Bloomberg News

Abortion Ban Republicans Favor May Be Deadly in Latin America

November 08, 2011

Nov. 2 (Bloomberg) -- Latin America, home to the world’s strictest abortion laws, may hold lessons for U.S. Republican presidential hopefuls who advocate a ban on the practice.

A consequence of the laws, whatever the moral arguments, is that Latin American women have more “unsafe” abortions per capita than women in any other region, according to the World Health Organization. An estimated 900 women died in 2008 from unsafe abortions in Central and South America, says a 2008 WHO report. The actual number may be higher because not all illegal abortions are reported, the study says.

Strict abortion laws “consistently generate poor physical health outcomes, resulting in deaths,” the United Nations Human Rights Council Special Rapporteur on health, Anand Grover, told the General Assembly on Oct. 24.

Almost four decades after the Supreme Court’s Roe v. Wade decision legalized abortion in the U.S., calling for its overturn is a political litmus test in Republican presidential primaries. In declaring his opposition to abortion with “no exceptions,” businessman Herman Cain has stated the strongest anti-abortion position among the current front-runners, including former Massachusetts Governor Mitt Romney and Texas Governor Rick Perry.

Cain said Oct. 30, on CBS’s “Face the Nation” broadcast, that he opposes abortion even in cases of rape, incest or when the life of the mother is at stake. That followed earlier remarks on CNN’s “Piers Morgan Tonight,” which drew attacks from his rivals when he said abortion should be illegal, but it may be a family’s or mother’s decision what to do.

‘100 Percent Pro-Life’

Republican presidential candidate Rick Santorum similarly supports a no-exceptions approach, and has said he favors prosecuting doctors who perform abortions.

When asked whether she supports exceptions during a June 13 Republican presidential primary debate, Minnesota Representative Michele Bachmann said she is “100 percent pro-life” and that “the very few cases that deal with those exceptions are the very tiniest of fraction of cases and yet they get all the attention.”

In Latin America, Nicaragua and the Dominican Republic have joined Chile, El Salvador and Honduras in making abortion -- even to save the mother’s life -- a crime that carries a prison sentence.

The strict laws in Latin America haven’t stopped abortion and, in some cases, have interfered with life-saving medical procedures for women.

Afraid to Intervene

In Nicaragua, where a complete ban was passed in 2006, psychologist Marta Maria Blandón recounts the case of a married young woman carrying her first child, who sought treatment for acute stomach pains. She died in a hospital bed because doctors, afraid to intervene, ordered more tests when a therapeutic abortion would have saved her life, according to Blandón.

Ipas, an international women’s advocacy group with an office in Managua, estimates that at least 100 women in Nicaragua have died in the past five years as a result of the law because health authorities didn’t perform abortion when atypical pregnancies put the mothers’ lives in danger.

The American Life League, an anti-abortion group, says on its website that “the use of the term ‘therapeutic’ is another pro-abortion attempt to sanitize a repulsive act.”

Anti-abortion activists such as Magaly Llaguno, who led the Latin American operations of Human Life International until last year, dispute that there is a link between a legal ban and high death rates. They point to Ireland and Poland as countries with restrictive laws that are among the world’s lowest maternal mortality rates.

Link Disputed

They cite a 2010 Chilean study which, using data from 1960 to 2007, found maternal deaths dropped 88 percent since the country made abortions illegal without exception in 1989. Deaths peaked in 1961, when abortion in special instances was still allowed.

Blandón counters that the decline reflects advances in medicine and hygienic conditions in Chile, and said that closer examination of mortality data for instances where women have problematic pregnancies would paint a different picture.

Abortion-rights activists also note that Chile is one of the region’s richest economies, meaning women have better access to health care. They may be able to afford to travel elsewhere to terminate a pregnancy or get black-market access to the abortion drug misoprostol, reducing the use of surgical abortions and other methods with higher health risks.

U.S. Shift

Aspiring Republican presidential candidates have ratcheted up their anti-abortion advocacy as U.S. public opinion is shifting to being slightly less favorable toward abortion rights, according to Clyde Wilcox of Georgetown University in Washington, author of “Between Two Absolutes: Public Opinion and the Politics of Abortion.”

Still, fewer than one in four Americans support a no- exceptions policy. A Gallup Poll conducted in May found 22 percent of respondents said that abortion should be illegal under all circumstances, up from 15 percent in 2006. Seventy- seven percent said abortion should always or sometimes be legal, down from 83 percent in May 2006.

