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Mexico City struggles
with law on abortion
By Elisabeth Malkin
and Nacha Cattan, Posted August 25, 2008
GayPASG e-mail August
26, 2008
MEXICO CITY: When Mexico
City's government made abortion legal last year, it also set out to make it
available to any woman who asked for one. That includes the city's
poorest, who for years resorted to illegal clinics and midwives as wealthy women
visited private doctors willing to quietly end unwanted pregnancies.
But helping poor women gain equal access to the procedure has turned out to be
almost as complicated as passing the law, a watershed event in this Catholic
country and in a region where almost all countries severely restrict abortions.
Since the city's legislature voted for the law in April 2007, some 85 percent of
the gynecologists in the city's public hospitals have declared themselves
conscientious objectors. And women complain that even at those hospitals
that perform abortions, staff members are often hostile, demeaning them and
throwing up bureaucratic hurdles.
"We had to resolve how to offer the service on the fly," said the city's health
secretary, Armando Ahued. "We were learning as we went along."
Now, even as the city's leftist government revamps its abortion services, the
law is coming up against its biggest challenge — in the courts.
On Monday, Mexico's Supreme Court begins public deliberations on a legal
challenge that was filed last year by the conservative federal government and
backed by anti-abortion groups. A decision could come as early as this
week.
In a measure of the passions that the debate has aroused, the Supreme Court
heard 40 speakers for and 40 against abortion during six public hearings that
began in April.
To overturn the city's law, which allows abortions during the first trimester, 8
of the 11 magistrates must vote against it.
The debate is unlikely to end with a court ruling. Anti-abortion groups
have already said that they will push for a referendum if the court ruling goes
against them, arguing that is a better way to decide such a momentous issue.
"It is a debate over absolutes," said Armando Martínez, president of the College
of Catholic Lawyers of Mexico. "It is an issue that is not really subject
to debate."
In the rest of Mexico, states allow abortions only under limited circumstances,
such as rape and incest, and Human Rights Watch reports that in practice such
abortions are almost impossible to obtain.
Mexico City has ignored the philosophical battle, pushing ahead with plans that
officials say will help them live up to the spirit of the law. "For the
people with money, this was not a problem," said Ahued, who sees the law as
righting a wrong that put many poor women in jeopardy. "But for our people
with no resources, what could they do? They went to clandestine clinics."
After so many doctors refused to perform abortions, the city hired four new
doctors to help handle the load at the 14 city hospitals where the city
initially offered abortions. Now 35 doctors offer the procedure in city
medical facilities.
Because the city determined its service was not fast enough, it has trained
doctors to use abortion pills when possible and perform speedier surgical
procedures.
It is unclear how many women may have decided not to get abortions at the
already overstretched public hospitals because it took too long to get
appointments or because they had to wait too long for the required ultrasound.
Since unrestricted abortions became legal in April 2007, doctors have performed
(or overseen when pills are used) some 12,500 of the procedures at public
clinics and hospitals, according to the Health Ministry.
But at least some women have tried other methods.
Alejandra, 24, who works for the city's women's institute, said that when she
went to get an abortion last year at a public hospital, a social worker there
told her that she would need to pay for her own ultrasound, which is supposed to
be free, and that she would need to be accompanied by a family member.
Scared off by the description of the risks and the procedure, she fled the
hospital.
She ended up taking pills to induce an abortion, without seeing a doctor, and
developed a serious infection. She asked that only her first name be used
because she said she recently received a death threat for speaking at a city
event celebrating the new law. Another woman, a 27-year-old high school
literature teacher, who spoke on condition of anonymity, said her friends told
her that they were treated like prostitutes at public hospitals. She also
took abortion pills but said they were ineffective, requiring her to visit a
doctor to complete her abortion.
To speed up treatment, officials are moving low-risk abortions out of overworked
public hospitals into three smaller public clinics, based in part on models in
Britain and the United States. The smaller staffs there should be more
supportive, they hope.
On a recent morning at one of those clinics, called Beatriz Velasco de Alemán,
in a working-class neighborhood, women waited with friends, husbands and
boyfriends in a small courtyard, chatting, fiddling with their cellphones or
staring into space.
One 27-year-old married mother of two who had come to the clinic for an abortion
saw no contradiction between her religion and abortion. "I'm Catholic but
now the law has been passed," she said as she went inside for her appointment.
There is one sign of opposition at the clinic. Brenda Vélez and two
assistants from the anti-abortion group Pro Vida arrive every day at 11 a.m. to
say the rosary and hand out pamphlets.
But unlike the very public battle over abortion in the United States, which is
played out on the streets and through the news media, the two sides here have
confined much of their argument to the courtroom.
Even the powerful Catholic Church, which threatened legislators with
excommunication last year if they approved the law, has muted its political
rhetoric. (In the end, the church did not kick any lawmakers out because
of their votes.)
There have been a few public protests as the Supreme Court's decision
approaches, but neither side has mobilized massive forces. It is the
doctors themselves who are on the front lines when it comes to choosing sides.
One gynecologist working at a public hospital, herself a new mother, said she
was an objector because she was uncomfortable with interrupting life. Some
women, she said, "are irresponsible because there are contraceptives." She
asked not to be identified.
Those who have chosen to perform abortions say it has not been easy. Laura
García was the only one of 13 gynecologists at her hospital who agreed to offer
abortions last year. Some days, she says, she performs as many as seven or
eight surgical abortions.
"I became a warrior there defending my convictions," said García, who moved to a
new hospital in May where the city plans to have abortions performed for minors.
She said she had been insulted by colleagues and chased down the street by
abortion opponents. But she said that having witnessed what happened to
women before abortion became legal — she saw cases of septic shock and
uncontrolled bleeding from botched abortions — helped her continue her work.
"I am contributing to rescuing women's rights," García said. "In Mexico,
women have always been marginalized."
She added: "I am a Catholic, but I have convictions. I don't think
I'm going to hell. If I go, it will be for something else."
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