible to Get. |language=en-US |work=The New York Times |url=https://www.nytimes.com/2023/06/26/us/guam-abortion.html |access-date=2023-12-24 |issn=0362-4331}}</ref>
=== 21st century === From the 2000s to 2016, there were two doctors in Guam who provided abortion services: Dr. Edmund Griley at Guam PolyClinic, and Dr. William Freeman, who worked at the Women's Clinic. Griley's retirement in November 2016 left Freeman as the sole abortion provider in the territory, with Freeman ultimately retiring in his own right in June 2018. ''[[Pacific Daily News]]'' reported that Freeman's successor at the Women's Clinic, Dr. Jeffrey Gabel, is personally opposed to abortion and refuses to provide abortion services.<ref name="Abor Guam" />
With abortion illegal in the nearby Philippines and [[Abortion in the Northern Mariana Islands|not possible to receive]] in the neighboring [[Northern Mariana Islands]], women in Guam seeking abortion care reportedly can pay out-of-pocket to travel to [[Hawaii]] or [[Japan]] for such services.<ref name="Abor Guam" /> It was estimated in 2021 by ''[[The Guardian]]'' that the cost of the eight hour flight to Hawaii for individuals seeking abortion care amounted to around $1,000.<ref>{{Cite news |last=Dyke |first=Michelle Broder Van |date=2021-02-22 |title=Getting an abortion on Guam requires a $1,000, eight-hour flight. A lawsuit could change that |language=en-GB |work=The Guardian |url=https://www.theguardian.com/world/2021/feb/22/guam-abortions-aclu-lawsuit |access-date=2023-12-24 |issn=0261-3077}}</ref>
Elected in the [[2010 Guamanian general election|2010 gubernatorial election]], [[Republican Party of Guam|Republican]] governor [[Eddie Baza Calvo]] signed [[Anti-abortion movements|pro-life]] legislation into law during his tenure.<ref>{{Cite web |date=2013-11-26 |title=Governor Signs 2 Abortion Related Bills Into Law |url=https://www.pncguam.com/new-laws/ |access-date=2023-12-24 |website=PNC News First |language=en-US |archive-date=2023-12-24 |archive-url=https://web.archive.org/web/20231224092123/https://www.pncguam.com/new-laws/ |url-status=dead }}</ref> In 2012, the Woman's Reproductive Health Information Act was implemented, creating new [[TRAP laws|restrictions for abortion provision]], including a 13-week [[Gestational age (obstetrics)|gestational age]] limit, a [[physician]]-only requirement, and a 24-hour [[TRAP laws|mandatory waiting period]].<ref>{{Cite web|title=Guam Legal Code|url=http://www.guamlegislature.com/Bills_Passed_31st/SBill%20No.%20B052-31%20(COR)%20passed.pdf}}</ref><ref>{{Cite web|title=DPHSS: Enforcement of "The Women's Reproductive Health Information Act " Will Begin June 2|url=https://www.pncguam.com/dphss-enforcement-of-qthe-womens-reproductive-health-information-act-q-will-begin-june-2/|last=Center|first=Pacific News|date=2014-03-31|website=PNC News First|language=en-US|access-date=2020-05-11|archive-date=2021-03-03|archive-url=https://web.archive.org/web/20210303143446/https://www.pncguam.com/dphss-enforcement-of-qthe-womens-reproductive-health-information-act-q-will-begin-june-2/|url-status=dead}}</ref> Following an ACLU lawsuit, the legislation was blocked by [[Frances Tydingco-Gatewood]], Chief Judge of the [[District Court of Guam]], in a 2021 ruling.<ref>{{Cite web |date=2021-09-09 |title=Our View: Judge's ruling reinforced a woman's right to choose |url=https://www.guampdn.com/opinion/our-view-judges-ruling-reinforced-a-womans-right-to-choose/article_711e807a-1072-11ec-b4f6-cb75749bd4c9.html |access-date=2023-12-24 |website=guampdn.com |language=en}}</ref> However, the law was reinstated in 2023 in a decision by the [[United States Court of Appeals for the Ninth Circuit|9th Circuit Court of Appeals]], citing the U.S. Supreme Court's decision in ''[[Dobbs v. Jackson Women's Health Organization]]'' in 2022.
