Thursday, October 6, 2016

Abortion in Uruguay & Law 18.987

Pro-choice activists in Uruguay have scored major victories over the past few years, but continue to fight to ensure that progress isn't repealed.

By: Courtney Mihocik
Produced & edited by:Alex Lumley

There are many ways to voluntarily end a pregnancy. Among them are low doses of poison, abuse of alcohol and drugs, self-inducing abortion pills, and doctor-performed abortions. 

Women who seek out services for unsafe, clandestine abortions and misuse medicine like misoprostol, which is normally used for preventing and treating ulcers, are using these services because voluntarily ending a pregnancy is illegal where they live.

"This marks the dawn of a new era in reproductive rights and women’s health in Uruguay, one of two Latin American countries with legalized abortion."

This is the situation that Uruguayan women looking to discontinue an unwanted pregnancy once faced, and in many cases still face.

According to the World Health Organization, between 1990 and 2000, the maternal mortality ratio in Uruguay hovered in the 30s, only dropping slightly from 37 in 1990 to 36 in 1995 and then 31 in 2000.

Mujer Y Salud en Uruguay, or Women and Health in Uruguay in English, released a video, “Abortion in Uruguay: Feminist chronology of a fight.” In this video, MYSU reported that in the middle of the economic crisis of 2001, four women died in clandestine abortions and two were prosecuted for abortion in Montevideo and Pando. The video also reported that there were 33,000 clandestine abortions in 2003.

These same statistics are echoed in the United States. According to NARAL Pro-Choice America’s “The Safety of Legal Abortions and the Hazards of Illegal Abortion” report, before the 1973 Roe v. Wade decision, an estimated 1.2 million women in America resorted to illegal abortions every year. Of those illegal abortions, 5,000 women died annually.

The scene at a 2012 protest in Uruguay advocating for the legalization of abortion. Photo courtesy of Flickr user Érico Matos.
Enter: Law 18.987 in Uruguay, approved Sept. 15, 2012, and de-penalized abortion. This marks the dawn of a new era in reproductive rights and women’s health in Uruguay, one of two Latin American countries with legalized abortion.

According to MYSU researcher, Santiago Puyol, the law, otherwise known as interrupción voluntaria del embarazo, or Voluntary Interruption of Pregnancy, allows termination of pregnancy with no particular reason in the first 12 weeks and the first 14 weeks in cases of sexual assault resulting in a pregnancy. There are no temporal limits in cases where the pregnancy poses health risks to the mother or the child will suffer extra uterine life malformations.

The Struggle Is Far From Over

Despite this progressive law, the political climate in Uruguay fostered an atmosphere calling for a referendum of the law and stigmas weigh heavily on women who are considering an abortion or have gotten one.

Organizations like MYSU played a role in developing and defending the law and providing support and health education to women.

Puyol works in the organization’s National Observatory on Gender and Sexual and Reproductive Health, one of the organization’s main areas of focus. Since the law’s approval, this department monitors women’s health services -- abortions, prenatal care and reproductive and sexual health -- that were installed due to the law’s approval. 

MYSU defended the law against anti-abortion conservatives and gynecologists who oppose the law through conscientious objection, or the refusal of performing abortion services for religious or moral and ethical reasons.

Despite abortion's legality, some in the United States
as well as Uruguay fight to repeal the laws that make it so.
Photo courtesy of Wikipedia user John Stephen Dwyer.
Conscientious objection is an ethical law for professionals who practice medicine, according to midwife obstetrician and executive director of Iniciativas Sanitarias in Montevideo, Ana Gladys Labandera.

Labandera explained that it is preferred that professionals who use conscientious objection do not work in sexual reproduction health or interruption of pregnancy services. Otherwise, women may not receive the correct consultation and information needed to make decision.

"Knowing the weaknesses and strengths of these services created by the law is one way to prevent the opposition overcoming what has been gained so far.”

Less than year after the Voluntary Interruption of Pregnancy law, politicians and pro-life conservatives began a campaign to gather enough signatures for a referendum of the law, Puyol said. With other pro-women’s health organizations, MYSU used campaigns like “Yo no voto. Y vos?,” “I won’t vote [for the referendum]. And you?” to defend the law.

The goal was not just to avoid the overturning of the law, but also to explain the importance of law 18.987 to push Uruguayan society toward progress.

Gathering information and using it is also one way of acting against opposition, knowing the weaknesses and strengths of these services created by the law is one way to prevent the opposition overcoming what has been gained so far,” Puyol said. “But also a way of thinking how to keep deepening the progressive change.”

Even with legal progressive change with the installment of the law in Uruguay, social progress is lacking. Although legally, women can seek out a voluntary interruption of pregnancy, Puyol said that between healthcare personnel perpetuating stigmas and the fear of being rejected by communities and personal support system, it is difficult for women to access safe services.
Labandera believes the stigmas are in the verbiage of professionals.

"The stigma is present in the attitude and in the words that the professionals use to do the assessments," she said.

As great as it is for a small country tucked away along the eastern coast of South America to have voluntary interruption of pregnancies legalized, there is room for improvement within the law, Puyol said.

Progress Takes Time
Unfortunately, these changes are not likely to happen soon. But it is possible.
Certainly, there are possibilities of improvement within the law,” Puyol said.

“Even though the political climate isn't as favorable for progressive changes as it was during the previous presidential term and legislative period.”

Current president of Uruguay, Tabaré Vázquez, has spoken out against abortion and in his previous presidential term, vetoed a law that would have allowed abortion in Uruguay four years before law 18.987, according to Puyol.

Despite the need for improvement, it is important to applaud Uruguay’s progress in health rights and women’s reproductive health, and the unfavorable political climate does not stop groups like MYSU from fighting for more change.

“Since finding problems in the implementation of sexual and reproductive health services, and particularly legal abortion services, we’ve been in contact with the Ministry of Health, the press, the health services providers and other social organizations,” Puyol said. “[We’re] working different angles to try and come with solutions to those problems or obstacles that arise in our investigations.” 

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