Abortion in Latin America

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Abortion in Latin America, like in many other regions of the world, is a very controversial issue which has always been linked with feminist movements. For the purpose of our study we have chosen six Latin American countries: Argentina, Chile, Colombia, Cuba, Peru, and Uruguay. These countries have a range of different policies in regards to abortion. Certain countries like Cuba and Uruguay is completely decriminalized whereas others such as Chile are criminalized on all accounts even when pregnancy is a threat to the woman's life. Opposition to women's reproductive rights is heavily influenced by organizations such as the Catholic Church and conservative governments. In Latin American countries, abortion remains inaccessible to many women and clandestine abortions are common practice. Due to unsafe conditions many women end up hospitalized or even die. Feminist movements have organized campaigns such as the September 28th Global Day of Action to Safe and Legal Abortion which originated in Latin America.


Peru

In Peru abortion is legal if it puts the women’s life in danger which has led to some of the highest maternal mortality rates in Latin America[1]. Although this form of abortion is ‘technically’ legal, many abortions that qualify under law are still turned away which in turn leads to a number of underground procedures. Awareness about abortion law and the proper administrative procedures are very vague, when a women believes she is entitled to an abortion the proper rules to follow are unknown and she usually gets turned away for fear of criminalization on part of the health ministry. There is a certain ambiguity in the legality surrounding abortion and as a result there is no standardized protocol plus this ‘grey area’ creates a position that no woman or health care professional wants to cross.

According to Human Rights Watch, “The Peruvian government's deliberate refusal to streamline procedures and approve guidelines for legal abortion is endangering the lives and health of women and girls who are often forced to use unsafe solutions for risky pregnancies”[2]. When women are forced to go ‘underground’ to undergo the procedure they were refused, it is a different road depending on the class in which you belong to. Women and girls who have enough money and resources to find a private clinic or someone certified to help can end up having safe and successful experiences[3]. However, when a poor woman or girl needs the same procedure it can be more unsafe because it is induced by unqualified practitioners or even themselves with their own remedies[4]. 350,000 women have clandestine abortions every year. Of these women, around 800 die from post-abortion complications—three women every single day[5]. Forty four percent of women living in extreme poverty will suffer serious complications from unsafe abortions, while only 5% of women with more financial resources will[6].

According to Human Right’s Watch report "My Rights, and My Right to Know: Lack of Access to Therapeutic Abortion in Peru,":

The drastic restrictions on abortion generally in Peru, and the failure to ensure access to even abortions authorized by law, can lead to violations of the fundamental human rights of women including the rights to health, life, non-discrimination, physical integrity, and freedom from cruel, inhuman, or degrading treatment.[7]

Furthermore, the criminalization of abortion generates stigma, because the unlucky women who are prosecuted are left with criminal records that will make it difficult for them to find work and study[8]. There are movements that are trying to take away this stigma and also decriminalize abortion so that there is a more standardized procedure and the unsafe ‘underground’ procedures do not happen. The outcome of would be a positive step in the right direction and would help many women but would also prevent women from being prosecuted. A feminist movement is at the forefront of this fight for decriminalization and awareness is Flora Tristán: Centro de la Mujer Peruana.

Flora Tristan is a civil non-profit institution and has the mission to “address the structural causes that restrict women's citizenship and / or affect its exercise. Accordingly it is proposed to influence the expansion of women's citizenship and the development policies and processes to meet the criteria and results of gender equity and justice”[9]. Flora Tristan holds information days on sexual health and medical abortion. They try and create awareness on all scales of class. They want women to know they have options and how to monopolize on those options. Furthermore, Flora Tristan wants to decriminalize abortion in Peru but also take action after the decriminalization. They recognize that even though there are legalizations and laws made they are not always followed. One of their goals is to create standard protocols and procedures that must be followed by the Ministry of Health. Flora Tristan is slowly helping awareness of the issues surrounding abortion and sexual health in Peru[10].