Elected governor in the [[2018 Guamanian general election|2018 election]], [[Lou Leon Guerrero]], a [[Democratic Party of Guam|Democrat]], has advocated in favor of abortion rights in Guam. In office, Guerrero has publicly supported the recruitment of an abortion provider to Guam.<ref>{{Cite web |last=Walker |first=Lannie |date=2019-08-19 |title=Inquiry into Guam abortion doctor continues |url=https://www.postguam.com/news/local/inquiry-into-guam-abortion-doctor-continues/article_297ae2b2-bfe4-11e9-8c13-1b55e0b63f91.html |access-date=2020-05-11 |website=The Guam Daily Post |language=en}}</ref> In 2022, Guerrero vetoed legislation passed by the [[Legislature of Guam]] that aimed to restrict abortion rights.<ref>{{Cite web |last=Admin |date=2022-12-28 |title=Guam governor vetoes anti-abortion bill |url=https://www.pacificislandtimes.com/post/guam-governor-vetoes-anti-abortion-bill |access-date=2023-12-24 |website=Pacific Island Times |language=en}}</ref>
== Access to services == [[Guam Memorial Hospital]] does not openly provide abortions and refused to refer women with life-threatening conditions to other medical facilities for abortions. Guam Regional Medical City also does not have any doctors willing to openly provide abortions and they did not provide referrals to doctors who provided them. The Department of Public Health and Social Services also refuses to provide abortion referrals.<ref name="Abor Guam" />
=== Telemedicine prescription of abortion pills ===
Doctors licensed to practice in Guam but resident elsewhere may prescribe [[Medical abortion|abortion pills]] to Guam residents via [[telemedicine]]. {{As of|August 2023}}, two doctors in [[Hawaii]] have done so.<ref name="Chen">{{cite news| url=https://www.nytimes.com/2023/06/26/us/guam-abortion.html | work=The New York Times | title=In Isolated Guam, Abortion Is Legal. And Nearly Impossible to Get. | first=David | last=Chen | date=June 26, 2023 | access-date=June 26, 2023}}</ref> In practice, this limits abortions in the territory to 11 weeks.<ref>{{Cite web |title=The Abortion Pill {{!}} Get the Facts About Medication Abortion |url=https://www.plannedparenthood.org/learn/abortion/the-abortion-pill |access-date=2023-12-24 |website=Planned Parenthood |language=en}}</ref> However, on August 1, 2023, the [[United States Court of Appeals for the Ninth Circuit|9th Circuit Court of Appeals]] upheld the law that women must consult a doctor in-person. The court reasoned that a doctor on Guam who did not perform abortions could refer women to one of the Hawaiian doctors who provided telemedical care. It was not known at the time if there would be Guamanian doctors willing to do so.<ref>{{Cite news |last=Chen |first=David W. |date=2023-08-02 |title=Federal Appeals Court Further Limits Abortion Access on Guam |language=en-US |work=The New York Times |url=https://www.nytimes.com/2023/08/02/us/guam-abortion-ruling.html |access-date=2023-12-24 |issn=0362-4331}}</ref>
== Statistics == In 2017, 239 abortions were performed, and 97% of these abortions utilized [[Surgery|surgical]] intervention, such as [[dilation and curettage]] or [[intrauterine saline infusion]]. All but three abortions were performed at Women's Clinic.<ref name=":1">{{Cite web|title=Guam 2018 Statistical Yearbook {{!}} Statistics for Development Division|url=http://sdd.spc.int/media/880|website=sdd.spc.int|access-date=2020-05-09}}{{Dead link|date=December 2024 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> As legal abortion is no longer readily available in Guam,<ref name="Abor Guam" /> the current rate of abortion is not known. {| class="wikitable" |+Abortions by Type of Procedure (number of cases)<ref name=":1" /> !Method of Abortion !2017 !2016 !2015 |- |Uterine [[Dilation and curettage|curettage]] or [[Dilation and evacuation|evacuation]] |219 |279 |259 |- |Intrauterine Saline Solution Infusion |13 |8 |3 |- |Medication-induced |3 |1 |1 |- |Feticidal injection |4 |0 |0 |- |Not reported |0 |1 |0 |- |'''Total Number of Cases''' |'''239''' |'''289''' |'''263''' |}
== Anti-abortion and abortion rights movements == The [[Catholic Church]] in Guam is active in support of restrictions on abortion through participation in the [[Rally for Life]] march.<ref name="Abor Guam" /> In 1990, Archbishop [[Anthony Sablan Apuron|Anthony Apuron]], then the archbishop of the [[Roman Catholic Archdiocese of Agaña|Archdiocese of Agaña]] in [[Guam]], threatened to excommunicate members of the [[Legislature of Guam]] who opposed banning abortion in the territory.<ref>{{Cite web |last=Hofschneider |first=Anita |date=2022-12-22 |title=The Fight Over Abortion Access In Guam Has Broad Implications For Women In The Pacific |url=https://www.civilbeat.org/2022/12/the-fight-over-abortion-access-in-guam-has-broad-implications-for-women-in-the-pacific/ |access-date=2023-12-24 |website=Honolulu Civil Beat |language=en}}</ref>
== References == {{reflist|3}}
{{Abortion by US state}} {{Abortion in Oceania}}
[[Category:Law of Guam]] [[Category:Society of Guam]] [[Category:Abortion in insular areas of the United States|Guam]] [[Category:Abortion in Micronesia|Guam]] [[Category:Abortion in Oceania|Guam]] [[Category:Health in Guam]] [[Category:Women in Guam]]