Abortion phone line: more information, fewer risks
CIP Americas The Americas Program http://www.cipamericas.org Abortion Phone Line: More Information, Fewer Risks According to the Ministry of Health, on the average we women abort twice in our lifetimes, including spontaneous and induced abortions. In Argentina, between 460,000 and 700,000 abortions are performed annually. Abortion is an undeniable reality.
But in this country abortion is still classified by the penal code as a crime, with a few exceptions, and isstill performed in secret, which affects especially those with fewer resources, less information, and lessaccess to healthcare. Some of the consequences are readily visible: 60,000 women end up hospitalized asa result of badly performed abortions and some 100 die per year.
Faced with this scenario, the organization Lesbians and Feminists for the Legalization of Abortion(Lesbianas y Feministas por la Legalización del Aborto) decided to move from making demands to takingaction. Fifteen activists from feminist, LGBT (lesbian, gay, bisexual, transsexual, and transvestite),student, leftist, and human rights movements got together for a common purpose, the "Abortion: MoreInformation, Less Risk" telephone line. They investigated how pregnancies can be terminated bypharmacological means, specifically with the use of Misoprostol and Mifepristone, medication that hasbeen around for more than 20 years and is recommended by the World Health Organization (WHO) andother groups because of its efficacy and low risk of fatality.
The strategy appeals to the rights to information and free expression, two pillars of liberalism, in order tobreak the monopoly on knowledge of the subject. "We are trying to democratize information for womenwho don't have access, and democratizing implies guaranteeing the greatest circulation possible, anobligation the state is not meeting. Basically, we spread information that is already public, that is on theinternet, and that is endorsed by the WHO as well as the Latin American Obstetric and GynecologicalFederation (Federación Latinoamericana de Obstetricia y Ginecología)," explained Verónica Marzano,social worker, feminist, and a member of the organization.
"We don't do counseling, nor do we make value judgments, and we believe that's where the success ofthe initiative lies. We simply repeat data on dosage, the danger signs, when it's necessary to see a doctor,what the woman's rights are when dealing with health professionals, and what rights protect women whenan abortion is in progress," adds Lía, a communications student.
The initiative for the phone line sprang from the Dutch organization Women on Waves and reached theArgentine activists by way of the Ecuadorian experience. Lesbians and Feminists for the Legalization ofAbortion then spent nine months studying the WHO protocol and planning together on how to reachwomen.
The phone line was launched in July of this year with actions in several different provinces. Its firstimpact came about thanks to friendly organizations that joined in spreading the word and to the support ofalternative media and community radio stations.
But the effect of the phone line was greatest soon after presentation of the first report to the Buenos Aireslegislature. In it the organization explained that the calls being received revealed a whole series of taboosabout the body, sexuality, maternity, and women's ability to make decisions. And they were confronted
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with enormous misinformation concerning the use of Misoprostol.
The report relates how references to the drug were intertwined with myths, errors, and prejudices andhow false, outdated, and incomplete information was being circulated. "Every professional orcommunications medium that spreads information that is partial, false, slanted, and full of misogynybecomes complicit as well, failing in the democratic duty to contribute to the development of criticalpolitical thinking through the dissemination of knowledge. Information about safe abortion can no longerbe spread like a secret. Silence is not health," the document concludes.
After the report was published there was a five-fold increase in the number of calls and today theorganization registers as many as 50 consultations a day. After the appearance in the mass media,outreach spread throughout the country as well and contacts with women expanded, now including arange of ages and social levels. This Nov. 25 the second report will be delivered in the nationalcongress—in the context of the day against gender violence—with the goal of appealing to legislators toapprove a bill legalizing abortion. The Consultations
"We thought the calls would come after a few months, when the line was better established. That theywouldn't call just because they had seen a sticker. It [the response] was very strong and that speaks to howalone the women are. Maybe it's a sticker they see on the train when they're returning from work, or on alamppost, at a time when they're pulling out their hair because nobody is reaching out to them," GracielaFernández comments.
The national reach of the initiative was a surprise not just to the women and men of the movement. Despite the fact that different women's and human rights organizations initiated discussion of abortionyears ago, this is the first time there has been a direct action initiative with such strong results.
The success is also partly explained by the use of technological developments, both in using advances incommunication and in the pharmaceutical industry as well. "Misoprostol is a drug that changed theparadigms of the debate. Now women can exercise their rights without doctors standing in the way. Withother methods, intervention is unavoidable. Besides, Misoprostol reduces the costs of the health system,"Luciana Sánchez, a lawyer for the organization, told the newspaper Crítica de la Argentina.
Misoprostol is a medication that is used at any stage of the pregnancy and that has the purpose oflowering maternal mortality. As a method of abortion, it can be used up to the ninth or twelfth week and itcan be administered at home, with subsequent medical control. It is a non-invasive method, has a 1% riskof infection and less than 5% risk of hemorrhage. The price is around 300 pesos ($75), one-fifth the costof surgical abortion. But despite these characteristics and despite its being considered an essentialmedication by the WHO, Misoprostol is not authorized in this country, even for obstetric use.
