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Why Mexico Is Proof Anti-Abortion Laws Don't Work

28/09/2017 08:51
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Leticia had been bleeding heavily for two weeks when she arrived at Marie Stopes Mexico's clinic in Chiapas. Desperate to end her pregnancy, she had taken some pills from a friend. However as the days passed it became clear that something had gone badly wrong.

Despite excruciating pain and massive blood loss, she ignored her friend's pleas to seek medical help for fear of being thrown behind bars for procuring an illegal abortion. Until finally, weak from anaemia and wracked with pain, she struggled to our clinic, where my team diagnosed a septic abortion and referred her to the public hospital. Any further delay in treatment and she would have died.

Sadly Leticia's story is not uncommon. In Mexico, we have some of the most draconian anti abortion laws in the world yet more than half (54%) of all unintended pregnancies are estimated to end in an abortion, most of them carried out by untrained providers or by women themselves. The resulting complications are one of the top five causes of maternal deaths in our country.

The situation is exacerbated by the morass of ignorance and misinformation surrounding abortion. Ignorance that inspires hostility, stigma and restrictive legislation that can do real harm to women like Leticia, forcing them to hide their pain and risk their lives. 

Since January, following President Trump's reintroduction of the Mexico City Policy (an Executive order that withholds American aid from health organisations that provide or even discuss abortion), that hostility has spiked, with abusive tweets like this one filling our social media feeds. 

"Why am I paying for women in Mexico to have abortions anyway? They should just keep their legs together."

This vitriol directed at Mexican women is infuriating on so many levels and inaccurate on at least three. But while the temptation is either to howl in rage or dismiss it as 'just another tweet', these digital outbursts are symptomatic of the misinformation that persists around abortion and the stigmatisation of women who choose to end a pregnancy. So this International Safe Abortion Day, I would like to jettison some of the myths and set the record straight. 

Myth number one: The Mexico City Policy blocks the U.S. Government funding abortions in Mexico

First things first, the US government does not fund abortions in Mexico - or anywhere else outside the US for that matter. Congress has prohibited U.S. foreign aid paying for abortions since 1973, when it enacted the Helms Amendment.

The Mexico City Policy is something different and actually has nothing to do with Mexico City, other than it was first announced there in 1984. What the policy means for organisations like Marie Stopes International is that we are ineligible for U.S. funding for our contraception services if we so much as tell a woman abortion is a legal option in her country, refer her to another provider or advocate for abortion rights using our own resources.

Marie Stopes Mexico has not been affected by the Mexico City Policy as we do not receive US funding, but for Marie Stopes International globally the loss equates to $30 million a year. Funding that has helped us provide contraception to millions of poor and disadvantaged women across Africa and Asia and prevent hundreds of thousands of abortions every year.

Myth number two: Blocking funding for abortion or legally restricting it prevents it happening

Attempts to stop abortion by withholding family planning aid do not work, because they do not eliminate women's need for abortion. In fact, studies have shown that by preventing USAID from partnering with organisations like Marie Stopes International that deliver comprehensive sexual and reproductive health services, the Mexico City Policy actually increases the number of abortions that take place in developing countries.

Legal barriers are equally ineffective. Latin America has extremely restrictive abortion laws and the highest unsafe abortion rates in the world. We have to face facts here. Legal or not - and by extension safe or not - when backed into a corner, a woman with an unwanted pregnancy will do anything necessary to end it and we have to stop ignoring that.

However, while laws do not appear to lower the number of abortions, they do increase the likelihood of health risks. In Mexico, more than one third of all women having a clandestine abortion are expected to have complications that require medical treatment. Tragically, a quarter of these women do not receive the care they need, with poor rural women like Leticia worst affected.

The only exception is the capital, where 10 years ago the federal district approved a watershed bill making abortion legal during the first three months of pregnancy. Today, legal first-trimester abortions carried out in Mexico City have almost no complications, providing a sharp contrast to the clandestine procedures that occur in the rest of the country.

It wasn't always that way of course. Growing up in Mexico City before the law was liberalised I knew friends and family who had undergone unsafe abortions and those who bore the consequences. Everyone did. It is one of those secrets that run in everyone's families.

Sadly in other parts of Mexico, women still have to hide; they are still treated like criminals and still have to travel miles across state borders in order to end an unintended pregnancy. While those without means, like Leticia, are forced to resort to clandestine clinics, traditional midwives and herbal potions, with scores dying every year.

Myth number three: Women should just keep their legs together if they don't want to get pregnant

Let's not shy away from the fact that not all sexual acts are loving and consensual. The Executive Commission for the Care of Victims (CEAV) estimates that one out of every four girls in Mexico suffers sexual abuse before the age of 18, and that six out of every ten cases of sexual abuse are committed in the home by relatives or close acquaintances.

Other women and girls are simply let down by a substandard sexual health education or lack of access to contraception. In Mexico, the continuing taboo around sexuality contributes to half a million girls under the age of 19 giving birth each year- the highest rate of teen pregnancy in the Organisation for Economic Cooperation and Development (OECD). Thousands more risk their lives by resorting to unsafe abortions.

So what do we do? Unintended pregnancy is far from inevitable. And the good news is that the solution is simple. What has been shown to work over and over again is access to affordable contraception, especially long-acting methods like IUDs, and good sex education that reduces stigma and empowers girls to engage in open dialogue.

Sadly though, no method of contraception is 100% effective. So if we want to truly empower women to control their fertility and steer their own destiny then the final piece of the puzzle has to be the provision of safe, legal abortion services.

It's not rocket science but to women like Leticia jettisoning the myths and addressing the ignorance surrounding abortion can be life changing and sometimes even life-saving.

Araceli Lopez Nava Vásquez is country director for Marie Stopes Mexico

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