FRIDAY FILE - On October 17, 2012, Law 18.987 was passed in Uruguay allowing women to voluntarily interrupt their pregnancy, but under certain restrictive conditions. AWID spoke to feminist activists, Lilián Abracinskas, Lucy Garrido, Ana Lima and Romina Napiloti, who have been involved in the 27 year long struggle for the passage of this controversial law.
By Gabriela De Cicco*
Law 18.987 establishes that women who need to voluntarily terminate their pregnancies within the first 12 weeks of their pregnancy - and up to the 14
Twenty-seven years of organising and alliance building
Proposals for decriminalizing or legalizing abortion in Uruguay began with the return of democracy.[1] In 1985, the Colorado (Red) Party submitted a decriminalization proposal and since then new proposals have been submitted in every new legislative period.
In 1988, the feminist organization Cotidiano Mujer launched a key book called: "Yo aborto, tú abortas, todas callamos” (I have an abortion, you have an abortion, we all keep silent). Lucy Garrido of Cotidiano Mujer says, “the title has somehow come back in the last three years, as a slogan, but now it says ‘Yo aborto, nadie más se calla’ (I have an abortion, nobody keeps silent any more’). This is an acknowledgement of the path we have travelled because there has been a change. Before, we spoke about the hypocrisy, but now we have secured the support of 60% of the people so ... nobody is keeping silent any longer”.
Executive Director at Mujer y Salud (MYSU) (Women and Health) Lilian Abracinskas recalls the first national Women and Health conference held in 1989, where women’s organizations that did not necessarily identify as feminists endorsed the proposals to make abortion legal. Since then, she says, “It was all hard work, step by step, to mainstream this agenda in other social movements. It is worth highlighting all this alliance building work, because we succeeded in making this not just a women’s or feminist’s claim but, rather to be more inclusive and have a very broad coalition of social organizations with a strong public presence. Many of them joined the Coordinadora por el Aborto Legal de Uruguay (Alliance for Legal Abortion in Uruguay).” [2]
In 2008 the parliament approved the “Law in defense of sexual and reproductive rights”, but Tabaré Vázquez, the president at that time, vetoed all the chapters related to decriminalization of abortion and the regulation of the practice through the law[3]. In December 2011 a proposal to restore the sections vetoed by Vázquez in 2008 was passed by the Senate, decriminalizing abortion up to the 12th week of pregnancy and allowing abortion on-demand for women. But Lilián Abracinskas recalls, “By the time the bill went to the Deputies’ Chamber, where the ruling coalition Frente Amplio has parliamentary majority, two of its deputies refused to vote based on their personal beliefs. In order to get the needed votes to pass the law politicians continued to use women’s rights as domestic political bargaining chips and the final text was completely different from the original. Even though it is called ‘Voluntary Termination of Pregnancy’, it does not contain the most basic demand raised by the Abortion Alliance, which was for a legal change towards effective decriminalization. This left us all with a sense of frustration.”
According to Abracinskas the new law “Makes the medical establishment responsible for decisions about women’s bodies. Historically, the medical establishment has never encouraged individual freedom and autonomy in the area of sexuality and reproductive health, but has rather been one of the patriarchal powers that mediates control over women’s bodies.”
Regulations
On November 21, 2012, the Uruguay Ministry of Health issued a decree to regulate Law 18.987 establishing that abortion is a public health issue. The Public Health Under Secretary, Leonel Briozzo, believes that “A balanced and impartial regulation has been achieved, acknowledging the right to responsible procreation and the social value of motherhood, while also guaranteeing the safety of patients, diminishing the unwanted collateral effects that terminating a pregnancy can have”.[4]
The decree ensures confidentiality in consultation, informed consent and that it is the woman who can make the free decision to terminate a pregnancy.
But the restrictive conditions are undeniable. According to this regulation, the abortion procedure begins with a gynaecological consultation where the woman must state her decision to terminate her pregnancy. The law prescribes, that a multidisciplinary team must be called within 24 hours, to support the woman and that she must leave the first consultation with appointment for the second consultation. The second consultation requires the woman to again meet the gynaecologist she has already consulted, as well as a mental health professional who will advise her on support available to her in the process; and a social worker who will inform her of the social benefits and adoption as an option. These professionals should not make judgements aimed at seeking to change the woman’s decision. Following these consultations, the law prescribes a five-day reflection period, which begins from the day of the first consultation. Once the five days are over, she must go back to her gynaecologist to ratify or rectify her decision. If her decision is to abort, she will sign an informed consent and the procedure will begin.
