I. Colombia: Reproductive Health and Abortion
Legality:
– Since 2006, abortion has been legal under three circumstances: in cases of rape or incest, when the woman’s life or physical or mental health is at risk, or when the pregnancy has a fatal fetal abnormality. (Constitutional Court. Sentence C-355)
Contraception:
– 80% of women in union practised contraception, 73% used a modern method, and 6% used a less effective traditional method (2010). Yet in 2008, 67% of all pregnancies were unintended, an increase from 52% in 1989.
Complications:
– While manual vacuum aspiration (MVA) is recommended by the WHO for first trimester abortions and costs ~USD 45, 80% of (surgical) abortions are performed via dilation and curettage (D&C), which is more invasive, time consuming, and costly at ~USD 200.
– 50% of all abortions are carried out with misoprostol, which is widely available and safe when used correctly. Yet in Colombia, due to a lack of information on its use, it has a high rate of complications (32%) primarily heavy bleeding and incomplete abortion.
– Poor women have less access to regulated abortion services and thus resort to misoprostol from the black market, pharmacies, and doctors, and/or other methods to induce an abortion.
– 33% of all women and 53% of poor rural women who have a clandestine abortion experience complications that require medical attention.
– 1 in 5 women who develop complications do not receive the treatment they need.
– Nearly 2/3 of health facilities that could provide post-abortion care do not, suggesting that there is a need to expand the number of facilities offering such care, particularly in rural areas.
SOURCE: Prada E et al. Unintended Pregnancy and Induced Abortion in Colombia: Causes and Consequences, New York: Guttmacher Institute, 2011. https://www.guttmacher.org/fact-sheet/unintended-pregnancy-and-induced-abortion-colombia
II. Recent accomplishments
Increased knowledge and capacity for advocacy:
– Collaborated with Colombia’s nurses’ association to develop a survey to assess nurses’ knowledge and perception on abortion regulations (report to be produced).
– Engaged with media in efforts to prevent and sanction obstetric violence.
– Trained doctors in reproductive health advocacy to increase the number of doctors able and willing to represent the mission.
– Provided medical evidence to political discourse via an article published by the Health and Human Rights Journal No. 19.1: Legal Knowledge as a Tool for Social Change: La Mesa por La Vida y la Salud de las Mujeres as an expert on Colombian Abortion Law.
– Presented twice regarding Zika at the CLACAI meetings:
– Focused on Zika and government responsibility: “The right to health and the Zika. Obligations of health systems: comprehensive access to sexual and reproductive health.”
– Highlighted the two main issues of state responsibility and lessons learnt: “Updating the evidence and strengthening the responses to the Zika virus epidemic, through the incorporation of comprehensive sexual and reproductive health care.”
– Shared reproductive health expertise at the National Abortion Federation Conference in Canada and the Latin American and Caribbean Feminist Meeting (Encuentro Feminista Latinamericano y del Caribe) in Uruguay.
– Began developing a workshop to train media experts and journalists to help more accurately and appropriately report on abortion in the media.
– Trained doctors in reproductive health advocacy to:
– increase the number of doctors with the skills and confidence to advocacy for more comprehensive reproductive health policies,
– represent GDC/Colombia in the media and advocacy initiatives, and
– influence fellow medical providers, their patients, and the general public.
Mitigated conscientious objection (CO) to abortion:
– Addressed CO by administering CO test in meetings with the Bogota OB/GYNs Society and the Police’s Hospital OB/GYN team.
– Presented on CO and ethics during FIGO.
– Researched the prevalence of CO among OB/GYN providers, and distributed evidence to advocate for policies to limit CO and increase access to safe and legal healthcare.
– Presented CO research results to the Colombia National Congress on Public Health, to advocate for abortion access and influence policy with national health leaders.
– Completed data analysis, finalized a report, and will distribute findings via publications. The Spanish journal Revista Bioética y Derecho accepted one article for publication (Conscientious Objection, Bioethics, and Human Rights: A perspective from Colombia) and another article is being drafted (tentative title: Knowledge and opinions of abortion regulation among Colombian gynecologists ten years after the C-355/2010 decision).
Engaged in political advocacy:
– Served as the go-to expert for reproductive health advocacy in Colombia.
– Submitted to the Constitutional Court a statement* highlighting the medical reasons to uphold the current law and constitutional right to abortion, and also distributed it among doctors to garner their support.* (*This statement is in Spanish.)
– Contributed to Constitutional Court decision to reiterate no gestational age limit for abortion (2018).
– Supported executive branch decision to reduce contraceptives costs by up to 50%.
– Participated in “Causa Justa” to decriminalize abortion.
– Helped create MoH guidelines for 2nd and 3rd trimester abortion provision.
Campaigned to liberalize the abortion law in Argentina:
– Testified during the hearing in the Chamber.
– Led a seminar on evidence to support the legalization of abortion.
– Contributed medical expertise to share the impact of the Global Gag Rule.
– Shared medical expert testimony and guidelines from the General Attorney Office to condemn the illegal prosecution of a woman who had an abortion.
SOURCE: Reprinted from: Global Doctors for Choice Colombia (Grupo Médico por el Derecho a Decidir), 11 July 2024