March 31, 2009

Overview
Argentina
Brazil
Chile
Colombia
Mexico
United States

Overview

Women's ability to access safe and legal abortions is restricted in law or in practice in most countries in the world. In fact, even where abortion is permitted by law, women often have severely limited access to safe abortion services because of lack of proper regulation, health services, or political will.

At the same time, only a very small minority of countries prohibit all abortion. In most countries and jurisdictions, abortion is allowed at least to save the pregnant woman's life, or where the pregnancy is the result of rape or incest.

Abortion is a highly emotional subject and one that excites deeply held opinions. However, equitable access to safe abortion services is first and foremost a human right. Where abortion is safe and legal, no one is forced to have one. Where abortion is illegal and unsafe, women are forced to carry unwanted pregnancies to term or suffer serious health consequences and even death. Approximately 13 percent of maternal deaths worldwide are attributable to unsafe abortion-between 68,000 and 78,000 deaths annually.

Women's organizations across the world have fought for the right to access safe and legal abortion for decades, and increasingly international human rights law supports their claims. In fact, international human rights legal instruments and authoritative interpretations of those instruments compel the conclusion that women have a right to decide independently in all matters related to reproduction, including the issue of abortion.

Key Documents

Latest Documents

More information on abortion and women's reproductive rights in general:

The organizations listed may or may not support legal reform to make abortion safer and more accessible. The opinions voiced by these organizations do not necessarily reflect the position of Human Rights Watch.

Argentina

An estimated 500,000 abortions occur every year in Argentina, representing an estimated 40 percent of all pregnancies. The consequences of illegal and unsafe abortion have constituted the leading cause of maternal mortality in this country, in the words of a public official, "since we had statistics." Access to abortion continues to be illegal though the penalty may be waived where the life or health of the pregnant woman is in danger, or where the pregnancy is the result of the rape of a mentally disabled woman. It is also largely a closed topic, despite the catastrophic effects of illegal abortion on women's health and lives, including debilitating hemorrhaging, severe uterine infections that may impede future pregnancies, and sometimes death.

Across the South American region, many governments and legislators have historically declared their opposition to modern birth control methods, usually with reference to Catholic Church doctrine. However, in Argentina the government went so far as to prohibit the sale of all contraceptives for several decades in the late twentieth century-an extreme display of opposition to birth control even by regional standards. This position is only partially explained by reference to Catholic Church doctrine. Historically, a central part of the identity of the political elite in Argentina has been that of a frontier nation to be colonized and populated by Caucasian immigrants from Europe. Indeed, the Argentine Constitution charges the federal government with the active encouragement of European immigration. This pro-natalist approach has historically set Argentina apart from the rest of South America, so much so that Argentina in 1996 was the only country in the region to provide no public support of any kind for access to contraception, and in 2001 the only country to provide no direct support.

In a positive development, in 2002 the Argentine Congress passed a law (National Law on Sexual Health and Responsible Procreation) which contains important provisions for the advancement of women's rights and health. However, this law does not address women's severely limited access to safe and legal abortion services.

History of Argentina's Law on Abortion

Abortion has constituted a crime in Argentina since the late nineteenth century. The current penal code entered into force in the 1880s, and abortion was included as a crime with no exceptions for punishment. In 1922, the penal code provisions on abortion were amended to allow for three exceptions for punishment:

  • where the pregnant woman's life or health was in danger;
  • where the pregnancy was the result of a rape; and
  • where the pregnant woman was mentally disabled.

During the 1976-83 military dictatorship, the penal code was changed to include further restrictions on abortion, requiring "grave" danger to a woman's life or health, and, in the case of rape, the commencement of criminal proceedings. In 1984, after the reinstatement of the democratic government, the provisions on abortion were amended again to return to the 1922 wording, with one small but substantive difference: a comma in the text was moved. The effect of this change was that women whose pregnancies were the result of a rape, after the 1984 change, no longer were permitted a non-punishable abortion unless they were declared mentally disabled.

As a result, the current penal code provides for only two exceptions to punishment:

  • where the pregnant woman's life or health is in danger; and
  • where the pregnancy is the result of the rape of a mentally disabled woman.

In 2004, several bills were pending in Argentina's Congress, all of which seek to amend the current penal code provisions to expand or limit the situations where penalties for abortion may be waived.

