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Telephone hotlines mount fight against backstreet abortions in South America

Source: Thomson Reuters Foundation - Mon, 25 Feb 2013 11:18 GMT
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By Anastasia Moloney

BOGOTA (TrustLaw) – When Carolina answers an evening call in the Chilean capital of Santiago, she is acutely aware that she could be giving potentially life-saving information to a woman on the other end of the line.

Carolina is one of 30 self-described “militant feminist” volunteers who run an abortion hotline in Chile, providing information to women about how they can induce an abortion using the drug misoprostol.

The World Health Organisation recommends misoprostol, both taken on its own and combined with another drug mifepristone, as a safe and effective way for women to have an abortion in the first trimester of pregnancy.

In a country where abortion is a crime under any circumstances – even in cases of rape, incest or if the life of the mother or foetus is in danger – the hotline has become a lifeline, offering women a way to sidestep Chile’s blanket ban.

“Regardless of any laws, if a woman feels she needs an abortion she will get one. We know women in Chile have abortions every day. Abortion is a reality,” said Carolina, a volunteer at Lesbians and Feminists for the Right to Information, the Chilean group that runs the hotline.

“What we aim to do is to help women avoid having unsafe and clandestine abortions. The phone line is our strategy to fight that,” Carolina told TrustLaw in a phone interview in Santiago.

Originally invented as an ulcer drug, misoprostol induces an abortion by causing contractions of the uterus and is from 75 to 90 percent effective when taken correctly, WHO says.

Neither misoprostol nor mifepristone is risk-free and incomplete abortions can happen. But doctors say inducing an abortion with oral drugs rather than a surgical operation means it is less likely for an infection or a uterus perforation to occur.

UNSAFE ABORTIONS

In much of Latin America, Asia and Africa, restrictive laws or blanket bans on abortion force millions of women with unwanted pregnancies to have illegal and often unsafe abortions every year, according to WHO.

Some 47,000 women die from botched abortions each year around the world, says WHO. In Latin America meanwhile, deaths from botched abortions, often caused by severe bleeding, infections or a combination of both, account for 17 percent of maternal deaths in the region, the United Nations agency says.

That is why volunteers like Carolina are adamant it is vital to give women the information they need to stop preventable deaths from unsafe abortions.

“All women have the right to know about how to get a safe abortion,” Caroline, 32, said.  

Since the hotline started in 2009, it has received more than 12,000 calls, up to 15 a day.

Sometimes it is a single mother of three who says she cannot afford to have another child. Other times, it is a young woman who does not feel ready to be a mother.

“We receive calls from young, old, poor, rich, married, single women, those with children and those without. Abortion is something that affects all kinds of women in Chile,” said Carolina, a sociologist.

Chile, like much of Latin America, is predominantly Catholic and the Catholic Church and conservative lawmakers argue that abortion infringes on the right of an unborn child, which should be protected by law at all costs.

Abortion, therefore, is both a taboo issue in Chile and a crime that can lead to imprisonment for those who perform abortions or assist on them. Because of this, hotline volunteers prefer to keep a low profile. They wear masks when promoting the hotline at public meetings and most choose not to give their full names.

It also means volunteers like Carolina are careful to only share public information with callers over the age of 18 based on a script approved by a lawyer. 

“We don’t convince women to have an abortion. All women who call have already made up their minds to have an abortion,” said Carolina.

“We just provide women with information about how to have a safe abortion using misoprostol, correctly following WHO protocols.”

BLACK MARKET PILLS

On top of the country’s absolute ban on abortion, women in Chile face the additional challenge of getting hold of misoprostol.

The drug was pulled off pharmacy shelves in Chile, where it had been available with a prescription, under Michelle Bachelet, the former first female president of Chile, who now heads the U.N. Women’s agency.

It means women have to try their luck on the black market. It costs around $250 for the 12 pills needed for an abortion.

Chile's safe abortion hotline was the brainchild of Dutch doctor and former Greenpeace activist, Rebecca Gomperts. Through her pro-choice group, Women on Waves, Gomperts has helped launch the abortion hotline in Chile, along with hotlines in Argentina, Ecuador, Peru and Venezuela.

“Medical abortion is such a revolution. Women …  can take their health, and life, in their own hands,” Gomperts told TrustLaw in an interview last year.

“PUSH AND PULL”

In Chile, any moves to decriminalise the country’s abortion laws are still a long way off, Carolina says.

“Chile is a very, very conservative country in all senses. The opinion of the Catholic Church holds a lot of weight in Chile. Maternity is seen as something sacred,” Carolina said.

“Currently, it’s not a priority among Chilean lawmakers to change the abortion laws and push for reform. Abortion isn’t an important issue in public debate.”

While there’s little headway on reproductive rights in Chile, elsewhere in Latin America attitudes have been changing.

In Colombia, for example, an absolute ban on abortion was partially lifted in 2006. A year later, abortion was made legal in Mexico City during the first 12 weeks of pregnancy and more recently last year in Uruguay.

“There’s a push and pull going on in Latin America,” Marianne Mollmann, a senior policy advisor on sexual and reproductive rights at Amnesty International, told TrustLaw.  “The countries that are stuck are Central America and Peru.”

As for Chile, the country remains a bastion for strict anti-abortion laws that force women to rely on underground activists and their telephone hotline to get a safe abortion.

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