Living on the streets and choice: abortion and motherhood for unhoused women

A person sitting on the sidewalk with a cat and kitten nearby, surrounded by bags and blankets. The setting appears to be an urban area with buildings in the background.

By Karen Villalobos

”I can’t be a mother anymore, I have a young daughter, I have an 18-year-old son, and I’m living on the streets. How am I going to support another child?” Rosario asked Alexa, coordinator and educator at El Caracol, an organization that works for the rights of the unhoused population. Rosario had a 12-week and 6-day pregnancy when she sought an abortion. The response she received was that the limit was 12 weeks, so she could no longer legally terminate her pregnancy.

In Mexico, abortion is regulated at a local level and considered a crime with non-punishable grounds; meaning, there are circumstances under which it is not punishable. The criminal codes of each entity establish what these non-punishable reasons are, which in reality translates to legal discrimination because women can only access a legal abortion if they live in certain areas.

In Mexico City, Oaxaca, Hidalgo, Veracruz, Coahuila, Baja California, Colima, Sinaloa, Guerrero, Baja California Sur, Quintana Roo, Aguascalientes, and Puebla abortion is decriminalized, at least during the first 12 weeks of gestation. At the national level, the only time abortion is considered legal is when the pregnancy is the result of rape (Nom, 046).

Rosario was told it was impossible to interrupt her pregnancy and decided to continue with it.

“We told her that she had to do everything in her power so that the baby that would be born wouldn’t go through everything that scared her. And so it was because at that time we knew nothing about legal abortion; we had little information, and we focused on other issues that were dealt with on the streets as a priority,” said Alexa.

According to the Human Rights Diagnosis of Mexico City (2020), unhoused women are denied motherhood with the argument that the lack of resources makes them incapable of it. Furthermore, when they access health services, they commonly experience obstetric violence and are forced to sign documents authorizing permanent contraceptive methods or the adoption of their children. They are also sometimes told that their children have died.

”We constantly face a double standard from society and institutions because first they think badly of them and judge them for having their children on the streets, but they also tell them: ‘No, how are you going to abort? It’s your baby, God is going to punish you’,” said Luis Enrique, director of El Caracol. “The idea of ​​motherhood for unhoused women is linked to the State, to have people who reproduce and break the chains of inheritance, that is, to prevent children from being born on the streets, not to protect them, but as an act of ‘social cleansing’.”

In society, there is only one way to “be a mother,” which requires meeting moral, physical, and economic criteria (to name a few). Gender stereotypes and discrimination against unhoused women label them as “bad mothers, irresponsible, addicts.” That is the stigma that they carry and the reason why the State acts without adopting special protection measures, deepening the inequalities and violence they experience from living on the street.

‘‘We never think about them and when we do, it is always in a negative way. It’s just, ‘How is she going to give birth? Of course she can’t, she can’t care for them.’ And not only society, but the State also says that motherhood cannot be carried out on the streets,” said Alehi, documentation lawyer at the Information Group on Selected Reproduction (GIRE).

What happens then is that the State, without asking or interviewing, decides to remove the girls and boys, who remain under the protection of the National System for the Comprehensive Development of Families, even though children and youth who have been there see it as a dangerous place. Between 2017 and 2023, El Caracol brought 15 complaints to the Human Rights Commission of Mexico City regarding family separation of the unhoused population; however, to date, no determination of the cases has been delivered.

After 2007, with the decriminalization of abortion in the then Federal District and the creation of socio-digital networks, the issue of abortion found broader and more decentralized platforms to provide information. These networks allowed voices and stories to multiply and reach other spaces. However, these discussions about the scope of the right to reproductive health are very far from the reality experienced by women and other people who can become pregnant in the unhoused population.

Even with legal advances, people who can access an abortion must have a series of resources that allow them to know that it is their right and to then understand under what conditions they can do it, where they can go, who can provide the service to them, and where they can find a support network to help them manage the journey.

