Once again, information, not legality, is the key issue for women's access to reproductive rights.
Two years ago, the Colombian Constitutional Court decriminalized abortion in three circumstances: when the life or health (physical or mental) of the woman is in danger; when pregnancy is a result of rape or incest; or in the case of severe fetal malformation.
The historic decision was the result of a lawsuit submitted by Women's Link Worldwide, through the Colombian lawyer Mónica Roa. The complaint referenced the CEDAW recommendations to the Colombian State, particularly those suggesting action to reduce the high number of unsafe, illegal abortions.
In Colombia, about 350,000 abortions were occurring every year, according to estimations of health authorities.
Although Colombia is the only country in Latin America where regulations of pregnancy interruption were developed immediately after its partial decriminalization and according to the World Health Organization guidelines, just nearly 200 legal terminations of pregnancies have been accomplished since the Constitutional Court's decision.
In fact, there are still many barriers standing
in the way of women gaining access to this right.
Recently, a health care provider denied an abortion to a 13 year old girl who had been raped. The supervising physician argued a conscience objection. However, the regulations state that in such cases, all private and public hospitals are required to refer patients to other institutions that will perform the necessary procedures.
Some women who have been raped are told that a judge has to authorize the procedure, which is not the regulations adopted by the Ministry of Social Protection (Ministry of Health). In fact, when the pregnancy is a result of incest or rape, all that is required to secure abortion care is a copy of the complaint to the police and the autonomous decision of the woman, and no time limit is set for making the complaint or requesting an abortion.
The good news is that a Constitutional Court verdict established instructions aimed at ensuring that the right to legal abortion is respected and enforced. Such legal action sets a precedent which will likely result in a reduction of barriers to abortion among the public and private health care centers. And women are overcoming their resistance to submitting complaints to police in cases of rape in order to access a legal termination of pregnancy. They are surmounting their fears and starting an empowering process, and, in the long term, working against impunity around sexual assault crimes.
The bad news is that when doctors refuse to provide abortion care, citing a conscientious objection, the delays that result can lead to the need for a later-term abortion, which must be performed at a higher-level medical center.
Women whose lives or health are in danger
as a result of pregnancy are also facing obstacles to accessing legal
abortion. In some cases the patient is told that she needs permission
from a team of doctors specifically convened for that purpose. However,
the regulations say just a medical certification is required. Doctors hesitate because the regulations do not establish a specific
list of illnesses that can be used to justify an abortion in case of
risk to a pregnant woman's health or life.
As for cases when grave fetal malformations
make life outside the uterus unviable, "some doctors have denied to
certify such kind of malformations, even in cases when the fetus has
cerebral or cardiac problems," says La Mesa por la Vida y la Salud
de las Mujeres, a coalition
of civil groups promoting and facilitating access to and autonomous
decision making for legal, safe and timely abortions in Colombia.
In addition, the amniocentesis, the test
that detects malformations, is not included in the basic health plan;
consequently, many women cannot afford the price of such a test.
According to La Mesa por la Vida y la Salud de las Mujeres, the lack of information about the Court's 2006 decision and its regulations among women, health care staff and other authorities, is the main obstacle to ensuring women's access to this right.
Therefore, health care staff and police officers have to be informed about the national regulations of pregnancy termination, as well as trained on the way to approach women and regarding the information they have the right to know.
A massive information campaign is needed, so women can make an informed decision about whether or not to end a pregnancy.
The coalition has already carried out workshops in various cities, but there is still too much work to do in this regard. The State holds primary responsibility for ensuring that access to abortion services is respected, guaranteed and promoted. In fact, in its latest report to Colombia, CEDAW expressed concern about the possibility that Colombian women cannot access the legal abortion services that are rightfully theirs.
