A Dangerous Trend: Dominican Republic Adopts Draconian Abortion Restriction

If Latin American policymakers truly want to reduce abortion rates, they must focus their attention on improving knowledge about and access to a wide range of family planning methods.
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When the Dominican Republic's National Assembly voted in April 2009 to amend its constitution to include a right to life beginning at conception, the country continued a troubling trend among Latin American jurisdictions toward virtually eliminating women's recourse to safe abortion care. Under Dominican law, doctors who perform abortions -- and women who obtain them -- face harsh penalties, including prison sentences.

The constitutional amendment was introduced by President Leonel Fernández and was widely supported by the national assembly. The measure echoes similar changes enacted at the state level in Mexico, where 12 states have recently adopted constitutional amendments declaring that life begins at conception. These amendments -- which essentially aim to preempt any liberalization of existing abortion laws and may even prohibit abortions that had previously been legal, for instance in cases of rape -- appear to be a backlash against the 2007 legalization of first-trimester abortion in Mexico City.

These moves follow the criminalization of abortion under all circumstances by Nicaragua in 2006, and El Salvador in 1998. In 2007, both Human Rights Watch and Ipas issued reports documenting the deaths of women whose lives would have been saved had therapeutic abortion been allowed.

This trend toward draconian abortion restrictions -- banning the procedure outright in places where it was already highly restricted -- ignores strong evidence from Latin America and other parts of the world showing that abortion rates are often as high, or higher, in countries where abortion is highly restricted as in those where it is broadly legal.

For example, Mexico's abortion rate increased by 33% (from 25 to 33 procedures per 1,000 women aged 15-44) between 1990 and 2006, despite highly restrictive policies. Further, Mexico's rate is more than 40% higher than the U.S. abortion rate (19 abortions per 1,000 women), even though the procedure is broadly legal in the United States. Another key difference between the two countries is that abortion is a very safe procedure for U.S. women, while it is often dangerous for Mexican women.

Global data likewise show that abortion restrictions do not lead to low abortion rates. A worldwide study on abortion conducted by the Guttmacher Institute and the World Health Organization (WHO) found that abortion rates are lower in regions such as Western Europe (12 abortions per 1,000 women), where abortion is largely legal, than in developing regions such as Latin America (31 abortions per 1,000 women), where abortion is largely illegal.

The worldwide data also underscore that abortion restrictions significantly diminish the safety of procedures. Where laws are restrictive, women -- especially those who are poor -- are forced to seek clandestine and unsafe abortions, which often endanger their health. According to the Guttmacher-WHO study, nearly all abortions (92%) in developed countries are safe, while more than half (55%) in developing countries are unsafe. Almost all abortion-related deaths in the world occur in developing countries. In Latin America, unsafe abortion is one of the main causes of maternal mortality. Ensuring access to safe and legal abortion would greatly mitigate the suffering and lost productivity caused by unsafe procedures.

Ultimately, however, it is important to remember that behind nearly every abortion there is an unintended pregnancy. If Latin American policymakers truly want to reduce their countries' abortion rates, they must focus their attention on improving knowledge about and access to a wide range of family planning methods. Draconian abortion restrictions will do nothing to better the lives of women in the Dominican Republic, Mexico or any other country in the world.

This article was co-authored by Dr. Fatima Juarez, professor and researcher at El Colegio de Mexico and a senior fellow at the Guttmacher Institute.

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