But in Peru a multidisciplinary committee in charge of revising the Penal Code has opened the door to decriminalizing abortion in cases of rape or severe disability of the fetus.
On October 6th, the Special Reviewer Commission of the Peruvian Penal Code supported a law that authorizes therapeutic abortion and proposed the decriminalization of abortion in cases of rape or congenital disorders in the fetus, also known as eugenic abortion.
The proposal has to be debated in Congress, which is likely to start its discussion this December. Therapeutic abortion, which has been authorized since 1924, currently has yet to be regulated.
Members of Congress, representatives of judicial power, and delegates from the associations of lawyers and of vice-chancellors are all a part of the Special Reviewer Commission.
As soon as the announcement was made, a lack of a unified governmental position was revealed. The Minister of Health, Oscar Ugarte, stated that therapeutic abortion is not against the right of life and announced that it will be regulated, because it is important to save the lives of women.
However, the Minister of Defense, Rafael Rey, rejected the proposition and warned that he will resign his position if Congress approves the decriminalization of abortion in these exceptional circumstances.
The female Minister of Foreign Trade and Tourism, Mercedes Araóz, also rejected the liberalization of abortion and suggested that the solution in case of rape is to bring the babies to adoption. But the Minister of Justice, Aurelio Pastor, went even further, calling on the Commission to repeat the session and vote again on the proposition.
Prior to the session, the streets of the capital city, Lima, were filled with protests and demonstrations by women's organizations in favor of the decriminalization of abortion in these special cases. Women gathered in public squares with banners explaining the different reasons which led them to seek an abortion, such as “I wanted to continue my studies," “I was raped," “My life was at risk."
On October 21st, the Special Reviewer Commission repeated the vote and ratified the proposition. More than 100 women organizations and NGOs devoted to sexual and reproductive rights applauded this decision in a declaration promoted by the Latin American and Caribbean Committee for the Defense of Women’s Rights; Campaña 28 de Septiembre, and Centro de la Mujer Peruana Flora Tristán.
As in other countries, the debate has the same three issues: judicial, ethic and medical.
From the judicial point of view, the opponents of decriminalization argue that the second article of the Peruvian Constitution orders the protection of life from the moment of conception. On the other hand, those for the liberalization of abortion ask to observe the international treaties on Human Rights signed by the State of Peru, and the recommendations from the Committee against Torture and the CEDAW.
Among the medical arguments against abortion is that scientific advancements have diminished maternal mortality. However, Peruvian women are living in poor conditions and the health system has yet to be updated to provide adequate universal health care.
Last but not at least, objectors state conscience reasons such as no one – not even a mother – has the right to decide the fate of an unborn human being and therefore to end a pregnancy is a crime in all cases. However, for those who support the decriminalization of eugenic abortions, the mental and physical health of a woman is more important than a fetus whose life out of uterus is nonviable.
Defenders of legal abortion in cases of rape believe that women cannot be forced by law to carry on an unwanted pregnancy after experiencing the trauma of being raped, moreover, they have the right to choose to become a mother as a result of a rape or to get an abortion. Complications of unsafe abortion are the leading cause of maternal death in Peru.
In addition, there are religious motivations behind many of the opponents, often unmentioned, particularly by members of the government. Because of this, women's organizations advocate respecting the secular status of Peru.
Public opinion is nearly equal on both sides of the issue. According the surveys conducted by the company Apoyo for the daily El Comercio, 53 percent disapprove of abortion when pregnancy is the result of rape, and 41 percent approve. Also 48 percent of respondents say no to eugenic abortion, and 46 percent state that they agree it should be allowed.
On April 4th 2008, the Constitutional Court of Chile banned free distribution of the emergency contraceptive (EC) pill in the public health system. The judicial ruling came after a debate on the reform of the National Norms on Fertility Regulation (2006), which had resulted in introduction and free distribution of EC by public health care centers to all women from 14 years of age, without their parents’ consent. Opponents of birth control objected to the reform, so Chilean President Michelle Bachelet secured access to EC by virtue of an executive order. However, the judicial ruling annulled the reform and the Bachelet’s order, deciding that the distribution of EC was unconstitutional because, according to the justices, the hormone levonorgestrel, contained in the EC pills, is “abortive”, and therefore against the right to life.
As a result of the court decision, EC was partially removed from pharmacies, whereas other pills containing levonorgestrel continued to be sold, but for a price that not all women can afford.
In Chile, a high number of illegal abortions and teen pregnancies present serious challenges to a government which has made reducing both abortion and unintended pregnancy a focal point of its reproductive health policy. So even despite the Court ruling on EC, Bachelet’s Administration continued to seek new legal mechanisms to ensure access for all women--poor and rich alike—to emergency contraception.
The government introduced a bill to regulate information and distribution of contraception methods. Last July the Lower House of the Parliament of Chile passed the bill, which allows –among other measures--the free distribution of EC in the public health system.
The bill aimed to guarantee “every person, regardless of their economic situation” free access to the pill.
"The state isn't imposing anything on anyone," Bachelet said. "Each person may decide on her own, but the state must guarantee equal conditions of access to birth control methods."
A vast majority of the legislators voted in favor of the bill--73 votes for, 34 against, and 2 lawmakers abstained from voting. All the votes against the bill were from members of the party Unión Demócrata Independiente, which has linkages with the Opus Dei organization. The feminist organizations celebrated the results while the Catholic Church denounced it.
Now the bill awaits Senate approval. Meanwhile, Chile is in the midst of an electoral campaign, a circumstance which certainly will have an influence in the votes at the Senate, with presidential candidates on the left and right seeking to assure their potential supporters of their own position on this and other issues. Candidates include Christian Democrat Eduardo Frei, who just three years ago sided with “pro-life” organizations and Catholics against the distribution of the pill. On the other hand is the right-wing candidate Sebastian Piñera, whose coalition also firmly backs the prohibition.
