I left Nicaragua in April of this year, a few weeks after International Women's Day. On that day, thousands of women gathered in front of the Supreme Court and elsewhere in the capital city of Managua to protest the ban on therapeutic abortion (abortion to save a woman's life) that had been passed unanimously by the Nicaraguan National Assembly in a misinformation-drenched political frenzy less than two weeks prior to the November 2006 presidential election, and signed into law by ex-president Enrique Bolaños shortly thereafter on November 17. The mood on International Women's Day was at once somber and hopeful-somber because several pregnant women had already died as a result of the ban, and hopeful because the Supreme Court was set to hear 25 separate challenges to its constitutionality in 2007. Although the highly polarized political climate in Nicaragua made feminists wary of expecting justice to be done, there was reason to be hopeful: the ban, after all, was actively opposed by the Nicaraguan medical community, dozens of community-based organizations and advocacy networks, and thousands of ordinary citizens, and even influential Church leaders and prominent members of the ruling Sandinista party had expressed doubt at the necessity of criminalizing abortion even in cases where a woman's life was at risk.
Sadly, events last week proved their hopes to be in vain. On Thursday, the National Assembly voted 66-3 to recriminalize therapeutic abortion during an overhaul of the Nicaraguan penal code, once again choosing unvarnished political opportunism over accepted medical consensus, not to mention concern for women's health (or, according to the ever-compassionate LifeSiteNews, women's "health") and lives. In the new penal code, which is expected to be approved when the National Assembly goes back into session next week, abortion remains illegal under any circumstances. That includes pregnancies that endanger women's lives, such as ectopic pregnancies, when an egg is fertilized outside a woman's uterus, putting her life in grave danger and leaving her fetus with no chance of survival. A doctor or health professional who performs a therapeutic abortion-even to save a woman's life when she's in the midst of a dangerous miscarriage-faces 1-3 years' imprisonment, and 2-5 years' suspension of his or her license. If a woman induces her own abortion or consents to anyone else doing so, she faces 1-2 years behind bars.
Nicaraguan advocates for women's health reacted to the renewed prohibition on therapeutic abortion with a mixture of consternation and disgust. Feminists felt betrayed by their elected representatives' willingness-yet again-to turn a blind eye to women's right to life in favor of narrow political interests. The alliance forged between the ruling left-wing Sandinista party and the right-wing Liberal Constitutional Party (PLC) in support of the ban was reminiscent of the infamous 1999 pact between the parties that led to Sandinista party leader (and current president) Daniel Ortega being all but immunized against his stepdaughter's accusations of sexual abuse several years ago. The Sandinistas' public discourse emphasizes equality, democracy, women's rights, and the rights of poor people, but, as many feminists have asked, what of the countless poor women whose lives will be lost and whose children will be orphaned as a result of the therapeutic abortion ban?
Representatives from the right-wing PLC claimed to be voting "in defense of life and against a culture of death," but criminalizing abortion in a country where the majority of the population lives in poverty, with little access to quality health services-including contraception and prenatal care-and almost no accurate information about sexual and reproductive health doesn't seem like the most efficient route to a culture of life. A quick review of comments made by representative Freddy Tórrez, who accused feminists of supporting therapeutic abortion because "they have never been mothers because their condition [as feminists, presumably] does not permit them to be mothers," and representative Wilfredo Navarro, who said that any woman who supports therapeutic abortion only does so because she is a lesbian, lays the party's true views bare. This ban is not about life: it's about contempt for women as moral agents, social and political subjects, and sexual decision-makers.
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The National Assembly's decision to reject an amendment that would have permitted therapeutic abortion only in cases where three separate doctors agreed that a woman's life was in danger-an amendment that was supported by Nicaragua's Episcopal Conference-also reveals a dangerous level of contempt for medical consensus. As Dr. Leonel Arguello, president of the Nicaraguan Society of General Medicine (SONIMEG), pointed out in a statement released last week, "The vote was neither the product of consensus nor the product of a serious discussion with Nicaraguan society, especially doctors and scientific associations…By making this decision, [National Assembly members] have once again disrespected the medical profession in our country, and they have put our patients' lives in danger."
