| | |  Editorials | Issues | August 2008 
Mexico City Struggles With Law on Abortion
 Elisabeth Malkin & Nacha Cattan - New York Times
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| | A man looked at portraits of women who support abortion rights during a recent demonstration in Mexico City. (Alexandre Meneghini/Associated Press) | | |
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, Dr. Armando Ahued. “We were learning as we went along.”
Now, even as the city’s left-wing 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 Dr. 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. Dr. 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 Dr. 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,” Dr. 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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