As if the debate was not already hot enough, this October the Ministerio de Salud Pública (Ministry of Health) of Chile authorized the sale of the EC pill “Escapel-1” in pharmacies. Conservative members of Parliament reacted against the decision, insisting that Escapel-1 has levonorgestrel, the hormone they declare to be “abortive”. The conservative movement “Red por la Vida y la Familia” (Network for Life and Family), through its lawyer Jorge Reyes, stated that this announcement shows that the health authorities of the government are acting in opposition to the current legal situation, where the public distribution of EC pills is banned.
At the same time, scientists and reproductive health advocates have expressed strong support for expanded access to EC in Chile. “Those opposed to this emergency contraceptive are a group of people that call themselves “pro-life,” who are well organized and have significant power and influence," said Dr. Soledad Diaz, president of the Chilean Institute for Reproductive Medicine (ICMER). "They have a very stubborn doctrinaire position that doesn’t want to recognize the scientific evidence that says the pill is not abortive. It’s an ideological position, there is no other explanation.”
Research and medical opinion back them up. The World Health Organization states, for example that “levonorgestrel emergency contraceptive pills (Epps) have been shown to prevent ovulation and [do not] have any detectable effect on the endometrium (uterine lining) or progesterone levels when given after ovulation. ECPs are not effective once the process of implantation has begun, and will not cause abortion.”
]]>]]>
On April 4th 2008, the Constitutional Court of Chile banned free distribution of the emergency contraceptive (EC) pill in the public health system. The judicial ruling came after a debate on the reform of the National Norms on Fertility Regulation (2006), which had resulted in introduction and free distribution of EC by public health care centers to all women from 14 years of age, without their parents’ consent. Opponents of birth control objected to the reform, so Chilean President Michelle Bachelet secured access to EC by virtue of an executive order. However, the judicial ruling annulled the reform and the Bachelet’s order, deciding that the distribution of EC was unconstitutional because, according to the justices, the hormone levonorgestrel, contained in the EC pills, is “abortive”, and therefore against the right to life.
As a result of the court decision, EC was partially removed from pharmacies, whereas other pills containing levonorgestrel continued to be sold, but for a price that not all women can afford.
In Chile, a high number of illegal abortions and teen pregnancies present serious challenges to a government which has made reducing both abortion and unintended pregnancy a focal point of its reproductive health policy. So even despite the Court ruling on EC, Bachelet’s Administration continued to seek new legal mechanisms to ensure access for all women--poor and rich alike—to emergency contraception.
The government introduced a bill to regulate information and distribution of contraception methods. Last July the Lower House of the Parliament of Chile passed the bill, which allows –among other measures--the free distribution of EC in the public health system.
The bill aimed to guarantee “every person, regardless of their economic situation” free access to the pill.
"The state isn't imposing anything on anyone," Bachelet said. "Each person may decide on her own, but the state must guarantee equal conditions of access to birth control methods."
A vast majority of the legislators voted in favor of the bill--73 votes for, 34 against, and 2 lawmakers abstained from voting. All the votes against the bill were from members of the party Unión Demócrata Independiente, which has linkages with the Opus Dei organization. The feminist organizations celebrated the results while the Catholic Church denounced it.
Now the bill awaits Senate approval. Meanwhile, Chile is in the midst of an electoral campaign, a circumstance which certainly will have an influence in the votes at the Senate, with presidential candidates on the left and right seeking to assure their potential supporters of their own position on this and other issues. Candidates include Christian Democrat Eduardo Frei, who just three years ago sided with “pro-life” organizations and Catholics against the distribution of the pill. On the other hand is the right-wing candidate Sebastian Piñera, whose coalition also firmly backs the prohibition.
As if the debate was not already hot enough, this October the Ministerio de Salud Pública (Ministry of Health) of Chile authorized the sale of the EC pill “Escapel-1” in pharmacies. Conservative members of Parliament reacted against the decision, insisting that Escapel-1 has levonorgestrel, the hormone they declare to be “abortive”. The conservative movement “Red por la Vida y la Familia” (Network for Life and Family), through its lawyer Jorge Reyes, stated that this announcement shows that the health authorities of the government are acting in opposition to the current legal situation, where the public distribution of EC pills is banned.
At the same time, scientists and reproductive health advocates have expressed strong support for expanded access to EC in Chile. “Those opposed to this emergency contraceptive are a group of people that call themselves “pro-life,” who are well organized and have significant power and influence," said Dr. Soledad Diaz, president of the Chilean Institute for Reproductive Medicine (ICMER). "They have a very stubborn doctrinaire position that doesn’t want to recognize the scientific evidence that says the pill is not abortive. It’s an ideological position, there is no other explanation.”
Research and medical opinion back them up. The World Health Organization states, for example that “levonorgestrel emergency contraceptive pills (Epps) have been shown to prevent ovulation and [do not] have any detectable effect on the endometrium (uterine lining) or progesterone levels when given after ovulation. ECPs are not effective once the process of implantation has begun, and will not cause abortion.”
]]>On April 4th 2008, the Constitutional Court of Chile banned free distribution of the emergency contraceptive (EC) pill in the public health system. The judicial ruling came after a debate on the reform of the National Norms on Fertility Regulation (2006), which had resulted in introduction and free distribution of EC by public health care centers to all women from 14 years of age, without their parents’ consent. Opponents of birth control objected to the reform, so Chilean President Michelle Bachelet secured access to EC by virtue of an executive order. However, the judicial ruling annulled the reform and the Bachelet’s order, deciding that the distribution of EC was unconstitutional because, according to the justices, the hormone levonorgestrel, contained in the EC pills, is “abortive”, and therefore against the right to life.
