Why is Uruguay a Model Country for Pro-Abortionists?
Tuesday, August 30, 2016
 

In what might come as a surprise to many, the relatively small Latin American country of Uruguay is considered by many pro-abortion activists as a model country for access to abortion. After years of implementing a strategy dubbed the “risk and harm reduction strategy” devised by Iniciativas Sanitarias, the country affiliate of International Planned Parenthood Federation, Uruguay decriminalized abortion in 2012 allowing it on demand during the first 12 weeks of pregnancy and for the rape exception up to the first 14 weeks of pregnancy. In the “risk and harm reduction strategy” government health providers issue advice to women on how to induce illegal abortion via medication and urge them to go to the hospital if they encounter complications.

This month, the International Journal of Gynecology & Obstetrics, published by the radically pro-abortion International Federation of Gynecology and Obstetrics (FIGO), has a special issue detailing the Uruguayan Experience, including highlights of the FIGO role in overturning the country’s pro-life policy. Reducing Maternal Mortality by Preventing Unsafe Abortion: The Uruguayan Experience, edited by Anibal Faúndes of Brazil, chair of the FIGO Working Group for the Prevention of Unsafe Abortion, contains nine articles that look at different aspects of the process in Uruguay to promote access to and use of abortion-inducing pills and to change the law.

The role of medical abortion in the implementation of the law on voluntary termination of pregnancy in Uruguay reports that an abortion study for the first two years under the new abortion law from December 1, 2012 to December 31, 2014 and found:

A total of 15,996 abortions were performed during the study period; only 1.2% were surgical and 98.8% were medical. Of the latter, only 3.4% required   hospitalization. Less than half of the pregnancies were terminated up to 9 weeks of gestation and 54% were at 10 to 12 weeks in a sample from the Pereira Rossell Hospital. Conclusion: The rapid nationwide rollout of voluntary termination of pregnancy services to all women was possible to a large degree thanks to the      availability and broad acceptance of medical abortion, facilitated by the prior   experience in applying the risk and harm reduction strategy.”

The article discusses the impact of conscientious objection to abortion and somewhat gleefully notes that self-induced abortion by a woman at home removes the doctor from the actual abortion procedure suggesting that distance reduces culpability for the doctor,

The other feature of medical abortion that assists in the application of the  law is that it puts a certain distance between the professional and the abortion. Prescribing some pills that the woman will take herself at home is a very different experience for the physician than removing the uterine contents in a surgical abortion. The distance that is achieved when prescribing drugs increases the percentage of physicians who are willing to provide these services.”

Conscientious objection as a barrier for implementing voluntary termination of pregnancy in Uruguay: Gynecologists’ attitudes and behavior takes a very negative view of conscientious objection and reports on the findings of the panel tasked with clarifying the meaning of conscientious objection, organized by the IPPF affiliate Iniciativas Sanitarias Contra el Aborto en Condiciones de Riesgo (Health Initiatives against Abortion in Risk Conditions). One the conclusions reached is that “when the professional who is being asked to terminate a pregnancy is a conscientious objector, this professional has the obligation to refer the patient to an appropriate non-objecting practitioner, which resolves the problem of conflict of interest.”

Concerns about the policy by objecting pro-life doctors led to a decision by the Administrative Court to make it “compulsory that conscientious objection be presented by a written declaration”. Additionally, institutions that provide abortion must create “registers of objectors” so institutions “will know who the objectors are, so that they can organize their services accordingly.”

The Uruguayan model has been implemented in the province of Buenos Aires in Argentina with the assistance of FIGO since 2012, the year that Argentina’s Supreme Court “ratified the legality of abortion in cases of rape and stated that the woman’s sworn declaration presented to the attending health professional was sufficient.”  A replication of the Uruguayan model in the province of Buenos Aires, Argentina, as a public policy for reducing abortion-related maternal mortality reports that the province followed two main strategies.  First it instituted a “risk and harm reduction strategy” in primary health care with general physicians and midwives and began to provide abortion services in primary health care centers in 2012 with the assistance of the Argentine Federation of Societies of Gynecology and Obstetrics (FASGO) and FIGO.  The advice offered also “enabled detection of situations in which the law allows legal abortion”.

The article elaborates on the justifications for legal termination of pregnancy (LTP) stating that “indication justifying LTP has also changed in recent years. Until 2011, there were no LTPs for health reasons and all were for rape. The first cases arose in 2012 and their number gradually increased until, in 2015, they accounted for almost three quarters of all cases”.  It also finds that legal termination of pregnancy can be dealt with at primary care level, “given the low complexity of the procedures recommended, whether medical abortion or MVA”.

The experience in Buenos Aires leads the authors to conclude that “data concerning the experience of the Province of Buenos Aires strongly suggest that the Uruguayan risk and harm reduction model applied to abortion can be replicated in other contexts, at least in the Latin American region. This experience also shows that, as happened in Uruguay, spending a number of years applying this strategy brings health professionals into contact with unplanned pregnancies and how women who decide to abort feel, making them more willing to provide pregnancy termination services to the full extent allowed by the law.

On the world stage, the Uruguayan government promotes abortion at various venues including the United Nations, the World Health Assembly and the Organization of American States where Uruguay’s former Minister of Foreign Affairs, Luis Almagro, now serves as Secretary General. Almagro has let it be known that he would like to see changes in the regions’ laws and policies on abortion.


 


Back