As a result of the women’s movements the unique situations that people with unwanted pregnancy are in have begun to be recognized such as: women cannot negotiate equally with their partners; they lack information and access to contraceptives; and these limitations have to do not only with individual decisions but also with problems with the educational system and with the health care system[11]. Flora Tristan says that it is starting to be successful because abortion is starting to be discussed as a public health problem rather than a crime[12].

An institution that is highly against the decriminalization of abortion is the Peruvian Roman Catholic Church. Peru is a highly Roman Catholic country with more than 80 percent of the Peruvian population identifying themselves as Roman Catholic[13]. This affects the subject of abortion because historically the Catholic Church has been against abortion and any kind of contraceptive measure. Consequently, this has a negative impact for those women who need an abortion but have a conflict with the instilled beliefs in the country that abortion is a criminal act. An archbishop named Salvador Pineiro Garcia Calderon has stated the Church would always resist abortion in all its forms, including abortion for alleged health reasons “no matter how much they to try to justify it by saying the baby is sick or deformed”[14]. When the general population is asked their thoughts on abortion most use religious terms to form their argument[15]. This just shows how difficult it will be to move forward in the decriminalization of abortion.


Cuba

After the Cuban Revolution in 1959, under Fidel Castro, abortion became legal and accessible to all women. Before the revolution, Batista reigned and placed much discrimination against women and their movement for equality and rights. The revolution brought about many changes for women and they were finally heard. Some say that there were two revolutions: the Cuban Revolution and the Women’s Revolution.

After Batista was forced to leave Havana, Castro called for the end of women’s oppression and for their full participation in the revolution. In his speech at the Santiago de Cuba city hall on January 2, 1959 he said, “A people whose women fight alongside men-that people is invincible”[16]. There was recognition by the Cuban revolutionaries that the impact of capitalist needs and the sexist ideas it promoted on women’s lives were oppressive and were part of the fundamental change that needed to happen[17].Part of this road to fundamental change was led by a non-governmental organization called Federacion de Mujeres Cubanas or the Federation of Cuban Women(FMC)[18]. They had nearly 4 million members who organized at every level of society[19]. They specialized in national literacy and health campaigns in rural areas. As they spearheaded many campaigns for women’s health to decrease infant and maternal mortality rates, Cuba began its rise to and outstanding health system which places a high priority on women’s needs[20].

Since that time abortion and contraceptives have been very common and accepted in Cuba. Cuba is the first Latin American country to legalize induced abortion and remains one of the few countries in the region where it is legal[21]. After the revolution, although abortion laws were loosened, enforcement was somewhat strict. However, abortion was finally decriminalized in 1965 because there was much maternal morbidity and mortality which had resulted in self-induced abortions and illegal pregnancy-termination procedures[22]. This lead the Cuban Government to adopt the World Health Organization definition of health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”[23]. This created a more liberal interpretation of abortion law and subsequently institutionalized induce abortion. In 1965 the Cuban Government made abortion available upon request up to the tenth week of gestation[24]. Furthermore, in 1979 there was a need for further liberalization because abortion services needed to be mad easily accessible to adult and adolescent women across the country[25]. Since this final change abortion within the first ten weeks of pregnancy has been available on demand and free of charge through the public health-care system[26].


Uruguay

In Uruguay, abortion is legal. This is significant because Uruguay is the second Latin American country after Cuba to legalize abortion for all women.[27] Basically, Uruguay allows women to have an abortion in their first 12 weeks of pregnancy. Even though Uruguay decriminalizes women’s abortion, there are still some groups who oppose the abortion law. Roman Catholicism and regions where evangelical faiths are deeply rooted in society are the strongest opponents of abortion law.[28] In order to criminalize abortion in Uruguay, conservative and anti-abortion politicians encourage adoptions. During Jose Mujica’s presidency, abortions laws were supported. With the support from the president, Uruguay was able to adopt abortion rights law.

