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Abortion in Chile: addressing the false debate of "pro-life vs pro-death"

Chile is one of only four countries in the world that prohibits all abortion, but for the first time in 25 years a law on therapeutic abortion is being seriously considered.

Inés Giménez
4 June 2015

 "In six years, we have answered more than 25,000 calls of women asking for advice on how to carry out a safe abortion at home, we have compiled public information about it, and produced a guide… through several campaigns we have set on the agenda the abortion as an issue to be discussed not in moralistic terms, but as a gender rights issue and as a public health problem in Chile,” states Mafe Barrera who works for Safe Abortion Phone Line (Línea Aborto Seguro), an autonomous initiative that has been providing information on how to use misotrol safely since 2009..

Linea Aborto Seguro operates from Concepcion, a town in the South of Chile, in one of the most restrictive environments in the world in terms of  sexual and reproductive rights. The current Chilean legislation dates from the Pinochet dictatorship which  abolished the article 119 of the Health Code in 1989, and makes Chile one of the four countries in the world that prohibits interruption of a pregnancy under any circumstances. Despite this severe prohibition, thousands of abortions are performed every year clandestinely in the country. Due to the lack of regulation, the data is incomplete, but numbers range from 33.830 hospital admissions after abortion in 2014 according to the National Health Service (SNS) registry, to 70.000 clandestine abortions calculated by the University Diego Portales, and between 120.000-160.000 abortions according to data included in the report to CEDAW in 2013.

Some of these abortions are carried out on children. According to the official data highlighted by Doctor Guillermo Galan and the organization Miles, in 2014, 72 girls under 14 became pregnant as a result of a sexual violence, and around 1000 girls under 15 fall pregnant in Chile every year. "Many of them are pregnant because of rapes or after incestuous relationships with their stepfathers… we owe it to them to take action, and we have to do something urgently. Just for this reason alone it would be worthwhile to adopt the bill proposed by the Executive", states Dr Galan, a gynaecologist who has worked in sexual and reproductive health for more than 40 years, and one of the increasing medical voices now speaking out openly about this issue in Chile.

On 31 January this year, President Bachellet submitted a bill on the termination of pregnancy. It regulates the therapeutic abortion under three clauses: a risk of death for the pregnant woman, a congenital malformation in the foetus incompatible with life, and a pregnancy as the result of a sexual violence. Since 1990, thirteen bills to decriminalise abortion have been submitted by different parliamentarians, but all of them were rejected before being discussed on the basis that they violated the right to life established in the Constitution of 1980 under the Pinochet dictatorship. Under today's presidential system, the bill proposed by Bachellet - a compilation of the previous bills - is finally being discussed at the Health Commission of the Deputies Chamber.

The General Secretary of government and the health sector are supporting the debate, and the director of the National Service of Women (SERNAM) in the Bio Bio region, Valentina Medel, says, "although this debate is taking place in the Parliament, women are the ones who decide over their bodies (…) and we want all women with their respective differences to understand that the spirit of the bill undoes the false debate between “pro-life versus pro-death"..

Safe abortions and the black market

However, the debate in the country is polarized. Many feminist groups consider the bill insufficient because it only regulates abortion under certain, and not statistically representative, circumstances. Meanwhile the  most conservative groups and churches are conducting an intense campaign claiming the “right to life of the unborn“.

The lesbian feminist women group running Safe Abortion Phone Line are clear about their experience: out of the 25.000 cases they have attended, 25% women wanted to abort because their economic situation was incompatible with having a child, 33% because the pregnancy and maternity was incompatible with their plans in life, 18% did not want to continue with a pregnancy that was a result of male violence, 10% had an illness, 10% planned a life without children, 4% gave no reason.

Mafe Barrera says, "nowadays we have enough biotechnologies to induce safe abortions autonomously, thanks to Misotrol, a medicine originally produced as a gastrointestinal protector that has been appropriated by the feminist movement. Therefore, we do not need to be submitted to medical control, inquires, judgment, surgical intervention and obstetrical violence, because women can have an abortion at home, taking control over their bodies".

“The former government of Bachellet controlled and restricted the use of Misotrol in 2009. It pushed the women who need it to obtain it on the black market, with the resulting speculation, price increase and associated adulteration risks,” adds Carla, also from the Line. “Also, women that practice abortions have some degree of juridical risk: if they have complications and go to the health services, they face a potential denunciation to the police by the health professionals. We have heard about cases where women were chained to the bed until the health workers stop the bleeding; so we recommend women to use sublingual misoprostol because it stays less time within the body than if introduced through the vagina“. “If the Bachellet government wants to do something for women, it should provide information and it should release misotrol, that was controlled and restricted under former government in 2009“, adds Paulina who thinks that the current bill will block the abortion debate “for another 100 years“.

Dr Galan recalls a time in the 1970s when clandestine abortions were performed surgically, and when many women arrived with serious troubles to the Public Hospital where he used to work. “I saw many women dying, the suffering of women, and tons of blood transfusions in the rooms of the hospitals. That pushed me to commit myself to reproductive health issues”. The first time that he heard about misoprostol (the generic formula of misotrol) was in the 1980s in Brazil where the commercialised medicine was cytotec. Soon after, it came to Chile, and most of the surgical clandestine abortions disappeared, as they were very expensive (between 400.000 and 2 million pesos in a country where minimum salary is 200.000 pesos) and misotrol was much safer.

Religious objections and international obligations

Religious and politically conservative voices oppose the therapeutic abortion initiative as an offence against the life of the unborn child even under the three clauses registered in the presidential bill. As a conservative Senator Ena Von Baer said in a debate two years ago in a much mocked comment that went viral on YouTube: “women do not own their bodies, women lend their bodies to host a new life.” The Catholic and some Evangelical churches have also conducted intensive miscommunication campaigns claiming that abortion is “the most traumatising experience a woman can be submitted to” and organising massive actions such as a national tour with a famous Virgin.

Some feminists groups occupying the middle ground, consider that moving forward in the debate is only possible if the bill that regulates therapeutic abortion under three clauses is passed, mainly because polls conducted by the University Diego Portales, FLACSO and Humanas reveal that between  43% to 80% of the population support a therapeutic abortion law, while a law regulating all types of abortions is much less popular. This is the case with Miles Chile, an organisation that recently launched a polemic and effective campaign. “We essentially back the law because it represents a step forward in the current state of affairs, although we think that some of its elements can be improved. For instance, we should consider, as a first clause “risk to life and/or health” and “health” involves a broad range of aspects beyond the biomedical concept of health, such as cultural, social, economic and psychological health aspects during the pregnancy but also for the future of a woman. We hope that the deputies will listen to the experts and make recommendations to improve the bill”.  

In addition to this, both Miles and Humanas state that Chile has signed several international agreements including the Convention on the Elimination of All Forms of Discrimination against Women, Beijing+15 Beijing+20, the Commission on the Status of Women and the "Convention of Belem do Para" of the Organisation of American States (OAS). Alejando Guajardo, from Miles, says, "Chile normally signs all the international treaties and conventions, and takes part in gender rights conferences, however it randomly complies with theses treaties, and neither it complies with the OAS mandate, as is evident in the fact that for many years the country has not responded to five of the calls made by the OAS in regards to sexual and reproductive health, particularly concerning the abortion".

For Valentina Medel, the bill is a step forward in complying with international obligations. In addition to the abortion law, SERNAM and the newly establishes National Ministry of Women are working on a bill on sexual and reproductive rights that promotes access to information, secular education, and more work on women's access to contraception. The current debates are, in one way or another, paving the way for  discussion of some of the key unresolved issues in Chile.

 

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