Monica had never used Reddit before. But sitting at her desk one afternoon in July — at least 10 weeks into an unwanted pregnancy in a state that had banned abortion — she didn’t know where else to turn.
Covert network provides pills for thousands of abortions in U.S. post Roe
Amid legal and medical risks, a growing army of activists is funneling pills from Mexico into states that have banned abortion
October 18, 2022 at 6:00 a.m. EDT
Within hours, she got a private message from an anonymous Reddit user. If Monica sent her address, the person promised, they would mail abortion pills “asap for free.”
Monica didn’t know it at the time, but her Reddit post connected her to a new facet of the battle for abortion access: the rise of a covert, international network delivering tens of thousands of abortion pills in the wake of the Supreme Court ruling in June that struck down Roe v. Wade.
The emerging network — fueled by the widespread availability of medication abortion — has made the illegal abortions of today simpler and safer than those of the pre-Roe era, remembered for its back alleys and coat hangers. Distinct from services that sell pills to patients on the internet, a growing army of community-based distributors is reaching pregnant women through word of mouth or social media to supply pills for free — though typically without the safeguards of medical oversight.
“You’re truly [an] angel,” Monica wrote in a string of messages reviewed by The Washington Post. “I think tonight will be the first night i will actually be able to sleep.”
This account of the illegal abortion movement that has grown quickly since the Supreme Court ruling is based on interviews with 16 people with firsthand knowledge of the operation, and includes on-the-ground reporting in four U.S. cities and Mexico. Many who spoke to The Post did so on the condition of anonymity to discuss activity that potentially breaks multiple laws, such as practicing medicine without a license and providing abortions in states where the procedure is banned. The Post was permitted to observe distributors handling pills in antiabortion states on the added condition that their locations not be identified.
Those interviewed described a pipeline that typically begins in Mexico, where activist suppliers funded largely by private donors secure pills for free as in-kind donations or from international pharmacies for as little as $1.50 a dose. U.S. volunteers then receive the pills through the mail — often relying on legal experts to help minimize their risk — before distributing them to pregnant women in need.
The system could upend Republican plans for a post-Roe America. Despite the strict abortion bans that have taken effect in over a dozen states, some antiabortion leaders fear that the flow of abortion pills could help make abortion more accessible than it was before Roe fell. Las Libres, one of several Mexican groups at the center of the network, says its organization alone is on track to help terminate approximately 20,000 pregnancies this year in the United States. That amounts to about 20 percent of all legal abortions that took place in 2019 in the 13 states where abortion is now almost entirely banned.
“Soon there will come a moment when we won’t be able to count any of this,” said Verónica Cruz Sánchez, the director of Las Libres, adding that the group works with a U.S.-based volunteer network that numbers about 250 and is “growing, growing, growing.”
The leader of another Mexico-based group that supplies pills, Red Necesito Abortar, said the elaborate volunteer structure was “like a spiderweb.”
“Once we get the pills into the U.S., they can distribute them across the whole country,” said Sandra Cardona Alanís, the group’s co-founder.
Most people interviewed for this story acknowledged that the network they are building is far from ideal, with participants taking legal and medical risks they would not face if abortion was still permitted nationwide.
The medication — a two-step regimen of mifepristone and misoprostol — was approved by the U.S. Food and Drug Administration in 2000 with a prescription, for use during the first seven weeks of pregnancy, a limit that was then extended to 10 weeks in 2016. But people involved in the network described a process that goes beyond what the FDA has endorsed. Organizations like Las Libres offer abortion pills without a prescription and, typically, without access to a medical professional — occasionally providing medication to those who say they’re at or beyond the FDA’s 10-week limit. To avoid detection in antiabortion states, the group also mails pills unmarked and unsealed, often in old bottles used previously for other medicines.
Some experts worry that as demand soars and cross-border networks expand to include less credible suppliers, women could start to receive illegitimate pills that are ineffective or, worse, dangerous. Fake abortion pills have been circulating in other countries with strict antiabortion laws, said Guillermo Ortiz, an OB/GYN and senior medical adviser with Ipas, an international abortion rights nonprofit.
“It’s scary,” he said. If women don’t know how to recognize real abortion pills, “it could cause huge harm.”
