[NYTr] COHA on Nicaragua's Murderous Abortion Ban
 
Date: Wed, 12 Dec 2007 16:17:12 -0600 (CST)

Via NY Transfer News Collective  *  All the News that Doesn't Fit
 
Council on Hemispheric Affairs - Dec 11, 2007
http://www.coha.org/2007/12/11/to-risk-not-saving-a-life-abortion-ban-in-nicaragua-and-its-societal-implications/

To Risk Not Saving a Life: 

Abortion Ban in Nicaragua and its Societal Implications

 by COHA Research Associate Michael Glenwick 

    * A born-again Marxist now upholding an ultramontane pedigree,
President Daniel Ortega has puzzled both sides of the political
spectrum.

    * The Church has taken on an incredibly influential role when it
comes to issues of social justice and personal rights.

About a month ago, 22-year-old Olga Reyes was suffering from an ectopic
pregnancy in which a fetus develops outside of the uterus, making its
survival an impossible outcome. Such a pregnancy also can put the
mother in grave danger, as there is a risk of excessive bleeding that
can lead, in extreme cases, to death. Unfortunately, this is exactly
what occurred in the case of Reyes. If an ectopic pregnancy goes
undetected, the only chance to minimize death or injury of the mother
is to terminate the pregnancy through an abortion. In most
countriesbeven many of the most conservative onesbabortions are
permitted when a motherbs life might be in danger.

Reyes, however, was Nicaraguan, and since November of last year, all
forms of abortion (including those in which a motherbs life may be in
danger) have been illegal. Because an environment of fear has been
created by the Churchbs behavior, most Nicaraguan doctors are hesitant
to treat cases like that of Reyesb. Her doctors at Bertha Calderon
Maternity Hospital refused to intervene, even when an abortion could
have potentially saved her life. A little more than a year ago, Reyes
would have been alive; the abortion ban was not in effect, and
abortions were permitted in extreme circumstances like hers. Since
being enacted in November of last year, the abortion ban has left an
indelible mark on Nicaraguan society, necessitating an evaluation of
the roles of religion, public health, and gender in the country.

Religion

Nearly three-fifths (59 percent) of Nicaraguabs population is Roman
Catholic. As a result, the opinions of the Church community are held in
the highest of esteem, and Church beliefs are treated as scripture. For
instance, a decade ago, there was a good deal of controversy
surrounding a Catholic-supported movement to flood the countrybs public
schools with textbooks produced by the Catholic archdiocese of Managua.
Such efforts to influence Nicaraguabs future generations with
pro-Catholic textbooks indicated the length to which the Church would
go in its efforts to influence the countrybs social policies.

The abortion ban, although more prone to receive mass media attention
than the use of Catholic textbooks in Nicaraguabs public schools, is,
to a certain degree, similar in that it is another example of the
strength of the Churchbs ongoing power and the Faustian bargain Ortega
was prepared to make. In 2006, with legislation related to the abortion
ban about to come up in the National Assembly, Nicaraguans were
anxiously waiting to see which side of the debate the three main
presidential candidates would take. Future President Daniel Ortega (who
once declared himself to be an atheist) had recently started attending
Catholic services, according to a 2006 article in Pine Magazine.
Although he was the most leftist liberal candidate in the race when
compared to the two social conservatives against whom he was running,
Ortega knew he could not win the general election without attracting
the necessary support of at least some of the more conservative
Catholics in Nicaragua. As a result, when the movement to enact the ban
began prior to the election, Ortega said and did nothing to oppose it.
In order for him to win, Ortega undoubtedly (and probably correctly)
believed that he would need to cater to some of the more symbolically
important forces to be found in Nicaragua, among the Church and its
constituents.

Given Ortegabs rapid change of heart on matters of great importance to
the party, many former Sandinistas who once were close allies of his,
were amazed at what appeared to be Ortegabs opportunistic nature
regarding a number of key issues. Having once been an ardent atheist
and foe of Cardinal Obando and Church strictures, Ortega now became an
active opponent of the right to an abortion and a supporter of Obando
and the primacy of the Catholic Church. Yet soon after victory,
however, Ortega seemed to switch sides once again, coming out in
support of Venezuelan President Hugo Chavezbs Bolivarian Alternative
for the Americas (ALBA). In addition, it should certainly be noted
that, at the time of his support of the abortion ban, Ortega also was
anxious for the Church to prove forgiving for his own alleged sexual
abuse shortcomings regarding his young step-daughter.

Interestingly, some of the leaders of the Catholic Church have used
recent technological and scientific break-throughs in medicine to make
the claim that a country can be consistent with Catholic principles
without ever putting the life of the mother in danger. Henry Romero, a
priest, was quoted last month in an Associated Press story saying that
bwhen two lives are in danger, you must try to save both the woman and
the child. Itbs difficult to say now that it isnbt possible to save
both.b Church leaders often cite somewhat questionable interpretations
of scientific findings that claim that, because of major improvements
in the field, one no longer has to balance the religious anti-abortion
message with the idea that a motherbs life must be protected at all
costs.