Full penal code provisions on abortion currently in force

1922 Penal Code, Articles 85-88, as amended in 1984

Article 85. He who causes an abortion will be punished: 1. with detention or prison from three to ten years, if the operation was carried out without the consent of the woman. This punishment may be raised to fifteen years, if the woman died as a result; 2. with detention or prison of one to four years, if the operation was carried out with the consent of the woman. The maximum punishment is six years, if the woman died as a result.

Article 86. The doctors, surgeons, midwives or pharmacists who abuse their science or profession to cause an abortion or cooperate to cause it will be punished as established in the previous article and will, additionally, be prohibited from exercising their profession for twice the time than that which they will serve. An abortion carried out by a medical doctor with the consent of the pregnant woman is not punishable:

  1. if it was done with the objective to avoid a danger to the life or health of the mother and if this danger could not have been avoided by any other means;
  2. if the pregnancy is the result of the rape or assault to the modesty committed against an idiot or demented woman. In this case, the consent of the legal representative is required for the abortion.

Article 87. He who causes an abortion with violence involuntarily will be punished with prison of six months to two years if the pregnant state of the patient was obvious or known to him.

Article 88. The woman who causes her own abortion or who consents to someone else causing it will be punished with one to four years of prison. The woman's attempt [to abort] is not punishable.

Relevant Statistics

  • Argentina's population is approximately 39 million, of which 27 percent is under 15 years old (2002).
  • The fertility rate is 2.4 children per woman, and the annual population growth is 1.1 percent (2002).
  • Reported maternal mortality rate is 46.1 per 100,000 live births (2002), up from 38.1 in 1997.
  • An estimated 30 percent of maternal mortality is due to consequences of illegal abortion (2004).
  • An estimated 500,000 illegal abortions occur in Argentina annually (2004), constituting approximately 40 percent of all pregnancies.
  • The most recent data available (from 1996) shows that contraceptive use in women of childbearing age was 75 percent.

More information on women's reproductive rights in Argentina?

The organizations listed may or may not support legal reform to make abortion safer and more accessible. The opinions voiced by these organizations do not necessarily reflect the position of Human Rights Watch.

Reports:

Brazil

Approximately one to four million abortions are performed in Brazil every year. The National Health System, SUS (Sistema Único de Saúde), estimates that 250,000 women enter emergency rooms every year with health problems that are a direct consequence of unsafe abortions. Unsafe abortion is the fourth leading cause of maternal mortality in the country, after hypertension, hemorrhaging (which could also include abortion-related hemorrhaging), and post-birth infections.

Under Brazil's penal code, abortion is only permitted to save the pregnant woman's life or where the pregnancy is the result of rape or incest. Over the past decade, Brazil's health system has increased the number of health clinics and hospitals where abortions are available for women who fit the penal code's exceptions. Nevertheless, very few women obtain such non-punishable abortions, since doctors and hospitals have generally required a judicial authorization to carry out the abortion. Indeed, the vast majority of abortions in Brazil are performed under unsafe medical conditions in illegal clinics or other clandestine settings.

Brazilian women's groups have been pressing for the right to safe and legal abortion for years, and in 2005 launched the "Brazilian Campaign for the Rights to Legal and Safe Abortion" (Jornadas Brasileiras pelo Direito ao Aborto Legal e Seguro).

In an encouraging development in 2005, the Brazilian Ministry of Health implemented a new set of norms that do away with some of the most onerous procedural requirements that until now have prevented women who are pregnant as the result of rape from getting access to legal abortion. Notably, the new norms do not require women to present a police report to the public hospital in order to obtain a legal abortion or post-abortion care. The norms have been vehemently opposed by the Catholic Church and by some doctors.

History of Brazil's Law on Abortion

Abortion has constituted a crime in Brazil since the late nineteenth century. The penal code from 1890 criminalized abortion in all circumstances. In 1940, the penal code provisions on abortion were amended to waive punishment on two grounds:

  • where the pregnancy is the result of rape or incest; and
  • where the pregnant woman's life is in danger.

In addition, a presidential decree from 1941, as amended in 1979, prohibits the advertising of a process, substance, or object designed to cause an abortion or to prevent pregnancy. These provisions are still in force.

In 2004, several bills were pending in Brazil's congress, all of which seek to amend the current penal code provisions to expand or limit the situations where penalties for abortion may be waived. In 2003, President Lula da Silva made a commitment to prioritize access to safe abortion during his term. In 2005, the government set up an eighteen-member tripartite (civil society, executive, and legislative) committee, with six representatives from civil society, to discuss the legalization of abortion in Brazil.

