Editor's Note: With this post we welcome Angela Castellanos, a journalist based in Bogota, to RH Reality Check. Angela will join our Global Perspectives team reporting on reproductive and sexual health and rights issues internationally.
It is hard to imagine a country banning contraceptive methods authorized by the World Health Organization, now in 2008. Believe it or not, that is what is happening in Chile, a country which once was known as one of the Latin American pioneers in contraception policies, and now is rolling the clock back nearly 40 years.
On April 4, the Constitutional Court of Chile banned the free distribution of emergency contraception (EC) in the public health system. The reason: the Court claims that this method is "abortive" and therefore it is against the Constitution, which states the right to life. The argument is based on the presence of the hormone levonorgestrel, contained in various other contraception methods (i.e. pills and cooper intrauterine devices) — which could also be declared forbidden.
The World Health Organization has unequivocally stated that "Levonorgestrel emergency contraceptive pills have been shown to prevent ovulation and they did not have any detectable effect on the endometrium (uterine lining) or progesterone levels when given after ovulation. Emergency contraception pills are not effective once the process of implantation has begun, and will not cause abortion."
Once again, men determined the rights of women. In fact, nine men of the Constitutional Court snatched away the reproductive rights of nearly five million women of childbearing age. This decision comes in addition to the one that forbade therapeutic abortion, adopted at the end of Augusto Pinochet's dictatorship.
Its consequence are already clear: an increase in clandestine abortions and likely the maternal mortality rate, as many women cannot afford a safe surgical procedure to terminate their pregnancies. Public sector health care staff held protests against the ruling, claiming that the ruling is contrary to women's access to health care.
Women's groups, unions, NGOs, health institutions, and human rights organizations organized demonstrations in the most important Chilean cities, and signed a public declaration rejecting the ruling and appealing the State to observe the reproductive rights.
Informed women think that they will replace EC by a bunch of ordinary contraceptive pills that contain levonorgestrel. However, this alternative does not replace the public recognition of women's rights, and the role the government can play in reducing instances of abortion and teen motherhood.
Actually, abortion and teenage pregnancy were some of the worries at the heart of the reproductive health policy promoted by the current government, led by the female president Michelle Bachelet, which offered low-income women access to EC by reforming the National Norms on Fertility Regulation. According to the new regulations announced in September 2006, the public health services were authorized to prescribe and provide — free of charge — traditional contraception methods as well as EC to all women from 14 years old, without their parents' consent.
Soon after, the detractors objected to the reform, so the President declared it a Supreme Act. The legal debate was driven by 36 members of the Low Chamber of Parliament from the rightist Alianza por Chile, with the support of the Catholic authorities and "Pro Vida" (For life), a group against abortion.
It seems very relevant that legal allegations came up when EC became freely distributed within the public health system, while no one protested between 2001 and 2006 when it was sold in pharmacies. For the government and progressive sectors of civil society, this is a "discriminatory" and "non equitable" decision, because it barred access for young and poor women. According to the Fifth National Survey of Youth, in Chile more than 40% of women from the low income levels became mothers between 15 and 24 years old, compared to only 14% of the middle and high levels.
The controversy has involved not only the government, but the whole society. The Catholic Church insists on defending the Constitutional Court decision and call for forbidding EC in private pharmacies. In fact, the Catholic Church put pressure on the Court during the legal debate. "During the allegations, in November 2007, the Monsignor of Santiago was seated in the first row, this is an example of the kind of pressures from ideological forces," stated Lidia Casas, in an interview with this correspondent. Casas, a female lawyer, represented the members of Parliament supporting the free distribution of EC in the public health system.
An economic interest could explain the motivations of the members of Parliament who raised the legal debate. In fact, their political forces represent the powerful economic groups, which are leading the country through an open market model. Some NGOs working for Chilean women, such as DOMOS, raise the question: Is EC a threat for economic power, which needs to ensure a cheap labor force to replace the current generation of workers? This question makes sense, because the active population in Chile and the fertility rate are quite low. In addition, such economic interest could explain the apparent contradiction between the promotion of a modern country and the adoption of regressive measures.