In Latin America and the Caribbean - a region with one of the most stringent abortion laws and the highest unsafe abortion rates in the world - promoting reproductive rights and access to family planning remains a key challenge.
It’s an issue that high-level government officials and non-governmental organisations meeting next week in Uruguay’s capital Montevideo will discuss as part of a United Nations-led regional conference on population and development.
The conference in Uruguay is part of an ongoing review of progress made following the first international Conference on Population and Development (ICPD) held in Cairo in 1994. At that meeting, 179 governments adopted a 20-year action plan to reduce maternal mortality rates and improve reproductive healthcare, among other issues.
The landmark conference was billed as the first time countries came together to declare that reproductive rights are human rights, and that governments have an obligation to ensure those rights are put into practice.
Giving women the right to decide if, when and how many children they want to have involves providing them with contraception and other family planning options. This goes a long way in reducing the number of unintended pregnancies, unsafe abortions, and maternal deaths, the U.N. says.
So what progress has been made by governments in Latin America and the Caribbean on reproductive rights over the last 20 years?
“Overall, the region has a better understanding and recognition of women’s rights and reproductive rights in general,” said Fernanda Doz Costa, Americas researcher on economic, social and cultural rights at Amnesty International.
Access to emergency contraception for rape victims has improved across Latin America, said Doz Costa.
In recent years, Bolivia, Ecuador and Venezuela have enshrined reproductive rights in their country’s constitutions.
And several countries have eased their total bans on abortion. In 2006, Colombia's constitutional court ruled to allow abortion under certain circumstances. More recently last year, Uruguay’s senate voted to allow women to have an abortion in the first 12 weeks of pregnancy.
“But there are still gaps between laws and implementation. Access to health systems still depends on how much you can pay,” Doz Costa told Thomson Reuters Foundation in a telephone interview from Buenos Aires, on her way to the ICPD conference in Uruguay.
There are seven Latin America countries - Chile, Haiti, Suriname, El Salvador, Nicaragua, Honduras and the Dominican Republic - where abortion is completely banned, with no explicit exception written in law made to save the life of a woman.
In most other Latin American countries, it is only allowed in cases of rape or if a woman's health is at risk.
“Sexual and reproductive rights remain unrealised for many. Unmet need for family planning is high among adolescent and young people, indigenous and other excluded populations,” says the U.N.'s ICPD website ahead of the Uruguay conference.
The Roman Catholic Church’s lingering grip on Latin American politics, influence on society and public condemnation of abortion, as well as the rise of evangelical groups, are all factors behind the region’s stringent abortion laws, rights groups say.
Evangelicals and the Catholic Church argue that abortion infringes on the right of an unborn child, which should be protected by law at all costs.
Latin America’s tough abortion laws mean women are more likely to undergo dangerous backstreet abortions, which put their lives at risk. According to the World Health Organization (WHO), botched abortions are a leading cause of maternal death in all parts of the world, accounting for 12 percent of maternal deaths in Latin America and the Caribbean, based on 2008 figures.
It’s in Central America and the Caribbean where the least progress has been made on reproductive rights over the past two decades, rights groups say.
Take the case of a young woman known as Beatriz from El Salvador. In May, Beatriz, an ill woman carrying a malformed foetus, caused global outcry when the country’s Supreme Court upheld the outright ban on abortion even though her life was at risk and the foetus was unlikely to survive. She later underwent a Caesarian section, and survived the procedure, though her baby died.
In July, Chile's President Sebastian Pinera was criticised for praising the decision of an 11-year-old girl, who became pregnant as a result of being raped by her mother’s partner, to keep her baby as “showing depth and maturity”. In the socially conservative nation, abortion is totally banned.
Latin America is also known for its high teenage pregnancy rates.
In Colombia, for example, nearly 20 percent of teenage girls aged 15 to 19 have been or are pregnant, according to 2012 government figures. Similar teen pregnancy rates are found in the Dominican Republic, Bolivia and Ecuador.
Much more still needs to be done to ensure women and girls - especially those from indigenous and black communities living in rural areas - have better access to family planning and sex education, rights group say.
“Sexuality of adolescents is still something we can’t talk about in Latin America. Teenagers don’t have easy access to family planning,” said Amnesty’s Doz Costa.
“There’s still the attitude that adolescents don’t have sex, or if they are having sex it’s a family issue. Religious groups put pressure on governments to think this issue is a family one, which takes away a government’s obligation to provide family planning and sex education.”