Other experts are less skeptical. Kristyn Brandi, a doctor and spokesperson for the American College of Obstetricians and Gynecologists, the leading professional organization for OB/GYNs, said she feels confident that patients can carry out abortions safely without medical supervision — as long as the pills they receive are clearly labeled.
“Medication abortion is one of the safest processes that you can go through,” she said. “Regardless of where you get that medication, based on the science … what’s happening in your body shouldn’t be any different.”
Monica’s abortion pills arrived in the mail on a Friday afternoon, hidden inside a cat flea medication box. While the pills themselves were sealed and labeled, Monica’s boyfriend said he wasn’t sure if she should take them.
“What if they’re fake?” he recalled asking. He’d recently read news reports of other drugs that had been laced with fentanyl.
“What if they’re sending you something that isn’t even the abortion pill?”
By that point, Monica — who relayed her experience to The Post in real-time texts and calls, and then later in a lengthy interview at her home — had known about her pregnancy for over a month. She knew she wanted to have kids one day, but she and her boyfriend lived paycheck to paycheck, without health insurance. At the end of the month, they’d sometimes get down to their last $40 — and have to decide between groceries and gas.
Without the money or time to get an abortion out of state, Monica had tried to give herself a miscarriage — first with mugwort tea, an herbal remedy she read about online, then with a heavy night of drinking. When none of that worked, she turned to Reddit.
“I’m scared, too,” she said she told her boyfriend.
“But this is my only option.”
A nurse joins the network
Two weeks earlier, on the day Roe fell, a nurse in a different city rushed from room to room at the abortion clinic where she worked — frantically telling patients where they could order illegal pills now that their state had banned abortion.
“Do you have Insta?” she asked at least 20 patients that day, waiting as they pulled up their Instagram accounts.
She instructed each patient to follow an online resource called Plan C, which compiles a list of sources where patients can buy abortion pills on the internet. The nurse reviewed various options, including Aid Access, the prominent online service run by Dutch physician Rebecca Gomperts, as well as various online pharmacies that sell abortion pills illegally to people in antiabortion states.
The next day, one of those patients found the nurse in the grocery store.
“I have the money,” the woman said, her eyes desperate. “Will you buy the pills for me?”
The nurse couldn’t remember the patient’s name, but she remembered other details the woman had shared about her life — pleading in Spanish in the clinic hallway five hours after the Supreme Court overturned Roe. A mother of four, the woman was an undocumented immigrant from Mexico with a history of severe pregnancy complications and a Catholic husband who did not believe in abortion.
She couldn’t order the pills herself, she explained, because she didn’t speak English and had no reliable access to the internet. If the pills came to her home, she also worried her husband would find them.
Hyper-aware of the other grocery carts moving around her, the nurse considered all she might lose if she helped the woman and got caught. Where she lived — a Republican-led state in the South — she knew she could be stripped of her nursing license for distributing abortion pills. Maybe even go to jail.
The nurse promised herself she would do it just this once.
“I’ll tell you when I have them,” she said to the woman.
Securing the pills was easier than the nurse ever imagined: She called a friend, who sent her the number for Las Libres. The organization, she learned, had been working with many volunteers like her — helping patients who, for one reason or another, couldn’t buy pills on their own.
Many patients had never heard of Plan C or Aid Access. Some couldn’t afford the advertised price tag of $100 or more. Then there were patients like the woman in the grocery store, desperate for pills but without a safe place to receive them.
On the phone with Las Libres, the nurse had requested just one set of abortion pills — enough to help her former patient. But, she said, the package arrived three days later with the means to end five pregnancies.
Las Libres soon followed up with the address for a woman in a different city.
“Can you help her?” a Las Libres activist asked over text.
The nurse, in her late 20s, thought about the lawmakers who had ushered in these laws — and those who had implemented similar restrictions years ago in Mexico, where she’d had to secure her own illegal abortion at age 16. She still remembered her feet in the stirrups in an empty apartment building. The unsure medical student who performed the abortion. The speculum and dilator boiling in a pot of water on the stove.
“I want those politicians to feel powerless,” the nurse said of her decision to join the ranks of the illegal abortion movement. “I want them to feel the same way my patients feel.”
She mailed her second set of pills the next day.
A supplier secures the pills
Before the pills arrived in the nurse’s mailbox, they occupied a corner of Cruz Sánchez’s closet — tucked away in the central Mexico headquarters that has housed Las Libres for almost two decades.
