Alleged bid to abort leads to baby's death
LAWRENCE -- An 18-year-old Dominican immigrant was charged yesterday with illegally taking prescription anti-ulcer pills to induce an abortion, a risky technique common in her native land that resulted in the death of her premature baby.
Despite taking the pills, Amber Abreu gave birth on Jan. 6 to a 1 1/4-pound girl named Ashley, who clung to life for four days at Tufts-New England Medical Center before dying.
Prosecutors said that Abreu may be charged with homicide.
Yesterday, the teenager stood silently in a gray hoodie in Lawrence District Court as she was arraigned on one count of procuring a miscarriage, a felony that carries a punishment of up to seven years in prison. However, Abreu's unusual case -- a collision of medicine, law, and culture -- could soon become far more serious.
"The medical examiner is inclined to rule it a homicide, and she could be facing more substantial charges," Assistant Essex District Attorney Jessica Strasnick said in court yesterday.
Abreu's fate hinges on how far along her pregnancy was when she took the pills, a point the state medical examiner's office is trying to determine in an autopsy. Prosecutors said they believe it was between 23 and 25 weeks. Abortion is illegal in Massachusetts after 24 weeks, and any action intended to cause a miscarriage after that threshold could prompt homicide charges, prosecutors said.
In court papers, Lawrence District Judge Michael Brooks wrote: "Death believed by [medical examiner] to be homicide -- further charges anticipated."
Abreu was held yesterday on $15,000 bail. Her public defender, Amanda Barker, could not be reached for comment after the arraignment.
Abreu has admitted taking three Cytotec pills, a brand name for the prescription drug misoprostol, in the two days before giving birth, prosecutors said. In addition to preventing ulcers, the drug, which causes uterine contractions and widens the cervix, can be combined with mifepristone (commonly known as the emergency contraceptive RU-486) to induce abortions. That combination method is approved by the US Food and Drug Administration as late as the eighth week of pregnancy.
Prosecutors said Abreu showed up in the Lawrence General Hospital emergency room on Jan. 6 complaining of stomach pains. She gave birth, but abruptly left about three hours later. Hospital officials contacted authorities, who sought her arrest. The baby was rushed to Tufts-New England for specialized care, and tests of the baby's urine found traces of Cytotec.
Strasnick said that when confronted by investigators, Abreu told police, "I killed my baby."
Prosecutors did not name the father, but said he lives in the Dominican Republic.
Abortions using Cytotec occur among Latina immigrants, according to advocates for reproductive health, because most Latin American nations, including the Dominican Republic, prohibit abortion. As a result, women seeking to end pregnancies turn to Cytotec as a cheap alternative, they said. And many women who emigrate bring knowledge of the technique with them.
"We find that Latina immigrants, particularly those new to the country, don't understand the abortion system in the US; they assume it's illegal here," said Jessica Gonzalez-Rojas, director of policy and advocacy for the National Latina Institute for Reproductive Health.
She said there are no reliable statistics for the frequency of Cytotec abortions. A 2000 study of Dominican women in New York City found that 37 percent were familiar with the technique.
Prosecutors said Abreu obtained the drug from a friend, visiting from the Dominican Republic, who has returned home.
Abreu arrived in the United States from the Dominican Republic 16 months ago, prosecutors said. She attended high school there, but earned a high school equivalency degree in Lawrence. Abreu had been working at a Macy's store until December. She was also enrolled in English as a Second Language courses.
Abreu lives with her two brothers and mother in an apartment on High Street in Lawrence. She has no prior criminal convictions, said authorities.
Abreu's aunt, Ana Rosario of Lawrence, said her niece is well behaved and hardworking.
"We're all very upset and surprised," Rosario said. "We don't know what's happened. We didn't know she was pregnant ."
Abreu's landlord, Kemnia Lantigua, said Abreu is a "nice girl." Lantigua herself gave birth last week and recalled yesterday that Abreu gave her a stack of baby clothing from Macy's as a present.
Her lawyer said Abreu's "intentions are to make a life here." After Barker said Abreu's family could not afford to post the $25,000 bail sought by prosecutors, Brooks reduced it by $10,000, but Abreu remained in jail last night. A pretrial hearing is scheduled Feb. 23.
Prosecutions for Cytotec abortions are extremely rare.
In 2004, 22-year-old Mexican immigrant Gabriela Flores was sentenced to four months in a South Carolina prison for taking Cytotec during the 16th week of pregnancy and miscarrying.
Gonzalez-Rojas said Latino immigrants take the drug if they cannot afford medical abortions. In the Dominican Republic, Mexico, and other countries, it is readily available over the counter for as little as $1 a pill, she said.
"A lot of time it's sent here by family members in their home country," she said. "It's actually quite effective and safe, but we don't want to endorse it."
However, she said most women take the drug far earlier in pregnancy than Abreu allegedly did.
"There are no good statistics on this," said Gonzalez-Rojas. "We only hear stories and anecdotes. It all occurs under the radar."
Brian R. Ballou can be reached at bballou@globe.com, and Raja Mishra at rmishra@globe.com.
Correction: Because of a reporting error, a Page One story yesterday about a Lawrence woman charged with illegally procuring a miscarriage incorrectly referred to RU-486 as emergency contraception. It is an abortion pill. 