A legal attack on a hormone now underway in Chile will help determine whether Chilean teenagers – and older women – are more or less likely to give birth to unwanted children. A group of Chilean parliamentarians is currently seeking to derail Chile’s state-of-the-art medical protocols regarding emergency contraception. But their efforts are fuelled by scientific ignorance and could have dire consequences for Chilean women’s health and well being.
The parliamentarians have asked the Chilean Constitutional Court to issue an injunction against the Ministry of Health’s National Guidelines on Fertility Regulation. They want the court to order the removal from all health services of emergency contraceptive pills, the intra-uterine device (IUD), and all hormonal contraception that contains levonorgestrel. They argue that these methods are forms of abortion, and therefore violate the constitution’s protection of life from conception.
But their characterization of these contraceptive methods is simply wrong: these methods work not by terminating pregnancies but rather by preventing them. The most recent scientific studies demonstrate that levonorgestrel, when administered as an emergency contraceptive, works by delaying or inhibiting ovulation and thus is not abortifacient — not by medical standards, nor by Chilean constitutional standards. The World Health Organization, the International Federation of Obstetrics and Gynecology, and the broader scientific community all agree on this point – which is why other countries with restrictive abortion laws, like Argentina, Brazil, Colombia, Nicaragua, Kenya and Thailand, allow public distribution of emergency contraception.
If the court accepts the parliamentarians’ faulty reasoning it will have a drastic effect on emergency contraceptive services. The pills, the IUDs, the routine oral contraceptives currently available in public hospitals, private clinics and pharmacies – and to rape survivors throughout Chile – will no longer be available to anyone, regardless of her age or circumstances.
In Chile, nearly 90 percent of women who rely on the public health care system for routine pregnancy prevention choose one of these methods. Widespread access to routine and emergency contraceptive methods in the public health care sector is especially crucial for poor and vulnerable sectors of the population, including rape survivors, indigent women and adolescent girls. Currently, 15 percent of all births in Chile are to adolescent girls between the ages of 10 and 19. In the last 16 years, more than half a million babies have been born to adolescent mothers.
And yet the parliamentarians who want to ban emergency contraception argue that providing clear information, confidential and non-judgmental counseling and easy access to affordable contraceptive methods to adolescents interferes with the rights of the parents to educate their children. They are wrong on this also: a system where disclosure is voluntary can provide a platform for discussion, trust and communication between adolescents and adults, including parents, while respecting the adolescents’ right to confidentiality and information, and willingness to seek care.
In fact, countries like Sweden, France, Canada and Great Britain achieve lower rates of pregnancy, abortion and infection of sexually transmitted diseases in part because adolescents have easier access to reproductive healthcare information and services. By attacking Chile’s guidelines, politicians are acting against the best interests of adolescent girls and almost guaranteeing continued high rates of unwanted adolescent pregnancies.
The court should deny the injunction and uphold the Ministry of Health’s national guidelines. These guidelines – researched and reviewed exhaustively by top medical experts – reflect Chile’s advance towards providing the best possible health care to its all of its citizens. Chilean women demand and deserve no less than what modern medicine can provide.