The pill supplier and her team of seven employees work from a mountainside home in Guanajuato, hidden from the road by an eight-foot electric gate and a tangle of red trumpet vines. Inside, the Las Libres office hums with the rhythms of a family: Cruz Sánchez’s nephew brews a pot of coffee while her sister fries up leftover chilaquiles, chatting about everybody’s weekend plans before they all have to get to work.
When Cruz Sánchez, 51, started Las Libres in 2000, she envisioned a feminist activist organization that would help Mexican women in desperate situations. In its early years, the group provided legal counsel for victims of domestic violence and demanded freedom for women whose abortions had landed them in jail. They’ve long provided free abortion pills without facing any legal trouble, despite recent laws in Mexico that criminalized abortion.
It wasn’t until Texas banned most abortions in the fall of 2021 — one week before Mexico’s Supreme Court decriminalized the practice across that country — that Las Libres began to consider an international expansion. Suddenly, Cruz Sánchez was getting calls from women across the border, begging for pills.
“We wanted to help the women in Texas because we understood their situation,” Cruz Sánchez said. “We’d experienced it.”
Demand skyrocketed as soon as Roe was overturned in June, Cruz Sánchez said. Las Libres went from sending 10 sets of pills to the U.S. every day to sending over 100 — all at no cost to the patient.
The rapid expansion has only been possible, Cruz Sánchez said, with the help of U.S. volunteers who find some of the patients and shepherd the pills along to their final destinations. Since the Supreme Court decision, she said, she has been inundated with messages from Americans eager to take a stand against the ruling. In one state, she says, she is working with a group of registered nurses. Elsewhere, 50 pastors and priests.
Some of the volunteers work with U.S.-based abortion funds and other abortion rights groups, connecting with pregnant patients through established pipelines that existed long before Roe fell. Others are doing this work for the first time, Cruz Sánchez said.
“They just show up and say ‘I want to organize my community, my neighbors, my friends — and I’m going to make a network,’” she said.
These days, the women of Las Libres spend much of their time fielding calls and texts from Americans, hunched over laptops at a table strewn with sticky notes and boxes of mifepristone. Cruz Sánchez regularly logs five or six Zoom calls a day — fundraising with American donors, or teaching volunteers how to safely join her efforts.
Until recently, Cruz Sánchez said, Las Libres received all its pills as in-kind donations. International advocacy organizations mail large shipments of pills to their office, she said. Individuals come by with donations of misoprostol, widely available at Mexican pharmacies to treat stomach ulcers. Sometimes Mexican pill distribution companies send over a batch of pills that is about to expire, free of charge, Cruz Sánchez said.
When American demand started outpacing the stash in her closet, Cruz Sánchez said, she called her contacts around the world, searching for the cheapest supplier. Las Libres had roughly $15,000 to spend, she said, from mostly American donors — the product of fundraising efforts they’d stepped up since June. On one recent Zoom call, a leader of a U.S.-based abortion rights group pledged $4,000, adding that she hoped to make the same payment quarterly.
Cruz Sánchez declined to disclose her group’s donors and said she has not been keeping detailed records of the money she has received from donors in the United States. Between 2009 and 2018, Las Libres received at least $193,000 in public grants from the Mexican government, according to government records.
On its search for cheap pills, Las Libres determined that Mexico-based suppliers were too expensive. One set of mifepristone and misoprostol costs about 26 U.S. dollars in Mexico, Cruz Sánchez said. But in South Asia, pills are a fraction of that price, according to Chris Purdy, chairman of the board of DKT International, one of the largest organizations that registers, imports and distributes abortion pills around the world. In India, where many of the largest abortion-pill manufacturers are based, combo-packs of mifepristone and misoprostol are widely available at pharmacies for as little as $1.50, Purdy said.
In mid-September, Cruz Sánchez boarded an overseas flight from Guanajuato, returning four days later with thousands of abortion pills. From there, Cruz Sánchez began sending the pills to towns along the U.S.-Mexico border, where volunteers were waiting to carry them into the United States.
When selling directly to patients, suppliers typically offer pills at a significant markup. Europe-based Aid Access prescribes and sells pills for just over $100 per dose, sometimes offering discounts or free pills for low-income customers. Other online pharmacies charge hundreds of dollars. A medication abortion at a licensed U.S. clinic typically costs between $500 and $600, on top of the price of transportation and accommodations for those who have to travel out of state.
