Barriers to Contraceptives and Abortion Cause Severe Health Consequences
(Buenos Aires) - Argentina's restrictions on access to contraceptives and abortion threaten women's fundamental rights to life, health and equality, Human Rights Watch said in a report released today.
The 85-page report, "Decisions Denied: Women's Access to Contraceptives and Abortion in Argentina," documents how judges, doctors and health workers prevent women from making independent reproductive decisions in violation of women's internationally recognized human rights.
"Argentina's restrictions on contraception and abortion prevent women from deciding how many children they want to have, and when," said LaShawn R. Jefferson, Women's Rights director at Human Rights Watch. "These laws and practices effectively treat women like minors."
The report also exposes some of the detrimental effects of domestic violence on women's reproductive health. The Argentine government has not done enough to remedy these abuses and their effects on women's health, Human Rights Watch said.
A 35-year-old mother of eight children, Gladis M. said for 14 years her husband beat her and prevented her from using contraceptives. Gladis said her husband repeatedly told her: "I am going to fill you up with children so you can't leave my side."
After decades of government opposition to the sale or use of contraceptives, including even condoms during the 1976-83 military dictatorship, the Argentine government in 2003 began to implement a national program to distribute certain contraceptives-like hormonal contraceptives and intrauterine devices (IUDs)-for free through the national health system. However, women continue to face multiple barriers in their access to family planning, including lack of accurate information, violence in the home, economic constraints and discriminatory laws.
Under Argentine law, one of the most effective forms of contraception-sterilization-is subject to discriminatory restrictions. Many public hospitals require that women obtain their husband's consent for the operation, that they have at least three children, and that they be older than age 35 to be eligible for the surgery.
"I thought I was going to die, but I wanted to do it.," said Laura P., 35, who already had five children when poor health caused her to seek sterilization. "In the hospital they set up every possible obstacle. The head of the hospital told me that it was the same as having an abortion." She appealed to a court, but was denied the operation despite fulfilling all the public hospital's requirements.
"Women seeking sterilization face Kafkaesque ordeals," said Jefferson. "In one public hospital, women had to beg approval from six different authorities, plus get their husband's signature in the presence of two witnesses."
Many women told Human Rights Watch they had endured unwanted pregnancies because of lack of access to or inability to use contraceptives, and some had abortions. In Argentina, abortion is illegal in all circumstances, yet an estimated half a million abortions occur every year. Though the law waives the punishment in cases where the pregnant woman's life or health is in danger, or where the pregnancy is the result of the rape of a mentally disabled woman, access to a legal and therefore safer abortion is almost nonexistent in practice.
As a result, women are forced to seek abortions through unsafe, unregulated clinics. In other cases, they induced their own abortions by methods that gravely jeopardized their health and lives. Without medical supervision, other women used anti-inflammatory drugs to induce abortion, resulting in severe health consequences and sometimes even death.
"You get overwhelmed by desperation. You seek all the ways out," said Paola M., a woman who had 10 children by the age of 36. "But if there is no way out, then you take a knife or a knitting needle."
Women's severely limited access to safe and legal abortions in Argentina is inconsistent with international law because it threatens the rights to life, health, equality, privacy, physical integrity, and freedom of religion and conscience. Amid continuing barriers to contraception, an estimated 40 percent of all pregnancies end in an illegal and therefore unsafe abortion in Argentina today. The consequences of illegal abortions have been the leading cause of maternal mortality for two decades.
Despite Argentina's responsibility under international human rights law to provide lifesaving health care without discrimination, Human Rights Watch also found that women in Argentina received inhumane and sometimes grossly inadequate treatment when they sought medical assistance for incomplete abortions or infections due to unsafe abortions. In these case, public health officials admitted that some doctors neglect or refuse to use anesthesia when performing curettage-the highly painful scraping of a woman's uterus with a sharp instrument.
"Argentina's restrictive abortion laws have a devastating effect on women's human rights, their health and lives" said Jefferson. "And the worst thing is that these effects are almost entirely preventable."
Human Rights Watch's position on access to safe and legal abortion:
Human Rights Watch believes that decisions about abortion belong to a pregnant woman without interference by the state or others. The denial of a pregnant woman's right to make an independent decision regarding abortion violates or poses a threat to a wide range of human rights. Any restriction on abortion that unreasonably interferes with a woman's exercise of her full range of human rights is unacceptable.
Governments should take all necessary steps, both immediate and incremental, to ensure that women have informed and free access to safe and legal abortion services as an element of women's exercise of their reproductive and other human rights. Government responsibilities relating to women's access to abortion that are founded on economic, social, and cultural rights must be implemented according to the principle of progressive realization to the maximum of available resources. Abortion services should be in conformity with international human rights standards, including those on the adequacy of health services. Governments have an obligation to protect the full range of human rights for all women.
Human Rights Watch called on the Argentine government to protect women's human rights to health, life, nondiscrimination, privacy, physical integrity, information, freedom of religion and conscience, equal enjoyment of rights, equal protection under the law, and the right to make decisions about the number and spacing of children. As a matter of priority, the government should:
- Ensure women's access to complete, accurate and timely information about contraceptives;
- Ensure women's access to a full range of contraceptives-including sterilization;
- Guarantee access to voluntary safe abortion where the penal code waives the punishment;
- Decriminalize access to abortion for all women; and
- Ensure access to humane post-abortion care without fear of criminal charges.