:: Background and recent developments
The debate on abortion reform in Uruguay has accompanied the country’s re-democratization. Since 1985, proposals to decriminalize or legalize abortion were presented in each new legislature, seeking to modify the 1938 law, which defined abortion as a crime and only allowed exceptional or attenuating circumstances in the cases of family honor, risk for the woman’s life, pregnancy resulting from rape or economic distress. The law had proved to be ineffective, as services to provide abortion in the non-punishable cases have never been regulated. Some lawyers consider, in fact, that it is not implementable, since it is just after the abortion is performed and the crime reported that a judge can intervene to decide if the exceptions can or cannot be applied.
The reality is that neither women nor professionals who perform abortions count on a clear framework to define the legal or illegal parameters around the practice. The law has not been effective either to discourage or eradicate abortions. There are very few prosecutions, even when available data estimates that 30,000 abortions are performed each year in a country where 47,000 births occur annually. The existing punitive legal frame only confines abortion to clandestine and unsafe practices.
At the legislative level — except for a proposal for decriminalization defended by the Colorado Party in the first post-dictatorship legislature – law reform provisions presented over the years were always driven by a coalition of left parties, known as “Frente Amplio”, which has governed the country since 2004. In 2008, a law provision on sexual and reproductive health and rights, authorizing abortion up to twelve weeks of pregnancy was approved by the Parliament, but had all articles regulating the procedure vetoed by the first socialist President Tabaré Vázquez. The law then enacted (No. 18426) recognizes sexual and reproductive rights as human rights and requires the State to respect and guarantee conditions for their exercise. But it has not altered the legal conditions to allow the practice of voluntary abortion.
Law No. 18426 is already regulated by the Ministry of Public Health and since January 2011 sexual and reproductive services have been integrated in the National Comprehensive Health System. All public and private institutions affiliated with this System must provide contraceptive counseling, as well as pre-and post-abortion care within a harm reduction frame. But abortion practice remains criminalized and its practice is confined to underground circuits. Since Misoprostol is the most used aborfacient the number of abortion related maternal deaths has decreased. No cases had been registered until early March, 2012, when a woman died in the Hospital de Clínicas de Montevideo, indicating that although the drug reduces risks, it does not ensure total safety when used clandestinely.
Furthermore, the Ministry of Health has no official data on maternal morbidity, but the press has reported cases of young women who became infertile after undergoing unsafe abortions. Access to Misoprostol is obtained through the illegal circuits; the product is sold in the proximities of public hospitals or in places that sell other illegal drugs. Inevitably its price has risen, reaching amounts between US$ 300 and US$ 500 for the correct dose required for the interruption of pregnancy. Moreover the quality and efficacy of the product is not guaranteed.
“Frente Amplio” was reelected, at the national level in the 2009 elections and once again ensured parliamentarian. However, two years elapsed before a new law provision, aimed at restoring the articles vetoed by Vasquez, was re-tabled. Finally on December 27th, 2011, the Uruguayan Senate has preliminarily approved, by 17 to 14 votes, a new text on the voluntary termination of pregnancy, which decriminalizes the practice up to 12 weeks, whenever the woman expresses her will to terminate the pregnancy. The number of weeks is extended in cases of rape, grave fetal malformation (incompatible with life) and when the pregnancy represents a health risk for the woman. The law includes a provision allowing practitioners to raise conscience objection and refuse to perform the abortion, but all institutions affiliated with the Health System are required to ensure that the service is provided. Abortion procedures neither can be a profitable practice, nor can they be done against the will of women.
The partially approved provision must still go through the parliamentary process. It will be discussed by the Health Commission of the House that must approve it and make a final vote. If no amendments are made the approval by the House will lead to the automatic enactment of the law. Once again the law reform was presented by the left wing coalition and President Mujica has publicly declared that, if approved, he will not veto it. However, not all the required votes within “Frente Amplio” itself are fully secured. Some Parliamentarians have expressed doubts and reservations, even though the coalition has received a mandate from the Congress leader to reform the law.
Social mobilization all around the country was essential to open the path for the penal code to be reformed, adjusting legal norms to the social consensus reached around the right of women to have access to legal abortions. Over 60 percent of Uruguayans are in favor of decriminalization and an expressive network of social organizations engaged in advocacy for the law reform. MYSU – Mujer y Salud en Uruguay (in English, Women and Health in Uruguay) is a feminist organization that, since 1996, has been engaged with the promotion and defense of sexual and reproductive rights as human rights. From 2002 onwards, MYSU developed a permanent campaign aimed at expanding public support to abortion legal reform.
One of our main contributions to enlarging the discussion on abortion rights has been the dialogue and interaction with other key social actors, such as the Central Única de trabajadores (PIT-CNT: in English, the Unified Center of Workers), various human rights organizations, but also afrodescendant, sexual diversity, rural women and students’ movements, as well as religious organizations such as the Methodist and the Waldensian protestant churches. We have also been working together with a large and heterogeneous network of women’s and feminist organizations. Another important realm with which we have established connections is professional, scientific and cultural associations. In this regard, it is worth noting that the Central Board of the University of the Republic has publicly expressed its support to abortion legal reform.
Systematic efforts aimed at making abortion a visible social problem and a subject discussed in political debates has paid off. In the past, if abortion was ever mentioned in public conversations this was done to insult and morally condemn women and health professionals. In contrast, the press coverage of the preliminary approval of the law provision on December 27th, 2011 had an entirely distinct tone. Abortion law reform was in the headlines of all the printed press, radio and TV stations and addressed in legal, ethical and political terms. Today the legalization of abortion is a theme that cannot be sidelined anymore by Uruguayan politics or the national social and health policy agenda.