Cruz Sánchez says she will never charge patients for abortion pills, which she believes should be widely accessible to all. She is critical of organizations that sell pills to patients for more than they bought them for, accusing these groups of engaging in the “corporatization” of illegal abortions.
The Aid Access website invites people who can’t afford to pay for the pills to “tell us,” so the organization can help.
“Aid Access believes that a just and equal system means that women with the financial means can pay this way and also support the service for women who cannot afford to pay,” Gomperts said.
While Gomperts and other Aid Access-affiliated physicians write prescriptions for abortion pills — and provide medical consultations to anyone who asks for assistance up to 12 weeks of pregnancy — Cruz Sánchez and her network of volunteers offer their own, more informal support services to women who need guidance while taking the pills. Cruz Sánchez has been expanding these connections, connecting with U.S.-based hotline services and medical professionals.
As far as she knows, Cruz Sánchez said, no one in the U.S. has had severe medical complications after receiving pills from Las Libres.
For most Americans working with Las Libres, Cruz Sánchez said, the more pressing concern is a legal one. Many of her U.S.-based volunteers are terrified of the prison sentence they could face if they get caught, adopting aliases and avoiding police.
Cruz Sánchez tells them not to worry.
“If they stop you, just point at your stomach and try to look old,” she advised one 80-year-old who picked up 500 pills en route home from her Mexican vacation.
“What’s the government going to do? Open every package in the mail? Conduct an inspection inside every woman’s home?”
“They don’t have a way to do it,” she’ll say with a smile. “There’s no way.”
A lawyer defines the ‘legal lines’
One thousand miles north, in Dallas, Tex., nearly 100 abortion rights advocates squeezed into a hotel conference room in late August to learn about the illegal abortion movement — and the risks of signing up.
The lawyer at the front of the room did not explicitly mention the abortion pills flowing into the U.S. from Mexico. But she singled out a group she calls “the helpers”: people who are helping American women secure pills in antiabortion states.
This group was particularly vulnerable to legal risk, she said.
At a conference led by SisterSong, a national reproductive justice group, attendees flocked to this particular session, “Self-Managed Abortion in the US After Roe.” Many in the room worked for abortion funds and other abortion rights groups, eager to bring what they learned back to their communities.
“Let’s say this one together,” the lawyer told the audience, gesturing to the all-caps message on the projector: “Don’t talk to cops.”
“One more time for the people outside.”
The room reverberated with dozens of voices: “DON’T TALK TO COPS.”
The lawyer leading the chants that day was Jill Adams, the executive director of If/When/How, an abortion rights group that in 2015 started supporting people prosecuted for ending their own pregnancies, or assisting in that process.
Staffed by over two dozen lawyers and bolstered by a network of law students, the organization runs a legal help line for those charged — and those who fear they might be charged. The hotline now receives 14 times more calls than it did before the Supreme Court decision, Adams said.
To get a sense of what their clients are facing, the group has been tracking pregnancy-related prosecutions over time. Between 2000 and 2020, 61 people were criminally investigated or arrested for either ending their own pregnancy or helping someone else end theirs, according to a preliminary report the organization published in August.
That number is likely a significant undercount, Adams said — and almost certain to climb now that the Supreme Court has overturned Roe.
Adams and her team don’t know of anyone who has gone to jail for shepherding abortion pills since the June ruling, she said. But she warned that could start happening soon. While the new wave of abortion bans explicitly prohibit prosecutors from going after the people seeking abortions, volunteers caught securing or distributing abortion pills could be charged as abortion providers, Adams said — subject to the same punishment as a doctor who performed a surgical abortion at a shuttered clinic. Across much of the South and Midwest, that means at least several years in prison.
Adams, in an interview after the conference, said that If/When/How doesn’t promote breaking the law.
“We don’t encourage them,” she said of her clients. “We just provide the information so they can conduct their own risk analysis. Our job is to make sure that everybody understands where the legal lines are drawn.”
The abortion pill pipeline creates a challenge for conservative state lawmakers, who had hoped the Supreme Court’s ruling would be a major step toward eliminating abortion. With the push for self-managed abortions and increased funding available for out-of-state travel, Missouri state Rep. Mary Elizabeth Coleman (R) said in an interview that she expects the number of abortions to increase in the wake of Roe’s reversal.