As a result of the court decision, EC was partially removed from pharmacies, whereas other pills containing levonorgestrel continued to be sold, but for a price that not all women can afford.
In Chile, a high number of illegal abortions and teen pregnancies present serious challenges to a government which has made reducing both abortion and unintended pregnancy a focal point of its reproductive health policy. So even despite the Court ruling on EC, Bachelet’s Administration continued to seek new legal mechanisms to ensure access for all women--poor and rich alike—to emergency contraception.
The government introduced a bill to regulate information and distribution of contraception methods. Last July the Lower House of the Parliament of Chile passed the bill, which allows –among other measures--the free distribution of EC in the public health system.
The bill aimed to guarantee “every person, regardless of their economic situation” free access to the pill.
"The state isn't imposing anything on anyone," Bachelet said. "Each person may decide on her own, but the state must guarantee equal conditions of access to birth control methods."
A vast majority of the legislators voted in favor of the bill--73 votes for, 34 against, and 2 lawmakers abstained from voting. All the votes against the bill were from members of the party Unión Demócrata Independiente, which has linkages with the Opus Dei organization. The feminist organizations celebrated the results while the Catholic Church denounced it.
Now the bill awaits Senate approval. Meanwhile, Chile is in the midst of an electoral campaign, a circumstance which certainly will have an influence in the votes at the Senate, with presidential candidates on the left and right seeking to assure their potential supporters of their own position on this and other issues. Candidates include Christian Democrat Eduardo Frei, who just three years ago sided with “pro-life” organizations and Catholics against the distribution of the pill. On the other hand is the right-wing candidate Sebastian Piñera, whose coalition also firmly backs the prohibition.
As if the debate was not already hot enough, this October the Ministerio de Salud Pública (Ministry of Health) of Chile authorized the sale of the EC pill “Escapel-1” in pharmacies. Conservative members of Parliament reacted against the decision, insisting that Escapel-1 has levonorgestrel, the hormone they declare to be “abortive”. The conservative movement “Red por la Vida y la Familia” (Network for Life and Family), through its lawyer Jorge Reyes, stated that this announcement shows that the health authorities of the government are acting in opposition to the current legal situation, where the public distribution of EC pills is banned.
At the same time, scientists and reproductive health advocates have expressed strong support for expanded access to EC in Chile. “Those opposed to this emergency contraceptive are a group of people that call themselves “pro-life,” who are well organized and have significant power and influence," said Dr. Soledad Diaz, president of the Chilean Institute for Reproductive Medicine (ICMER). "They have a very stubborn doctrinaire position that doesn’t want to recognize the scientific evidence that says the pill is not abortive. It’s an ideological position, there is no other explanation.”
Research and medical opinion back them up. The World Health Organization states, for example that “levonorgestrel emergency contraceptive pills (Epps) have been shown to prevent ovulation and [do not] have any detectable effect on the endometrium (uterine lining) or progesterone levels when given after ovulation. ECPs are not effective once the process of implantation has begun, and will not cause abortion.”
]]>Many projects supported by international organizations have been implemented over the past decades with very low success in terms of maternal mortality decrease. Currently, the government is developing a new strategy based on intercultural reproductive health care approach.
In recent years, some initiatives carried out by non-governmental organizations have also explored how cultural rights can bring about changes to make access to high quality sexual and reproductive health services available for all women in multi-cultural settings.
The Government of Evo Morales, the first indigenous President of Bolivia, has given to traditional medicine an institutional relevance. Since 2006, the Ministry of Health and Sports has a Vice-Ministry of Traditional Medicine and Intercultural affairs, which is in charge of promoting, protecting and guaranteeing the conservation of traditional medicines according to the indigenous knowledge and cultures.
Officially, Bolivia's name is "Plurinational State of Bolivia" because this Andean country has 34 aboriginal nations, which represent 55 percent of the total population. The largest ethnic groups are the Quechuas and the Aymaras, and it is estimated to be 30 percent Quechua-speaking and 25 percent Aymara-speaking people.
That is why the intercultural health approach is using the aboriginal languages, taking advantage of the regional resources and respecting the habits and traditions. Moreover, there are post-graduated programs at two Bolivian universities on Intercultural Health.
With the new Political Constitution, which came into force early this year, intercultural consciousness in reproductive health has gained in prominence. In fact, the intercultural health is also focusing to contribute to the reduction of cultural barriers related to the universal access to sexual and reproductive health care services. Cultural barriers make it difficult for indigenous women to receive qualified health care which constitutes one of the indirect causes of high levels of maternal mortality experienced in Bolivia.
Some of these barriers are the doctor's relation which the patient, the isolation of the women in hospital because they are often separated from their families and the positions used for delivery.
The intercultural dialogue between practitioners of western and traditional medicine is currently stimulated. Nurses of various health care services and hospitals from the city of Cochabamba are assisting traditional childbirths, whereas rural midwives are been trained to improve their capacities to evaluate risks.
In Bolivia, a culture of rural midwifery known as partera, midwives speak the local language. Some of them understand the importance of evaluating risks, and for that purpose they use a sort of oracle, based in coca leaves.
Among indigenous peoples, 78 percent of children born at home and 53 percent of maternal deaths occurred also at home.
Indigenous women prefer to deliver at home because they do not feel confidence in hospitals, mainly because their customs are ignored or denied in such health services.
In traditional deliveries, women can choose the position. Most of them choose to squat, with their family around, and drink infusions of medicinal plants. Soon after the childbirth, women must keep warm and avoid contact with cold water.
