By Irene Escudero
Bogota, Feb 20 (EFE).- After decades of having to obtain clandestine and dangerous illegal abortions, since Colombia legalized the procedure hardly any women have been coming to the Orientame (Guide Me) clinics around the country bleeding or in pain from badly performed procedures.
It’s a legal change that’s been saving lives in the South American country.
“Since the (decriminalization) ruling came out, treating improperly done abortions has taken a nosedive,” said Luisa Fernanda Alvarez, the coordinator of the non-profit foundation’s programs to provide help on matters of sexual and reproductive health in cities around Colombia.
On Feb. 21, 2022, the Constitutional Court decriminalized voluntary abortion up to the 24th week of pregnancy, a move that has translated into the fact that “women know that they can ask for an abortion when they need it,” Laura Gil, one of the activists with the Causa Justa movement that pushed for legalizing the procedure, told EFE.
Women can freely request that their pregnancies be interrupted now and “it’s rare to find patients with incomplete abortions at this point,” said Alvarez, although they do continue to occur in areas where there are still barriers to the legal procedure, like in rural zones.
Every woman in Colombia who wants an abortion prior to the 24th week of pregnancy has only to ask for a medical appointment and, at that time, “mechanisms are activated so that she can get a consultation where they assure her that they’re going to provide the service within the next five days,” said Gil, who is a gynecologist and an obstetrician.
“There are still patients who have difficulties because they express their opinion at the appointment because the person who receives the first request does not have full information or thinks that it’s still not a right, but in general … patients easily find the way in which to interrupt their pregnancies,” she added.
From the point at which a women enters the private Orientame clinic in Bogota’s Teusaquillo district until she leaves after the abortion, five hours elapse. They give them a checkup, they pay between 450,000 and 1.3 million pesos (between $91 and $265), according to the kind of procedure, and they move to the first appointment with psychologists.
“It’s an appointment where basically they determine how the person is,” said Alvarez, adding that the different procedures are discussed. According to how the pregnancy has been progressing, a pharmacist or a doctor will discuss the various methods, and then the women go on to have the abortion as walk-in patients.
One of the myths floating around after the decriminalization of abortion is that voluntary pregnancy interruptions have been increasing, but although the Health Ministry has provided no figures, specialists know that “really it’s the same women who were going to get abortions ‘solo’ who now know that they have the right to do it via the health service.”
At Orientame, in 2020 a total of 9,223 abortions corresponding to the then-legal circumstances were provided, and that figure increased by about 1,500 in 2021 due to the coronavirus pandemic, but last year, when the procedure was fully legal, the figure increased by just 120 to 10,844.
“Women have always been seeking alternatives to manage unwanted pregnancies,” said Alvarez. And although the number of abortions has not declined, the number of deaths of women certainly has because the mortality risks during a safe and legal abortion are significantly lower than those inherent in actually delivering the child.
According to preliminary data from the National Institute of Health, in 2022 255 women died prematurely, down from 2021, when 457 died, and 2020, when 399 died.
“A dignified abortion comes with … an adequate infrastructure,” said Alvarez, adding that it’s not just the abortion itself that women receive but also “accompaniment on the emotional level,” where the health professionals clearly explain what’s going to happen and the safety measures, but they also advise the patients on contraceptive methods and overall sexual health.
Women now know that the risks are very low and that you only need to swallow a pill – if the pregnancy has not advanced more than a few weeks – or undergo a simple medical procedure that can be done in an obstetric chair.
“There’s almost no bleeding,” said Alvarez, adding that when someone donates blood, they provide about 450 milliliters (about 15.5 ounces), while during a surgical procedure before the 15th week of pregnancy a patient loses only 60-100 ml (2 – 3.5 oz.), and when the pregnancy is terminated in the second trimester the blood loss is between 200-350 ml (7 – 12 oz.), “that is, much less than what a donor would provide.”
Despite the advances, there’s still a lot of work to be done to eliminate the myths and other barriers, dealing with qualms and objections of conscience and providing the service to remote communities where women must sometimes travel for days to get to the site where they can terminate their unwanted pregnancies.