“People don’t know that it’s happening,” said Coleman, who has championed aggressive antiabortion legislation.
Now that strict new bans have taken effect across much of the country, some lawmakers have turned their attention to local prosecutors, eager to make sure their laws are enforced.
Once prosecutors realize the extent of the illegal activity, Coleman said, “they are going to be interested in making sure that the law is followed.”
A distributor hosts a ‘packing party’
By the time Roe was overturned, some abortion rights activists had been mailing pills illegally, without prescriptions, for years.
In one Republican-led state in the south, a leader of a high-profile abortion rights group launched her organization’s “shadow side” in 2019, sending medication to women who couldn’t make it to a clinic: Minors with antiabortion parents. Domestic violence victims trapped with abusive partners. Anyone who couldn’t afford the high cost of clinic care.
When she first started out, the distributor mailed a few sets of pills a year.
Now, she mails 12 a day — more than the number of abortions performed at many clinics.
The distributor, in her sixties, messages Cruz Sánchez of Las Libres every few weeks to ask for more inventory. Once the pills arrive, she convenes what she calls “packing parties” at her suburban home, where she and her colleagues mete out the medication, dose by dose.
“It would be nice to be able to send them something more professional,” the distributor said as she readied a new batch in early September, pouring 150 misoprostol pills out of a calcium bottle.
The pills she poured into a bowl were slightly different shapes and sizes. Some scored, others smooth. The distributor plucked out a few that had broken in half.
When she used to buy pills from various online pharmacies, the distributor said, they would arrive in individual blister packs, with an expiration date. But those were $200 a set — and Cruz Sánchez sent hers for free.
“I want women to feel like it’s legitimate,” said another participant at the packing party, a younger activist. “Like they haven’t just gotten drugs in a nightclub, you know?”
“Like we’re not a back-street type of organization,” said a third helper, an 80-year-old who had smuggled the pills from Mexico.
They did what they could to create a dignified operation in the distributor’s living room. While the pills were out on the coffee table, the women would not eat. They would not drink wine. They would wear blue latex gloves.
“If I were taking pills that someone sent me, I’d hate to think that they’d been rumbling around in hands that might have just pet a dog,” said the distributor, her fingers swirling around in the misoprostol.
The 80-year-old raised her eyebrows.
“You just pet your dog with that glove on,” she said.
“I did?” said the distributor.
“Well, you know what?” said the younger activist, throwing up her hands. “We’re not f---ing doctors, we’re not health-care workers. Everyone is taking some risk in this somewhere along the line, and what can you do when it’s illegal?”
Since Roe fell, the distributor has become a teacher of sorts for newcomers joining her in the abortion pill movement. Among her students was the clinic nurse who had recently begun distributing Las Libres pills after reconnecting with a patient at a grocery store. By the end of the summer, the nurse was receiving bulk shipments of 150 abortion pills and consulting with women across eight states.
On a call in late August, the distributor offered the nurse a long list of tips: Look up houses for sale to use as return addresses. Set your messages with Las Libres to delete after 24 hours. Absolutely never meet a patient in person. If you have legal questions, reach out to If/When/How.
“It’s legally risky to do this,” the distributor told the nurse. “You need to take every precaution possible.”
As these networks expand, the distributor said, there will be even more to worry about. She said she recently saw a public service announcement issued by Ipas Partners for Reproductive Justice, the abortion rights nonprofit, warning about online abortion pill scammers — a message that echoed concerns frequently voiced by antiabortion advocates.
“We don’t know what’s coming in the mail,” said Ingrid Skop, an OB/GYN and a senior fellow at the Charlotte Lozier Institute, an antiabortion organization. “We’re inclined to think they’re getting misoprostol and mifepristone — but are there contaminants in the drugs? Does it contain the quantities that is advertised?”
Asked if she worries about the authenticity of her pills, the distributor is quick to shake her head.
“I get them from a verified source,” she says, her tone reverent: “Verónica,” the founder of Las Libres.
With Cruz Sánchez’s blessing, the distributor says, she has helped send pills to women as far as 15 weeks along in their pregnancies. Many in the medical community, including Brandi, the spokesperson for the American College of Obstetricians and Gynecologists, say it’s safe to take abortion pills beyond the 10-week limit imposed by the FDA.