Taking into account this situation, the Hospital Manuel Ascencio Villaroel in the municipality of Punata opened in August. The first delivery room in which indigenous culture and delivery habits are observed, even a kitchenette is available so they can prepare the traditional infusions.
The intercultural childbirth - as it is called- is designed in such a way that indigenous women feel confidence. All details are considered, for instance the indigenous are not forced to use hospital clothes. The hospital has also accommodation facilities for women's relatives. The delivery is supported by a doctor, and a midwife can assist it as well.
So far, this "intercultural childbirth" has been well accepted by indigenous communities. But to be replicated, big efforts should be made in order to bridge the gap between doctors and midwives, and to get funding to build more "intercultural childbirth rooms." The Hospital Manuel Ascencio Villaroel was awarded a US$ 65.000 donation from the Japanese Agency of Cooperation.
Over the last 15 months, 16 Mexican states have approved constitutional reforms defining personhood as beginning at the moment of conception, which means that all civil rights have to be protected, including the right to life, and that, consequently, the legal termination of pregnancies will not be allowed.
In late 2007, the Supreme Court upheld a law, which decriminalized abortion up to 12 weeks of gestation in Mexico City. For some women’s organizations and academics, the constitutional reforms are reactions against the law of abortion ruling in Mexico City.
Mexico's federal structure allows the Congress of each state to modify their constitutions and Penal Codes independently, but reforms cannot contradict the National Constitution nor the National Penal Code.
The reform of the local Constitution, approved on November 11 2008
and published the 11th of December in the official journal “Tierra y Libertad”, states that the “in the state of Morelos it is recognized that all human beings have the right to judicial protection of their lives from the moment of their conception”.
According to the reproductive health advocacy group Grupo de Información en Reproducción Elegida (Group of Information on Reproduction Choice, GIRE), who is supporting the petition before the IACHR, “this reform infringes on the human rights of women regarding their reproductive autonomy, health, life and freedom”.
“None of the authority of the Mexican State nor of Morelos’ federal state has contested the constitutional reforms using the constitutional control mechanisms, therefore one can affirm that Mexico has neglected its duty of efficiently guaranteeing the human rights of women”.
The women who filed the petition are represented by GIRE, Academia Mexicana de Derechos Humanos and Centro de Análisis e Investigación. They also argued that the constitutional reforms are not observing international treaties signed by Mexico, such the American Convention on Human Rights and the Inter-American Convention on the Prevention, Punishment and Eradication of Violence against women, known as Convention of Belém do Pará.
According to the petition, the constitutional reform infringes the rights to: a decent life in which women can choose their life’s project, a personal integrity, a health protection, a private life (freedom of conscience and thought), an equal protection before law without discrimination, and the right to a life free of violence.
In most of the Mexican states, therapeutic abortion is authorized in cases of rape, when the women’s health is in risk, and when the fetus suffers a severe malformation. Out of these cases, the majority of Mexican states establish in their Penal Codes sanctions to women who choose to end their pregnancies, even with several years of prison.
In the state of Veracruz, for instance, women can be sentenced from six months to four years in jail. in Jalisco, from four months to a year, in Guanajuato, from six months to three years, and in Baja California from two months to two years.
The petition also denounces the Penal Code reform of Morelos which authorizes a psychological treatment as an alternative sanction to prison or fine.
In a press release, more than twenty Mexican NGOs supporting the petition pointed out that “this option offends women’s dignity as it assumes women as psychologically affected just because they choose to end an unwanted pregnancy and appeal to their health and reproductive rights”.
For the women petitioners, the constitutional reforms contravene the Political Constitution of the United Mexican States, which guarantees that “all persons have the right to choose in a free, responsible and informed way the number of children they will have and when they will have them”; and which states that “all persons have the right to health protection”.
The IACHR has already received the petition and it is studying its admission. If the international commission accepts it and determines that such constitutional reforms violate human rights, it could lead to a recommendation for the Mexican State to annul such reforms.
For GIRE and Catholics for Choice, the interruption of pregnancies should be considered a health matter, not as part of the Penal Code.
]]>These are just some of the situations resulting from the law which bans abortion in all circumstances, approved in 2006 by the National Assembly of Nicaragua. But there is more. Amnesty International carried out a field mission and described what they have seen as “sheer horror,” in the words of Kate Gilmore, Amnesty International’s Executive Deputy Secretary General.
Last July, Amnesty International issued the report The total abortion ban in Nicaragua: Women's lives and health endangered, medical professionals criminalized, concluding that Nicaragua’s total ban on abortions is endangering the lives of girls and women, denying them life-saving treatment, preventing health professionals from practicing effective medicine and contributing to an increase in maternal deaths across the country.
"Nicaragua’s ban of therapeutic abortion is a disgrace. It is a human rights scandal that ridicules medical science and distorts the law into a weapon against the provision of essential medical care to pregnant girls and women," said Gilmore, at a press conference in Mexico City, where the report was disclosed.
In fact, the revised Penal Code stipulates prison sentences for girls and women who seek an abortion and introduces criminal sanctions for doctors and nurses who treat a pregnant woman or girl for illnesses such as cancer, malaria, HIV/AIDS or cardiac emergencies where such treatment is contraindicated in pregnancy and may cause injury to or death of the embryo or fetus.
The law allows no exemption, even when continuing a pregnancy risks the life or health of the woman or girl or when the pregnancy is the result of rape.
In Nicaragua, according to media reports cited by Amnesty International, 16 percent of pregnancies in teenage girls were the result of rape, including incest, and 87 percent of them were between 10 and 14 years old.
During the mission, Amnesty International delegates met with girls who were victims of rape by close family members or friends, who were nonetheless compelled to carry the pregnancy to full term. But Amnesty researchers could not talk with some of the pregnant teenagers because several had just committed suicide by consuming poison, or lost their lives while trying to interrupt their pregnancies using unsafe methods.