Full penal code provisions on abortion currently in force

1940 Penal Code, Articles 124-128, as amended in 1998 (Human Rights Watch translation)

Abortion induced by the pregnant woman or with her consent
Article 124. Induce an abortion on herself, or consent to another person inducing it: Punishment - detention of 1 (one) to 3 (three) years.

Abortion induced by a third party
Article 125. Induce an abortion, without the consent of the pregnant woman: Punishment - imprisonment of 3 (three) to 10 (ten) years.

Article 126. Induce an abortion with the consent of the pregnant woman: Punishment -reclusion of 1 (one) to 3 (three) years. First para. The punishment of the prior article [article 125] will be applied if the pregnant woman is not older than 14 (fourteen) years, or if she is disturbed or mentally ill, or if her consent was obtained through fraud, serious threats, or violence.

Amendments
Article 127. The punishment established in the two prior articles will be augmented by a third if, as a consequence of the abortion or the measures taken to induce it, the pregnant woman suffers serious physical harm; the punishment will be doubled if, for any of these reasons, she dies.

Article 128. An abortion carried out by a medical doctor will not be punished:

Necessary abortion

  • I - if there is no other way to safe the life of the pregnant woman; Abortion in the case of pregnancy resulting from rape
  • II - if the pregnancy is the result of rape and the abortion is preceded by the consent of the pregnant woman, or, if she is unable, by her legal representative.

Relevant Statistics

  • Brazil's population is approximately 180 million, of which 28 percent is under 15 years old (2002).
  • The fertility rate is 2.2 children per woman, and the annual population growth is 1.1 percent (2002).
  • Reported maternal mortality rate is 45.8 per 100,000 live births (2000), down from a recent high of 68 in 1998.
  • Unsafe abortion is the fourth leading cause of maternal mortality in the country (2004).
  • An estimated one to four million illegal abortions occur in Brazil annually (2004).
  • The most recent data available (from 1996) shows that contraceptive use in women of childbearing age was 77 percent.

More information on women's reproductive rights in Brazil

The organizations listed may or may not support legal reform to make abortion safer and more accessible. The opinions voiced by these organizations do not necessarily reflect the position of Human Rights Watch.

 

Chile

Abortion in Chile has been illegal in all circumstances-even where the life of the pregnant woman is at stake-since 1989. Notwithstanding the penal code provisions, an astounding number of women every year risk illegal and therefore generally unsafe abortions, reflecting a general inability of women to control their fertility by other means. Indeed, surveys suggest that a very high proportion of pregnancies in Chile are not desired. About 35 percent terminate in abortions, corresponding to approximately 160,000 abortions per year, 64,000 of them by girls under eighteen.

The illegality of abortion in Chile takes a devastating toll on women's health and lives. The consequences of illegal abortion constitute a leading cause of maternal mortality in this country, which in general has lower maternal mortality rates than its neighbors. Experts note that Chile could significantly lower maternal mortality if women had ready access to safe and legal abortions.

Women's rights NGOs have long worked for less restrictive abortion laws, including through a 2003 paid advertisement in one of Chile's national newspapers where 232 women declared that they had aborted and demanded that Chile legalize unrestricted abortion.

History of Chile's Laws on Abortion

Abortion has constituted a crime in Chile since 1874. The 1874 penal code, still in force, prohibits abortion in all cases. In 1931, a national health law (Código Sanitario) gave doctors the possibility to provide abortions, without criminal penalties for the doctor or the woman, where necessary to save the pregnant woman's health or life (so-called "therapeutic abortion.") According to this law, a woman needed the consent of two doctors to obtain a non-punishable abortion. In 1989, President Pinochet annulled this statutory exception to the general illegality of abortion as one of his last acts in office. Consequently, the national health law now prohibits abortion in all circumstances.

President Michelle Bachelet, has expressed a need for Chile to have an open and public debate on the topic of abortion, something that has been lacking for the past decades.

