The struggle for safe abortion in Latin America

There is a slogan commonly heard among Latin American feminists: "The rich women abort and the poor women die." Among those who fall through the cracks of the extreme wealth inequalities of Latin America, the women who die or suffer health problems due to unsafe abortions are invisible victims. Those who can afford clandestine or overseas abortions remain shrouded by social taboo, while those who cannot afford such measures often die from hemorrhaging caused by self-inflicted abortion attempts.

On September 28th, feminist activists across the continent marked the International Day for the Decriminalization of Abortion in Latin America and the Caribbean. Their goals include calling for attention to unsafe abortion as a public health problem and for changes in access to abortion laws.

According to the World Health Organization, 68,000 women die each year from unsafe abortions and 3,700,000 unsafe abortions occurred in Latin America alone in the year 2000. Despite the recommendation from the UN Committee on the Convention for the Elimination of All forms of Discrimination Against Women (CEDAW) that the criminalization of abortion constitutes a barrier to women's right to health, abortion access in Latin America is among the most restrictive around the world.

Apart from Cuba, Guyana and Mexico City (only this year), legal access to abortion in Latin America is mostly restricted to cases of rape, incest, or to save the mother's life. El Salvador and Nicaragua eliminated even these exceptions in recent years, the result of high-profile political alliances with the official Catholic Church. A group of women protesting the ban at the central Cathedral in Managua, Nicaragua, on September 30 faced insults and a line of police guards. A recent Human Rights Watch report has called the impact of the ban "devastating," causing further deaths and also instilling a climate of fear and criminalization on healthcare for pregnant women in general.

In Venezuela, the country with the highest teen pregnancy rate in the continent, a coalition of feminists and sexual diversity activists are pushing for reforms to the constitution. Currently Venezuela's constitution guarantees parents' right to choose how many children to have, but defines the start of life at conception.

Dr. Asia Villegas, a member of the monitoring committee of Belem do Pará Convention on violence against women, argues that the inclusion of abortion as a felony under the Criminal Code penalizes vulnerable women. Instead, she says, sanctions should target the causes of clandestine abortions or the precarious conditions that can lead to long-term health consequences and death, particularly among poor women. Although a series of constitutional reforms will be voted on by referendum in December, proposals to decriminalize abortion are so far not on the agenda.

There are no definitive statistics on deaths due to unsafe abortions in Venezuela, because these deaths are generally registered under other causes. Hospital sources cited by the coalition estimate that nearly a third of deaths among girls age 15-19 can be attributed to botched abortions. "Unsafe abortions cause rapid hemorrhaging, and many women have died bleeding in my hands," says Dr. Alberto Waithe, a gynecologist and public health specialist in the city of Mérida.

Despite the major investment in basic health services by the Chávez government and the improvement in many health indicators, the maternal mortality ratio (96 per 100,000 live births in 2000, while the mortality rate for women of reproductive age is 27 per 1,000) has not shifted significantly. For Dr. Waithe, this suggests that "we are doing something wrong and something must change â€" doctors must open their minds."

For Ana Belén Jarra, a member the feminist collective Pachamama, it is the role of social movements to push the government to protect reproductive rights and public health. "It is a historical debt owed to women, but we must raise consciousness among communities and politicians," she says. Juramis Varela dressed up as a pregnant priest for the day of action to spread the message that "a woman's body does not belong to the state, her partner, and much less to the church, so the decision is hers."

Yet abortion remains a taboo issue in much of Latin America. "We must start speaking of abortion in the first person," declared Diluvina Cabellos, the representative of the Venezuelan National Assembly who received the proposals for constitutional reform. Telling the story of her own clandestine abortion at the age of 17, she says that only by making safe abortion a priority of public health will there be any chance of stemming the tide of "too many deaths of our daughters."

Jen Peirce is a graduate student in international development, currently researching gender equality and social movements in Venezuela. She has worked with community organizations promoting women's rights in Nicaragua, El Salvador, Gambia, and Halifax.