Before abortion law was adopted, Uruguay punished both women and doctors who performed abortion. Women who had an abortion were jailed for 3-12 months. Doctors who performed an abortion were jailed for 6-24 months. Even though during the time abortion was illegal in Uruguay, judges were concerned about circumstances of the pregnant women. If the judge recognized economic hardship, risk for the women’s life, rape or family honor (which make abortion more inevitable) the judge showed more generousity.[29]

In order to have an abortion in Uruguay, there are several steps to follow. First, the pregnant woman has to explain why she wants to have an abortion to a panel of at least three people including a gynecologist, a social worker and a mental health professional. Second, these panels of at least three people must discuss abortion-related health risks and other alternatives including adoption. After this meeting, the pregnant woman reflects for five days before she finally comes to a decision about whether or not she will have the abortion.

Due to the significant relationship between feminist movements and abortion laws, Uruguay has a long history of feminist movements involved with abortion laws. Compared to other Latin American countries, Uruguay is the only country where feminist movements were able to propose the decriminalization of abortion in congress twice.[30]

During the military dictatorship (1973-84) in Uruguay, the feminist movement started to organize in two different spheres. While some feminist movements worked within social movements, other feminist movements worked with political parties. In terms of abortion laws, feminist movements were effectively organized and successfully passed the abortion laws.

On February 14 1985, the National Coordination of Women was created. This political party issued abortion laws. Since the creation of the National Coordination of Women of 1985, a bill proposing the decriminalization of abortion has been debated in every congressional session. With support from the political party, whose concerns were mostly about women's issues, feminist movements not only developed the quality but also increased the size of the movement. With eight network organizations and at least 40 regional organizations in country, feminist movements achieved successful decriminalization of abortion campaigns. In the campaign, they did not only support abortion rights for women but also free and safe abortion. In other words, feminist movements recognized the economic and social problems that abortion is inaccessible to poor women and some abortions are performed within unsafe condition. After these problems were recognized they were able to fight for these rights.

The Uruguayan Branch of the Latin American and Caribbean Committee for the Defense of Women’s Rights (CLADEM Uruguay), National Commission for Democracy, Equality and Citizenship (CNC) and Women and Health Uruguay (MYSU) are three most influential feminist movements in Uruguay that led to the decriminalization of abortion. These feminist movements focused on women’s health issues particularly reproductive rights. Through the abortion campaigns, they supported women’s rights to have a safe, free and legal abortion. For example, CNS introduced the “Agenda de las Mujeres” (Women’s Agenda). Through this campaign, feminist movements emphasized the importance of the prevention of unsafe abortion. Moreover, they assisted women who had unsafe abortion.


Chile

In Chile, abortion has been illegal since 1989 even when pregnancy poses a risk to the mother’s life. Therapeutic abortion had been legal since 1931 in Chile, although many poorer women still had to rely on illegal abortion due to inaccessibility[31] . Before the military coup of 1973, women’s reproductive rights were progressing with copper IUDs being available and encouraged. Although accessibility to copper IUDs was a step forward for reproductive rights, the motives behind IUD availability were to help control population growth, as governments saw overpopulation as a sign of underdevelopment[32] [33]. After the military coup in 1973, a “pro-natalist” regime was put in place, and contraceptive accessibility was restricted[34] .

During in the 1980s, feminist movements in Chile started to fight for reproductive rights. They demanded further decriminalization of abortion, and accessibility. It is important to note that feminist movements were also the first groups to oppose the dictatorship, and openly protest for a democratic government[35]. As a direct result of feminists demands for abortion rights, in 1989 Pinochet’s last act in office was to make abortion illegal on all circumstances.

When Pinochet criminalized therapeutic abortion, he also reframed abortion as a “moral issue” [36]. This was further advocated by the Catholic Church, who having acted as a moral authority for the Chilean people during the dictatorship, gained power and influence over Chilean politics and policies. With the return to democracy in 1990, many feminists quickly fought to have the abortion law overturned, but the bill of 1991 died in congress without being debated[37] . This was due to lack of political support, as the new government, the Christian Democrats, were careful to not support any bills which went against Church teachings, as the Church has supported their return to power[38].