The Churchbs Heavy Hand

Yet the problem is that, in certain (admittedly rare) cases, the
motherbs life still may be put in jeopardy, even with the remarkable
advances in science. Meanwhile, Church leaders like Managuabs current
Archbishop Leopoldo Brenes (who led the successful movement to ban all
abortions in El Salvador) and its retired Archbishop, Miguel Obando,
refuse to admit that therapeutic abortionsbabortions that are necessary
to save the life of the motherbare necessary. As Brenes told the
Washington Post a year ago: bThis idea of btherapeutic abortionb was
being abusedb&.People were easily getting doctors to say that the
abortion was being done to save the motherbs life, when in reality it
was a person who just said, bI donbt want this child.bb Although, to an
extent, he might have been right to some extent, he still has chosen to
ignore the more scientifically orthodox statements put forth this
October by Human Rights Watch (HRW). In its report on this subject, the
organization noted that, no matter how far we have come scientifically,
the need for therapeutic abortions never will be entirely eliminated.

For the past 115 years, largely because of religious factors, almost
all abortions were banned in Nicaragua (excluding therapeutic
abortions, which could have saved Reyesb life), highlighting the
critical role religion has had in Nicaragua for quite some time. Yet
the 2006 ban, which even prohibits those abortions that can save a
motherbs life when she is in danger, indicates that the Catholic Church
has taken on a newer and bolder position in Nicaraguan society and
politics. The HRW report on the abortion ban cited the Center of
Reproductive Rightsb research, which says that, along with Chile and El
Salvador, Nicaragua is one of only three countries in the world with an
entire bblanket banb on abortion. Only in countries where the influence
of religion is so great could such a ban be possible. When a protest
against the ban was organized in Nicaragua last October, the Catholic
Church immediately mobilized more than 3,000 militants to march in the
street in support of it. With the Church being able to count on such
numbers in so short amount of time, there is no question regarding its
influential sway, particularly when contrasted with citizens (of
Nicaragua and elsewhere in the region) who have been trying to reverse
the ban with few resources to do it.

Although the weight of Nicaraguabs Catholic community has been one of
the central factors in putting the ban into effect, it should be noted
that not all Catholics in the country support the prescription. In
addition to the significant portion of the population opposed to the
ban, some Catholics have bswitched sidesb to now support therapeutic
abortions (and, in some cases, other forms of abortion). For example,
Catholics for Free Choice in Nicaragua, an organization made up of
Nicaraguans who support abortion in certain cases, has mobilized some
of the population to protest the ban, as it believes the ban will lead
to tensbif not hundredsbof avoidable maternal deaths.

Public Health Aspects

There has been little debate among members of Nicaraguabs medical
community regarding the pros and cons of the abortion ban, given the
fact that 95 percent of the members of the countrybs National Society
of Obstetricians believe that, at the very least, therapeutic abortions
should be permitted. Yet, given the fact that there is a growing sense
of fear of prosecution among Nicaraguabs or even the cancellation of
onebs license as a result of malpractice proceedings, even legal
pregnancy-related operations have become less likely. For instance,
treatments for hemorrhaging women have declined due to a prevalent
culture of fear. Doctors simply do not want to get involved in matters
relating to difficult pregnancies, as they worry that they may be
putting their careers at risk. As Dr. Oscar Flores Mejia of Nicaraguabs
National Society of Obstetricians and Gynecologists told the Boston
Globe in 2006, after the ban was put in place: bThis law is forcing us
to be delinquent on our jobs.b

Underground Abortions

Another reason that many of Nicaraguabs obstetricians are so opposed to
the ban is the fact that Nicaraguaband Latin America in generalbhas had
a very high rate of unsafe abortions for a long period of time. It is
often hard to make a compelling case for a therapeutic abortion, and,
as a result, many Latin Americans resort to unsafe methods to eliminate
their fetuses. For example, in Chile (where, like Nicaragua, abortion
is entirely proscribed), more than 30,000 woman suffer injuries because
of unsafe abortions each year. In fact, according to the Alan
Guttmacher Institute, Latin America has the worldbs highest rate of
maternal deaths due to unsafe abortions, with slightly more than
one-fifth of all pregnancy-related deaths caused by unsafe abortions.
Such bback-alleyb abortions often require desperate pregnant woman to
use hangers or unsafe medicines to expel the fetus from the womb. Of
course, such practices occur mostly in countries where an abortion is
illegal or hard to obtain. The World Health Organization, too, has made
similar findings regarding the high rate of unsafe abortions in Latin
America, advocating the position that something should be done to
alleviate the problem. If one adds such a problem to the fact that it
has been only a little more than a year since the ban was put into
place, there is a growing fear that the abortion policy in Nicaragua
could put the country on an even more dangerous road to a continued
elevation of unsafe abortions and, more than likely, deaths.