The distributor refers the later-term cases to an abortion doula she’s known for years, who counsels them over text about exactly what they will see when they pass the pregnancy. A 12-week fetus is roughly the size of a plum; a 15-week fetus, the size of an apple.
These cases, in particular, present significant legal risk to the patient, who has to figure out how to surreptitiously dispose of the remains. The abortion doula said she often sends a small amount of acid so the client can dissolve some of the fetus, and bury whatever is left.
“I try to emotionally prepare them and say, ‘It’s going to look like a baby,’” the doula said.
The distributor has seen enough of these complex cases to know how to respond, she said. She worries about the new volunteers joining the movement: eager to help, but green.
“Someone is going to end up getting less than ideal treatment, and someone is probably going to get arrested,” the distributor said. “There are just so many things that could go wrong.”
Sitting in her living room, the distributor shook her head and sighed: Time to focus on the things she could control. She powered up her burner phone and logged into her Proton Mail account, an encrypted email service she uses to correspond with patients who need pills.
Some of the women get her contact information from Cruz Sánchez. A few hear through a friend, or a friend of a friend. One of the biggest spikes in demand came after the distributor met several volunteers who offer advice in a Reddit forum frequented by anonymous women searching for abortion care.
“I can handle more traffic,” the distributor had told the volunteers.
She immediately started mailing packages to Reddit users — answering their frantic calls for help.
A woman takes the pills
Monica’s cramps didn’t start until she took the second set of pills on a Sunday morning. She said she lay down in bed as soon as she felt the first one coming on, wearing her favorite oversized T-shirt and a diaper pad.
This was her first pregnancy, but Monica imagined this was what contractions might feel like: intense pain, a few minutes of relief, then more pain — each wave of cramping a little worse than the one before. Balled up in the fetal position, she said she called a friend who’d had a medication abortion a few years before at Planned Parenthood, with a doctor beside her.
“Dude, I don’t know if this is normal,” her friend said when Monica described the pain. “Maybe you should go to the hospital.”
But Monica couldn’t go to the hospital — surely, she thought, the doctors would know what she’d done and report her. Her boyfriend threw some clothes in a bag anyway.
“Turn on the bath,” Monica said she yelled out to him. “I need to get in there.”
She felt a flood of liquid in her underwear and stepped into the bath with her clothes still on. Lying back in the tub, she said, she felt some pressure release. Then she screamed.
The fetus was floating in the water. Slightly smaller than her palm, the fetus had a head, hands, and legs, she said. Defined fingers and toes.
She leapt from the bath and collapsed in her boyfriend’s arms. Desperate for some guidance, soaking wet and crying, she took out her phone.
“I just passed the fetus,” Monica wrote to whomever had sent her the pills. She learned later that her fetus matched descriptions of those roughly 13 weeks along, well beyond the 10-week cap set by the FDA for taking abortion pills.
“I’m just feeling a little scared,” she added.
The anonymous user, whose identity is not known by The Post, immediately started typing. Everything would be okay, they assured Monica: The worst was over. Whatever she was feeling — sadness, relief, grief, anger — it was all normal.
“Going through an abortion can bring up a lot of emotions,” they wrote. “Just take some time for yourself.”
Three hours later, Monica said, she and her boyfriend selected a tree in a quiet corner of their favorite park — far enough back in the forest, they hoped, that a dog wouldn’t catch the scent. While most people flushed the fetus down the toilet, the Reddit user had told her, others preferred to do some kind of ritual.
Monica knew she wanted to say goodbye.
When she was ready, she gathered a handful of wildflowers. Her boyfriend dug a small hole. As Monica lowered the cardboard box into the ground, she said, she knew she’d made the right choice. She couldn’t give that fetus a good life yet, she thought to herself. She wasn’t ready to be a mom.
“I hope in the future, when I am ready, your soul will find me again,” Monica remembers saying as she knelt in the dirt.
“It just wasn’t our time.”
Story editing by Peter Wallsten. Photo editing by Natalia Jiménez-Stuard. Copy editing by Sam-Omar Hall. Design by Madison Walls. Alice Crites, Mary Beth Sheridan, Nora D. Palma, Alejandra Ibarra Chaoul, Danielle Villasana, Antonio Campos Ayala and Gabriela Montejano Navarro contributed to this report.
