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The Struggle for Safe Abortion in Latin America    [

    Legal or Not, Abortion Rates Compare
    By Elisabeth Rosenthal
    The New York Times

    Friday 12 October 2007

    Rome - A comprehensive global study of abortion has concluded that abortion rates are similar in countries where it is legal and those where it is not, suggesting that outlawing the procedure does little to deter women seeking it.

    Moreover, the researchers found that abortion was safe in countries where it was legal, but dangerous in countries where it was outlawed and performed clandestinely. Globally, abortion accounts for 13 percent of women's deaths during pregnancy and childbirth, and there are 31 abortions for every 100 live births, the study said.

    The results of the study, a collaboration between scientists from the World Health Organization in Geneva and the Guttmacher Institute in New York, a reproductive rights group, are being published Friday in the journal Lancet.

    "We now have a global picture of induced abortion in the world, covering both countries where it is legal and countries where laws are very restrictive," Dr. Paul Van Look, director of the W.H.O. Department of Reproductive Health and Research, said in a telephone interview. "What we see is that the law does not influence a woman's decision to have an abortion. If there's an unplanned pregnancy, it does not matter if the law is restrictive or liberal."

    But the legal status of abortion did greatly affect the dangers involved, the researchers said. "Generally, where abortion is legal it will be provided in a safe manner," Dr. Van Look said. "And the opposite is also true: where it is illegal, it is likely to be unsafe, performed under unsafe conditions by poorly trained providers."

    The data also suggested that the best way to reduce abortion rates was not to make abortion illegal but to make contraception more widely available, said Sharon Camp, chief executive of the Guttmacher Institute.

    In Eastern Europe, where contraceptive choices have broadened since the fall of Communism, the study found that abortion rates have decreased by 50 percent, although they are still relatively high compared with those in Western Europe. "In the past we didn't have this kind of data to draw on," Ms. Camp said. "Contraception is often the missing element" where abortion rates are high, she said.

    Anti-abortion groups criticized the research, saying that the scientists had jumped to conclusions from imperfect tallies, often estimates of abortion rates in countries where the procedure was illegal. "These numbers are not definitive and very susceptible to interpretation according to the agenda of the people who are organizing the data," said Randall K. O'Bannon, director of education and research at the National Right to Life Educational Trust Fund in Washington.

    He said that the major reason women die in the developing world is that hospitals and health systems lack good doctors and medicines. "They have equated the word 'safe' with 'legal' and 'unsafe' with 'illegal,' which gives you the illusion that to deal with serious medical system problems you just make abortion legal," he said.

    The study indicated that about 20 million abortions that would be considered unsafe are performed each year and that 67,000 women die as a result of complications from those abortions, most in countries where abortion is illegal.

    The researchers used national data for 2003 from countries where abortion was legal and therefore tallied. W.H.O. scientists estimated abortion rates from countries where it was outlawed, using data on hospital admissions for abortion complications, interviews with local family planning experts and surveys of women in those countries.

    The wealth of information that comes out of the study provides some striking lessons, the researchers said. In Uganda, where abortion is illegal and sex education programs focus only on abstinence, the estimated abortion rate was 54 per 1,000 women in 2003, more than twice the rate in the United States, 21 per 1,000 in that year. The lowest rate, 12 per 1,000, was in Western Europe, with legal abortion and widely available contraception.

    The Bush administration's multibillion-dollar campaign against H.I.V./AIDS in Africa has directed money to programs that promote abstinence before marriage, and to condoms only as a last resort. It has prohibited the use of American money to support overseas family planning groups that provide abortions or promote abortion as a method of family planning.

    Worldwide, the annual number of abortions appeared to have declined between 1995, the last year such a broad study was conducted, and 2003, from an estimated 46 million to 42 million, the study concluded. The 1995 study, by the Guttmacher Institute, had far less data on countries where abortion was illegal.

    Some countries, like South Africa, have undergone substantial transitions in abortion laws in that time. The procedure was made legal in South Africa in 1996, leading to a 90 percent decrease in mortality among women who had abortions, some studies have found.

    Abortion is illegal in most of Africa, though. It is the second-leading cause of death among women admitted to hospitals in Ethiopia, its Health Ministry has said. It is the cause of 13 percent of maternal deaths at hospitals in Nigeria, recent studies have found.

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    The Struggle for Safe Abortion in Latin America
    By Jen Peirce
    ZNet

    Thursday 11 October 2007

    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 Par a1 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 M rida.

    Despite the major investment in basic health services by the Ch a1vez 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 - doctors must open their minds."

    For Ana Bel n 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."