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Last Updated: Friday, 12 October 2007, 10:54 GMT 11:54 UK
Divisions deep over abortion ban
By Jane Dreaper
Health correspondent, BBC News

Campaigner
Campaigners have protested about the ban
A series of reports in the Lancet medical journal highlights the global problem of avoidable deaths among pregnant women.

The problem is starkly illustrated in Nicaragua, where a new law has put a blanket ban on abortion - even in cases of rape or where the mother's life might be in danger.

Campaigners say it has led to 82 deaths this year among women with pregnancy-related complications - and a culture of fear among doctors.

But Catholic activists in Nicaragua describe the anti-abortion law as an amazing victory for life - which illustrates what they can achieve elsewhere.

I met a slightly-built teenager, who can be identified only as Raquel.

She sat beside her mother as she relived the moment she was raped at the age of 11. Her daughter, who is now nearly two, was conceived as a result of the attack.

When Raquel was raped and became pregnant a second time at the age of 13, she felt there was only one option.

"I had to have the abortion because with my age I couldn't have two children," she told me.

"I'm angry because I know who my attacker is. He is 22 years old. I see him in front of my house and he is just laughing."

Illegal abortion

A woman who sympathised with Raquel's plight took the risk of getting her an illegal abortion. Raquel hopes that one day she will be able to resume her education.

Dr Rafael Cabrera
People are still going to have abortions but now they will self-consciously know they are doing something wrong, as defined by the law
Dr Rafael Cabrera
Obstetrician

She said: "Someone in my case should be able to have an abortion. Maybe I would have been able to study, if I hadn't had my daughter.

"I hope to go back to studying one day - and I hope I can give to my daughter what I didn't have for myself."

Tears slid down her cheeks at that point and I ended the interview.

Earlier, I had met Nicaragua's leading pro-life campaigner, Dr Rafael Cabrera. He is an obstetrician and gynaecologist, but he is fiercely opposed to the use of contraception.

On the veranda of Dr Cabrera's home, I put it to him that women would continue to seek abortions, regardless of the law.

"Yes, people are still going to have abortions but now they will self-consciously know they are doing something wrong, as defined by the law," he said.

Dr Cabrera denies claims by abortion rights activists that there have been avoidable deaths among women with complications in pregnancy.

"This is a very important issue - which they have made into a huge propaganda, in order to confuse the population," he added.

Deep concern

Not everyone agrees though. Another prominent doctor, Leonel Arguello, is head of the Nicaraguan Society of General Medicine. He is highly concerned about the effects of the new law.

Carlos Fernando Chamorro
My prediction is there will be a permanent problem and a permanent controversy over this
Carlos Fernando Chamorro

"As a physician, you feel as though you are nothing," he said. "This government is saying - if you are pregnant and it might harm you, it doesn't matter - keep going."

Dr Arguello said doctors on salaries of £200 a month were scared of prosecution if they were seen to intervene in any cases where an unborn child was still alive.

He described how a young woman died after doctors failed to treat her ectopic pregnancy - this is a life-threatening condition where the foetus starts to grow outside the womb.

Dr Arguello said: "This girl was 18 years old. She went to the hospital and the doctor ordered an ultrasound, because they wanted to see whether the foetus was still alive.

"She left the hospital. The doctor didn't stop her and say - this is really dangerous - you need a surgical intervention, and if you don't have it, you will die.

"The girl was visiting a friend and she had more pain again. So she called back at the hospital. She had haemorrhage and shock, and then she died."

Avoidable deaths

There are no official figures about the effects of the anti-abortion law, but a recent investigation by Human Rights Watch said fear and delay had led to avoidable deaths.

Carlos Fernando Chamorro, who edits a weekly news magazine called Confidencial, says Nicaragua is still a conservative society - but there are signs of international pressure.

He said: "I recently iterviewed the EU foreign affairs high representative, Benita Ferrero, and she expressed a lot of concern about this situation in Nicaragua.

"My prediction is there will be a permanent problem and a permanent controversy over this. Each week we will see more reports about the health problems of women."

The ministry of health in Nicaragua didn't respond to the BBC's repeated requests for an interview.

Campaigners are hopeful that eventually doctors may get more flexibility, but they acknowledge that the chances of changing the law are slim.



SEE ALSO
Nicaragua votes to ban abortions
26 Oct 06 |  Americas



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