NICARAGUA:
Doctors Fight
No-Abortion Policy
By TRACI CARL - The
Associated Press
MANAGUA, Nicaragua (AP)
— Two weeks after Olga
Reyes danced at her
wedding, her bloated and
disfigured body was laid
to rest in an open
coffin — the victim, her
husband and some experts
say, of Nicaragua's new
no-exceptions ban on
abortion.
Reyes, a 22-year-old law
student, suffered an
ectopic pregnancy. The
fetus develops outside
the uterus, cannot
survive and causes
bleeding that endangers
the mother. But doctors
seemed afraid to treat
her because of the
anti-abortion law, said
husband Agustin Perez.
By the time they took
action, it was too late.
Nicaragua last year
became one of 35
countries that ban all
abortions, even to save
the life of the mother,
according to the Center
for Reproductive Rights
in New York. The ban has
been strictly followed,
leaving the country torn
between a strong
tradition of women's
rights and a growing
religious conservatism.
Abortion rights groups
have stormed Congress in
recent weeks demanding
change, but President
Daniel Ortega, a former
leftist revolutionary
and a Roman Catholic,
has refused to oppose
the church-supported
ban.
Evangelical groups and
the church say abortion
is never needed now
because medical advances
solve the complications
that might otherwise put
a pregnant mother's life
at risk.
But at least three women
have died because of the
ban, and another 12
reported cases will be
examined, said
gynecologist and
university researcher
Eliette Valladares, who
is working with the Pan
American Health
Organization to analyze
deaths of pregnant women
recorded by Nicaragua's
Health Ministry.
Before the ban took
effect on Nov. 18, 2006,
fewer than a dozen legal
abortions were recorded
per year in Nicaragua.
They were performed only
when three doctors
agreed a woman's life
was in danger. However,
the Roman Catholic
Church estimates that
doctors and other
medical staff carried
out about 36,000
"secret" abortions a
year, because under the
old law they had little
fear of government
reprisals.
This year the Health
Ministry has recorded 84
deaths of pregnant women
between January and
October, compared with
89 for all of last year
and 88 the year before.
It listed hemorrhaging
as the most common
cause, with 27 cases
reported. The ministry
refused to comment
further on the ban.
Abortion rights groups
have disrupted Congress
several times, demanding
that lawmakers lift the
ban. On Oct. 25, unable
to get past increased
security, they held up
signs at Congress' front
door that read: "Women
assassins" and "They
want to keep us quiet
and dead." A minority of
lawmakers are still
trying to lift the ban,
but don't have enough
votes.
The Roman Catholic
Church mobilized nearly
300,000 people to march
and sign petitions in
support of the ban.
"A child is not a
sickness," said Henry
Romero, a priest who
helped lead the
campaign. "When two
lives are in danger, you
must try to save both
the woman and the child.
It's difficult to say
now that it isn't
possible to save both."
Law student Reyes was
one of the three
confirmed fatalities.
She knew something was
horribly wrong, and went
with her husband to
their small town's
medical center. They
were sent to Bertha
Calderon maternity
hospital, more than an
hour away in Managua.
There, Perez said, Reyes
was given a cursory
exam, sent home and told
to return the next day.
By that time, the
bleeding and cramping
were worse. Perez said
he rushed her to a
hospital in nearby Leon,
but after she had an
ultrasound that
confirmed her condition,
they left her bent over
and in agony for hours
in a waiting room. When
a doctor at a shift
change saw her
condition, she was
rushed into surgery. She
suffered three heart
attacks and an
exploratory surgery.
Valladares said doctors
should have acted
quicker.
"They knew she had a
limited amount of time
before she bled out. The
whole world knows that
with an ectopic
pregnancy," Valladares
said. "They didn't treat
her, out of fear."
The hospital director,
Olga Maria de Chavez,
said Reyes arrived late
at night, and was told
to return the next
morning when specialists
were available. The
doctors who handled her
case in Leon refused to
talk to The Associated
Press.
Walter Mendiata,
president of Nicaragua's
Association of
Gynecologists and a
supporter of the
abortion ban, said
doctors are taking the
new law too far. He
argues that surgery for
an ectopic pregnancy
isn't the same as
carrying out an
abortion.
"There's no discussion
in a case like that," he
said. "It's urgent, and
you operate."
But he acknowledged that
many doctors fear they
will be accused of
performing an abortion,
which could mean a
license suspension and
several years in prison,
even though no one has
yet been prosecuted.
Some doctors privately
admit to carrying out
what they believe are
illegal procedures,
while others say they
won't jeopardize their
careers.
"Many are thinking that
instead of taking the
risk, it is better to
let a woman die," said
Dr. Leonel Arguello,
president of the
Nicaraguan Society of
General Medicine.
Doctors frequently see
women coming in with
infections, many likely
brought on by illegal
abortions that they
refuse to disclose for
fear they might be
punished, said Dr. Carla
Cerrato. Because the
people with some medical
training who used to do
illegal abortions have
disappeared, Cerrato
said, women more
frequently take drugs or
pull the fetus out on
their own using wires or
other crude objects.
"What we are seeing are
complications that
before we never saw,"
Cerrato said, sitting in
the dingy pre-labor room
at a crowded public
hospital in Managua.
She added that she sees
hysterectomies and
severe infections that
leave women sterile or
dead because
obstetricians can't take
any action that might
harm a living fetus.
"We have to wait until
the fetus dies," she
said. "But often, for
the woman, it's too
late."
That appears to be what
happened with Reyes. Her
aunt, Gioconda Reyes, a
devoted Catholic dressed
in a worn T-shirt in
which Jesus promises
eternal life, said the
sudden death has changed
her views.
"I don't support
abortion to get rid of
unwanted pregnancies,
but in cases like that
of Olga's, it is
necessary," she said,
adding: "How could they
let four days pass when
every minute was
precious? They denied
her the right to medical
care, to a life." |
