Ipas > Human Rights Watch: Nicaraguan women denied care

Human Rights Watch: Nicaraguan women denied care

October 2, 2007

A recent report from Human Rights Watch bolsters efforts by activists to repeal blanket ban on therapeutic abortion.

Nicaragua’s ban on all abortions has scared doctors into delaying or avoiding patient care, discouraged women from seeking necessary medical treatment and resulted in preventable deaths, says a new report from Human Rights Watch.

On October 2, Human Rights Watch released “Over their dead bodies: Denial of access to emergency obstetric care and therapeutic abortion in Nicaragua.” The report documents the impact of the blanket ban on abortion, which was approved by the country’s National Assembly in October 2006.

The new law prohibits previously legal therapeutic abortions — abortions that are needed to protect a woman’s health or save her life. Additionally, any doctor who performs an abortion can be sentenced to one to three years in prison, while the woman who had the abortion can be jailed for up to two years.

“The criminalization of medical procedures necessary to save women´s lives and protect their health is in clear violation of the right to health, among other human rights,” said Angela Heimburger, Americas Researcher for the Women´s Rights Division of Human Rights Watch. “The resulting cases of maternal mortality and search for clandestine services for medically necessary procedures are tragic and unjustifiable.”

Since the ban went in effect in November 2006, the policy has had a chilling effect on women and their doctors. “Over their dead bodies” cites one March 2007 case in a large public hospital in the capital Managua, in which a woman was admitted for an ultrasound and, according to the doctor informant, clearly needed a therapeutic abortion. But the doctor informant feared prosecution if he provided the abortion because the fetus showed signs of life. “The woman was here two days without treatment until she expulsed the fetus on her own. And by then she was already in septic shock and died five days later,” the informant said.

Ipas Central America Director Marta María Blandón said: “Women are dying because doctors feel that they are essentially handcuffed by this law. Under fear of prosecution, doctors are forced to make choices between their professional futures and their patients’ well-being. Women are forced to consider whether they should even seek medical help. And ultimately, some women are paying for these delays in care with their lives.”

The Human Rights Watch report also points out that while the Nicaragua Ministry of Health (MOH) has issued mandatory guidelines for addressing obstetric emergencies, including ectopic pregnancies (in which the egg has implanted somewhere outside the uterus), few hospitals are actually implementing them. Therefore, women who have nonabortion-related pregnancy complications are suffering under the ban as well.

Blandon continued: “Today, a Nicaraguan woman with an unwanted or dangerous pregnancy has few options: Risk her life and a prison sentence with an unsafe abortion, or risk her life with an unsafe pregnancy. This dangerous dynamic is a profound denial of human rights; international human-rights agreements and legal decisions have repeatedly stated that governments have the obligation to ensure therapeutic abortion when pregnancies can be fatal or when they are the result of rape or incest.”

Ipas supports Human Rights Watch’s recommendations for governmental and health institutions in Nicaragua. The recommendations urge:

Nicaraguan President Daniel Ortega to publicly support women’s access to safe therapeutic abortion and legislation that will facilitate their access to safe abortion care;
the Nicaraguan Ministry of Health to collect data on denials of care and case-by-case information about causes of maternal deaths;
the repeal of penal-code provisions that make abortion a crime punishable by prison time;
efforts to guarantee that women are aware of and can receive postabortion-care services; and
the use of resources to update, disseminate and train health-care workers on evidence-based national norms for emergency obstetric care.

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258