Full penal and health code provisions on abortion currently in force

1874 Penal Code, articles 342-345 (Human Rights Watch translation)

Crimes and misdemeanors against family order and public morals

  1. Abortion (articles 342-345)
    Article 342. He who maliciously causes an abortion will be punished:
    1. Where he caused violence to the pregnant woman, with the punishment of [imprisonment from five years and one day to ten years, as defined in Penal Code article 56].
    2. Where he acted without the consent of the women, with the punishment of [imprisonment from three years and one day to five years].
    3. Where the woman had given her consent, with the punishment of [imprisonment from 541 days to three years.]

Article 343. He who causes an abortion with violence, even if he did not have the intention of causing such abortion, will be punished with [imprisonment from 541 days to five years], where the pregnancy of the woman was noticeable, or the aggressor knew of it at the time of the act.

Article 344. The woman who causes her abortion, or who consents to another person causing it, will be punished with lesser jail-time in its maximum degree [three years and one day to five years]. If she did it to hide her dishonor, she will be punished with [imprisonment of 341 days to three years].

Article 345. He who, by abusing his profession, causes an abortion or cooperates in performing an abortion, will be punished with the punishments established in Article 342, increased by one degree, as relevant.

1931 Código Sanitario, as amended in 1989 (Human Rights Watch translation)

Article 119. No action may be taken which provokes an abortion as a result.

Relevant Statistics

  1.  
    • Chile's population is approximately 15 million, of which 27 percent is under 15 years old (2002).
    • The fertility rate is 2.3 children per woman, and the annual population growth is 1.2 percent (2002).
    • Reported maternal mortality is 16.7 per 100,000 live births (2002), down from 22.3 in 1997.
    • Unsafe abortion accounts for an estimated 25 percent of maternal mortality (2004).
    • An estimated 160,000 abortions occur annually in Chile.
    • The most recent data (from 1996) shows that contraceptive use in women of childbearing age was 60.1 percent.

More information on women's reproductive rights in Chile

The organizations listed may or may not support legal reform to make abortion safer and more accessible. The opinions voiced by these organizations do not necessarily reflect the position of Human Rights Watch.

  1.  

Colombia

There are an estimated 450,000 illegal abortions in Colombia every year, and unsafe abortion is a leading cause of maternal mortality. Recent studies indicate that a higher proportion of adolescent girls than adult women undergo illegal abortions: 36 percent of adolescent pregnancies end in abortion, whereas 12 percent of other pregnancies do. Colombia's penal code prohibits abortion in all circumstances, though the penalty is substantially lower where the pregnancy is the result of rape or non-consensual artificial insemination. In such cases, a judge may also waive the punishment altogether on a case-by-case basis, when the abortion occurs in "extraordinary situations of abnormal motivation" and where he or she considers the punishment "unnecessary."

Since the early 1970s, several bills have been introduced that would have expanded, at least theoretically, the possibility for women to have a legal abortion. However, many of these bills have included the explicit requirement that the pregnant woman's husband give her consent to the procedure. The result of this requirement is that women's human rights, including the rights to nondiscrimination, health, and health care services, would still be in jeopardy. Most of these bills were not passed.

Over the years, the Colombian Constitutional Court has issued opinions on various penal code provisions related to abortion. In 1994, the court found that the general prohibition on abortion was constitutional, and in 1997 it added that it also was constitutional to legislate for mitigating circumstances that lower the penalty imposed for abortion.

In 2001, the court held that the possibility of waiving the punishment for abortion was constitutional because it was limited to certain "strictly outlined" circumstances. In a clarifying statement attached to this 2001 decision, four constitutional court judges, who had voted in favor of the decision, clarified the law relating to women's criminal responsibility for abortion where the pregnancy is the result of rape or non-consensual artificial insemination. In such cases, argued these judges, "the exceptional and admirable thing would be for the woman to decide to continue the pregnancy until she gives birth. ... But she cannot be required to procreate, nor can she be the object of penal sanctions for having exercised her fundamental rights and for having tried to minimize the consequences of the rape [by having an abortion]."

In 2005, a Colombian lawyer challenged the constitutionality of the principal prohibition of abortion (article 122 of the penal code), charging that this provision runs counter to women's rights to life, health, and physical integrity. This constitutional case drew the support of human rights groups across the region, including Human Rights Watch. In a landmark decision for the region, in May 2006 Colombia's Constitutional Court handed down a decision on the case, declaring the country's blanket criminalization of abortion in violation of women's constitutional rights. The court declared that neither women nor doctors can be penalized for procuring or providing abortions where one of three conditions is met: 1) the pregnancy constitutes a grave danger to the pregnant woman's life or health; 2) the fetus has serious genetic malformations; or 3) the pregnancy is the result of rape or incest.

