Chile: The Long Struggle for Access to Emergency Contraception


In Chile, women’s rights are
perhaps even more contested than in other countries in Latin America. It is the
only country in the region where the law grants men the right to “manage the
patrimony” of their marriage.  It
was the last country in the region to legalize divorce. And it is one of the
few countries in the world where therapeutic abortion is criminalized.

 

On April 4th 2008,
the Constitutional Court of Chile banned free distribution of the emergency
contraceptive (EC) pill in the public health system. The judicial ruling came
after a debate on the reform of the National Norms on Fertility Regulation
(2006), which had resulted in introduction and free distribution of EC by
public health care centers to all women from 14 years of age, without their
parents’ consent.  Opponents of
birth control objected to the reform, so Chilean President Michelle Bachelet
secured access to EC by virtue of an executive order.  However, the judicial ruling annulled the reform and the
Bachelet’s order, deciding that the distribution of EC was unconstitutional
because, according to the justices, the hormone l
evonorgestrel, contained in the EC pills, is “abortive”, and therefore against the right to
life.

As a result of the court decision,
EC was partially removed from pharmacies, whereas other pills containing l
evonorgestrel continued to
be sold, but for a price that not all women can afford.

In
Chile, a high number of illegal abortions and teen pregnancies present serious
challenges to a government which has made reducing both abortion and unintended
pregnancy a focal point of its
reproductive
health policy.  So even despite the
Court ruling on EC, Bachelet’s Administration continued to seek new legal
mechanisms to ensure access for all women–poor and rich alike—to emergency
contraception.

The government introduced a
bill to regulate information and distribution of contraception methods. Last
July the Lower House of the Parliament of Chile passed the bill, which allows
–among other measures–the free distribution of EC in the public health system.

The bill aimed to guarantee
“every person, regardless of their economic situation” free access to the pill.

"The state isn’t
imposing anything on anyone," Bachelet said. "Each person may decide
on her own, but the state must guarantee equal conditions of access to birth
control methods."

A vast majority of the
legislators voted in favor of the bill–73 votes for, 34 against, and 2
lawmakers abstained from voting. All the votes against the bill were from
members of the party Unión Demócrata Independiente, which has linkages with the
Opus Dei organization. The feminist organizations celebrated the results while
the Catholic Church denounced it.

Now the bill awaits Senate
approval. Meanwhile, Chile is in the midst of an electoral campaign, a
circumstance which certainly will have an influence in the votes at the Senate,
with presidential candidates on the left and right seeking to assure their
potential supporters of their own position on this and other issues. Candidates
include Christian Democrat Eduardo Frei, who just three years ago sided with “pro-life”
organizations and Catholics against the distribution of the pill. On the other
hand is the right-wing candidate Sebastian Piñera, whose coalition also firmly
backs the prohibition.

As if the debate was not
already hot enough, this October the Ministerio de Salud Pública (Ministry of
Health) of Chile authorized the sale of the EC pill “Escapel-1” in
pharmacies.  Conservative members
of Parliament reacted against the decision, insisting that Escapel-1 has l
evonorgestrel, the hormone they declare to be “abortive”. The conservative
movement “Red por la Vida y la Familia” (Network for Life and Family), through
its lawyer Jorge Reyes, stated that this announcement shows that the health
authorities of the government are acting in opposition to the current legal
situation, where the public distribution of EC pills is banned.

At the same time, scientists
and reproductive health advocates have expressed strong support for expanded
access to EC in Chile.  “Those
opposed to this emergency contraceptive are a group of people that call
themselves “pro-life,” who are well organized and have significant power and
influence," said Dr. Soledad Diaz, president of the Chilean Institute for
Reproductive Medicine (ICMER). "They have a very stubborn doctrinaire
position that doesn’t want to recognize the scientific evidence that says the
pill is not abortive. It’s an ideological position, there is no other
explanation.”

Research and medical opinion
back them up.  The World
Health Organization states,
for example that
levonorgestrel emergency
contraceptive pills (Epps) have been shown to prevent ovulation and [do not]
have any detectable effect on the endometrium (uterine lining) or progesterone
levels when given after ovulation. 
ECPs are not effective once the process of implantation has begun, and
will not cause abortion.”

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