Clandestine abortion kills Latin American women

Off Our Backs, Dec 1998 by Capozza, Korey I

Clandestine Abortion Kills Latin American Women

According to a 1996 report by the World Health Organization, Latin America has the highest incidence of illegal abortions of any other region on the planet, and by a long shot. The report, which received very little media coverage, pointed to the dire state of women's health in the Third World. In Latin America the numbers are shocking -- 41 of every 1,000 women undergo unsafe abortions and 6,000 women die every year as a direct result of the practice. Despite the gravity of the situation, abortion remains a taboo topic that receives little public discussion. But for Latin American women, time is running out for hushed debates: Each year, 4 million women undergo induced abortions and complications claim lives on a daily basis.

Marta, a 19 year old from Cochabamba, Bolivia is among the millions of casualties of the clandestine abortion system. Four years ago, Marta fell in love with her first boyfriend. That same year she became pregnant by him. With no means to support a baby, and basically a child herself, Marta went to La Paz, Bolivia's capital city, to undergo a clandestine abortion procedure. She had been referred to the doctor by a friend of friend. When she arrived at the clandestine clinic in La Paz's seedy market neighborhood, the doctor asked her boyfriend to leave and come back in a few hours. Once the "abortion doctor" had Marta alone in the operating room, he raped her.

Marta's story is tragic but not uncommon. Every year Bolivian women's sexual and reproductive rights are violated in the maze of unregulated "medical clinics" that perform clandestine abortions throughout the country. Despite the gravity of the abuse that Marta suffered, she had no legal recourse against the abortion doctor.

In Bolivia, as in every Latin American country besides Cuba, Puerto Rico, and Guyana, abortion is illegal. The social taboo that surrounds the issue and the illegality of the practice has insulated clandestine abortion clinics from scrutiny and denied the women who have been abused by them any possibility of legal recourse.

The Bolivian Example

Bolivian women have one of the highest fertility rates in Latin America and one of the highest maternal mortality rates in the world. Poverty is debilitating to one half of Bolivian families. The economic squeeze caused by demographic changes that are driving poor families into cities has increased the incidence of abortion in recent years making the epidemic a serious public health issue in Bolivia. The Bolivian example provides an instructive look at what is going wrong with reproductive health in Latin America.

Dangerous abortion procedures are widely practiced in Bolivia

According to a recent United Nations study, Bolivian women bear between four and five children during their reproductive life cycle. The abortion epidemic in Bolivia stems largely from the fact that of these five children only two or three are wanted by Bolivian women. With the ongoing pressures of poverty, and the migration to urban slums, Bolivian women are faced with the difficult decision of having a child that they cannot provide for or seeking an abortion procedure that is illegal, expensive, not always successful, and sometimes lethal.

One of the few ways to measure the magnitude of the "abortion problem" is through the internment statistics of Bolivia's public hospitals which register the number of deaths caused by abortion complications. Given that many of the women who undergo abortions die in obscurity and are never officially registered, most estimates probably represent a fraction of the actual number of deaths.

According to data from Obrero Hospital, La Paz's largest emergency health provider, between 1977 and 1987, 50.6% of the beds in the Gynecology ward were occupied by patients with abortion trauma. These statistics calculate out to an astronomical cost on the Bolivian health care system with each bed costing $74/day. Internment due to abortion complications is not covered by the public health care system. But because most of the women who undergo clandestine abortion procedures are poor and simply can't pay the cost of emergency care, the state safety net generally picks up the cost.

As Bolivia's hospitals feel the squeeze of state health budget cutbacks, the abortion epidemic has exacerbated their already inadequate resources. Dr. Gustavo Mendoza Rios, Executive Director of La Paz's Women's Hospital has seen the disturbing increase in women arriving with complications transform his hospital's service strategy.

"Of every three women that comes through here, one is an abortion case," he said. Many of these women arrive with hemorrhages, punctured uteruses, and generalized septicemia as a result of desperate attempts at self-induced abortion.

Some hospitals however, simply refuse to attend abortion patients. "Many women are practically condemned to die because when they arrive with intense bleeding in the emergency rooms the doctors say, `This is an abortionist. I won't help her,'" said Juana Martinez of the Federation of Popular Women's Organizations, a grassroots group in La Paz.