Raids Fuel Abortion Debate in Dominican Republic
SANTO DOMINGO, Dominican Republic _ Two months pregnant and bleeding, Yanira Then says she went to a clinic in her low-income Santo Domingo neighborhood, where her doctor said she had suffered a miscarriage.
Then was still in her hospital gown that February morning when her doctor’s office was stormed by police, prosecutors and television news cameras. Accused of having had an abortion, Then, a 27-year-old law student, was arrested along with two other patients, the nurses and her physician.
She faces 3 to 10 years in prison. The doctor faces 50.
Saying that he wants to spark a public debate on preventing unwanted pregnancies, Santo Domingo’s district attorney last month arrested 12 people and closed three clinics he described as well-known illegal abortion mills.
In a region where abortion is largely illegal _ Cuba and Guyana are the only nations that permit it _ what has long been tolerated in hushed tones and back rooms suddenly was splashed onto the front page, infuriating women’s groups.
“I swear to you, God, and everyone, I did not have an abortion,” said Then, insisting she had a routine post-miscarriage procedure. “I think abortion is a crime. We don’t have the right to take life from anyone. It’s not in the law or the Bible either.”
Then said she is in a stable relationship with her boyfriend, with whom she already has a toddler, and can well afford another child. What’s more, she had several prior pre-natal care visits, proof that she was trying to keep her baby, not abort it, both she and her doctor said.
“This birth was planned,” she said. “These charges are illogical.”
Lawyers and doctors involved in the case said the majority of abortions performed in the Dominican Republic are the result of misprostol, an ulcer medication often taken illegally as a way to induce abortion. Doctors say bleeding women regularly show up at their offices after taking the medicine, and that now the physicians risk jailtime for treating their patients.
Defense lawyers said prosecutors will be hard-pressed to keep doctors from treating women who show up bleeding.
“Go to all the hospitals in town, and there are lines of women bleeding,” said Then’s physician, Numas Perez. “They take the ulcer medication, get infections, and then you have to attend to them. It’s the end of what was a pregnancy.
“I don’t go out on a loudspeaker announcing: `Come, I’ll take care of it!’ but they arrive, and you take care of it.”
Perez’ private clinic remains closed, and he’s not practicing while the charges are pending, but his lawyers are fighting to have it reopened.
Experts say the Dominican Republic has one of the region’s highest abortion rates, and also a high number of women hospitalized after illegal abortions. According to the Alan Guttmacher Institute in New York, a group that conducts sexual and reproductive health research and policy analysis, a survey conducted in the early 1990s showed 82,000 illegal abortions a year in the Dominican Republic.
The Dominican Republic’s rate of 44 abortions per 1,000 women is more than double the rate in the United States, where abortion is legal on demand, according to the Alan Guttmacher Institute.
Despite having some of the strictest anti-abortion laws in the world, Latin America has the second highest rate of terminated pregnancies in the world, according to U.N. figures. Only Eastern Europe’s is higher than this region’s rate of 37 per 1,000 women of childbearing age. The U.N. figures estimate that 4 million abortions take place in Latin America annually _ and 5,000 women die each year from complications.
According to the U.S. Centers for Disease Control and Prevention, between 1990 and 2000, each year there were four to 11 deaths per year related to legal abortion in the United States.
The Guttmacher Institute says 10 out of every 1,000 women of child-bearing age wind up in hospitals each year in the Dominican Republic after illegal abortions. The criminal sweep, the group says, is likely to push the number higher, because it will make it more difficult to find doctors willing to risk performing illegal abortions.
“In general the likely consequence is: reduction in safe clandestine services, at least for some period of time, and likely increase in unsafe procedures, with a rise in health complications and in admissions to hospital,” said the group’s vice president for research, Dr. Susheela Singh. The arrests are “unlikely to result in a decline in the number of abortions.”
Doctor’s Association President Enriquillo Matos said that after the arrests, Dominican doctors will likely think twice when treating such cases.
“We feel threatened as doctors,” Matos said. “The drama of abortion is a social drama, cultural drama and economic. Finally, lastly, medical.”
In the past year, many women’s groups in Latin America have lobbied to loosen restrictions on abortions, pushing for changes that would permit them in cases of rape. Colombia’s Constitutional Court agreed to the change, while Nicaragua’s legislature went the other way, lifting such exceptions and now banning abortions all together. Brazil and Uruguay are also debating approving such exceptions.
The U.S. Supreme Court’s Roe v. Wade allows a woman to end a pregnancy at least until fetal viability, which is determined by a physician. After viability, states may restrict abortions or ban them entirely, except when necessary to protect the woman’s life or health, Singh said.
Proposed changes to the penal code in the Dominican Republic, which would allow abortion in cases of rape, have been on hold in the legislature.
“The congress wants the new law, but they don’t want to fight the church or the doctors,” said attorney Carlos Olivares, who represents Dr. Perez. “I believe this case is undoubtedly related to the proposed new penal code.”
The Archdiocese in Santo Domingo did not return several messages seeking comment.
Santo Domingo District Attorney Jose Manuel Hernandez denied any connection between the arrests and the penal code proposals, but added that he did hope to instigate a debate on issues such as allowing condom distribution or the morning-after pill.
“This is a matter of public health, and we have to determine what our public health policy is,” he said in an interview. “The discussion has begun. That’s what we wanted.”
His office conducted a five-month investigation of the three clinics, even tapping the doctors’ cell phones and sending undercover agents posing as couples. He said tapes show the doctors freely discussed prices and procedures.
“Everyone knows what goes on at these places, and nobody was doing anything,” he said. “Ask nine out of 10 Dominicans, and they will tell you the doctors should be punished. … That’s a message that needs attention.”
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PHOTOS (from MCT Photo Service, 202-383-6099): DOMINICAN-ABORTION
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