The Total Abortion Ban in Nicaragua

‘Pro-life’ lobby has swept aside women’s rights

In the ongoing debate between ‘pro-life’ and ‘pro-choice’, there are really not many advocates of the ‘pro-life’ stance who would insist on denying a woman’s right to a termination if her own life is at risk. Fundamentalists might shake their heads where pregnancy is a result of incest or rape, yet still make that one life-and-death concession. 97% of countries make that concession, even if they send rape and incest victims to prison.

In Nicaragua, since July 2008, abortion has been illegal in every circumstance without exception. In the run-up to elections in 2006, the two major parties - Liberal Alliance and Sandinistas - were running neck and neck. The Catholic Church and other religious groups saw an opportunity. They ran a saturation campaign in the media and from the pulpit, calling on electors to vote only for candidates who favoured a total abortion ban. The campaign was overwhelmingly emotional and did not take medical issues into account, ignoring scientific opinion. Doctors were portrayed on posters as medieval sorcerers, and nurses as witches.

Both parties, fearful of losing the Catholic vote, adopted a total ban as policy. Daniel Ortega’s Sandinistas were re-elected after sixteen years in opposition, and denial of women’s rights was the shameful price they were prepared to pay. Over the following two years new restrictions were added to the abortion law, until by 2008 every loophole was closed. Now, a pregnant woman diagnosed with cervical cancer must carry the foetus to the full term, even if the cancer is not treated and she subsequently dies. Any doctor who gives her the option of a termination risks prosecution. Nor is the option available in cases of ectopic pregnancy, or where the foetus is anencephalic (where a large part of the brain has failed to develop).

Let us be clear about this. Where abortion is illegal, women are denied the right to choose. Narrow, often life-threatening choices are imposed upon them. On the other hand, where abortion is legal women are free to choose - either to have an abortion, or not to have an abortion. A Nicaraguan doctor told an Amnesty International researcher: “before [2008], no woman was forced to have a therapeutic abortion, or to have any particular course of treatment. They had the right to decide over their life or death. A woman used to be informed of the choices she had and then had every right to say, ‘I understand the risks, I know I might die, but I choose to continue anyway with this pregnancy.’ It was my obligation to support her in this decision. Equally if a woman told me, ‘No I have children already, I need to live. It makes me sad to lose this pregnancy, but I want the cancer treatment in order to give me the best possible chance.’ I would be able to respect her right to choose life.” Abortion is never compulsory. The difference between liberal and prohibitive abortion laws is the difference between freedom and tyranny.

According to a recent Amnesty report*, ‘Doctors who act in accordance with the Obstetric Protocols, intervening in order to save a patient from dying as a result of obstetric complications, risk their professional career and, potentially, their liberty. Examples of such interventions include treatment for malaria or HIV/AIDs, urgent cardiac surgery or intervention in an obstructed or otherwise complicated birth. Even health care providers trying to save the foetus during a difficult delivery which, through no negligence or intention to do harm, results in the injury or death of the foetus, could be subject to criminal prosecution’. In short, pregnant women are virtually denied treatment of any kind.

Of course, the ‘back-street’ abortion trade has grown. Reliable figures for deaths and serious complications are not available for Nicaragua, but a global statistic will suffice. In countries where abortion is legal the abortion mortality rate is 0.2-1.2 per 100,000 abortions; in countries where it is penalized is 330 per 100,000.

Amnesty has risked losing some of its religious members and has taken on the abortion issue, declaring that a woman’s right to choose is fundamental and cannot be excluded from human rights campaigning. As well as the resignations of some - though by no means all - individual Catholic members, Amnesty has had to face a general Church boycott. Catholic organisations have been directed to cease making donations to the organisation - thus depriving Amnesty of funds necessary to fight torture, the recruitment of child soldiers, and human trafficking. Nevertheless Amnesty has stood firm on a principle which has its reference points in humanist values rather than religious dogma.

These humane principles are supported by obstetricians and gynaecologists everywhere, and are written into protocols issued by the World Health Organisation and the Pan-American Health Organisation. There is a long-term campaign by Amnesty and other human rights organisations to restore women’s rights in Nicaragua and other Latin American countries such as Chile and Peru, where the plight of women is scarcely better.

Poor Nicaragua. Its recent history hardly bears thinking about. After the Sandinista revolution in 1979, huge progress was made in alleviating poverty and creating a more equal society. But the introduction of such socialist iniquities as free health care and elementary education led to Nicaragua becoming a target of the global US crusade against all governments of the left, the most moderate and democratic as well as single-party communist regimes. Armed and financed by the Reagan administration, the notorious ‘Contras’ entered Nicaragua from neighbouring countries and burned down schools and health clinics - as if such things were weapons of mass destruction - and murdered teachers and doctors. By the 1990s much of the achievement of the Sandinistas had been destroyed.

Then, in October 1998, came Hurricane Mitch, the most powerful since the ‘Great Hurricane’ of 1780. No doubt some of the more irrational of religionists saw it as the wrath of God. It left 800,000 homeless and carried on the work of the Contras, demolishing 340 more schools and 90 more health clinics. 70% of the country’s roads were destroyed. An estimated 75,000 American landmines were uprooted by floodwaters.

Now, struggling to recover from these disasters, and still one of the world’s poorest countries, Nicaragua must endure a ‘moral’ tyranny. It is all the more bitter because it has been imposed by President Ortega’s administration and party, the same revolutionary socialists who offered such hope two decades ago.

* ‘The Total Abortion Ban in Nicaragua’: Amnesty International, July 2009