In Latin America, abortion is an issue that draws on strong emotions and is used as a political card in heavily Roman Catholic nations.

“Elections are a crucial time when politicians have learned that to speak against abortion is going to make them look good and make the bishops happy,” said Blandón, Central American director of Ipas, in an Oct. 18 telephone interview.

Emergency Contraception

In Chile, abortion was allowed for medical purposes until 1989, just before the end of the Pinochet regime. Then in a gesture to pacify the church, the dictator eliminated the possibility of legal abortion, even for therapeutic purposes.

As Chile’s first female president from 2006 to 2010, Michelle Bachelet tried to provide free morning-after pills to women aged 14 or older in a bid to make emergency contraception more available to poorer Chileans. It was a controversial move that drew angry protests and was struck down by the Constitutional Tribunal.

Bachelet, a feminist and a doctor who went on to become the first head of the United Nations’ agency for women, never attempted to legalize abortion in the deeply Catholic country. Bachelet, via her UN office, declined to comment.

In Nicaragua, opposition to abortion pays political dividends. Daniel Ortega, the former leader of the Sandinista revolution who governed between 1979 and 1990, returned to power by backing a blanket ban on abortion that the incumbent government passed in the run-up to 2006 elections.

Transformed View

Ortega, an advocate of abortion rights in the 1980s, underwent a transformation after losing three elections and facing a sex scandal when his stepdaughter accused him of abusing her as a child. He denied the allegations and the case never went to trial.

The Marxist revolutionary turned devout Catholic is now seeking a third term in a Nov. 6 vote with a slogan that reads: “Christian, Socialist and Solidarity.”

The extent of illegal abortions in Latin America is difficult to gauge. Women are reluctant to admit to an induced abortion, especially when it is illegal, meaning that many cases remain unreported.

“The only thing the legality of abortion affects is whether it’s safe,” said Marianne Mollman, author of “Over Their Dead Bodies,” a 2007 report for New York-based Human Rights Watch on the impact of the ban on Nicaraguan women.

In Chile, with a population of 16 million, there may be as many as 160,000 clandestine abortions each year, according to a 2008 editorial in the Chilean Gynecology and Obstetrics Review by the magazine’s editor, Enrique Donoso.

Uncounted Women

It is almost impossible to know the actual number of women killed by back-street abortions or complications from self- initiated efforts to end an unwanted pregnancy.

In Latin America, the annual number of unsafe abortions per 1,000 women aged 15-44 is higher than any other region, including Africa, according to the 2008 WHO report. In Western Europe, where most countries permit abortions, the unsafe abortion rate was “negligible,” while in Latin America it was about 31 per thousand, the report said. For Africa, which had a much higher overall number of abortions, the population-adjusted rate was 28 per thousand.

WHO defines unsafe abortion as a procedure by people without the necessary skills or in an environment that doesn’t meet minimum medical standards.

Abortion Pill

“Despite large numbers of unsafe abortions, the risk of death associated with unsafe abortion is low at an average of 10 per 100,000 live births in Latin America and the Caribbean,” versus 40 for developing countries overall, according to the 2008 WHO report.

A 2006 study, published in The Lancet medical journal, said that the introduction of the abortion-inducing drug misoprostol, supplanting some surgical abortions, is “one of the most significant factors” in reducing hospital admissions for abortion complications. The report looked at estimated abortion- related hospital admissions in 13 developing countries, including Chile.

Improving access to sex education, contraception and health care are the most effective ways of reducing abortions, Mollman said.

Women’s rights activists want the experience of Latin American women to serve as a cautionary lesson for U.S. politicians. Blandón recounts the case of a woman in Nicaragua who was carrying a baby with anencephaly, a fatal defect in which major parts of the brain are missing. The woman was required to carry the child to birth by the doctors, who told her not to worry because the money she had set aside for a cradle could be used to buy a coffin.

-- With assistance from Sebastian Boyd in Santiago. Editors: Terry Atlas, Jim Rubin.

To contact the reporters on this story: Flavia Krause-Jackson at the United Nations at fjackson@bloomberg.net Caroline Alexander in London at calexander1@bloomberg.net;

To contact the editors responsible for this story: Mark Silva at msilva34@bloomberg.net; Andrew J. Barden at barden@bloomberg.net


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