The maternal mortality rate in Nicaragua for the year 2000, based in the reviews and estimations of UNICEF, WHO and UNFPA, is 170 per 100.000 live births, and it is even higher in the Atlantic region, the country’s poorest region.
According to Amnesty International, 13 percent of all maternal deaths in Nicaragua are due to unsafe abortions.
Although it is hard to estimate the maternal deaths resulting from the ban, according to official figures 33 girls and women have died due to complications of pregnancy this year as compared to 20 in the same period last year, whereas a Human Rights Watch mission to Nicaragua reports the deaths of at least 80 women in the eleven months following the ban.
The report filed by Human Rights Watch, entitled “Over their Dead Bodies, Denial of Access to Emergency Obstetric Care and Therapeutic Abortion in Nicaragua”, issued on October 2007, documented the same negative effects which Amnesty International verified in its mission to Nicaragua. This is to say, that the Nicaraguan government has been deaf to the evidence of human right violations.
“Girls pregnant as a result of incest had the courage to meet with us to speak out against the situation but President Ortega did not. It appears the Nicaraguan authorities could not stand up for the law, would not be accountable for the law nor commit themselves to its urgent repeal,” added Gilmore, according to a international media.
Although the bill restricting abortion was signed by the former Nicaraguan President Enrique Bolaños, none of the members of the National Assembly voted against it, so the result was 52 in favor, 9 abstaining and 29 absent. The law was approved considering political interests, since the vote occurred just before the presidential elections. In fact, rejecting the bill could result in loosing votes in the presidential elections.
Current President Daniel Ortega, who was a defender of Nicaragua's limited abortion rights and a critic of the Catholic Church when he led a left-wing Nicaraguan government in the 1980s, today prefers to turn a blind on human rights regarding women.
Amnesty International is urging the Nicaraguan authorities to repeal the law that bans all forms of abortion; guarantee safe and accessible abortion services for rape victims and women whose lives or health would be at risk from the continuation of pregnancy; and protect the freedom of speech of those who speak out against the law and offer comprehensive support to the women and girls affected by the law.
Amnesty International is also calling on Nicaragua’s Supreme Court to issue a decision on the legality and constitutionality of the law as a matter of the utmost urgency.
]]>Human Papilloma Virus is one of the causes of cervical cancer. HPV infects 20 percent of men and women in Latin America, but it does not always result in cervical cancer. When it affects men, it can cause cancer of the penis or anus.
"There are about 100 types of HPV, and just 30 or 40 of them attack the female and male genitals. Moreover, there is an 80 percent chance of getting infected over the lifespan," explained Nubia Muñoz Calero, Colombian pathologist and physician, a member of the committee of scientists in charge of supervising the HPV vaccine Gardasil's clinic trials, and nominated for the Nobel Prize for Physiology and Medicine 2008.
According to the Mexican governmental Subsecretaría de Prevención y Promoción de la Salud, the mortality rate due to cervical cancer has decreased over the last 15 years. In fact, in 1990 there were 25.3 deaths for 100,000 women. In 2006, the rate was 14.6. However, this decrease was not homogeneous within the country. Most of the Mexican victims are poor women from states with a low human development index.
Nevertheless, cervical cancer can be treated if it is detected early. According to the National Survey on Reproductive Health (2003), just 70.7 percent of Mexican women had a Pap smear in the last three years.
The Pap smear, a method used for early cancer detection, has a low detection rate, and often provides false negative diagnosis, which is why the HPV vaccine is very important, pointed out Muñoz. However, the Colombian scientist warned that the girls vaccinated required early detection tests as well, since the vaccine is not 100 percent effective, to prevent high grade damages and the cervical cancer associated to HPV types 16 and 18.
These HPV types cause between 65 and 70 percent of the cervical cancer worldwide, and in Latin America respectively.
In 2007, the Mexican government launched the Programa de Acción Específico de Cáncer Cérvico Uternino 2007-2012 (Specific Action Program on Cervical Cancer 2007- 2012), a comprehensive plan aimed "to reduce the mortality and morbidity rates through the provision of excellent services for the promotion, prevention, detection, diagnosis, treatment and suffering control, as well as the responsible participation of the population on health care."
Through the program's implementation, by 2012, the detection coverage will be 85 percent every three years among women between 25 and 34 years old. Other goals are diminishing the mortality rate among women 25 years old or older by 27 percent, compared to the rate of 2006. Another goal is to reduce the disparities of the mortality rate 50 percent.
It is in the framework of this program that the free distribution of the HPV vaccine was considered.
The Mexican vaccination announcement came after Panama launched a national free HPV vaccination campaign, last October. The Mexican vaccination will cover, so far, the capital city, and will be provided to about 35,000 girls between 11 and 13 years old, in all the health care centers of Mexico City.
As it is a prophylactic vaccine, it has to be applied before the sexual life starts in order to have better results, since the HPV is a sexually transmitted infection.
Last December, thousands of girls received the first dose of the vaccine, as well as a short information session, which included various sexuality topics and documentation related to gender violence.
The Mexican State, the metropolitan area which surrounds the capital, announced that in 2009, it will implement a vaccination campaign aimed at students in the sixth grade.
The HPV vaccine has been sold in Mexico since 2006, but it was only provided by the private health centers at a high price of 600 US Dollars. The vaccine, in any of its marks, is one of the most costly vaccines worldwide. Panama's budget for the vaccination of all 10-year-old girls is 5,6 million dollars. For the implementation of the Mexican campaign, the government allocated about 10 million dollars.
