One night not too long after I arrived in Buenos Aires in January 2006, I was invited by a friend of a friend to a birthday party. The party was in San Isidro, a wealthy neighborhood in the north of the city.
Unsurprisingly, the party was a swank affair—hors d'oeuvre poolside. I began talking to a group of five girls around my age—in their mid-twenties. After explaining the work I had done for Planned Parenthood, I asked them a question that, having grown up in the United States, I have never had to answer.
"If abortion is outlawed," I asked, "what do you do if you get pregnant and don't want to be?
They all answered at once: "You can still have an abortion. It's not so hard. There are doctors. Or you go the U.S. It's not so difficult."
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"But… isn't it dangerous? I mean, what if…"
"Someone's been lying to you, Nadia," one of the girls said. "They say people die, but no one actually ever dies."
"Don't worry," another of the girls assured me. "No one actually dies."
* * *
The World Health Organization estimates that 68,000 women die every year as a consequence of illegal abortion. Latin America, a region with some of the strictest abortion laws in the world, also has the world's highest rate of unsafe abortion: the World Health Organization estimates 3.8 million illegal abortions are performed every year in Latin America and the Caribbean, causing 4,000 deaths.
Around 100 of these deaths are in Argentina. Though precise numbers are hard to come by, the Argentine Ministry of Health estimates that half a million abortions take place each year. This means 40 percent of pregnancies end in abortion. And because every abortion is a criminal act in Argentina, by law, nearly all of these 500,000 women should face trial and imprisonment. What Argentine women face instead is fear, shame, permanent injury, and even death. Abortion is the nation's leading cause of maternal mortality and one of the major causes of hospitalization.
To outlaw abortion is to create a law that has nothing to do with women's real lives and needs, but is based instead on a moral fantasy that is founded on secrecy, willful blindness, and denial. And the women that are most in danger are those who are most invisible in the highly stratified society. A recent Human Rights Watch report notes that the U.N. Human Rights Committee has expressed its "concern over discriminatory aspects of the laws and policies in force, which result in disproportionate resort to illegal, unsafe abortions by poor and rural women." According to one report, a relatively "safe" abortion can cost 1500 pesos—nearly 500 U.S. dollars, or approximately three times the monthly minimum wage (see page 40 of this PDF).
Although all abortion is illegal, there are certain circumstances where it is considered "not punishable." These are:
- In cases where the health or life of the woman is endangered by the continuation of the pregnancy.
- In cases where a mentally disabled or insane woman ("idiota o dementa") becomes pregnant after being raped.
But even these slight exceptions from prosecution offer a false promise. Because, in a country where abortion is illegal, there is no network of abortion providers. Nor is there a standard policy by which doctors, hospitals, or the courts review cases and grant exceptions. This leaves many women, especially victims of sexual assault, without options or legal recourse. But last summer, two cases where abortion was denied seized the public's attention, leading to much-needed policy reform.
One of them involved L.M.R., a severely retarded nineteen-year old who lives in Guernica, a small city in the province of Buenos Aires. L.M.R., who has the mental age of an eight year old, became pregnant after being raped by her uncle. When her mother took her to a hospital to terminate the pregnancy, a local judge stepped in to block the abortion from taking place.
By the time the Buenos Aires Supreme Court reversed the judge's order, the hospital refused to terminate the pregnancy, claiming that it was too far advanced. As a consequence, a network of women's groups raised funds for a secret late-term abortion.
At around the same time, in the Province of Mendoza, the Catholic Church tried to prevent a 25-year old mentally and physically disabled women who had been raped from having an abortion. The court was forced to intervene to allow the procedure to go forward.
Because of the outcry occasioned by these two cases, various organizations have increased the pressure on federal and local governments to make sure women whose circumstances demand it can gain access to an abortion without delay. And there has been significant progress. This March, Claudio Mate, Health Minister for the Province of Buenos Aires, signed a resolution that will make abortion services easier to access for sexual assault survivors and women facing dangerous pregnancies.
Rather than rewrite the section of the penal code concerning "non-punishable" abortions, the resolution expands the interpretation of health emergencies. The new resolution stipulates that a woman's health should be understood to refer to her complete well-being: physical, psychological, and social. In particular, depression, sexual assault trauma, and threats of suicide should be taken to constitute serious health emergencies.
The resolution also clarifies and expedites the procedure around obtaining a "non-punishable" abortion. Instead of requiring judicial authorization, each hospital is obligated to create a review board to evaluate each woman's case. The board must include an OB/GYN, a psychologist, a psychiatrist, and a social worker, none of whom can object to abortion as a matter of conscience. The review board must come to a decision within five working days; and the abortion should be performed within eight days of request.
In addition, the resolution stipulates that all hospitals must guarantee to provide abortion services. Doctors who refuse to perform abortions can register themselves in a public registry of "conscientious objectors."
These reforms come in the footsteps of a nationwide policy that created basic and humane standards of post-abortion care for doctors and hospitals to follow. Increasingly, legislators and the Argentine public are realizing that abortion laws should be determined in the interests of public health, not of private morality.
I haven't stayed in touch with the young women I met poolside, that evening last year in San Isidro. It will be their generation that determines whether abortion becomes safe, legal, and truly accessible to women at all levels of Argentine society—or whether it remains the privilege of a lucky few.