The Abortion Debate
Capozza, Korey, Hemisphere
Church and state confront social realities in Latin America
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. 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, compared to 26 in Africa, 12 in Asia and two in Europe. Despite the gravity of the situation, abortion remains a taboo topic that receives little public discussion. But for Latin American women, the time for hushed debates is running out: Each year, four million women undergo abortions and 6,000 die as a direct result of the practice.
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, to undergo an abortion. She had been referred to the doctor by a friend of a 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 with the exceptions of Cuba, Puerto Rico and Guyana--abortion is illegal. The social taboo that surrounds the issue and the illegality of the practice has insulated abortion clinics from scrutiny and denied 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. At the same time, one-half of Bolivian families live in poverty. The economic squeeze caused by demographic changes that are driving poor families into cities has increased the numbers of abortions in recent years, resulting in a serious public health issue for Bolivia. The Bolivian example provides an instructive look at what is wrong with reproductive health care 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 lifecycle. The abortion epidemic in Bolivia stems largely from the fact that of these five children, only two or three are wanted. With the ongoing pressures of poverty and 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 are never officially registered and die in obscurity, most estimates probably represent a fraction of the actual number of deaths. According to data from Obrero Hospital, La Paz's largest emergency health care provider, 50.6% of the beds in the gynecology ward between 1977 and 1987 were occupied by patients with abortion trauma. Considering that each bed costs $74 per day, these statistics represent an astronomical cost to the Bolivian health care system. 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 cannot pay the cost of emergency care, the state generally picks up the cost. …