"The governments should negotiate the prices with the pharmaceutical laboratories, or work together at regional level in order to get lower cost prices through PAHO's Rotary Fund," recommended Muñoz.
]]>The bill reflects the recommendations of the Spanish parliamentary commission, which for six months examined the effect of Spain's restrictive abortion laws. Last February, the parliamentary commission proposed a reform decriminalizing abortion in Spain so abortion would be removed from the Penal Code and included under the sexual health regulations.
The report, along with one issued by the expert panel of doctors, lawyers, academics and government representatives appointed by the Spanish government in September 2008, is at the base of the draft abortion reform bill to be introduced in the legislature this year.
The proposed reform authorizes free abortion between the 14th and 22nd week of pregnancy if a medical certification states risks for the mother or the baby. Moreover, it would allow16-year-old girls to have an abortion without consent of their parents. In addition, it states that providers' conscience objections cannot become an obstacle for women's access to the medical proceeding in the public health system.
Since 1985, abortion has been legal in Spain only in instances of rape, severe fetal abnormalities or if the mother's mental or physical health is at risk. However, Spanish women have to struggle to get a medical certification or a police report (in case of rape) in order to access a legal abortion, which is why women prefer to travel to London if they can afford it to end their unwanted pregnancies. Those who get the required document for legal abortion often have to pay a private clinic because doctors in the state health service refuse. In fact, the public system performs only 3 percent of the 112,000 abortions performed in Spain each year.
This situation seemed discriminatory by the defenders of the voluntary termination of pregnancy, and inequitable for the Socialist Party.
The proposed bill is in line with other sexual and reproductive reforms carried out by Spanish Prime Minister José Luis Rodríguez Zapatero such as the free sale of the emergency contraception pill in pharmacies without prescription.
The question now is does the Catholic Church have the influence required to stop the abortion reform?
One can realize that Spain is no longer the bastion of the Catholic Church if we take into account other reforms promoted and approved by Zapatero's Socialist government such as the full marriage rights for gay couples, the facilitation of divorce proceedings, embryonic stem cells research authorization and the removal of Catholicism being taught at public schools.
Looking at society, several polls are showing a secular trend. According to an annual survey by sociologist Juan Díez-Nicolás, president of Asep research institute, less than 25 percent of Spaniards say they practice Catholicism beyond social events like weddings and baptisms.
Regarding abortion, the daily El País carried out a survey that found 65 percent of Spaniards support abortion in the first three months.
The Catholic Church is not alone in its campaign against abortion. Pro-life activists are checking the activities of the clinics accredited for voluntary termination of pregnancies. As a result of their formal complaints, police investigations have opened files against various clinics, but defenders of the proposed reform are not sleeping.
In order to promote the abortion law, they started a YouTube channel, called "A favor 2009, Por el Cambio de la Ley en España" (In favor 2009, for the change of Spanish law), which can be viewed at http://www.youtube.com/user/afavor2009.
]]>
The morning-after pill was authorized in Spain in 2001, and it is distributed for free by public health centers in some regions, while in others, it is more difficult to obtain due to the particular ways of implementing the national norms by the regional administrators of the health care system.
Socialists leaders argue that the measure will contribute to eradicating the territorial inequality regarding the access to family planning methods.
Currently, the pill is sold in pharmacies for 20 euros (about 27 US Dollars) with prescription. But, according to Concha Martín, director of the Family Planning Association of Madrid, women often have to go to several doctors before finding one who will prescribe the EC.
That is why, for the Socialists, the announcement is part of a package of measures promoting "the development of the fundamental right to sexual and reproductive health for all citizens."
"The aim is to make it available to anyone who wants it without any difficulty," said the Ministry of Health's Trinidad Jimenez, who made the announcement May 11th.
Jimenez underscored that EC use is aimed to "avoid unwanted pregnancies" and "unexpected sexual relations without protection," therefore it cannot be regarded as routine method of contraception.
Nevertheless, the General Secretary of the Sociedad Española de Ginecología y Obstetricia (Gynecology and Obstetric Spaniard Society), Luis T., called the governmental measure "frivolous." Mercé Alberto argues that there is a risk, especially among young women, of using EC as a regular contraceptive method for occasional sexual intercourse.
Mercé Alberto added that the generalization of its use as conventional contraceptive "could increase the number of unwanted pregnancies and sexually transmission diseases as well."
In addition, this measure did not address sexuality education, which is a problem to be solved by the school system, Mercé Alberto pointed out.
"Emergency contraceptive pills are for emergency use only and not appropriate for regular use as an ongoing contraceptive method because of the higher possibility of failure compared to modern contraceptives. In addition, frequent use of emergency contraception results in more side-effects, such as menstrual irregularities. However, their repeated use poses no known health risks,"
According to an official document of the World Health Organization.
Some associations of consumers have asked for more information in order to avoid the use of the morning-after-pill as a conventional contraception method.
The conservative forces, such as the Catholic Church and the conservative opposition, the Popular Party, have reacted by arguing that the number of abortions will increase as a result of its implementation.
Socialist leaders said statistics in countries that have made the pill available over the counter, such as the United States and France, show it has helped reduce the number of abortions significantly.
According to official data of the Ministry of Health, of the 112,000 women who had abortions in Spain in 2007, 6,000 were minors.
For many people, sexuality education and access to contraception are the ways to diminish unwanted pregnancies and abortions.
A Spanish blogger stated that this measure will reinforce sexist behaviors. "Probably many men from their male condition will say "Thanks." Once again, the consequences of a not thought-out act can be stopped with just a pill. I am worried because day by day it is getting harder to explain to a daughter that a woman is equal to a man, and she deserves respect."
So far, pharmacies have not expressed any objection. The Ministry of Health is confident that its managers will not argue conscience objection, since the pill is not abortive.
