When a judge in Cochabamba authorized an abortion for a 12-year-old girl who became pregnant after being raped by her stepfather, the decision sparked outrage. The girl’s mother could not find a health-care provider who would perform the procedure — many physicians protested, and others were wary of taking on such a high-profile case. With the help of local women’s groups, the mother and daughter finally found a health center willing to perform the abortion. While the girl received a safe and legal abortion, the family, the health center and the provider have all kept their identities secret to avoid retaliation from the public, the government or the Catholic Church.

The combination of poverty, sexual violence and limited access to health care has tragic consequences for Bolivian women. Bolivian women are more than 30 times more likely to die during or shortly after childbirth than women in the United States — and many of those deaths are the result of unsafe abortion. Bolivia’s penal code prohibits abortion except in cases of rape, incest or when the woman’s life or health is endangered, and physicians must receive judicial authorization to legally perform abortions.

Ipas Bolivia works both to improve women’s ability to receive reproductive health care and to prevent and reduce sexual violence. Ipas Bolivia is training a new generation of health-care providers to improve care for women who have had induced abortions or miscarriages. Ipas Bolivia is also helping to train health-care providers in the use of medical abortion. Additionally, because violence against women is such a pervasive problem, Ipas Bolivia and the Bolivian government are working to call greater attention to sexual violence and to change the legal system to help victims of violence find justice.