Amendment 48: Constitution and Consequences

If Colorado's proposed constitutional amendment to bestow legal rights on fertilized eggs passes this November, the state should look to Nicaragua for a model of likely effects of an abortion ban.

Kristi Burton, 20, a resident of Peyton, Colorado, is the public face of Amendment 48 in Colorado, the ballot measure that would change the state constitution to bestow all rights currently held by human beings onto a fertilized egg. Burton told the press that the idea of fighting for the unborn came to her when she was sick in bed at the age of 13.

“Me and a lot of my friends want to do what we can to create a culture of life,” she says, using the oft-repeated favorite phrase of fundamentalist Christians.

Burton claims she hasn’t really thought about the implications of the proposed constitutional change and is happy to leave the fallout to the courts. She also says she sees a future for herself in public policy.

If her interest in public policy should one day include considering the impact of the policies she hopes to enact, she could study the emerging situation in Nicaragua, where in November 2006 the conservative government banned all abortions for all reasons, including rape, incest and the life and health of the mother. Prior to this change, a woman could have a therapeutic abortion if her life or health were in danger or if the fetus were malformed in such a way that it would not live after birth.

But now any doctor who performs an abortion for those reasons can be sent to prison. Likewise, a woman who has an abortion, even to protect her health, can also be prosecuted and sent to prison.

According to Human Rights Watch, an international nonprofit organization that has studied the situation in Nicaragua, the law has resulted in an increase in preventable women’s deaths from causes related to pregnancy. The organization’s findings were published in October 2007 in a report titled “Over Their Dead Bodies.”

“Although it appears that actual prosecutions are rare,” the report states, “the ban has very real consequences that fall into three main categories: denial of access to life- or health-saving abortion services; denial or delay in access to other obstetric emergency care; and a pronounced fear of seeking treatment for obstetrical emergencies. The net result has been avoidable deaths.”

The report details instances in which doctors have hesitated to treat women suffering from ectopic pregnancies, uterine hemorrhaging or even life-threatening cancers because doing so would either terminate her pregnancy or put it at risk, thus leaving both doctor and hospital vulnerable to prosecution.

Though the Nicaraguan Health Ministry issued a number of mandatory protocols regarding obstetrical emergencies hoping to address the unforeseen consequences of the blanket abortion ban, many hospitals are still hesitant to enact them for fear that the protocols are still open to interpretation. So, although the ministry calls for immediate termination of ectopic pregnancies, Human Rights Watch documented cases in which women died of ectopic pregnancies that went untreated due to the hospital’s or doctor’s fear of prosecution.

The report also documents a very real fear among women who miscarry naturally that they will be accused of having an abortion if they seek medical treatment. Again, women have died.

And yet, for all of this, the law hasn’t stopped women from seeking abortions. As the report further documents, the law has simply resulted in more women dying from the procedure.

Women are suffering in other ways, as well. Before the ban was in place, a woman found to be pregnant with a badly deformed, nonviable fetus – a fetus afflicted with congenital deformities such as anacephaly (missing most of the brain) or trisomy-18 (a complex of deformities incompatible with life) – could terminate her pregnancy. Now, she is required to carry the pregnancy to term and endure labor on behalf of a fetus that cannot possibly survive for long outside her uterus.

“To make a woman who knows that she has an anacephalic child in her womb carry it to term and make her suffer though giving birth – a patient who sees her child born with those problems suffers devastating psychological consequences,” an obstetrician from a major hospital in Managua told Human Rights Watch. “What we normally do when there are malformations incompatible with life is to terminate the pregnancy when we detect it. But now, according to the law, it cannot be done. We have encountered various cases of young girls whose pregnancies we could not terminate; so we told her… that she has a pregnancy, that the baby is not going to live, and that it will die when it is born. But we can only explain; there is nothing we can do.”