History of Colombia's Law on Abortion

Abortion has constituted a crime in Colombia at least since the implementation of the penal code of 1936, which criminalized abortion in all circumstances, though it permitted reduced penalties where the abortion was performed to protect the honor of the pregnant woman. In the penal code currently in force (Law 599 of 2000) abortion continues to be illegal in all circumstances. The penal provisions establish a substantially lower punishment where the pregnancy is the result of non-consensual conception (rape or artificial insemination without consent), noting that a judge may wish to waive the punishment altogether in the case of such non-consensual conception and in "extraordinary situations of abnormal motivation" where he or she considers the punishment "unnecessary."

Full penal code provisions on abortion

Law 599 of 2000 (as amended in 2004 with effect in 2005) (Human Rights Watch translation) Please note that after the May 2006 Constitutional Court decision, this law is not enforceable.

Article 122. Abortion. The woman who causes her own abortion or permits another person performing it will be punished with imprisonment from sixteen (16) to fifty-four (54) months. This same sanction will be applied to he who, with the consent of the woman, carries out the action noted in the prior sentence.

Article 123. Abortion without consent. He who causes an abortion without the consent of the woman will be punished with imprisonment from sixty-four (64) to one-hundred-eighty (180) moths.

Article 124. Mitigating circumstances. The punishment indicated for the crime of abortion will be lowered by three fourths were the pregnancy is the result of a conduct constituting abusive or non-consensual carnal or sexual access, or non-consensual artificial insemination or transfer of a fertilized ovum.

Paragraph: In the events of the prior paragraph [article 124], when the abortion is carried out in extraordinary situations of abnormal motivation, the judicial officer may forego the punishment when it is unnecessary in the concrete case at hand.

Relevant Statistics

  • Colombia's population is approximately 45 million, of which 31 percent is under 15 years old (2002).
  • The fertility rate is 2.6 children per woman, and the annual population growth is 1.5 percent (2002).
  • Reported maternal mortality rate is 98.6 per 100,000 live births (2001), up from 71 in 1998.

More information on women's reproductive rights in Colombia

The organizations listed may or may not support legal reform to make abortion safer and more accessible. The opinions voiced by these organizations do not necessarily reflect the position of Human Rights Watch.

 

 

Mexico

Abortion is a crime in Mexico, and women in some states continue to be prosecuted for it. At the same time, all jurisdictions establish some exceptions for the general criminalization of abortion, and all penal codes permit legal abortion for rape survivors.

As in most countries where abortion is criminalized, estimates on the prevalence of abortion vary widely. In 2003, the Autonomous National University of Mexico (UNAM) published a study estimating that approximately half a million girls and women undergo abortion (both legal and illegal) every year in Mexico. In 2005, UNAM updated its study, concluding that the previous figure had seriously underestimated the prevalence of abortion and that the annual number of abortions in Mexico was closer to one million. This would constitute approximately 30 percent of all pregnancies in a year. An estimate published by the Latin American Center on Health and Women (Celsam) concluded in 2004 that the annual number of abortions was between half a million and 850,000. Meanwhile, government figures dating from 1995 estimate that only 100,000 clandestine abortions are carried out each year.

Mexico's constitution protects the universal right to decide on the number and spacing of one's children, and the general health law from 1984 (last amended in 2004) establishes a duty on public health clinics and hospitals to provide a relatively wide range of contraceptives free of charge.

History of Mexico's Laws on Abortion

Abortion has constituted a crime in Mexico at least since 1931. The initial federal law, still on the books, makes abortion punishable with one to three years of imprisonment when carried out with the pregnant woman's consent and three to six years when carried out without consent. Both women and abortion practitioners can be prosecuted for this crime. The 1931 penal code waives all criminal penalties for abortion after rape where the pregnant woman's life would be endangered by a continued pregnancy or where the abortion is the result of negligent behavior on the part of the pregnant woman.

Due to Mexico's federal structure, the federal penal code provisions on abortion are generally irrelevant to the treatment of this issue at state level and would only apply if the abortion were carried out under exclusively federal jurisdiction. Nevertheless, the 1931 penal code has served as a model for state penal codes. As of January 2006, all state penal codes criminalize abortion both for the pregnant woman who procures the abortion and for the health professional who provides it. Applicable penalties vary from state to state, but the most commonly mandated sentence is anywhere between six months and five or six years. In eleven states, as well as in the federal penal code, the sentence is substantially lower when the woman who aborted "does not have a bad reputation," when the pregnancy was the result of a sexual relationship outside of marriage, and when the woman had managed to keep the pregnancy secret.