Nor did the advantages of the method make the decision to give out information on how to perform apharmacological abortion easy for members of the organization. "It was all a process of wiping thesecrecy out of our own heads, of understanding that what we were going to do was legal. The penal codemakes us feel that not only is it against the law to decide about our own bodies and to perform abortions,but that it is also against the law to talk, that there is punishment for telling about it. That's why the effect
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we are looking for is to remove abortion from the place of silence that criminalization confines it to andto remove the dramatic burden it carries. It puts an end to the pact of silence," Verónica comments.
The report "Forbidden Decision," published in 2005 by the organization Human Rights Watch, showsthat one of the main problems contributing to the lack of contraceptive methods in this country and to badabortion practices (like the use of needles, infusions, catheters) is doctors' refusal to supply information. Health professionals usually cite reasons of conscience for not giving the instructions necessary to avoidexposing the patients to risk and for not performing legal abortions, that is, according to the penal code, inthose cases in which the woman's life is at risk or in which the pregnancy results from rape or an "attemptagainst the purity of a feeble-minded or demented woman."
For fear of losing their licenses, they often also request the intervention of a judge in these cases and,because of the time the justice system takes, the abortion ends up not being performed. It also frequentlyhappens that they report abortions as they are taking place, thus violating the right to privacy.
"One of the questions we ask is the woman's location. That lets us know if there are hospitals availablethat are free of obstetric violence, that is, institutions that do not report women who consult them afterinducing an abortion. Most doctors violate the law for eradicating violence against women, which, among Verónica says.
"What we are also seeing with the phone line is that women have had enough of hiding. They even callus from the bus, from the office, or from the hospital itself. Women with children, without children,single, married, from every social stratum and province. They feel that they have the ability to choose forthemselves, without the mediation of the doctors, parents, husbands, who usually do it for them," Gracielaadds. "Legal Abortion to Stay Alive"
Every year 19 million women in the world undergo unsafe abortions and one of every 300 of thosewomen dies. Statistics from the Ministry of Health in Argentina indicate that currently one of every 530women is at risk of dying from causes related to pregnancy, birth, or maternity, that 4.4 women—one ofevery 10 live births—dies from causes related to maternity, and 24.2% of cases by pregnancies terminatedby induced abortions and that for every pregnant woman who loses her life, 20 women suffer illnesses orinjuries resulting from the secrecy of abortion. These deaths are unnecessary and preventable. Argentinaaccepted the United Nations commitment of reducing maternal deaths by three-quarters by 2015, a goaldifficult to reach when we take into account current indicators and the unlikely prospects for legalizationof abortion by parliament in the short term. Nevertheless, the thrust of the phone line and recentstatements by Supreme Court Minister Carmen Argibay against the secret abortion market make thatpossibility a little closer to reality.
"One of the most important things the phone line brought out was the voices of women having abortions. It is no longer about people who speak for the women, it is the women ourselves. There are abortions, wehave to recognize that that argument is settled and to struggle to make the state organize to make themsafe and free," Verónica comments.
There are currently at least three bills in congress for the legalization of abortion. Since the 90s, the fate
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of such proposals has been failure for the absence of parliamentary action, but the organizationsconcerned with the demand hope the tendency will be reversed in the near future. The bill with the mostacceptance was offered by the National Campaign for the Right to Legal, Safe, and Free Abortion(Campaña Nacional por el Derecho a un Aborto Legal, Seguro y Gratuito), which carries the signature ofsocialist Representative Silvia Augsburger. Another bill is by Representative Vilma Ibarra, but it did notreceive as many supporters because it establishes that only doctors can perform abortions, leaving outpharmacological methods.
The Campaign is a group of organizations from all over the country that for six years has beenarticulating different positions in pursuit of a unified demand that is now expressed by the slogan "Sexeducation for deciding, contraceptives for avoiding abortion, legal abortion for avoiding death." Someorganizations, like Lesbians and Feminists for the Legalization of Abortion, question this motto for itsstepped, sequential approach: "We believe we have to question the patriarchy itself and to separatecontraception from abortion. Abortion is a woman's right and what matters is that they have all theoptions available so they can choose which they prefer," Graciela explains.
Nevertheless, despite differences, almost all the feminist organizations and others dealing with genderissues now hope the bill will become law in order to work toward the democratization of the doctor-patient relationship. "What's important besides is that compliance with these laws then be assured. Thestate needs to organize around the right to choose about our bodies in order to give us the tools, whichmeans, among other things, the public manufacture of Midroposol," Verónica concludes.
1. Obstetric violence is that which health professionals commit on women's bodies, consisting of
dehumanizing treatment and abuse of the medicalization of natural processes. For moreinformation, see the law to prevent, punish, and eradicate violence against women within thefamily and in interpersonal relations:
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