According to the World Health Organization, "Levonorgestrel emergency contraceptive pills have been shown to prevent ovulation and they did not have any detectable effect on the endometrium (uterine lining) or progesterone levels when given after ovulation. ECPs are not effective once the process of implantation has begun, and will not cause abortion."
]]>"Emergency contraceptive pills prevent pregnancy. They should not be given to a woman who already has a confirmed pregnancy. However, if a woman inadvertently takes the pills after she became pregnant, the limited available evidence suggests that the pills will not harm either the mother or her fetus."
In 2008, the Constitutional Court of Chile banned the free distribution of the emergency contraception pill (EC) in the public health system. In Colombia, the high court Consejo de Estado ratified the government health agency INVIMA's authorization of importation and distribution of emergency contraception pills.
This year, Peruvian and Honduran legislators and judges continue to give opposing statements.
Last March, the Superior Court of Justice of Lima issued a sentence recognizing the right of all Peruvian women to have equal access to the EC, while rejecting a judicial request calling to stop the free distribution of EC by the Ministry of Health to poor women. Stopping its free distribution would be discriminatory, since the EC pills are sold to women who can afford the cost.
Meanwhile, on April 2, the Parliament of Honduras approved in just one plenary session a bill prohibiting the promotion, commercialization, free distribution and use of EC pills. The bill also prohibits the dissemination of information about the use of contraceptive pills like EC, and states that those who violate the bill will be subject to the punishments established for the crime of abortion.
The Penal Code establishes three to six years of prison for the agent (doctor, midwife, etc.) when abortion is practiced with woman's consent, six to eight years of prison without her consent and without violence or intimidation and eight to 10 years of prison when the agent uses violence and intimidation. Moreover, women are punished with three to six years in prison to consent an abortion.
According to Centro de Derechos de Mujeres (CDM),"the bill was approved without debate, in just one session, taking advantage of a circumstance where the national attention was focused in a football game," and it was voted in a plenary "with the participation of just 50 legislators."
The bill was submitted to the Parliament by female legislatorsNelly Jeréz (from the National Party) and Martha Lorena Alvarado (Liberal Party).
In a protest statement,a Honduran NGO asks, "How is it possible that two legislators, from their sectarian and fundamentalists visions, impose a legal act which will have dramatic consequences for millions of women, ignoring their sexual and reproductive rights, and their rights to be informed, to access medicines and to get timely and appropriate health care?"
Once again, the motivation of the legislators is that the belief that emergency contraception is an abortifacient, and therefore is against the national legislation, which penalizes abortion.
The pharmacies "are offering to our youth an abortive medicine, because it is made to be used after sexual relations, so it is not a normal contraceptive but an overdose of hormones, whose effects were analyzed by the Colegio Médico de Honduras (Medical College of Honduras) and declared as an abortive pill," Alvaro said to a local daily.
The World Health Organization (WHO) clearly explains that "Levonorgestrel emergency contraceptive pills (ECPs) have been shown to prevent ovulation and they did not have any detectable effect on the endometrium (uterine lining) or progesterone levels when given after ovulation. ECPs are not effective once the process of implantation has begun, and will not cause abortion."
The EC pill has been used by women who cannot face a pregnancy at a particular time in their lives. In such a way, EC avoids an undesirable pregnancy and even an unsafe abortion. The EC pill is also recommended for women who have been raped as long as the EC is used up to 72 hours after sexual intercourse.
Just in 2007, 4,000 instances of rape were reported to Honduran authorities. According to the National Survey on Demography and Health, the prevalence of women being abused since 12 years of age is close to 10percent.
The Consorcio Latinoamericano de Anticoncepción de Emergencia (CLAE) called the President of the Honduran Parliament and its legislators to revise their decision regarding the EC pill upon the international scientific evidence at the base of the WHO statement, which says the EC method is not abortive.
However, so far the Presidential veto would be the last thing to stop the bill.
The Red de Salud de las Mujeres Latinoamericanas y del Caribe and the Latin American and Caribbean Committee for the Defense of Women's Rights, along with the CLAE and the CDM, issued a protest declaration in which these organizations underlined that the approved bill violates various international conventions signed by Honduras such as the Convention for the Children's Rights and the American Convention on Human Rights,and it infringes on Honduran public policies as well.
Soon after the bill was approved, the medicine's price increased and it is being sold by a clandestine market, according to local media.
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Such a definition means that all civil rights have to be protected, including the right to life, and that, consequently, the termination of pregnancies will be criminalized in all circumstances.
Mexico's federal structure allows the Congress of each state to modify their constitutions independently. Currently the states in which such reform has been approved are governed by the conservative parties, National Action Party (PAN) and the Institutional Revolutionary Party (PRI).
Reforms have passed in the states of Morelos, Sonora, Baja California, Chihuahua, Jalisco, Puebla, Colima, Durango, Nayarit, Quintana Roo, Campeche, and Guanajuato.
However, Mexican women did not keep quiet.
On February 17, the Congress of Colima approved a constitutional amendment which establishes that the state will protect the right to life from the moment of conception. Sixty-seven women denounced this amendment on May 15, arguing constitutional fraud, claiming that the President of the Congress of Colima did not observe proper legal proceedings.
Moreover, these women argued that the new statement ignores and violates fundamental rights recognized in the Federal Constitution, such their rights to health, to gender equality, andto freedom of faith, as well as their sexual and reproductive rights, among others.
The legal measure submitted by the 67 women was accepted by the local judges, and therefore a judgment process will be opened. According to the reproductive health advocacy group Grupo de Información en Reproducción Elegida (Group of Information on Reproduction Choice, GIRE), in this process, the Congress from the state of Colima has to explain to the federal judiciary the reasons to modify the constitution and respond the accusations of fraud, while the 67 women can submit cases and opinions of experts in order to demonstrate the reform abrogates fundamental rights.
