Big gap between ideal and reality for therapeutic abortion in Peru
By Carla Samon and Cristina Bazan
Lima, Jan 19 (EFE).- A century has passed since Peru legalized therapeutic abortion, but there are still many obstacles facing girls, teens and women who want to interrupt a pregnancy, even when it is the only way to save their lives or prevent permanent damage to their health.
Stigma, disinformation, religious beliefs, the scanty supply of the service and, up until 2014, the lack of a unified protocol for getting an abortion – among other barriers – have made access to this health service very limited and have caused a significant gap between what’s on paper and reality.
“It’s been many years and we’re still far from a real implementation of the therapeutic abortion protocol. We still have a large number of young women, teens and girls who cannot access it and that causes forced maternities,” the senior official at the Planned Parenthood Global programs for Peru, Pilar Montalvo, said.
Since 1924, the abortion law has remained intact and allows abortions only if the health or the life of the mother is at imminent risk if the pregnancy were to continue.
So, if there is a congenital deformity in the fetus, or the pregnancy is the result of rape there is still an “urgent” reason to make abortion more accessible in a country where one in every five girls under age 15 has suffered sexual violence, according to figures from the Inter-American Commission for Human Rights (ICHR).
The statistics on sexual violence explain the terrifying figures revealed by the official reports, collected by the Committee for Latin American and the Caribbean for the Defense of Women’s Rights (Cladem) about child pregnancies: Since 2016, each day there are an average of at least five girls younger than 14 who are forced to become mothers because they cannot get abortions.
That scenario was especially dire for girls younger than 10 in 2020, when in the middle of the Covid-19 pandemic births quadrupled compared with the average for earlier years: 24 cases per day, compared with 5 in 2018 and 9 in 2019, according to the Live Birth Certificate Registration System also cited by Cladem in its latest report.
“Were those girls informed about therapeutic abortion? Were they offered the service or were they given advice?” asked the director of the Promsex programs, Rossina Guerrero, who called these cases “a death sentence” and noted that Peru is the only Latin American country that has been sanctioned twice by international courts for having denied therapeutic abortions to two minors.
The first case dates back to 2005, when the UN Human Rights Committee issued a statement supporting a 17-year-old girl who was forced to continue with a pregnancy where the fetal was deformed and could not survive.
In 2011, the Committee on the Elimination of Discrimination Against Women (Cedaw) also held Peru responsible for the case of a 13-year-old girl who tried to commit suicide after being raped repeatedly. Tragically, the minor became a quadriplegic due to delayed surgery that she only had after she suffered a spontaneous abortion.
To get a therapeutic abortion in Peru, a female must get the approval of a medical board and have it done at a hospital with basic specialties. These are requirements that Rossina Guerrero says constitute barriers to abortion.
“There’s a lack of awareness. Many professionals say that they don’t have the ability to do that, despite the fact that there’s been a lot of information about it,” Pilar Montalvo said.
Luis Flores, the director of the Peruvian Society of Obstetrics and Gynecology, said that it is “impossible” that healthcare professionals are unaware of the handbook for therapeutic abortion, but there certainly is “fear” surrounding the issue because the doctor thinks that he might be put on trial for performing an abortion. “It’s rank and file work. You’ve got to go hospital by hospital,” he said.
According to Ministry of Health data, between 2018 and 2020 there were 643 medical abortions performed in Peru, with 325 of them being performed in the latter year. However, Flores said he does not trust those statistics: “Therapeutic abortion has no subclassification in the international medical code, so it’s just entered as another abortion. There are no statistical data that can tell us the situation for therapeutic abortions in Peru.”
If it’s difficult to get an abortion in the big cities, the obstacles get even worse in the more remote parts of the country. There, the work of municipal and feminist organizations working to raise awareness of sexual and reproductive rights becomes even more important.
One of those organizations is Centro Ideas, which operates in the rural zones of the northern Piura region, and its representative, Milagros Mendoza, said that, advances in getting the issue on the local political agenda are moving “very slowly.”
Language is often an additional barrier for Quechua-speaking rural women or those who speak other indigenous languages.
Meanwhile, on Dec. 10, 2021, a female legislator from the leftist Juntos por el Peru party presented in Congress a bill to decriminalize abortions performed when a pregnancy results from rape.
The latest initiative of this kind was undertaken in 2016 and although it was shelved without congressional debate, it was a landmark in the feminist “Let her decide” campaign, which for the first time managed to get a “taboo” issue on the political agenda and about which had only been discussed amid “the stigma of risk, danger and sin,” Montalvo said.