On April 6th, 2016, the Inter-American Dialogue hosted a discussion on “Criminal Abortion Laws in Latin America”. The panel consisted of Oscar Cabrera, executive director of Georgetown University’s O’Neill Institute for National and Global Health Law, Bia Galli, senior policy advisor for Latin America at Ipas, and Luz Patricia Mejía Guerrero, technical secretary of MESECVI at the OAS Inter-American Commission of Women. The event was moderated by Michael Shifter, president of the Inter-American Dialogue.
Bia Galli presented Ipas’ findings on abortion and human rights in the Americas. She revealed alarming numbers of unsafe abortions and the consequent deaths of women in countries that either criminalize abortions or fail to put already adopted laws into practice. Through three examples – Argentina, Bolivia and Brazil – Galli showed how difficult it is for women to access safe abortions and sometimes contraceptives in countries that do not completely criminalize abortion. One case was a 20-year-old woman who was raped and, due to an unsafe abortion, suffered health complications and was arrested while still hospitalized, illustrating the harsh treatment of women who seek abortions. Galli also called the criminalization of abortion in cases of rape particularly discriminatory since they directly affect more vulnerable women.
Cabrera focused his presentation on the role that public health officials and rules play in this issue. Breaches of doctor-patient confidentiality due to a “duty to disclose”, explicitly stated in Peruvian law, fuels mistrust of the public health system. According to Cabrera, this mistrust creates a “culture of suspicion” that undermines the health care women receive. Women are forced into having unsafe abortions that sometimes result in their death. Cabrera called the lack of access to safe reproductive health care and “duties to disclose” clear violations of human rights because they deprive women of their rights to health and to life. “The main duty of the physician is the patient”, said Cabrera while advocating for a fairer healthcare system for women. He concluded his presentation by highlighting how the Zika virus will inevitably expose structural problems in the region’s public health systems. Cabrera hopes that Zika will force the region to reframe the debate more as a public health issue.
Luz Patricia Mejía discussed the structure of the MESECVI, the OAS follow-up mechanism for the Belém do Pará Convention on violence against women. Mejía explained that the mechanism has worked on the issues of sexual and reproductive rights that are threatened by gender-based violence. Similar to Galli’s presentation, Mejía identified the countries in the region that criminalize abortion without exception–Chile, the Dominican Republic, El Salvador, Honduras and Nicaragua.
She argued, however, that “the problem is not only about the law,” because many other countries have numerous cases of obstetric violence justified by the state.
She emphasized the need to grant immediate access to emergency oral contraceptives as a way to mitigate the number of unsafe abortions, to educate young women on their rights, and to apply the legal provisions that allow abortion in certain circumstances. Mejía added that Uruguay, the only country besides Cuba that has totally decriminalized abortion, has decreased the rate of unsafe abortions significantly after the new law was implemented.
Event participants raised questions on PAHO’s reaction to Zika and the role that the Sustainable Development Goals (SDGs), dialogue, and US diplomatic engagement can play in the issue. Michael Shifter asked whether the panelists had been pleasantly surprised by any state’s actions to guarantee safe abortion.
Cabrera praised PAHO’s prompt response to Zika yet highlighted that a more rights-based language is necessary for governments to improve overall access to abortion. Galli added, “because [governments] are failing women we are facing situations like [the Zika epidemic].” On the question of SDGs, Galli praised the more holistic framework they provide for dealing with Zika. In terms of US engagement and dialogue, Cabrera argued that political context is key, not every country in the region would benefit from the same approach.
In response to Shifter’s question, Mejía emphasized Uruguay’s success, detailing that they had effectively reduced the maternity mortality rate. Galli said she was impressed by civilian mobilization on the issue, rather than state action. She explained how in Brazil citizens collected more than 40,000 signatures to put forward a bill to decriminalize abortion, which successfully led to Senate hearings on a proposal to decriminalize abortion. . Cabrera expressed disappointment in the region’s outlook for reproductive rights. However, Cabrera added, “In Zika, there is an opportunity.”