Edited remarks from a speech given by Susana Chavez of Centro de la Mujer Peruana Flora Tristán at an October 22, 2003 briefing for the U.S. Congress about Breaking the Silence: The Global Gag Rule’s Impact on Unsafe Abortion
My name is Susana Chavez, of the Peruvian women’s organization Flora Tristán. Flora Tristán does not receive U.S. government funds for population and family planning, so we are not gagged. That is why it is possible for me to speak with you today. For my colleagues at organizations that DO receive U.S. funds, it would be risky for them to speak up about why they dislike the gag rule. For some, the global gag rule is a simple contractual promise which establishes an agreement between USAID and a non-governmental organization. For those of us who work to improve the health and to recognize the reproductive rights of women, this is not the case. A woman was recently found buried in an abandoned lot (baldío) on the outskirts of Lima. She had been dead for several months and had died from the complications of an unsafe abortion. No one ever claimed this woman’s body, and she remained uncounted in the statistics. For the women’s health and reproductive rights movement in Peru, the global gag rule is connected to the death of this woman, and hundreds like her.
Abortion in Peru
Let me give you a sense of the tragedy of unsafe abortion in Peru. Around 350,000 women have clandestine abortions every year. Of these women, around 800 die from post-abortion complications—three women every single day. Poor women, rural women, and women abandoned by their partners are the most likely to die. Forty four percent of women living in extreme poverty will suffer serious complications from unsafe abortions, while only 5% of women with more financial resources will. This constitutes discrimination and denies most poor women the right to life, health, and control of their own fertility. Considering the risks, why do women resort to unsafe abortion? In my country, 850,000 women, or 25% of sexually active women of reproductive age, do not desire more children but do not have access to contraceptives. In rural areas of Peru, 25% of 15 to 19- year-old girls are pregnant or already mothers, often before they want to be. They have no information about how they get pregnant or they are frequently victims of coerced sex or rape. For many women, access to the family planning services that exist is blocked by economic, social, and cultural barriers. These women decide to undergo clandestine abortion despite the risks, because they lack access to contraception, to safe abortion, and to quality post-abortion care. In this context, the global gag rule contributes to preventable deaths by blocking NGOs from improving access to safe abortion in the cases where it is legal. It also means NGOs cannot work together to bring our abortion laws into better alignment with the needs of our people. In Peru, abortion is only legal in the case of serious risk to the life or health of the woman. However, obtaining a legal and safe abortion in those limited cases is very difficult. Recently a 17-year old young woman found herself pregnant with an anencephalic fetus— a fetus that, if carried to term, would have no brain and could not survive. This kind of pregnancy is dangerous to the pregnant woman’s physical and mental health. But her request for an abortion was denied by officials at a public hospital. After being forced to give birth, she was forced to nurse the anencephalic child until its certain death. As you can see, the application of this law does not always protect the life and health of Peruvian women. It results in even more women resorting to clandestine and unsafe procedures. The criminalization of abortion generates stigma, because the unlucky women who are prosecuted are left with criminal records that will make it difficult for them to find work and study. And of course criminalization impacts women in other ways – some die, many suffer severe complications, and many are forever labeled criminals. That is why we consider it so urgent that abortion be decriminalized. I want to add that none of the women, nor the organizations that fight for the decriminalization of abortion, want women to have abortions, but we recognize that as long as unwanted pregnancy exists, abortion will remain part of women’s lives. To deny its existence would be like denying poverty or injustice: they are there. We must recognize that fact, and above all we should fight for change and help women in this situation.
The response of women’s groups to abortion
Women’s groups in my country have responded to unsafe abortion. We have been active around public health and human rights for more than 20 years in Peru. They are widely recognized to play an important role in society, providing services that our government neglects and calling attention to how public policy should address women’s needs. During the 1990’s, Peruvian NGOs were able to conduct research and educate the public about the financial impact of unsafe abortion on our health system, and the impact that punitive abortion laws and the specter of unwanted pregnancy have on women’s lives. Before the gag rule, issues like abortion in the case of rape had entered into public debate. There were openings for NGOs to provide information to the public and to decision makers, so that they could make better decisions. More people began to recognize that unwanted pregnancy is the result of very complicated situations: women cannot negotiate equally with their partners, they lack information and access to contraceptives, and these limitations have to do not only with individual decisions but also with problems with the educational system and with the health care system. We consider it a success that we were able to start shifting discussion from abortion as a crime to abortion as a public health problem.
Implications of the Global Gag Rule
The global gag rule has been like a “veto” on this gradual political and scientific opening, by cutting off further accumulation of knowledge and the free exchange of ideas about how to deal with the issue of unsafe abortion. We do not want this issue to be further hidden away. You in the U.S. have very active debates on abortion and your women are not dying from unsafe abortion. For us, it seems very hypocritical. Some groups in my country have struggled to make an impossible choice. Some groups decided to keep receiving U.S. government money because they did not want to lose economic resources to go to the most remote zones of the country to provide health services. But they had to give up maintaining research, advocacy and educational work and being responsive to Peruvian women’s demands to address unsafe abortion. Because some groups felt they had to choose to take the U.S. money, it has affected our advances, our social organization, our coalitions, our unity. So, the global gag rule affects not only NGOs receiving U.S. aid, but also affects the women and the autonomy of our country. Thousands of women each day encounter the desperate choice between unwanted pregnancy and unsafe abortion, a situation which deprives them of health, their ability to work, and their dignity by making them resort to subhuman services. We are convinced that if abortion were not criminalized, women would have more opportunities to receive medical attention, and would be better able to access contraceptives, without putting their health and well-being at risk. It would avoid the suffering of thousands of women. If we look at how the arbitrary and abusive global gag rule has affected the civil society of Peru, we can see that it has done nothing good. Clandestine abortion continues to be one of the main ways women control their fertility. Our belief in democracy and that the decriminalization of abortion is a just fight continues. I think that for none of the groups, gagged or not, this is in doubt. It is just that some groups are now forbidden by your country from speaking. What has the American government achieved from two years of the global gag rule? Women continue to lack information, to lack contraception, to turn to unsafe abortion, and to suffer death or serious complications. In the face of an uninterested national government and congress, the global gag rule blocks NGOs that receive USAID funds from advocating for these women or from providing them with life-saving services and information. I want to repeat it one more time: Three women die each day from unsafe abortion — needlessly.