By Stéphanie Hamel & Juan Manuel Sierra
In December 2020, Argentina made history by legalizing free voluntary abortion. The law has led to significant changes and helped remove the stigma around existing practices for both patients and doctors, yet there are still many obstacles to a universal access to reproductive health. 9to5’s Stéphanie Hamel and Juan Sierra investigate the impacts of the law a year after its implementation.
After composing the available number of the only abortion clinic in the province of Salta in the North of Argentina, the dial indicates that the number is unavailable. When reaching out to a clinic in the neighboring province of Jujuy, the phone rings on and on, to no avail. Voluntary interruption of pregnancy has been legal for more than a year in Argentina, but walls seem to rise up before even completing the first step of getting information.
Law 27.610 allows women in Argentina1 to seek out an abortion, regardless of their circumstances, within the first 14 weeks of gestation. Confidentiality, anonymity and support post-procedure is guaranteed by all of the 1243 clinics that perform abortions in the Latin American country. The procedure for the majority of patients consists of taking a misoprostol pill, causing symptoms that will lead to an abortion within 1 to 4 hours. In 2021, 340 new clinics providing the procedure opened, according to Minister of Health Carla Vizzotti.
When the first Penal Code of Argentina was established in 1921, voluntary abortion was punishable by a prison sentence for both the patient and the doctor. The medical procedure was however legal under two specific conditions: when giving birth might bring a major health or life risk to the pregnant patient, or when a mentally challenged woman was raped and this assault led to a pregnancy.
Throughout three decades of grassroots feminist activism, data collection and networking between medical and legal professionals, gradual changes were brought to the law – incorporating a more global understanding of health and its psychosocial components. However, 2015 was the year that took pro-choice and feminist activism to the mainstream, with movements such as Ni Una Menos flooding the streets of Argentinian cities as a Marea Verde (green tide), in reference to the green handkerchieves worn by the protestors.
According to Amnesty International, an estimated 370 thousand to 500 thousand illegal abortions were taking place every year in Argentina before 2020, accounting for 17.4% of pregnancy related deaths as shown by the Directorate of Statistics and Health Information. Feminist movements deemed imperative that the lives of those receiving an abortion would no longer be threatened and called for a removal of the stigma surrounding the medical procedure, in a country where traditional Catholic and machismo values are embedded within society.
A pioneer in reproductive health in South America
When the new legislation passed, it showed a new, more open side of Argentina to the world – one that was willing to reverse even its most recent stance on abortion law, as seen with the rejection of the bill in 2018. On the field, medical professionals finally saw their efforts spanning from decades being rewarded.
“More than 90% of abortions are safely practiced in health centers, with medication, in conditions that are safe and with a guarantee that patients will be accompanied and provided with information,” tells Dr. Ceci Karagueuzian, a general practitioner who has worked for the last 10 years attending patients in need of reproductive health services in Buenos Aires and its periphery. “The new legal framework embraces patients in a much more loving way, and above all, shields them from illegal and dangerous practices.”
Dr. Karagueuzian is a member of the Red de Profesionales de Salud por el derecho a decidir, a network of medical professionals with over 2000 members and over 700 healthcare teams around the country. The Red has been dedicated to improving the right to legal, free and safe abortion for over 6 years and has had an influential part in the recent legislation. In contrast with what might be expected from a Catholic Latin American country, Dr. Karagueuzian notes that Argentina has been particularly pioneering in integrating training for general practionners to be able to assist patients requiring an abortion, or what medical professionals call “first level” (the second and third levels being the hospitals).
The narrow framework before the legalisation of voluntary abortion was a sword of Damocles above the heads of medical professionals. Any misinterpretation or opposition from an angry family member of a patient could cost a doctor their career, not to mention complex lawsuits. The new law has broken this barrier, asserts Karagueuzian: “the approval that health professionals receive to perform these procedures without jeopardizing their professional practice is a big barrier that has been lifted… At some point, it was common to deny an abortion because the legal framework didn’t protect us enough. So everyone would just hide under that big umbrella of conscientious objection.”
A law does not magically become reality
Law 27.610 imposes a whole set of protections for abortion patients and doctors on a federal level, but since December 2020, it has not always come to fruition. This can be traced back to the historical systemic inequalities in riches and resources woven into the fabric of Argentina. The application of Law 27.610 relies heavily on provincial powers and resources, themselves incredibly unequal. With 10% of the population holding more combined capital than 60% of the population, and this 10% finding itself in richer provinces such as Buenos Aires and Cordoba, infrastructural differences along with conservative values have seen the process of guaranteeing free, safe and legal abortion stalled in some provinces compared to others where it has become smoother.
“We’ve had to put a lot of effort into the Northern provinces to ensure the law is being properly implemented,” says Pate Palero, the executive director of pro-choice Feminist organization Católicas por el Derecho a Decidir (Catholic Women for the Right to Choose). “We were in Formosa2 a lot, working really hard to ensure that the law is not only enacted upon but done so effectively.”