Had legislators actually sought to reduce the incidence of abortion in Nicaragua, consulting with the medical community might have been a helpful strategy, since, as Arguello argues,
The criminalization of therapeutic abortion will do absolutely nothing to reduce the incidence of abortion. The only thing it achieves is that it put woman's lives at risk, allowing them to die when they could instead be saved through medical intervention. If the objective of criminalizing therapeutic abortion was indeed to eliminate abortion in this country, the focus should have been on induced abortion or abortion sought for non-medical reasons, and the only way to reduce these kinds of abortions is through reducing unwanted pregnancies, which will only occur if we have sexual and reproductive education taught in schools from an early age, and if we have access to scientific methods of family planning and quality health services, especially adolescent-friendly health services.
Of course, if you bring physicians into the conversation, you might be faced with a reality, like the one described above, that doesn't match your political agenda. Just like if you have a serious, informed national discussion on a vital healthcare issue, you might actually make your constituents feel as though they are living in a democracy. But when it comes to banning abortion, democracy is dangerous. Too much healthy discussion and debate might expose the fact that condemning women to death is not, in fact, a "pro-life" position. And why wrestle with the intrinsic hypocrisies of such a position when it's so much easier to just misrepresent yourself?
Speaking of misrepresentation, if you get your news from LifeSite, you might believe that the new Nicaraguan penal code permits abortion in cases of life-threatening pregnancy. Last week, the site reported that in Nicaragua, "All abortion is punishable by law, although this is not understood as prohibiting medical procedures to save a woman's life that could threaten the life of the fetus." Because hey, when you're supporting an indefensible law, sometimes you just have to lie a little bit!
It's possible, of course, that this is just another example of sloppy reporting on LifeSite's part, but given the site's abiding willingness to bend the truth in its coverage of so-called "life" issues, I wouldn't be surprised if the mistake was less than 100% honest. After all, LifeSite is fond of disseminating baseless accusations: in the same article, the site glibly reported that the Nicaraguan Society of Obstetricians and Gynecologists (SONIGOB) only opposed the therapeutic abortion ban because the Society had been "purchased by the abortion lobby" (accusations that were leveled by Dr. Rafael Cabrera, president of the Nicaraguan Association for Life, and refuted by in an open letter from SONIGOB member Dr. Oscar Flores inviting Cabrera to review SONIGOB's accounts and pointing out that Cabrera himself had deliberately disseminated false information about abortion in various public forums).
Most damagingly, LifeSite-and other supporters of Nicaragua's abortion ban-continue to promote the myth that therapeutic abortion is nothing more than a "slogan" used by the "pro-abortion lobby" to trick lawmakers into permitting abortion under any circumstances. Let me be clear: I lived in Nicaragua, and there's nothing "alleged" about the need for therapeutic abortion. Yes, many of the same people who support therapeutic abortion in cases where women's health and/or lives are at risk also support the legalization of abortion under wider circumstances, but they are not the same thing. From October 2006, when the National Assembly first banned therapeutic abortion, to April 2007, when I left Nicaragua, several pregnant women who had been rushed to the hospital with dangerous miscarriages died because the attending physicians were afraid that intervening to save their patients' lives would put them in violation of the new law. When therapeutic abortion was legal in Nicaragua, only a handful of women actively sought them each year. The major difference was that before the ban passed, physicians were free to do everything in their power to intervene in emergency situations. They didn't have to choose between upholding the Hippocratic Oath and abiding by the Nicaraguan Penal Code.
So therapeutic abortion is not a political gambit, it's a public health necessity. And next week, it will likely be confirmed as a piece of Nicaraguan history. In its place will remain a "pro-life" law that makes it a crime to save a pregnant woman's life, and a public health policy shaped by politically driven misinformation rather than evidence-based medicine. Opponents of abortion may argue that a natural consequence of allowing abortion in cases where women's lives are at risk is that it might open the door to allowing women to terminate their pregnancies under less extreme circumstances. True enough. But it doesn't take a rocket scientist to figure out that a natural consequence of not allowing abortion in cases where women's lives are at risk is that pregnant women die.