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Almost three years ago, the last abortion provider in Guam retired, leaving a significant hole in reproductive care access for the island, an unincorporated U.S. territory. To worsen matters, until recently, Guam’s laws did not allow access to reproductive care or medication abortion via telehealth.  
 
That left the island – with a population of over 170,000 people – without abortion providers and abortion services throughout the first year of the COVID-19 pandemic.  
 
Guam has been designated a Health Professional Shortage Area (HPSA) and a Medically Underserved Area (MUA) by the federal government – meaning that most specialized medical services are thousands of miles away.    
 
The number of surgical abortions in Guam prior to 2017 was about 200 per year. Now, the number is zero, and people must leave the island to receive surgical abortion care. 
 
Most make the 8-hour flight to O'ahu, Hawai'i as their closest option. To the U.S. mainland, it’s a flight of 12 hours or more.  
 
The Honolulu Planned Parenthood Health Center is a top choice among Guam patients. While there are technically over 20 abortion providers on the island of O'ahu, only four are clinics, which tend to offer greater scheduling and payment flexibility for patients. Guam patients may also choose an appointment at the Planned Parenthood health center on Maui in Kahului, depending on what works best for their travel and scheduling needs. 
 
We see patients from Guam a lot more than you might think. We actually helped a patient from Guam the other day!” exclaimed Lisa Perry, Kahului Health Center Manager. 
 
“Patients from Guam are coming from an area with literally zero options so we’re going to make sure they can get care when they come to us,” said Area Services Director Lolita Kinsey-Brown. 
 
Honolulu Health Center Manager Chellsea Delapena noted that health center staff are used to accommodating patients who travel from other islands to receive care. 
 
“Some of the needs we’re used to seeing – like expense, lodging, transportation – are magnified because they’re coming from a greater distance,” she said. 
 
Delapena pointed out that the average cost of a flight from Guam to Hawai’i is $1,000. 
 
Communications Marketing Manager Rebecca De León noted that the American Civil Liberties Union filed a lawsuit to restore at least some form of abortion access in Guam in early 2021 - medication assisted abortion via telehealth. While the lawsuit will not create providers where none currently practice, it did challenge the telehealth restriction in Guam’s laws.  
 
Although the ACLU scored a victory with their lawsuit, Guam has filed an appeal, and the legal process continues. However, as the appeal is being processed, providers in Hawai'i can still provide abortion medication to Guam via telehealth. 

  
“With the expansion of direct-to-patient telehealth visits, we can broaden our access to patients on other islands, including Guam!” said Perry. 
 
Starting October 1, patients in Guam will be able to access direct-to-patient telehealth appointments for medication abortion. “For Guam... we mail the medication to patients,” Perry explained. 
 
To support Planned Parenthood health centers in Hawai'i and ensure abortion access for patients from Guam, please donate here. 

Tags: Access to Health Care, AbortionProviders