Pregnant and studying abroad where abortion is not legal

Originally Published: January 8, 2010
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Hello Alice...

I am really nervous because my period is a week late so far and I am studying abroad in Egypt. I really don't know who to talk to about this. Premarital sex is a big taboo, abortion is illegal, and I can't even find a pregnancy test at a pharmacy. What should I do? I can't come back to the US with a big belly — I can't tell my family! I am so afraid! I left the US a month ago (my partner is still there). I read that jetlag can influence your menstrual cycle, as can weight gain or loss. I was jetlagged, but my weight is more or less the same (except I am eating more rice and oil than I do normally). Could diet change your cycle? Anyway, I guess my main question is, what should you do if you find out you are pregnant in a conservative country where abortion is illegal and don't have enough money to fly home and back? Thanks.

Dear Reader,

Missing a period can be nerve-wracking, especially in a situation where your options for an unintended pregnancy are limited. Accessing abortion care while abroad may involve some effort and expense, but you don't have to go it alone. Your trip leaders and friends at home can provide information and support to help you get the care you need.

As you mentioned, pregnancy isn't the only possible cause of a late or missed period. For example, the stress of traveling and adjusting to life in a different country may have disrupted your menstrual cycle. Eating new foods, adjusting do a different daily pattern, or going through a change in physical activity levels can also alter your cycle. A pregnancy test will give you information so you can decide what steps to take next. Sometimes pregnancy tests are kept off the shelves in stores; you could try asking a pharmacist to help you locate one. You trip leader may also know how to get an in-home or office pregnancy test.

If you are pregnant, it sounds like you want to obtain an abortion. In certain countries including Egypt, cultural beliefs and legal barriers make it difficult for women to access reproductive health services, including abortion. Be wary of underground or "back-alley" providers in places where abortion is illegal. Unsafe abortion can lead to severe complications such as hemorrhaging, sepsis, and infertility.

If it's not feasible for you to fly back to the United States for health care, have you thought about travelling to a nearby country (perhaps in Europe) where abortion is safe and legal? Your health care provider at home, insurance provider, or study abroad program may be able to help you find a reputable women's health care provider in a nearby country. If you trust your trip leaders, perhaps you could talk with them and ask for help in finding the care you need. The trip leaders should be familiar with accessing health care abroad and they may have encountered a similar situation with another student.

Figuring out how to pay for medical services while abroad can feel overwhelming. Speaking with a trusted friend or your trip leader can help you sort through the financial considerations, including assessing who might be able to lend some financial assistance. In the meantime, connect with friends at home for emotional and financial support if needed. Even though it may be difficult to bring up your pregnancy worries or abortion concerns, a trusted friend can provide reassurance to help you through this tough time. Consider splurging on a calling card, or if you have internet access you can get in touch with friends via email, instant messenger, or video chat.

If you are not comfortable speaking with your in-country trip leader, it may be worth contacting the study abroad coordinator at your home institution for guidance. If you're a student at Columbia College, you can contact the Study Abroad office. Students in other Columbia programs or universities may want to contact the academic advisor who helped you coordinate the trip, personal insurance provider, or your university's study abroad office for medical advice.

Studying abroad can be exciting, but scary when you're faced with a stressful situation in an unfamiliar environment. Even though you're far from home, you don't have to confront your pregnancy concerns alone.

Alice