Illegal abortion in Chile is common practices, although there is much underreporting of abortions due to its illegality, it is estimated that one third of all pregnancies in Chile end in abortion[39]. This constitutes to about 160,000 or more abortions annually. Abortion method is also determined by socioeconomic status. More well-to-do families have access to private clinics and aftercare, which makes abortion much safer. There is also a drug called misoprotsol, which is intended for gastric ulcers but also has abortive effects[40]. This drug is fairly expensive, although available in pharmacies and on the black market, forcing most poor women to resort to unsafe back alley abortions[41][42]. Poor women are of the biggest risk for repercussion from abortion. Because they often have to resort to back alley methods, these women run a high risk of having complications. More than 30,000 women are hospitalized annually from unsafe abortion[43]. Poorer women are also more likely to be reported for having abortions, because they must rely on public health care, which breeches patient confidentiality in order to report abortion users. Public hospitals have been known to even coerce women by withholding treatment until they admit to having had an abortion, and give up who preformed it for them [44]. Feminist movements have tried to reframe abortion as a human rights and equality issue, but so far have been unsuccessful in any attempt to reinstate therapeutic abortion. Grass root organizations, such as “Sí al Aborto Therapéutico” have utilized social networking initiatives such as Facebook to reach women from all around the country and globally. These groups support the 28th of September campaign, as well as post media from current protests and reproductive rights news from Chile and other places.


Colombia

Colombia legalized therapeutic abortion on May 10th, 2006 through the ruling of C-355[45]. Abortion is now legal under three circumstances: when the pregnancy risks the mother’s mental or physical health, in the case of severe malformations of the fetus, or when the pregnancy resulted from a criminal act such as rape or incest[46]. Not only was abortion decriminalized in these instances, but it has also been legally mandated to be accessible in certain cases[47]. Feminist and project director of Women’s Link Worldwide, Monica Roa, was the leader of abortion reform, and was able to lift the ban on abortion by reframing it as unconstitutional[48] . By challenging the constitutionality of abortion, Roa was able to file a law suit directly through the Constitutional Court[49]. This way she was able to bypass the National Assembly, where previous attempts had been unsuccessful due to political agendas and opposition from the Catholic Church [50]. During the process of legalizing abortion, Roa took a unique stance, networking with NGOs, women’s rights groups, along with Yale and Harvard Law Schools, and many other international groups[51]. This strategy of incorporating international human rights activists, strengthened her cause, and shortly after she gained support from local politicians and officials[52]. Public demonstrations were led by both sides of the debate across Colombia[53]. A key part of Roa’s campaign for legal abortion, was to disempower the Catholic Church by framing abortion and reproductive rights as a move towards public health, gender equality and social justice[54]. Even with the reframing of abortion away from a moral issue, the Catholic Church still held up a heavy opposition. Church officials formed a petition with more than two million signatures of people who wanted to maintain the ban on abortion, which they publicly handed to the National Assembly [55]. Fortunately for feminists and women’s rights activists, 2006 was also an election year, and with growing public support for the decriminalization of abortion, politicians openly supported abortion to gain popularity and votes [56]. Abortion had been illegal in Colombia for over thirty years, and the 2005 lawsuit against the abortion ban was not the first attempt at changing the law. The legalization of abortion in Colombia has been a huge achievement for women’s rights advocates. However, due to the restrictive nature of legal abortion, many women will still resort to unsafe abortion in order to terminate an unwanted or untimely pregnancy [57]. The State has implemented regulations in regards to financial barriers in seeking safe abortion, and in the case where poor women are unable to afford the service, the cost will be subsidized or completely assumed by the state[58]. This is an especially important clause when looking at an equality-based approach to reproductive rights and sexual health. Before the legalization of abortion in 2006, it was estimated that 288,400 abortions occurred annually [59].


