An Overview of Clandestine Abortion in Latin America
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Each year, more than four million women in Latin America undergo an induced abortion. Because most abortions are illegal, these procedures are performed under clandestine and often dangerous conditions. As a result, the region faces a serious public health problem that threatens women's lives,endangers their reproductive health and imposes a severe strain on already overextended health and hospital systems.
The practice of induced abortion in Latin America is shrouded in secrecy, a direct result of the stringent legal limitations on abortion throughout most of the region. Induced abortion is punishable by law in almost every country except Cuba and a few other Caribbean nations. In mostof the region, doctors may legally terminate a pregnancy that threatens the life of the woman, that results from rape or incest, or that is characterized by fetal deformity,1 but these options are rarely used.
Concern over the high level of clandestine abortion in Latin America is not new. Policymakers and health professionals have been aware for the past 20-30 years that unsafe procedures werebeing performed in most countries of the region, and at a leve l with serious consequences for women's health and for the cost of national health care services.
Community surveys conducted in Chile in the early 1960s were the first attempt to measure the extent of the problem. These surveys found that women were likely to have two or three abortions over the course of their childbearing years.2And studies in the 1970s in countries as diverse as Brazil, Colombia, the Dominican Republic, Mexico, Peru and Venezuela indicated that women averaged 0.5-1.5 induced abortions over their reproductive lifetime in these coun tries, and 2.0 or more induced abortions in Chile and Cuba.3
Although most Latin American health experts were aware of the general scale of clandestine abortion and relatedproblems, until recently they had little reliable information with which to answer many questions. What methods are used to induce abortion? Who are the major practitioners? How many women are hospitalized for the treatment of complications, and what proportion is this of the actual numbers of women experiencing induced abortion? Which women are most likely to have induced abortions, and for whatreasons?
This report presents an overview of the practice of induced abortion in Latin America. It draws upon a number of sources: a collaborative study on clandestine abortion in six countries; a large-scale study in urban Colombia; an in-depth study of trends i n abortion and contraception in three countries; and a number of smaller studies. Findings from many of these studies were presentedat the first regional meeting on induced abortion in Latin America, held in Colombia in 1994.4
Current Level of Abortion
Estimated rates of abortion are highest in Peru and Chile (each year, almost one woman in every 20 aged 15-49 has an induced abortion), intermediate in Brazil, Colombia and the Dominican Republic (about one woman in 30), and lowest in Mexico (approxi mately one in 40). Ifthese rates continue to prevail throughout the 35 years of a woman's reproductive lifetime, the average woman in Mexico is likely to have had at least one abortion by the time she is 50, compared with about 1.6 abortions among women in Chile and about 1.8 among women in Peru.
If the annual number of abortions estimated to occur in these six countries (2.8 million in the early 1990s) is extrapolatedto the entire region, then about four m illion induced abortions are being carried out each year in Latin America (Table 1).
|Table 1. Abortion Incidence |
|Country/year |Annual no. of |Rate per 1,000 |Average per women |
| |abortions |women | |
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