All states waive penalties for abortion in at least one circumstance: where the pregnancy is the result of rape. Other reasons for waiving the penalty for abortion are:

  • the abortion is the result of negligent behavior on the part of the pregnant woman (valid in twenty-nine states);
  • to save the life of the pregnant woman (valid in twenty-seven states);
  • the fetus has serious genetic malformations (valid in thirteen states);
  • to protect the health of the pregnant woman (valid in ten states);
  • the pregnancy is the result of non-consensual artificial insemination (valid in eleven states); and
  • where the woman already has three other children, for economic reasons (valid only in Yucatán).

For almost seventy years, the laws on abortion remained virtually untouched. A number of important developments on the criminalization of abortion have happened since 2000. In August 2000, the Guanajuato Congress approved reforms that eliminated the possibility for legal abortion after rape, though the governor of the state vetoed the law a month later amidst national furor. In the same month, after much public debate, the Morelos Congress approved an additional article for that state's criminal procedure code which sets out procedures for access to legal abortion. Despite having threatened to do so, the governor of Morelos, under pressure from women's groups and health advocates, did not veto the new procedures.

Also in 2000, the head of government in the Federal District, Rosario Robles, proposed an amendment to the penal code and the criminal procedure code of the Federal District to lower the penalties for criminal abortion and oblige public health authorities to provide access for abortion after rape. The bill-dubbed the "Robles Law"-was approved by the local congress, entered into force, and was immediately subject to a claim of unconstitutionality before Mexico's national Supreme Court. This lawsuit stalled the implementation of the law until 2002. In January 2002, the Supreme Court declared the law constitutional.

Legal reforms in two jurisdictions were aimed at further guaranteeing the right to abortion after rape. In March 2005, Baja California Sur reformed its penal code to include an additional exception for the criminalization of abortion-where the woman's health is endangered by the pregnancy-and to establish lower penalties for illegal abortion. Baja California Sur also reformed its criminal procedure code to include specific procedures for access to legal abortion after rape. These reforms entered into force in September 2005. Both Baja California Sur (in 2005) and Mexico City (in 2003) reformed their general health codes to include an obligation to provide abortions free of charge in public health institutions in those cases where abortion is not subject to penal sanctions, including after rape. Most developments toward decriminalization of abortion have occurred only after years of organizing and pressure by women's rights activists and despite staunch opposition from conservative groups.

Federal legal provisions on abortion currently in force

Chapter VI

Article 329. - Abortion is the death of the product of conception at any point during pregnancy.

Article 330. - He who causes a woman to abort will be punished with one to three years imprisonment, regardless of how the abortion was caused, and where the woman consented. Where there is no consent, the imprisonment will be from three to six years, and if he used physical or moral violence the criminal will be subject to six to eight years' imprisonment.

Article 332. - The mother who voluntarily obtains an abortion or consents to someone else causing the abortion will be subject to six months' to one year's imprisonment, if these three conditions are fulfilled:

  • I. She does not have a bad reputation;
  • II. She has managed to keep her pregnancy secret; and
  • III. The pregnancy is the result of an illicit relationship.

Where any one of these conditions is not fulfilled, she will be subject to one to five years' imprisonment.

Article 333. - Where the abortion is the result simply of the negligence of the pregnant woman, or where the pregnancy is the result of a rape, the abortion is not punishable.

Article 331. - If the abortion is caused by a medical doctor, a surgeon, a midwife, or an obstetrician, in addition to the corresponding sanctions in the prior article, the person will be suspended from exercising his profession for two to five years.

Article 334. - No punishment will be applied where, according to the doctor assisting the woman, the pregnant woman or the product [fetus] would run the risk of dying unless the abortion were performed; as supported by the opinion of another doctor, wherever it would not be dangerous to wait [for such opinion].