Provinces with poorer populations and significantly less resources spent on education have struggled to properly implement law 27.610 due to ideological oppositions and a lack of proper infrastructures that would allow both medical staff and patients to be more informed about the procedure. These obstacles continue to hamper the effectiveness of the new legislation and still require large and costly monitoring efforts to ensure its implementation. “There are situations that are known from the public like these girls who have been abused and became pregnant at 10 or 12 years of age. These things still happen, regardless of the new law. There is still a long road ahead to make it a reality, and this has to do with ressources, public policies, money and teams that must be hired and sent to places where there is a need,” deplores Dr Karagueuzian.
“The biggest obstacles come from the lack of political effort made by provincial governments in the interior of the country,” said Mercedes Barros, a researcher for CONICET, Argentina’s National Research Institute of Science and Technology. “The law is applied differently in each province and if these local governments do not put the necessary effort, it will be difficult for the law to be applied at its full extent.”
This lack of effort, according to Barros, comes from the fact that provinces such as Tucuman, Salta and other northern provinces have conservative leaders in power, who use their judicial influence to continue to push their own ideology. Such efforts, or lack thereof, have contributed to maintain a sense of insecurity that medical professionals feel towards performing the procedure as well as continue to hamper the resources and safety of patients seeking an abortion.
Perhaps the most striking development during the first year under the new abortion law was the temporary imprinsonment of Dr. Miranda Ruiz in the Salta province, reported in many newspapers, including the LA Times. Working in the small town of Tartagal, Dr. Ruiz performed around 90% of all abortions in her province and all abortions in her town. This record rate was due to the fact that Dr. Ruiz was the only available practitioner of abortions as no other medical personnel consented to the practice and declared themselves conscientious objectors. She was imprisoned after being sued by the aunt of the patient who received an abortion, claiming the doctor forced her niece to go through the treatment without her consent. Dr. Ruiz faced up to 10 years in prison, and she was eventually released after a substantial amount of effort from feminist organizations around Argentina that fought for her freedom.
Added to the systemic issues preventing the 2020 law to be effective in all of Argentina, is the recent rise of a virulent pro-life current. As the legalisation of abortion started to become a real prospect in 2018, the first Argentinean pro-life political party emerged. Sporting sky blue handkerchiefs as a wink to the party’s name – and as a jab to the feminists’ green handkerchiefs – the Partido Celeste Provida garners more than 50 thousand facebook followers around the message that life begins at conception and abortion is murder. Their symbol became a 6 meter tall paper maché baby that was wheeled around their demonstrations, meant to represent life after 12 weeks of gestation.
When 9to5 Groningen talked to Dr Fernando Secin, an Argentinean urologist surgeon with 10,5 thousand Twitter followers who uses the platform to share his pro-life views, he explained that this was a question of science: “I’m only telling you what medicine books tell me and they say life begins at conception, if you want to murder, go murder.” When asked if he thought that sex education could help preventing unwanted pregnancies, he replied: “This isn’t a question of sexual education. It’s humanitarian education, not a religious or biological argument. We’re discussing to murder or not to murder.” When pressed about the argument of the safety of legal abortions over clandestine ones, Secin argued that it would be the same as advocating the abolition of traffic lights when some drivers choose to skip them.
A March for Life (Marcha por la Vida) is to happen in Buenos Aires on March 26, 2022, but if online followers can give us an indication, the public support is significantly inferior to the one encountered by prominent feminist movements such as Ni Una Menos and their 80,7k followers on Twitter.
In with the law, gone with the social stigma
“To us, the law is very solid at the moment,” Pate Palero tells 9to5. “It has received huge amounts of public support from all over the country, it is very interesting to see… especially with elections coming up in 2 years.”
Such support, coming from the people, medical professionals, and the continuous efforts from NGO’s such as Católicas por el Derecho a Decidir have made the prospects of an Argentina without free, safe and legal abortion appear almost impossible. “To me, the law is irreversible,” says Barros, “you can’t promise consistency in politics but everything is pointing towards increasing effectiveness and not returning to the old rules.”
With the law seemingly here to stay, it is of absolute importance that the successes seen in large and more liberal provinces spread around the country to ensure that no other life is lost. The battle for organizations that vouch for pro-choice legislation has not finished but the implementation of such a law has already seen huge advances in removing the social stigma coming with abortion. Dr Karagueuzian concludes: “The fact that there is now a label on the misoprostol box that says Republica Argentina, it just relieves that burden patients were feeling. It empowers them.”
1 Reproductive health and access to abortion are issues affecting women as well as non-binary and transpeople. As this investigation is based on official data and cases dealing with cisgender women, the term “woman” will be predominantly used in this article without ideological intents.
2 Northeastern province