Decades ago, Mexican activists drove women into the United States to terminate their pregnancies at clinics. Now it's women in the U.S. who are facing more challenges to accessing abortion services and again Mexican activists are stepping up to offer support.

The changing dynamic has to do with the reversal of the legal fortunes of abortion rights on both sides of the border and the expertise of Mexican activists in helping women overcome legal and social barriers.

In September, Mexico's Supreme Court issued a decision declaring that abortion was not a crime in the heavily Roman Catholic nation. That same month, the most restrictive abortion law in the United States went into effect in Texas. And the U.S. Supreme Court is expected to rule on a case this year that could throw out the 1973 decision guaranteeing women access to abortions, potentially allowing nearly two-dozen states already with laws in place to severely restrict or ban abortion.

This week, advocates from both sides of the border plan to develop strategies to circumvent new restrictions and find ways to coordinate assistance for women who want to safely end their pregnancies, including getting abortion pills to women in the U.S.

"We want to create networks to put the pills in the hands of women who need them," especially immigrants and women in vulnerable situations, said Verónica Cruz, director of Las Libres or "The Free," an abortion advocacy group in Mexico.

The pills Cruz refers to are misoprostol and mifepristone, a two-drug combination used for medical abortions during the first 12 weeks. Misoprostol, which was used to treat ulcers, doesn't need medical prescription in Mexico and can end a pregnancy alone but is more effective in combination with mifepristone, which does need prescription but the advocate groups get for free from donors.

The World Health Organization and International Federation of Gynecology and Obstetrics endorse their use and they have been widely used for abortions in Europe and other parts of the world.

In the United States more than 4 million women have had medical abortions since the U.S. Food and Drug Administration approved those drugs in 2000 with a doctor's prescription. The FDA eliminated a 20-year-old requirement in December that women had to pick up the medication in person so now they will be able to get a prescription via an online consultation and receive the pills through the mail.

But more than half of U.S. states have local restrictions on medical abortions — such as the need to have a physician in the same room — that make it complicated or unfeasible to carry out the practice at home.

Jacqueline Ayers, vice president of Planned Parenthood, said opponents are using "medically unnecessary restrictions put in place by out-of-touch politicians."

Some women living in U.S. border areas have for years crossed to Mexican pharmacies to buy misoprostol, in some cases to avoid the cost of a clinic abortion or simply because it is easier and the drugs are cheaper in Mexico.

"I really didn't want to deal with all the restrictions and unnecessary stress that goes along with the abortion in a clinic so I started looking into the medical abortion options," said Liz Stunz, a graduate student at the University of Texas-El Paso, who ended her pregnancy with a pill from Ciudad Juarez in 2015.

Cruz, a lawyer, said advocates will look closely at the new Texas law to ensure that the women and those assisting them are not put in jeopardy.

Her group, Las Libres, has been assisting Mexican women with home abortions since 2000, including safely getting the pills to even the most remote locations. They argue that no medical supervision is needed during the first 12 weeks.

At that time, abortion was illegal in all of Mexico and Las Libres was known for successfully petitioning courts to free poor and Indigenous women accused of having abortions. Much of the stigma remains, but now it is legal in four states and the September decision by the Supreme Court decriminalizing it has given momentum to efforts to strike it from state penal codes throughout the country.

More established groups like Las Libres have trained others in advocacy network, a push that accelerated after Mexico City became the first place to legalize abortion in 2007.

At the border, it wasn't necessary for Mexican women to cross to clinics in the United States anymore. "We no longer needed a clinic, nor health professionals, and the process was safe and much simpler and affordable," said Crystal P. Lira, part of the Tijuana advocacy collective called Feminist Accompaniment — Tijuana Safe Abortion Network.

Now offers of assistance from these groups, especially during the pandemic, circle the globe.

A message on social media from Las Libres garnered inquiries from as far away as India. An animated video from a small advocacy group in Mexicali, across from California, spread through Peru, Ecuador and Argentina, said Perla Martínez, one of the group's three members.

With the pandemic forcing people into increasingly virtual existences, the advocates' assistance moved onto platforms like WhatsApp and Zoom too. There they can give instructions, send advice, even judge whether the bleeding is normal and if necessary refer them to a doctor with advice on what to say to avoid legal trouble. But generally "everything flows in a positive way," said Lira of the Tijuana group, emphasizing the most important thing is that the women feel they are not alone.

Since the Texas law went into effect prohibiting abortions once medical professionals can detect cardiac activity — usually around six weeks, before some women know they're pregnant — a growing number of women have sought abortions outside the state. The Texas law also allows private citizens to sue doctors or anyone who helps a woman get an abortion.

Texas conservative groups and Republican Gov. Greg Abbott celebrated the new law. "The life of every unborn child with a heartbeat will be saved from the ravages of abortion," Abbott said.

Mexican advocates have begun receiving more messages from women across the border, including from migrants. Those living in border areas without legal status can't drive to major U.S. cities even within Texas without passing through Border Patrol internal checkpoints.

Some of the advocates see it as an opportunity to pay back the assistance Mexican women received at a time when the U.S. was the only option for many to access abortion services.

"It's not just abortion for abortion's [sake] that is fundamental," said Lira, who had an abortion in a U.S. clinic in 2012, but now advocates for abortions at home. Advocates want to rethink how to meet women's needs on both sides of the border. "There is also a vision behind it, a way of working, of organizing ourselves."

Maria Verza reports for the Associated Press. AP writer Claudia Torrens in New York contributed to this report.

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