The ban has also brought back to the spotlight the stormy issue of
contraception in Latin America. Due to both the influence of the
Catholic Church and to the ineffective methods of sex education in the
country, it can be very difficult for teenage girls in Nicaragua to
receive informational and practical tools necessary to prevent
undesired pregnancies. Furthermore, it should be noted that, when young
girls (and, for that matter, boys) are taught about sex and pregnancy
prevention, they are not necessarily provided with accurate
information. According to the previously mentioned Guttmacher Institute
report, almost half of all Nicaraguan women have at least one child
before they reach the age of twenty. It also states that b36 percent
[of sexually active women between the ages of 15 and 19] have an unmet
need for effective contraception.b As a result, such studies and
reports highlight the fact that aspects of the recent abortion ban are
much more than a simple case of domestic policy making; rather,
Nicaragua and, to an extent, other Latin American countries, have been
unsure of how to responsibly handle pregnancy and maternity issues for
decades.

The ban brings back the longstanding debate that many Nicaraguans have
had about the pros and cons of abortion and contraception, among other
sexual health matters. Given the inadequacies in the governmentbs
education of its citizens regarding the provision of accurate
reproductive health information, one must question how eager the
country is to repair its image. Although cases like Reyesb do not occur
every day, the Pan American Health Organization reported that, in 2005,
there were 397 ectopic pregnancies; given the fact that deaths from
such pregnancies can be avoided without an abortion if they are
detected early enough, educating Nicaraguabs population is now more
important than ever and more urgently needed in a timely manner.

Gender and Womenbs Rights

Although not as prominently discussed in the press as the abortion
banbs relationship to religion and public health, the equally critical,
if widely ignored matter of womenbs rights and gender roles in
Nicaraguan society also has been brought to light. In 2002, after an
eight-year-old girl was raped and as a result became pregnant, she and
her family fought to have an abortion. When Nicaraguan Assemblyman
Wilfredo Navarro was asked about the case in the aforementioned Boston
Globe article, he responded that bb&she should have the baby because
that child has rights.b Although one can sympathize with the fact that
the Assemblyman wanted to protect the rights of the unborn child, his
marked lack of empathy for the rape of a young girl and the problems
that it would cause for her and her family has to be noted as an
alarming indicator of the state of female rights in the country.

As a male, Navarro is unlikely to have had to deal directly with
pregnancy (let alone pregnancy following rape), and if anything, he
shows a lack of sensitivity, respect and understanding for the rights
of half of Nicaraguabs population. Such attitudes appear to be
pervasive among the highest ranks of Nicaraguabs political and
religious elites. The abortion ban was motivated largely by the leaders
of the Catholic community in the country and in the region, many of
whom have never consistently shown much sympathy for the plight of
women citizens. The aforementioned Archbishop Brenes never will have to
balance the pros and cons of saving his own life versus that of a fetus
because pregnancy is simply something with which he will never have to
contend. Thus, with the overwhelming majority of the National Assembly
composed of males and the leaders of the Catholic Church mostly male,
the voices of many Nicaraguan women have been silenced and their
opinions on the abortion ban ignored. Even before the total ban came
into effect, 50 Nicaraguan women died between 2000 and 2003 from
pregnancy-related complications of which they were neither fully aware
of, nor told were preventable. Such statistics presumably mean much
more to Nicaraguabs women, than the countrybs male leaders who have not
demonstrated a particularly strong desire to respond to those figures
in an effective, appropriate manner.

Gender hierarchies and male leadership issues aside, the total ban on
therapeutic abortions has shed light on what HRWcalled in October a
violation of binternational human rights standards on the right to
life, the right to health, the right to non-discrimination, and a
number of other established human rights.b Obviously, the only people
whom the right to life directly affects in the case of therapeutic
abortionsband, for that matter, any abortionbare women. The
internationally agreed upon human rights norms that HRWcited in its
October report suggest what many objective critics long have known:
bans on any sort of abortion that would save a motherbs life are
contrary to established legal standards that protect a womenbs right to
life. In a country and region where there is a tendency for males to
dominate politically, economically, and culturally, the ban on
therapeutic abortions has put women even lower on the societal totem
pole, which shows an alarming disdain for international legal gender
questions.

Conclusion

Reyes was not the first victim of the abortion ban. Just after the
interdiction was implemented in 2006, Jazmina del Carmen Bojorge died
in a similar fashion, as her doctors failed to appropriately treat her
when, five months into her pregnancy, she was feverish and suffering
from abdominal pain. At the time, Juanita JimC)nez of the Womenbs
Autonomous Movement in Nicaragua pointed out that doctors were scared
of the repercussions had they aided Bojorge. Furthermore, women are now
nervous about trying to get any sort of treatment for complications
during their pregnancies. As a United Nations official told Human
Rights Watch, bWomen are afraid of seeking treatment. Thatbs the first
stepb&.And doctors are afraid of providing treatment.b&And the
combination may have caused deaths.b

Bojorge was the first Nicaraguan woman to have drawn significant
international media attention, Reyes is just the most recent case, and,
unfortunately, there will be more to come unless the powerful
combination of the Church and state have a radical change of heart.
Petitions to declare the abortion ban unconstitutional have been filed
in the Supreme Court, but for now, the chances of reversal are highly
unlikely. A reversal would require much more coordination between
Nicaraguabs womenbs rights activists and international human rights
groups than currently exists. Until that day, however, they will
continue to live, like few other women in the Western Hemisphere,
without even the most rudimentary guarantee of the right to their
survival if a pregnancy goes wrong. 

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