Argentina

Abortion in Argentina is strictly limited by laws.[60] Abortion is strictly allowed for two circumstances in Argentina. First, if the pregnancy was a product of rape and it threats the mother’s health, abortion is allowed. Second, mentally disabled women can have an abortion. The significant fact of abortion law in Argentina is that it was created by upper class males. In other words, when Argentina reformed its criminal code to include issues of abortion, it held by exclusive male elites such as lawyers, doctors and politicians. Moreover, it was also held in closed debate so that the public would not be involved.

Argentina faced several negative impacts due to the legal limitations of their abortion laws. According to UNICEF, Argentina had 24.2 percent maternal death in 2007. The primary cause of maternal death is the practice of unsafe abortions. Argentinean doctors know that they would get punishment for performing an abortion. Therefore, they mostly refuse to perform abortions. Most cases, pregnant women who desire to have an abortion go to unprofessional abortion performers and have an abortion in unsanitary conditions. There is a common belief in Argentina that having a safe abortion depends on the economic status of the pregnant woman. For example, richer pregnant women have easier access to have a safe abortion while poorer pregnant women have difficulty accessing safe abortion or even post-abortion care.

Since abortion in Argentina is strictly limited by laws, feminist movements in Argentina carries heavy responsibilities. In fact, feminist movements in Argentina have been successful in introducing and keeping the issue of abortion in political agenda. However, it failed to decriminalize abortion in Congress. During the military dictatorship, feminist movements were suppressed by government’s monitor. However, feminist movements continued to privately meet and discuss issues about banned policies.

Throughout the history, Argentinean states have a lack of acknowledge about sexual and reproductive health. As a result, people did not have enough information about reproductive rights including abortion rights. Due to lack of support and acknowledgement of the public, the feminist movements in Argentina have struggled. In order to pass the decriminalization of abortion in Congress, feminist movement recently demanded support from other key actors in societies such as lawyers and doctors. After the feminist movements gained some support from the public and other key actors of society, they started to have official and public campaigns about the decriminalization of abortion.

Most Argentinean doctors frequently mistreat pregnant women in the emergency room when they find evidence of abortion or see her desire to have an abortion. It is important to recognize that feminist movements in Argentina focused on not only advocating decriminalization of abortion but also raising public consciousness among sexual and reproductive rights. In regard to political culture in Argentina, feminist movements frequently mobilized protests and confrontation of the conservative government. Due to active feminist movement’s campaign, the public has started to acknowledge sexual and reproductive rights. In a recent survey in September 2011, nonprofit organization Catholics for Choice found out that 45% of Argentinean people are in favor of abortion for any reason in the first twelve weeks of pregnancy.[61]


Discussion

Looking across these six different Latin American countries, there are many similarities in regards to opposition faced in the creation of reproductive rights policies. The Catholic Church has a large influence throughout Latin America, on both the individual and institutional level. This influence has been a main obstacle in decriminalizing abortion, or further advocating other reproductive rights. Although some countries, such as Colombia, have been able to reframe reproductive rights as human rights and equality issues, many countries have not been able to reach the same objective. However, feminist movements across the region where abortion is not completely legal, have been trying to advocate change including changing platforms from decriminalization to one of human rights. Inaccessibility to safe abortion, regardless of legal status, is another common problem in Latin America. This has led women, and especially women of the lower classes, to resort to back alley methods to terminate unwanted or untimely pregnancies. Throughout the region, class differential is crucial in determining women's ability to access safe abortion procedures. Some governments, such as in Colombia, have mandated access for poor women to safe abortions via subsidies, but only when the women meets the required restrictions. Globally feminist movements are actively advocating reproductive rights domestically and internationally. Although some countries such as Uruguay and Cuba have fully decriminalized abortion, there is still much work to be done in the rest of the region.



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