The provision was discussed in a special session held during the week between Christmas and the New Year and the session lasted more than nine hours. Despite the fact that it was scheduled during the holidays, a large public audience attended Parliament and exploded into applause when the law was approved. The press coverage (in Spanish) can be viewed atMYSU website. While the debate evolved inside the building, a wide citizen’s mobilization surrounded the Parliament. Opponents of the law proposal carried crosses and sang religious songs, but they also attacked the groups supporting legal reform and the aggression levels increased as time went by. Organizations in favor of the law proposal did mainly urban interventions. The symbol of the campaign – an orange hand that manifests a vote favorable to the law – was distributed and planted on the lawns.
:: The time is ripe
Given that the provision still has to go through the full legislative process, the public campaign in favor of law reform has to be sustained. This was done, even during our Carnival, which is said to be the longest in the world, because the performances of street musicians – murgas and comparsas – begin in early February and continue until the end of March moving around different neighborhoods and cities across the country.
Since 2010, MYSU has participated in the Carnival inauguration party, taking part in one of the better known murgas, La Mojigata. We carry posters calling for LEGAL ABORTION and distribute leaflets in the various places visited by this murga. During the last carnival, La Mojiata and other musical groups have incorporated the topic of abortion into their lyrics, which openly criticize politicians who continue to hamper abortion law reform. People’s reaction to these songs and parades was highly positive. There was applause at each and every mention of the potential legal change in ways that reflect a major and deep cultural change.
In the course of the next few months, debates on the issue will continue in Montevideo and across the country. Since in Uruguay parliamentarians are elected in districts (departamientos) it is always more effective to have people living in these areas to directly pressure their representatives. The campaign slogan we have crafted is: YOUR VOTE IS YOUR VOTE, REPRESENTATIVES MUST REPRESENT OUR POSITIONS. MYSU has also elaborated materials on public health and epidemiological, legal and philosophical arguments on abortion and human rights and information on comparative legislation reform. Information Communications Technologies have been used in online campaigns (www.hacelosvaler.org) directed to young people and designed to facilitate the public mobilizing around the law reform. Connections have also been made with regional networks and campaigns in Latin America and the Caribbean.
MYSU’s central argument in favor of the reform is that the right to decide pertains to the realm of individual freedom but it is inherent to necessary political and cultural transformations aimed at the emancipation of women, as full citizens and moral subjects able to make ethical decisions. Another key argument of the campaign is that the legalization of abortion is fundamental to consolidate and deepen democracy. It implies the creation of a legal framework in line with principles of laicité to promote the peaceful coexistence of diverse beliefs and values present in the society, which cannot be subordinated to any religious or ideological hegemony. Social justice, the eradication of inequalities and enabling conditions for the full exercise of human rights are the other premises we claim in calling for legal change.
The challenge ahead is enormous. If the law provision is approved in the House, the rules prohibit the tabling of another proposal addressing the matter during the same legislative period. Discussions within “Frente Amplio” indicate that Tabarés Vázquez may be nominated as presidential candidate for the national 2014 elections. If this happens and he wins, the prospect of abortion reform law being proposed once again may have to be postponed until after 2019. These conditions make it crucial to approve the provision in 2012 and for that to happen high levels of citizenship participation is needed between now and the voting.
It is also interesting to map how the adversaries of the law have been moving. In Uruguay, as elsewhere, some organizations have been created specifically to mobilize against the law reform, as in the case of the Coordinadora por la vida a pro-life group. In recent years these voices have been modifying their arguments against abortion. Instead of exclusively calling upon religious doctrines they are now resorting to “scientific” and rights language. While the majority of their leaders are male, more recently they have also recruited more women in order to change their image. However, their aggressiveness, intolerance and the authoritarian modes of operation they use to influence legislative decisions has generated a negative public reaction.
Their main spokesmen, in particular, has been discredited, because they use false arguments and fake evidence when speaking against abortion and promote fanaticism among their followers. This rejection increased further when they called Herod, the parliamentarians who voted for the law, and threatened them with excommunication. The tradition and profile of the Uruguayan political culture is rather refractory to these types of behaviors. But even so, these groups can still can influence lawmakers.
It is also worth reminding that, in 2004, the Senate did not approve a similar law provision because President Batlle (from the Colorado Party) made an agreement with the Union Cívica, the only religious party in the country, even though it does not have parliamentarian representation. The agreement was that if abortion remained criminalized, Unión Cívica would support Battle in the second turn of the upcoming national elections. Today, once again, the pressures on representatives of traditional political parties to vote against the law provision are quite intense. During the last few weeks public advertisements have been posted in various cities that seek to intimidate politicians and the population itself through the use of images linking abortion to murder.
As a feminist organization, MYSU has been, for many years, investing all possible efforts to make this legal change possible. Today we project two potential future scenarios in relation to abortion in Uruguay. If the law is approved, great pressure will be required to immediately ensure the implementation of abortion services with high quality of care. It will also be necessary to monitor the whole process as a state duty to enforce women’s citizens’ rights. But if the law is not approved, our work has to continue under restrictive legal conditions in order to expand the access to safe medical abortion, in particular for women that experience higher levels of vulnerability, as to prevent death and morbidity. The work towards cultural and ideological change will also have to be sustained. The challenge is big, but victory is possible and the time is ripe.
*Lilián Abracinskas is Director of Mujer y Salud en Uruguay (MYSU)