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Nicaragua: Abortion ban killing women

by Lance Lattig and Angela Heimburger

Wednesday 24 October 2007

Published in Miami Herald, Oct. 20, 2007

MANAGUA — A year after elections in Nicaragua returned Daniel Ortega
to power, scores of pregnant women have died, many as a consequence
of a new law that prohibits doctors from providing lifesaving

In the run-up to the hotly contested elections last November,
Sandinistas in the National Assembly helped to overturn a legal
provision that had permitted lifesaving abortions since 1893.
Nicaragua thus joined the handful of countries in which abortion is a
crime punishable by prison for both a woman and her doctor — even in
cases of rape, incest or when a woman’s life is at risk.
During the past year, the new law has had a devastating impact on
women in Nicaragua.

* Pregnant women suffering from illnesses such as kidney failure
have died because they were not allowed to interrupt their
pregnancies to treat their conditions.

* A poor, single mother died of a heart attack after doctors
refused to treat her severe hemorrhaging because the fetus was still
alive. Neither the fetus nor the woman survived, and her 3-year-old
son now lives with his indigent grandmother in precarious conditions.

Human-rights organizations have come under fire for addressing the
issue of abortion, but many critics have simply missed the point. The
issue isn’t abortion per se but the human-rights violations that
occur when access to safe and legal abortion is restricted. Freedom
of religion is a basic right, but the Nicaraguan government should
not use religious doctrine as a pretext for violating women’s
fundamental rights to life and health.

Untreated ectopic pregnancy

In many other countries, even Catholic hospitals perform therapeutic
abortions necessary to save a woman’s life. Although Nicaragua’s
health ministry issued protocols on emergency obstetric care, it has
since failed to follow up by clarifying what other procedures could
be considered therapeutic abortion. Even according to the
government’s own figures, maternal mortality has shot up by 100
percent in the past year. One woman died in April from an untreated
ectopic pregnancy — that is, when a fertilized egg is implanted
outside the uterus and has no chance of survival. Normally, doctors
around the world intervene as soon as the ectopic pregnancy is
detected. But Nicaraguan doctors are now reluctant to act out of fear
that their interventions might be considered criminal. Another reason
women are dying in Nicaragua is that they are afraid to seek medical
help. Women seeking abortions fear mistreatment and discrimination by
medical personnel, as well as the threat of prosecution by the
authorities. Human Rights Watch interviewed several women who were
able to obtain safe but illegal abortions. None of them was able to
obtain the procedure in the public sector, however, despite the
medically certified risks to their health posed by their pregnancies.
Here, traffic intersections feature giant posters of Ortega with the
slogan, ’’Arise ye poor of the world!’’ Under Ortega’s government,
however, the sad irony is that richer, better-informed women can fly
to Miami or seek a costly and illegal abortion in Managua, while poor
women often die preventable deaths after they are rejected from
public health services or denied emergency obstetric care. Ortega has
made many promises to end the misery of the disenfranchised in
Nicaragua. A good place to start would be to guarantee the state’s
obligation to ensure the health and lives of Nicaraguan women. The
Sandinista government should inform women about their right to
procure emergency obstetric care in the public-health sector and
remind doctors of their obligation to treat them. Nicaragua has a
long history of struggle for social justice. But the total ban on
abortion denies equality and protection to women in the poorest and
most vulnerable sectors of Nicaraguan society.

Lance Lattig and Angela Heimburger are editor and women’s rights
researcher at Human Rights Watch, respectively.

[Related matter]

Over Their Dead Bodies:
- Denial of Access to Emergency Obstetric Care and Therapeutic Abortion
in Nicaragua
- A Report by Human Rights Watch