Surely A Large Human
Date registered: Jun 2006
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Last November it became a crime for a woman to have an abortion in Nicaragua, even if her life was in mortal danger. So far it has resulted in the death of at least 82 women. Rory Carroll reports on the fight to have the law changed.More at the link.
Mar├*a de Jes├║s Gonz├ílez was a practical woman. A very poor single mother, the 28-year-old's home was a shack on a mountain near the town of Ocotal in Nicaragua. She made the best of it. The shack was spotless, the children scrubbed. She earned money by washing clothes in the river and making and selling tortillas.
That nowast quite enough to feed her four young children and her elderly mother, so every few months Gonz├ílez caught a bus to Managua, the capital, and slaved for a week washing and ironing clothes. The pay was three times better, about ┬ú2.60 a day, and by staying with two aunts she cut her costs. She would return to her hamlet with a little nest-egg in her purse. She bought herself one treat - a pair of red shoes - but she would leave them with her family in Managua, as they were no good on the mountain trails she had to go up to get home.
During a visit to Managua in February she felt unwell and visited a hospital. The news was devastating. She was pregnant - and it was ectopic, meaning the foetus was growing outside the womb and not viable. The longer Gonz├ílez remained pregnant, the greater the risk of rupture, haemorrhaging and death.
What Gonz├ílez did next was - when you understand what life in Nicaragua is like these days - utterly rational. She walked out of the hospital, past the obstetrics and gynaecological ward, past the clinics and pharmacies lining the avenues, packed her bag, kissed her aunts goodbye, and caught a bus back to her village. She summoned two neighbouring women - traditional healers - and requested that they terminate the pregnancy in her shack. Without anaesthetic or proper instruments it was more akin to mutilation than surgery, but Gonz├ílez insisted. The haemhorraging was intense, and the agony can only be imagined. It was in vain. Maria died. "We heard there was a lot of blood, a lot of pain," says Esperanza Zeledon, 52, one of the Managua aunts.
Gonz├ílez was not stupid and did not want to die. She knew her chance of surviving the butchery was small. But being a practical woman, she recognised it was her only chance, and took it. The story of why it was her only chance is an unfolding drama of religion, politics and power that has made Nicaragua a crucible in the global battle over abortion rights. This central American country has become the third country in the world, after Chile and El Salvador, to criminalise all abortions. It is a blanket ban. There are no exceptions for rape, incest, or life- or health-threatening pregnancies.
Gonz├ílez was told at the hospital that any doctor who terminated her pregnancy would face two to three years in jail and she, for consenting, would face one to two years. "Nicaraguan doctors are now afraid of going to trial or jail and losing their licence," says Leonel Arguello, president of the Nicaraguan Society of General Medicine. "Many are thinking that instead of taking the risk, it is better to let a woman die."
For the Nicaraguan rich, a problematic pregnancy need not be a death sentence. You can fly to Miami or bribe a discreet private clinic in Managua. But in this wretchedly poor country most young women do not have money. Their choice is to go through with a pregnancy that may kill them, or attempt a DIY termination that may kill them.
As a result of the blanket ban enacted last November at least 82 women have died, according to advocacy groups. "This new law intentionally denies women access to health services essential to saving their lives, and is thus inconsistent with Nicaragua's obligations under international human rights law," says Human Rights Watch.
Nicaragua is famous for its misfortunes: the Somoza dictatorship, the civil war, the impoverishment, the natural disasters. Pro-choice groups say article 143 of the new penal code should be added to that list since it bucks the international trend towards greater abortion access and drags women back to the dark ages.
The anti-abortion camp, in contrast, is euphoric. The new law, it says, is a beacon in the fight to protect the unborn. It is time to celebrate. "Now it is all penalised. And Catholics agree that is should be this way," says Roberto Gonz├ílez, 50, a Franciscan priest in Managua. "The population sees the church as behind the law - behind the pressure that succeeded in getting the government to change the law."
Abortion has long been illegal in Nicaragua but there had been exceptions for "therapeutic" reasons if three doctors agreed there was a risk to the woman's life. Those exceptions were no longer necessary, said the Nicaraguan Pro-Life Association, because medical advances obviated the need to terminate pregnancies. "The conditions that justified therapeutic abortion now have medical solutions," says a spokesman. Pope Benedict XVI welcomed the ban but added that women should not suffer or die as a result. "In this regard, it is essential to increase the assistance of the state and of society itself to women who have serious problems during pregnancy."
Nicaragua provides no answer to the debate about when, between conception and birth, life begins. But in the case of Gonz├ílez it is clear when it ended: at 28 years. According to Zeledon, the doctors left Gonz├ílez with few illusions. "When she came back from the hospital she was very upset. They said they couldn't help her. She knew what this meant: I think she knew she was going to die." Her children have been taken into care and her mother now lives alone. The only mementos of Gonz├ílez's visits to her aunts in Managua are some clothes and the red shoes.
No one knows how many other women have died, or are going to die, as a result of the law. The Pope seemed to acknowledge an increased risk to women's health but Nicaragua's government has made no formal study of the law's impact. Women's rights organisations say their 82 documented deaths are the tip of the iceberg. The Pan-American Health Organisation estimates one woman per day suffers from an ectopic pregnancy, and that every two days a woman suffers a miscarriage from a molar pregnancy. That adds up to hundreds of obstetric emergencies per year.
In an attempt to clarify matters, the health ministry issued protocols last December that said doctors should respond to most obstetric emergencies, including ectopic pregnancies and post-abortion care. To terminate an ectopic pregnancy is legal, it turns out, because since the foetus is not in the womb the procedure would not be an abortion. But such is the climate of fear and confusion that the protocols are widely ignored and misunderstood. The doctors who turned Gonz├ílez away from the hospital in Managua thought it was illegal, as did medical staff the Guardian interviewed in Ocotal, Gonz├ílez's home town.
"The ban has people frightened. You could lose everything - that's the first thing on your mind," says Dr Arguello, a leading critic of the ban. So far there have been no prosecutions but many doctors are unwilling to take the risk on behalf of women who are often poor, uneducated and from a lower social class.
It is a grim irony that this is happening under a Sandinista government - a movement whose ranks once included advocates for feminism and abortion rights. That was in the 1980s, when the Sandinistas were secular marxists, wore combat fatigues and fought a bloody civil war against US-backed Contra rebels. Things changed. The war ended and the Sandinista leader, Daniel Ortega, lost the presidency in a 1990 election. Church and state were supposedly separate but clerics wielded political clout, none more so than Cardinal Miguel Obando y Bravo. His hostility sank Ortega's attempted comebacks in 1996 and 2001 elections.
The campaign's problem is that at home it is politically outgunned and unpopular. Lobbying for abortion rights, however limited, is a hard sell to a population largely deferential to the pulpit. The taboo is especially strong in rural areas. Edith Morales, an extrovert mother of two in Sahsa on the Miskito coast, is loud and proud when discussing indigenous rights and her impoverished community's needs. But when discussing the termination of an ectopic pregnancy she had 15 years ago, an act that probably saved her life, she lowers her voice, as if it was something shameful. "People here are very conservative," she explains. Asked if she supports the ban on therapeutic abortions, she shakes her head, and murmurs no.
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