A handbook will be distributed to health staff recommending that the best method to follow is pharmaceutical abortion by providing women with Misoprostol. The recommendation is to treat women as outpatients; and that if hospitalization is required, to make it as short as possible.
The decree acknowledges conscientious objection for professionals and ideological objection for health facilities that decide they cannot assist in or provide the service of abortion because of their beliefs or legal statutes. If the gynaecologist treating the woman is a conscientious objector, they are mandated to refer her to another institution or professional to ensure the termination of pregnancy.[5] None of these objections apply to therapeutic abortion or when the woman’s life is at risk.
Outreach and monitoring
Negotiations around the final text of the law and disregarding what the social movement for abortion were pushing for generated different reactions among the ruling Frente Amplio party supporters and Abortion Alliance members. According to Romina Napiloti of Proderechos, “There were deep disagreements within the Alliance with regard to our position before the Bill – some supported the passing of this Bill with closed eyes while others said this law is not progress, or it is a step forwards but a very uncommitted one”.
Beyond this split, one thing on which our interviewees agree, is that this is the law they have and now is the strategic moment to assess how it is being put into practice and to do outreach on what it guarantees.
Ana Lima, National Coordinator of CLADEM Uruguay, says they will be watching how the law is regulated and enforced, “Because the medical establishment has already said they can’t absorb the demand due to lack of staff. What is going to happen outside the main cities where there is not enough staff for three-person interdisciplinary teams? They must take women to the closest facility where they can find those professionals, and in the meantime the deadline is reached”.
Organizations like CLADEM have already begun designing strategies for outreach and education for women on how to make use of the law. Lima believes that “We need to be monitoring and overseeing that the State abides by the law. If they don’t, we have to report them. Together with the National Monitoring Commission [6],we are thinking of setting up a legal advice service because cannot not rule out the possibility of situations where we will need to submit appeals for legal protection”.
Napiloti says, “Some of us, as part of the Alliance, want to start a hotline for Safe Abortion, which has been implemented by organizations in Argentina, Ecuador, Peru and Chile. The idea would be to have a mechanism for consultations and also to do outreach to women on what they can and can’t do, protected by the law.”
According to Garrido, “The law includes many elements that make no sense, but we must take into account that it (abortion) is free and available everywhere. That is, all private and public health facilities are compelled to do abortions, which is very good. And now there are thousands of people convinced that abortion has really been decriminalized. We have to use that to empower women. As soon as the law is regulated, we have to run to the press and publish announcements saying ‘You have the right to abortion’. It will be useful to do a cultural revolution”.
* The author thanks Alejandra Scampini and Ana Inés Abelenda.
Translator: Alejandra Sardá-Chandiramani
[1] It is interesting to point out that abortion was legal in Uruguay between 1933 and 1938. The Terra’s dictatorship criminalized it again, with the support of and under pressure from Catholic members of the Union Civica and White parties: http://www.chasque.net/frontpage/comision/dossieraborto/cap3_3.htm
[2] According to Lilian Abracinskas, 60% of the public was in favour of decriminalization. It was a very broad coalition including, not only all women’s and feminist organizations, but also Confederation of Unions, Federation of University Students, sexual diversity groups, and other community-based and human rights organizations. This alliance is structured around four principles: 1) clandestine abortion is a public health problem; 2) clandestine and unsafe abortion is a social justice problem; 3) it is a democracy issue because in these matters there is not just one truth and then we need a law that takes into account the secular nature of the Uruguayan State and the peaceful coexistence of a diversity of beliefs and values; 4) the recognition that women must have the right to decide because pregnancy happens in their bodies and that the body is the only material good that nobody lacks of, and there can be no interference by others or by other interests to decide on that territory.
[3] “Ley en defensa del derecho a la salud sexual y reproductiva” (Law in defense of sexual and reproductive rights”, passed by the Senate on November 11, 2008: http://www.choike.org/documentos/6nov2007.pdf
[4] “Reglamentación consagra autonomía de la mujer para abortar”: http://www.180.com.uy/articulo/30063_Reglamentacion-consagra-autonomia-de-la-mujer-para-abortar
[5] Ana Lima said, “We think that the inclusion of institutional conscientious objection in the law is very serious. Even though the institutions whose mission/vision or ideology is against performing an abortion commit with the Public Health to refer the women, conscientious objection can never be institutional, it is always personal”.
[6] Established in 1996, the National Monitoring Commission is a network of women’s organizations from across the country.