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NICARAGUA
Abortion law fallout
Lorraine Orlandi
1/11/2007
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Nicaragua becomes the third nation in Latin America to ban abortions entirely.

Earlier this year, Ecipcia Chévez, a 28-year-old mother of two, had a life-threatening ectopic pregnancy, in which the fetus grows outside the uterus. Doctors terminated the pregnancy to protect Chévez’s life, but such abortions now are prohibited under reforms signed into law in November by outgoing President Enrique Bolaños, making Nicaragua the third nation in Latin America to ban abortions entirely, along with Chile and El Salvador.

"I would like to try again, but I’m afraid to get pregnant," Chévez, an instructor at the swimming school she owns with her husband, said at their modest home in the northern colonial city of Leon where they live with her two children, aged 9 and 11, from a previous marriage.

Her husband wants a child, she said, "but he is afraid of losing me."

The previous Nicaraguan law permitted therapeutic abortion when the woman’s life was in danger. Other acceptable circumstances were cases of rape, incest, and grave defects in the fetus such as anencephaly, where the brain fails to develop.

Bolaños, a conservative whose term ends in January, along with Catholic and other religious leaders who spearheaded the reform, argued that therapeutic abortion has been regularly used to perform elective abortions illegally, under the guise of protecting the mother’s life.

The president’s office said the new law aims to end "criminal acts disguised as therapeutic abortion, through which innocent children are executed daily in the mother’s womb." Women who receive abortions and the doctors and health workers who perform them in Nicaragua, face up to six years in prison.

Nicaraguan and international rights groups, medical associations and community organizations say the new ban will condemn thousands of women to death from pregnancy complications.

"The new penal code doesn’t just go against basic human rights: it goes against fundamental principles of humanity," said José Miguel Vivanco, director of the Americas Division for the New York-based Human Rights Watch.

Opponents of the law are asking Nicaragua’s Supreme Court to block the ban, arguing that it violates constitutional rights to life and equality for women, among other guarantees. They also plan to present a case to the Inter-American Commission on Human Rights in Washington.

Health experts and women’s groups predict a rise in Nicaragua’s already high maternal mortality rates, which United Nations Population Fund estimates to be 230 deaths per 100,000 live births.

In this largely Catholic nation built on a volcanic chain and marked by polarization, the emotional debate over abortion seems to reflect a shift in the political landscape.

The national assembly voted unanimously to pass the abortion ban just days before Sandinista leader Daniel Ortega won his presidential election bid on Nov. 5. (LP, Nov. 15, 2006) Lawmakers from Ortega’s leftist Sandinista Front supported it, in what pro-choice critics saw as a political bargain with Catholic and right-wing leaders (LP, Sept. 20, 2006).

"Ortega, [Eduardo] Montealegre and [José] Rizo condemned us to death," women’s groups including the Women’s Autonomous Movement, or MAM, said of Ortega and the top two conservative candidates.

Although the 1979 Sandinista revolution Ortega led helped redefine women’s roles in society, as many became rebel leaders and later joined the army and his Sandinista government, MAM and other feminist groups say Ortega sold out Sandinista ideals in his quest to return to power.

Poor women with limited access to maternal health care will be most vulnerable to the abortion ban’s dangerous consequences, say activists and health workers. Eight of 10 Nicaraguans struggle on less than US$2 a day.

"Women who can only go to public health services will die," said Marta Maria Blandón, director of the Central America arm of Ipas, a US-based reproductive rights organization.

Almost 2,000 Nicaraguan women receive therapeutic abortions at public hospitals each year, Blandón said. Health Ministry records show a far lower number, with only six such abortions recorded last year. But those did not include ectopic pregnancies and other abnormalities, which numbered more than 1,800 cases, most of which involved a severely malformed fetus. Figures for private facilities are unavailable.

Health ministry estimates put the number of clandestine abortions in Nicaragua as high as 30,000 a year. Blandón and others say the ban will not make much of a dent in those numbers for women who can pay for illegal procedures or leave the country to have abortions. Women without such resources, on the other hand, may face resistance to treatment at public hospitals or resort to dangerous methods at home.

In neighboring El Salvador, deaths among pregnant women have increased since a similar ban was imposed in 1998, Blandón said, although El Salvador’s maternal mortality rate remains lower than Nicaragua’s.

Right activists and health workers monitoring pregnant women at Nicaragua’s dilapidated city hospitals and ill-equipped rural clinics say they began seeing dangerous, possibly fatal repercussions even before the ban took effect.

In early November, 19-year-old Jazmina Bojorge bled to death at a public hospital in Managua two days after arriving with painful contractions five months into her pregnancy.

Authorities are investigating her death and that of the fetus, but her family, women’s rights activists and leaders in the medical community believe confusion and fear over the new abortion ban contributed to a delay in treating her properly.

"The penalty for therapeutic abortion is already claiming victims: the poor women of Nicaragua," said Ana María Pizarro, an obstetrician and director of the Managua women’s health clinic and nongovernmental organization, Sí Mujer. "If they had intervened immediately this would not have happened."

Such headlines worry Chévez.

Last May, two months pregnant, doctors found the fetus had begun to form in a fallopian tube and ruptured it, causing internal hemorrhaging.

Chévez begged her physician, Isabel Rizo, to save her baby. But Rizo said Chévez’s own life was at risk, and a fetus cannot normally survive in an ectopic pregnancy.

"We were not committing a murder," Rizo said. "We were saving the life of a mother of two children."


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