“Abortion has existed since the beginning of times, in all countries, in all places, regardless if it’s legal or not,” Antonia Biggs, a researcher for the Turnaway Study, told Ms. “Abortions are no lower in Chile than they are in countries were it is legal. In fact, they are somewhat higher. Criminalizing is not preventing abortion. What is doing instead is punishing women.”
The Turnaway Study followed almost a thousand women over five years—comparing outcomes for women who had abortions with women who were denied access. In Chile, with a population of almost 18 million inhabitants, 134,000 to 150,000 abortions are estimated every year.
Chile’s Constitutional Tribunal decriminalized abortion on August 21, ending a 28-year total ban on the procedure that was the strictest in the world. Abortion is now legal in Chile under three circumstances: when the woman’s life is at risk, when pregnancy is a result of rape and in the case of lethal fetal anomaly. Although the bill had broad public support—up to 70 percent of Chileans were in favor of the measure—conservative deputies tried to stop it twice. Biggs, who is originally from Chile, was one of the 135 participants in public audiences before the Constitutional Tribunal. She spoke out days before the rule was approved to share the findings of the Turnaway Study.
Now, a question looms: Will other countries in Central America follow Chile’s lead? Experts are optimistic that Chile’s decision will have a positive impact in the region, but its extent remains to be seen. Honduras’ Congress opened debate on the topic in April while reviewing its penal code, President Juan Orlando Hernández vetoed a proposal that would have shifted its abortion laws.
Nicaragua may be out for the count, too—the country established a total ban on abortion just 11 years ago in 2006. And whereas Michele Bachelet, Chile’s President, was crucial in striking down its abortion ban, in Honduras and Nicaragua political structures make that pathway to progress more slim. “Nicaragua right now is in the hands of two people [the president, Daniel Ortega, and his wife, the vice-president, Rosario Murillo],” Mayte Ochoa, a social worker at Ipas Central America, said. “The rule of law and institutional framework do not exist, so we think it is very difficult that the recent change in Chile will have a positive impact here. Nicaragua is kind of isolated in this particular issue.”
In 2015, 6,000 citizens signed a petition in support of abortion rights in Nicaragua. In Honduras, 900 girls get pregnant as result of rape each year. None of this seems to affect the decision-makers. “We will definitely have to wait until there is a better scenario,” Ochoa said, “but this does not mean that we will not keep working towards a change.” She remains optimistic, despite this, that Chile’s move could still accelerate change in El Salvador and the Dominican Republic. But even in Chile, she hopes for more.
“I believe in formal terms this is a great step forward,” Ochoa explained, “especially because of its symbolic and ideological meaning for governments and women. As feminists, we would like to see further progress.”
It is unclear exactly what impact Chile’s new policy will have for women in the country. There remains skepticism about a reduction in the number of clandestine abortions, and legal changes can’t address the significant stigma women who abort face. “Even for women who should benefit from the law, it might be hard to have an abortion,” Biggs explained. “First, they need to find clinician who can demonstrate that they fall in one of the three cases. And also they need to find a doctor who can provide an abortion, in a country were they have received very little training, or who may not be willing because of the stigma around abortion provision.”
Pontifical Catholic University of Chile, one of the best universities in the region, has already claimed that its medical school will claim conscience objection as an institution. “It is certainly possible that some other religious universities will follow,” Biggs asserted, “and then, at an individual level, I think providers will consciously object. This may be an issue. I think this is the next challenge ahead.”
Despite backlash, the ruling does open doors to new opportunities to train clinicians. Ipas and other organizations are already working with Chilean health providers to close gaps in access that run deep due to the longstanding ban. “Legalization and enforcement of the law does not guarantee access,” Ochoa stated. “There is a lot of work to do with the health personnel so the service is a reality for women.”
There remain wide gaps between law and practice, between the decriminalization of abortion and real access. To close the gap, underground abortion networks have long taken the cause into their own hands—literally.“It is one of the solutions women have historically sought to make this service less unsafe,” Ochoa said. “If the state does not resolve, someone else has to. It should be the state—but people, organizations are risking their own safety to provide a service for a woman who is going to do it with or without help. She is going to do it anyway.”
“Freedom is a right,” Ochoa continued. “And that right includes women. The freedom to choose when to be or not to be a mother is fundamental. It is fundamental not only for women, and her life, and her health, but for the society, and the new individuals taking part in that society.”