Relevant Statistics

  • Mexico's population is approximately 105 million, of which 32 percent is under 15 years old (2002).
  • The fertility rate is 2.4 children per woman, and the annual population growth is 1.4 percent (2002).
  • Reported maternal mortality rate is 64 per 100,000 live births (2002), up from a reported 47 in 1997.
  • Illegal abortion is considered the fourth leading cause of maternal mortality (2004).
  • An estimated 100,000 to 500,000 illegal abortions occur in Mexico annually (2004).
  • The most recent data available (from 1996) shows that contraceptive use in women of childbearing age was 68 percent.

More information on women's reproductive rights in Mexico

The organizations listed may or may not support legal reform to make abortion safer and more accessible. The opinions voiced by these organizations do not necessarily reflect the position of Human Rights Watch.

What You Can Do

Write Mexico's President-elect, Felipe Calderón, to urge him to guarantee access to safe abortion services where abortion is currently permitted under Mexican law. Tell Mr. Calderón to implement the recommendations submitted in 2006 by the United Nations Committee on Economic, Social, and Cultural Rights (CESCR) and the United Nations Committee for the Elimination of Discrimination against Women (CEDAW). These expert committees have asked Mexico to:

  • implement a comprehensive strategy that ensures effective access to safe abortion in situations provided for under the law; and monitor the full access of rape victims to legal abortion;
  • harmonize legislation pertaining to abortion at the federal and State levels; and
  • ensure full access by everyone to reproductive health services and education, and to allocate sufficient resources for these purposes.

You can find a model letter here.

Reports:

 

 

United States

Restrictions on women's access to safe abortion are not limited to Mexico. Even in the United States, where abortion is legal, services are not readily accessible. In fact, many women and girls face serious legal or financial obstacles to accessing safe abortion services because of burdensome regulations, lack of providers, insufficient funding, or political opposition.

Obstacles to safe abortion in the United States seem to be on the rise. Since the landmark Supreme Court decision in Roe v. Wade in 1973, which established women's right to decide with regard to abortion as a matter of privacy, both state and federal legislators have limited access to legal abortion. These roll-back measures generally seek to do one of two things:

  1. curtail women's access to legal abortion (such as through mandatory waiting periods or mandatory-and at times manifestly inaccurate-counseling); or
  2. limit legal access to abortion to certain populations (such as rape victims or women whose lives are endangered by their pregnancy).

Women with limited economic resources face additional obstacles to safe abortion, resulting particularly in discrimination against women who may already be marginalized. Abortion services have been subject to a federal funding freeze since 1977 except in cases of life endangerment, rape, or incest. Furthermore, the majority of states do not provide funding for abortion services that fall outside these exceptions. A safe abortion often costs $500-$1,500. As a result, women with limited resources-who have not been raped or whose lives are not endangered by their pregnancy-may be forced to choose between carrying an unwanted pregnancy to term or taking desperate measures that could seriously jeopardize their health.

Regulatory Obstacles to Abortion in the United States

Since 1973, the United States Supreme Court has consistently ruled that an outright ban on abortion is unconstitutional. However, the Court has allowed states to regulate and limit access to abortion, so long as they do not place an "undue" burden on the individual seeking to terminate her pregnancy.

Over the past decade, legislators at the state and federal levels have pushed the limits of this Supreme Court mandate, and at times have imposed regulations with the explicit aim of challenging the constitutionality of legal abortion. Many states implement regulations that, in practice, may be unduly burdensome. For example, some states require that women and girls who wish to terminate a pregnancy submit themselves to counseling, which, in addition to being unsolicited, is often manifestly biased and medically unsound.

Inaccurate or Imposed Information

According to the nongovernmental research organization Alan Guttmacher Institute (AGI), as of September 2006 well over half the states in the United States (32) subject all women seeking abortion to mandatory counseling. Three states require clinics to inform women of a purported link between abortion and breast cancer, which numerous scientific studies have conclusively disproved. Four states also stipulate that women must be told that the fetus might be capable of feeling pain at any point during gestation. Such information, however, is contrary to recent scientific studies that conclude that fetuses cannot feel pain until the twenty-ninth week of gestation. In fact, as 90 percent of abortions in the United States occur in the first twelve weeks of the pregnancy, the mandatory information on fetal pain is not only scientifically wrong, but also irrelevant to the vast majority of abortion patients.

Access to accurate and complete information on medical procedures is an integral part of the human right to the highest attainable standard of health, and also essential to the principle of informed consent. When health professionals are required to give women and girls one-sided or inaccurate information about medical procedures-as the law mandates in many jurisdictions in the United States-the human right to health is threatened.

