COLOMBIA:
Therapeutic Abortion - A
Right in Name Only?
By Constanza Vieira
BOGOTA, (IPS) - A
woman in Pasto, the
capital of the western
Colombian province of
Nariño, found out that
the baby she was
expecting was severely
deformed. But when she
went to the provincial
university hospital for
an abortion, the chief
obstetrician
gynaecologist told her
that "If your son is
born deformed, take him
to a circus."
Cases like this one gave
rise to LAICIA (High
Impact Litigation, the
Unconstitutionality of
Abortion Law in
Colombia). The group is
headed by Mónica Roa, a
young lawyer with
Women's Link Worldwide (WLW),
which works for gender
equality through legal
action and "the
development and
strategic implementation
of human rights laws"
around the world.
Since 2005, Roa has been
fighting to get the
Constitutional Court in
Colombia -- where
abortion on demand is
illegal, as in the rest
of Latin America, with
the exception of Cuba
and Mexico City -- to
take a stance on the
issue.
Her group is backed by
the Mesa por la Vida y
la Salud de las Mujeres
(Committee for the Life
and Health of Women),
which has been working
for several years to
make sexual and
reproductive rights a
reality in Colombia.
In May 2006, the
Constitutional Court
handed down a verdict
that decriminalised
therapeutic abortion in
cases where pregnancy is
the result of rape or
incest, the foetus has a
deformity that would
prevent survival outside
the womb, or the
expectant mother’s
health or life is in
danger.
Since then, abortion in
such cases has become a
legal right, and Roa has
worked at making sure
that the court’s
decision does not remain
a paper promise.
The powerful Roman
Catholic Church
excommunicated the five
Constitutional Court
magistrates who voted in
favour of the verdict,
and threatened to do the
same for doctors who
perform therapeutic
abortions.
Of all pregnancies in
Colombia, 24 percent end
in abortion and 26
percent in unwanted
births, says a Ministry
of Social Protection
report made available to
IPS by Deputy Minister
Carlos Ignacio Cuervo.
More than half of all
pregnancies are
unplanned, and in one
out of four illegal
abortions, the patient
ends up in a hospital or
clinic because of
complications. Between
1990 and 1995, more than
80,000 women were
hospitalised as a result
of abortion-related
complications.
This figure "suggests
that for every 10 live
births, there are nearly
four abortions, and for
every 100 women between
the ages of 15 and 49,
three have had an
abortion," says the
report. The Ministry of
Social Protection
estimates that around
300,000 illegal
abortions a year are
practiced in Colombia.
According to the
ministry, abortion is
the third cause of
maternal mortality in
this country, a rate
that Colombia must
reduce by 75 percent by
2015, from 1990 levels,
to meet the fifth of
eight Millennium
Development Goals (MDGs)
adopted by the
international community
in 2000.
But Beatriz Quintero,
general coordinator of
the Mesa por la Vida y
la Salud de las Mujeres,
does not believe the
decriminalisation of
therapeutic abortion has
had an impact on
maternal mortality.
According to the
Ministry of Social
Protection regulations
drawn up in late 2006
and 2007, based on the
Constitutional Court
ruling, therapeutic
abortion must be
performed under the
specified conditions by
all public or private
health services.
Health clinics and
hospitals are also
required to submit
quarterly reports on
abortions practiced in
their institutions. But
instead of statistics,
there is merely "a black
hole," Quintero told IPS.
"There is no data. An
information system does
not yet exist," she
added.
In eight cities where
the Mesa is active, and
where 60 percent of the
coalition’s right to
information petitions
received a response, the
women’s rights group
obtained more nationwide
data, and covering a
longer time period, than
the Ministry of Social
Protection did: on 40
cases in 22 months,
compared to 21 cases in
just the year 2007.
And while the ministry’s
report does not specify
the ages of the 21 women
nor the reasons for the
abortions, the
information compiled by
the Mesa indicates that
of the 40 cases, 67
percent involved rape,
20 percent foetal
malformations, and 13
percent risks to the
expectant mother’s
health.
"The Colombian Family
Welfare Institute (ICBF)
reported 12 adolescents
under the age of 18 who
sought an abortion
because of sexual
abuse," Inspector
General Edgardo Maya
said in a press
conference Wednesday.
But Quintero said "there
are many administrative
barriers standing in the
way of women gaining
access to this right,
because of a lack of
information on the part
of women themselves,
among health service
providers, and among the
authorities."
Many hurdles not
established by the new
regulations are thrown
up, said the activist.
For example, in some
cases the patient is
told that she needs
permission from a team
of doctors specifically
convened for that
purpose, and in others,
the women are told that
a judge has to authorise
the procedure, she said.
"The Ministry of Social
Protection should carry
out a much more
aggressive campaign…and
begin to train public
employees and health
professionals, because
they try to implement
the new regulations in
accordance with their
own moral decisions on
abortion," she added.
"They treat women like
invalids, incapable of
making their own
decisions. The training
would be aimed at
getting health
practitioners to act
according to the new
regulations," said
Quintero.
In many cases, the
obstacles lead to the
birth of severely
deformed babies, or
force women or girls who
have been raped or are
ill to suffer severe
trauma and damages to
their health.
"When a woman is unable
to gain access to an
abortion to which she
has a right, it is not
just something that
happened, but a
violation of the woman’s
rights," said
Constitutional Court
magistrate Fernando José
Cepeda.
He mentioned a
Constitutional Court
verdict that refers to
an abortion denied a
14-year-old rape victim,
which establishes
sanctions and
instructions aimed at
ensuring that the right
to therapeutic abortion
is respected and
enforced.
The office of the
inspector-general (Procuraduría
General de la Nación)
and Women's Link
Worldwide announced an
inter-institutional
cooperation agreement
for jointly monitoring
implementation of the
new regulations.
After the Constitutional
Court handed down its
landmark ruling in 2006,
health clinics run by
religious groups and
Catholic doctors
announced that they
would refuse to perform
abortions on any
grounds.
But only individuals,
and not institutions,
can raise objections of
conscience to refuse to
practice therapeutic
abortions in the
circumstances in which
they are now allowed.
All clinics are either
required to have doctors
on their staff who are
not conscientious
objectors or must refer
patients to institutions
that will perform the
necessary procedures,
according to the
Ministry of Social
Protection regulations
drawn up in late 2006
and 2007, based on the
Constitutional Court
ruling.
If the pregnancy is the
result of rape or
incest, all that is
needed is a copy of the
complaint to the police,
and no time limit is set
for making the complaint
or requesting an
abortion.
The regulations do not
establish a specific
list of illnesses that
can be used to justify
an abortion in case of
risk to a pregnant
woman’s health or life.
Only medical
certification is needed.
For example, a woman has
a right to an abortion
if her pregnancy could
aggravate serious
cardiac problems, or if
it stands in the way of
treatment of chronic or
terminal diseases, like
cancer.
The same doctor who
diagnoses the woman’s
health problem can
practice the procedure,
under a confidentiality
agreement.
Even if she is a minor,
the woman does not need
permission from any
family member or
guardian to undergo a
therapeutic abortion,
which must be performed
within five days after
the request is made.
However, the World
Health Organisation
(WHO) defines health as
"a state of complete
physical, mental and
social well-being, and
not merely the absence
of disease or
infirmity," which opens
a path to expanding the
arguments that could be
used to invoke the right
to therapeutic abortion. |
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