Unhoused women lack all these resources. No one is aware of their reproductive health and they do not appear in the State programs for vulnerable populations. Although they are named as priority care groups, the reality is that there are no policies that address their specific needs because they are not even known.

”These women, they don’t come and tell us: ‘Hey, I haven’t menstruated for weeks.’ Normally, we find out when the pregnancies are already very advanced, and if we manage to find out in time to access a legal abortion, there are other series of difficulties that we have to overcome,” said Alexa.

Although the profiles of the unhoused population are heterogeneous, they share some health conditions due to living on the street. El Caracol has kept a record of the women, young people, and girls who come to the organization in search of support, and through this, they have been able to identify their physical and psychological conditions.

  • Physical conditions: poor diet, language problems, substance abuse, respiratory diseases, dehydration, gastric diseases, skin lesions, STIs, and neuronal and organic damage.
  • Psychological conditions: hyperactivity, frustration, disturbed sleep, fear, stress, intolerance, anxiety, sadness, depression, psychosocial disability, and problematic substance use.

Women and young people from the unhoused population consume substances because that’s how they deal with pain, worries, fear, and everything that living on the streets generates. Therefore, access to reproductive health in this population has particular implications.

Sandy approached El Caracol for substance use issues, and during this process, they realized that she was pregnant, so they looked for support from an allied organization that handles reproductive health cases; they contacted GIRE.

For Sandy, several modifications had to be made to the protocol that GIRE follows because she didn’t have a phone number or location to reach her at, or specific times she could be contacted. With the help of El Caracol, a video call was made in which GIRE was able to give Sandy the necessary information so that she could decide what to do.

”It was very important that she understood everything that was going to happen and that the decision she made was completely hers. When the accompaniment process is accepted, we begin negotiations on a particular service since if this abortion access is sought via public health, stigma could be an issue and could become a delay in the service, and it was something that we would no longer be able to do,” Alehi said.

Although an attempt was made to assess the number of women belonging to the unhoused population who had requested and agreed to a legal or voluntary interruption of pregnancy, no data was obtained since no public health institutions kept records of the unhoused people who were guided.

For health reasons, Sandy had to undergo surgery, so she needed time to rest and other post-operative care and she couldn’t just be returned to the street. Between both organizations, they managed to provide the necessary care for two weeks in a clinic, however, she began to have problems derived from substance use withdrawal.

”We realized that the fact that she was in that recovery process implied an issue of complete abstinence; there, we also had to face an issue of stigma from the health sector. There were very complicated days when she said: ‘I’m leaving, let me go,’ because she was also locked in a hospital room, ” said Alehi.

In the end, the worries that existed due to the stigma that Sandy faced because she was a young woman from the unhoused population who used substances disappeared, but part of the treatment she was undergoing for consumption did have to be suspended to prevent it from interfering with the termination of the pregnancy. She managed to recover in the hospital, and her partner, who also belonged to the unhoused population, was able to visit her and support her in the process.

The stories of Sandy and Rosario would have been different if civil society organizations had not intervened, since accessing a basic health service, such as a doctor’s consultation, is full of barriers for the unhoused population – from refusing to allow them access to facilities for hygienic purposes to giving them a bad diagnosis so that they leave quickly.

Currently, there is no specific international treaty that commits States to protect the rights of the unhoused population due to its heterogeneous profile in which children, youth, women, men, people from the LGBTQIA+ community, and older adults coexist. In March 2020, the Interinstitutional Protocol for

Comprehensive Care for Homeless People Living in Mexico City was made public, but to date, there has been no clarity on its application or compliance monitoring. The invisibility that this population experiences prevents them, among many other things, from exercising their human rights and us as a society from ensuring that they are respected.

Let’s all work towards maternity becoming a choice and abortions legal, safe, and accessible to all.

This entry was selected as one of the winners for the “Writing about abortion” contest created in collaboration with Abortion Data, Ayudaparaabortar, ComoAbortarConPastillas, and MxM Fundación.