Mandatory Waiting Periods Add Cost

According to AGI, 24 of the 32 states that require mandatory counseling also require women and girls to wait for a specific period of time-most often twenty-four hours-between the counseling session and the abortion. While a waiting period before a medical procedure may not in and of itself be incompatible with the right to health, it can create additional, and potentially unduly burdensome, barriers to access to safe and legal abortions. For example, in those states where the law requires an in-person counseling procedure (as opposed to over the phone) a mandatory waiting period requires that the patient travel at least twice to the abortion facility. As a consequence, many must leave work for several days, and where there are no abortion facilities nearby-and 87 percent of U.S. counties have no such facilities (2000 figures, latest available)-the mandatory waiting period may require such additional cost as an overnight stay or several long-distance trips.

Added Restrictions for Girls

Many U.S.-based NGOs note that girls typically are subject to more restrictions than adult women regarding access to safe abortion. AGI and NARAL Pro-Choice America note that 44 states have laws on the books requiring parental consent or notification prior to a minor's abortion. More than 20 states enforce parental consent laws requiring consent from a parent before a minor may obtain a legal abortion-in 3 cases the laws require consent from both parents. Further, more than 10 states have laws requiring that a parent be informed of a minor's intent to have an abortion, and 2 states require that both parents be informed.

Mandatory parental consent and notification regulations are problematic for a number of reasons, especially in cases where both parents must consent or be notified. Abortion providers in the United States note from experience that the vast majority of teenage girls already seek support and guidance from one or both parents. The impact of notification and consent laws thus falls hardest on particularly vulnerable girls unable to involve their parents in their decision, including girls who do not have contact with either or both parents.

International human rights law requires governments to prioritize the best interests of children at all times, and to give the child's opinion due weight according to his or her evolving capacities. A parent's declared opposition to abortion should not automatically result in the assumption that carrying a pregnancy to term is in the best interest of the child, especially when the pregnant girl herself declares a desire to terminate the pregnancy. A U.S. Supreme Court precedent mandates that parental consent laws must have a judicial procedure to waive parental consent in specific circumstances. It is incumbent upon states to ensure that this precedent is reflected in law and adequately protects the interests of all children.

Criminalization of Doctors and Family Members

Women and girls who procure abortions are currently not subject to criminal sanctions anywhere in the United States. However, in some states, family members, doctors, nurses, and friends who support women and girls in need of an abortion soon could be.

In July 2006, the U.S. Senate passed a version of the Child Custody Protection Act, a version of which had already passed as the Child Interstate Abortion Notification Act in the House of Representatives in April 2005. If this law enters into force, any adult who helps a minor cross a state line to procure an abortion in circumvention of parental consent or notification regulations in the child's home state would be committing a federal crime.

Furthermore, some states have passed legislation to criminalize medical doctors who perform abortions on certain types of patients. Most prominent is the blanket ban on abortion in South Dakota, signed into law in March 2006, which makes abortion illegal except when the procedure is carried out to save the pregnant woman's life. Nongovernmental advocacy organizations that follow closely the developments of abortion legislation note that several other states-including Georgia, Indiana, Ohio, Louisiana, and Tennessee-have moved to enact similar legislation.

Conclusion

Abortion is a highly emotional subject and one that excites deeply held opinions. However, equitable access to safe and legal abortion services is first and foremost a human right. In the United States the legality of abortion co-exists with cumbersome regulations, thinly veiled political opposition to a woman's right to make independent decisions regarding pregnancy and abortion, and a lack of federal and state funding for the provision of abortion services for poor women that seriously hampers women's ability to exercise this right. Until access to safe abortion is guaranteed, the human rights of women and girls across the United States will not be fully secure.

What you can do:

Write letters to your federal and state senators or representatives urging them to ensure equitable access to reproductive health services, including modern contraceptive methods, emergency contraception, and voluntary abortion services. A number of bills have already been introduced on these issues. In particular, you should encourage your federal congressperson to support:

  • The Compassionate Assistance for Rape Emergencies Act ("CARE" S.1264/H.R.2928). This bill would ensure that survivors of sexual assault are offered the "morning-after" pill in the emergency room.
  • The Freedom of Choice Act ("FOCA" S.2593/H.R.5151). FOCA guarantees a woman's right to choose to bear a child or to terminate a pregnancy without interference by the state or others.

You can find a model letter here.

 

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