As for the constitutional fraud, the women argued that the amendment was published by the Official Journal "El Estado de Colima" on March 21, 2009, which did not observe the 30 day approval period during which municipalities can respond to amendments.
The 67 women consider the constitutional reform is discriminatory, since women are disproportionately affected by the imposition of a forced pregnancy and the consequences of an unwanted pregnancy.
Some certain consequences are illegal and unsafe abortions. According to a study presented in 2008 by the Colegio de México, the Population Council and the Guttmacher Institute, an estimated 880,000 abortions are carried out annually, an average of 33 for every 1,000 women a year.
Many such abortions are performed in unsafe conditions, with the risk of women's death.
While legislators are promoting constitutional reforms across Mexico to avoid laws that would decriminalize abortions, such the one approved in Mexico City, public opinion is increasingly in favor of decriminalization.
The Population Council carried out two public opinion surveys among residents of Mexico City on 2007 and 2008, just before and one year after the passage of the abortion law.
The surveys found that "there were significant increases in support for the law being extended to other parts of Mexico; a woman being the one to make the final decision about abortion; and women from other states and those under aged 18 having the right to legal abortion in the capital."
For women activists, having a national capital where the abortion is
legal and many other states where it is illegal is openly discriminatory,
because it means to Mexican women are divided into those of the
"first class and others of second one."
According to Mexican academics quoted by the Press Agency of CIMAC, in some cases, the reforms do not clarify topics related to embryonic research, in-vitro fertilization, or IUDs, which according to some of such amendments is an abortive method, and therefore it has to be banned, or examine the negative consequences for women.
For GIRE and academics, the constitutional reforms are reactions against the law of abortion ruling in Mexico City, and are impromptu amendments which did not take into account the international pacts signed by Mexico, such the CEDAW.
Looking at the international level, one can see in these reforms the pro-life trend currently touching Central America and the Caribbean.
]]>The new Article 30, approved by a large majority of 167-32, states "the right to life is inviolable from conception until death. The death penalty cannot be established, pronounced, nor applied, in any case."
For weeks the Catholic bishops, led by Cardinal Archbishop Nicolas de Jesus Lopez of Santo Domingo, promoted the pro-life article through marches, television speeches, and protests outside of government buildings and in other places.
"The Crusade for Life" included collecting one million signatures to present to the National Congress.
The offensive tenor of their campaign provokes fear among the believers and outrage among the doctors. Referring to abortion supporters and the constitutional reform process, the Archbishop of Santo Domingo said on his Sunday homily:
"We know that there are butcher doctors, there are legislators who like to trade in life, there are people who have authority who make a living from that." He added that "we will be upfront, always upfront, clashing," and that "We are here to tell you, 'yes to life, no to death,' definitely." Lastly, he said that abortion is a "crime," that it "exploits women" and that it is "terrorism."
The Cardinal Archbishop Nicolas de Jesus Lopez went further. He attacked members of Parliament, saying that Minou Tavares and Víctor Terrero, were ‘abortionists' (pro-abortion).
So not only are parishioners feeling afraid, but so are legislators who want to keep the believers' votes and be reelected on the coming elections of May 2010.
In fact, some legislators showed no shame in admitting that they feel fear, as some local media recorded.
Therefore, votes are more valuable than women's lives.
In fact, the legal provision will increase the maternal mortality rate, since therapeutic abortion will be penalized and unsafe abortions will proliferate.
According to the report "Análisis de la Situación del Aborto Inseguro" (Analysis on Unsafe Abortion), certified by the Sociedad de Obstetricia y Ginecología (Obstetric Society), the maternal mortality rate in Dominican Republic is 159 deaths for 100,000 newborns, from which 20 percent is due to unsafe abortions.
Moreover, women whose life or health is in danger as a result of a pregnancy will be unprotected, particularly low income Dominicans, who cannot afford a trip to Colombia or other country where the therapeutic abortion is legal.
Many women legislators were aware of the provision's consequences for women and were vehement in the debate; however, others moderated their tone in order to avoid clashes with the Church.
One can see the influence of Catholic thinking in the way of voting - the legislators approved the article 29, which states the right to gender equality, and next the article 30, which denies some of women's reproductive rights.
We have to recall that Dominican Republic is not a secular state. The Concordat between the State and the Catholic Church goes back to 1954, when the country was under the Trujillo's dictatorship.
Despite a UNICEF top official declaration, the mobilization of women's organizations, and the opinion of medical societies, 80 percent of legislators supported the article 30.
The Dominican women's movement tried to alert the public about the provision's negative consequences for women. The NGO Colectivo Mujer y Salud implemented the campaign "For women's health," which showcases the consequences of forced pregnancy on the lives of women who are pregnant as a result of rape.
Last March, Nils Kastberg, UNICEF's regional director for Latin America and the Caribbean, visited Dominican Republic and in the context of the constitutional reform "called on legislators ‘not to be hypocrites, trying to make abortion illegal,' as he believes that this type of measure would mainly affect poor adolescents between the ages of 15 and 17 who by resorting to unsafe services would lose not only the baby but their lives as well," stated a UNICEF press release.
The Dominican Obstetric Society and the Science Academy also expressed their disagreement with the provision before its approval, and have announced their decision to call on the support of similar international organizations to apply pressure, since there still a second reading with formal promulgation by the President also required.
The current Dominican Penal Code criminalizes the abortion in all circumstances. With this provision, the possibilities to liberalize the abortion in particular cases would practically disappear in the near future, since it would require a new Constitutional reform. ]]>