Abortion ban leads to more maternal deaths in Nicaragua
2009; Elsevier BV; Volume: 374; Issue: 9691 Linguagem: Inglês
10.1016/s0140-6736(09)61545-2
ISSN1474-547X
Autores Tópico(s)Global Maternal and Child Health
ResumoNicaragua's complete ban on abortion, which came into effect last year, has had a devastating effect on women in the country, say human-rights campaigners. Anastasia Moloney reports.A blanket ban on abortion in Nicaragua is endangering the lives of women and contributing to an increase in maternal deaths across the country, according to a report by Amnesty International.Dozens of pregnant women have died since the total ban on abortion—even in cases of rape, incest, and life threatening pregnancy—came into force in July, 2008. “Nicaragua's total ban on abortions has had a devastating impact on women in Nicaragua denying them life-saving treatment, preventing health professionals from practising effective medicine”, said Kate Gilmore, deputy general secretary at Amnesty International.According to the Nicaraguan Government, so far 33 women and girls have died while pregnant this year compared with 20 during the same period last year. The figure is believed to be higher as maternal deaths are under-reported by the government, according to Amnesty International.By law, obstetricians, gynaecologists, and family doctors can no longer legally provide emergency medical treatment to pregnant women and girls for life-threatening diseases, such as HIV/AIDS, and ectopic pregnancies, because of the potential risk to the fetus. “Treatment for obstetric complications has become a lottery. The treatment women receive depends not on what the Obstetric Protocols say, but on whether the individual doctor feels sufficiently confident to provide the best practice treatment and defy the law”, states the Amnesty report.The high-profile ban, which carries a maximum 14-year prison sentence for medical staff who carry out abortions, has created a climate of fear in which many doctors are too afraid to do abortions even if a women's life is clearly at risk. “I know of several cases where women with cancer and kidney problems died because they could not get treatment. If they could have had therapeutic abortions, they would still be alive”, said Leonel Arguello, a Nicaraguan doctor.Victims of sexual violence, most commonly girls aged between 10 and 14 years, who have been raped by close family members or friends are being compelled “to give birth in many instances to their own brothers or sisters”, says Amnesty International.The human-rights organisation also highlights a recent rise in the numbers of pregnant teenagers committing suicide by consuming poison.With no legal alternatives, more women are being forced to seek backstreet abortions, said Arguello. “Some women, especially girls, who have been victims of rape and incest, will do whatever it takes to get a backstreet abortion where unsafe and unhygienic abortions are being practised. Adolescents are dying as a result.”The effect of the country's abortion laws has been most obvious among poor women and girls, especially those living in rural areas. Richer and better-educated women can fly to the USA or seek a costly and illegal abortion in the capital Managua. Women are also dying because they are too afraid to seek medical help, often life-saving treatment, for fear of mistreatment and discrimination by medical staff, as well as the threat of prosecution by the authorities, according to the Amnesty report.Abortion in Nicaragua is a highly charged political affair. Ahead of the hotly contested 2006 elections that brought the Sandinista party, headed by leftist Daniel Ortega, back to power after years in opposition, the party enthusiastically backed calls from the Roman Catholic Church to ban abortion under any circumstances, overturning a legal provision that had permitted life-saving abortions in Nicaragua since 1893.Some Nicaraguans, like Arguello, believe the country's strict abortion laws were endorsed by the country's major political parties to secure votes during the last presidential elections and gain the support of the Roman Catholic Church and the Evangelical Church. “The abortion ban is the result of a political deal between the Church and the Sandinista ruling party”, said Arguello. “It was done to ensure that the Sandinistas could secure votes they needed to get into power, so it's unlikely that the ban will be overturned while they remain in power.”Nicaragua is one of a handful of countries in Latin America, along with Chile, the Dominican Republic, El Salvador, and Honduras, where abortion is prohibited under all circumstances. Only 3% of the world's countries have such absolute bans in place. Nicaragua's complete ban on abortion, which came into effect last year, has had a devastating effect on women in the country, say human-rights campaigners. Anastasia Moloney reports. A blanket ban on abortion in Nicaragua is endangering the lives of women and contributing to an increase in maternal deaths across the country, according to a report by Amnesty International. Dozens of pregnant women have died since the total ban on abortion—even in cases of rape, incest, and life threatening pregnancy—came into force in July, 2008. “Nicaragua's total ban on abortions has had a devastating impact on women in Nicaragua denying them life-saving treatment, preventing health professionals from practising effective medicine”, said Kate Gilmore, deputy general secretary at Amnesty International. According to the Nicaraguan Government, so far 33 women and girls have died while pregnant this year compared with 20 during the same period last year. The figure is believed to be higher as maternal deaths are under-reported by the government, according to Amnesty International. By law, obstetricians, gynaecologists, and family doctors can no longer legally provide emergency medical treatment to pregnant women and girls for life-threatening diseases, such as HIV/AIDS, and ectopic pregnancies, because of the potential risk to the fetus. “Treatment for obstetric complications has become a lottery. The treatment women receive depends not on what the Obstetric Protocols say, but on whether the individual doctor feels sufficiently confident to provide the best practice treatment and defy the law”, states the Amnesty report. The high-profile ban, which carries a maximum 14-year prison sentence for medical staff who carry out abortions, has created a climate of fear in which many doctors are too afraid to do abortions even if a women's life is clearly at risk. “I know of several cases where women with cancer and kidney problems died because they could not get treatment. If they could have had therapeutic abortions, they would still be alive”, said Leonel Arguello, a Nicaraguan doctor. Victims of sexual violence, most commonly girls aged between 10 and 14 years, who have been raped by close family members or friends are being compelled “to give birth in many instances to their own brothers or sisters”, says Amnesty International. The human-rights organisation also highlights a recent rise in the numbers of pregnant teenagers committing suicide by consuming poison. With no legal alternatives, more women are being forced to seek backstreet abortions, said Arguello. “Some women, especially girls, who have been victims of rape and incest, will do whatever it takes to get a backstreet abortion where unsafe and unhygienic abortions are being practised. Adolescents are dying as a result.” The effect of the country's abortion laws has been most obvious among poor women and girls, especially those living in rural areas. Richer and better-educated women can fly to the USA or seek a costly and illegal abortion in the capital Managua. Women are also dying because they are too afraid to seek medical help, often life-saving treatment, for fear of mistreatment and discrimination by medical staff, as well as the threat of prosecution by the authorities, according to the Amnesty report. Abortion in Nicaragua is a highly charged political affair. Ahead of the hotly contested 2006 elections that brought the Sandinista party, headed by leftist Daniel Ortega, back to power after years in opposition, the party enthusiastically backed calls from the Roman Catholic Church to ban abortion under any circumstances, overturning a legal provision that had permitted life-saving abortions in Nicaragua since 1893. Some Nicaraguans, like Arguello, believe the country's strict abortion laws were endorsed by the country's major political parties to secure votes during the last presidential elections and gain the support of the Roman Catholic Church and the Evangelical Church. “The abortion ban is the result of a political deal between the Church and the Sandinista ruling party”, said Arguello. “It was done to ensure that the Sandinistas could secure votes they needed to get into power, so it's unlikely that the ban will be overturned while they remain in power.” Nicaragua is one of a handful of countries in Latin America, along with Chile, the Dominican Republic, El Salvador, and Honduras, where abortion is prohibited under all circumstances. Only 3% of the world's countries have such absolute bans in place.
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