Unhealthy power

A new abortion law has been in force in Nicaragua since 17 November 2006. It makes terminating a pregnancy a punishable offence, no matter the circumstances. Since then, six women have died as a direct result of untreated complications. Lindabeth Fariñas Corea from the Sonia Bello women’s refuge in Rivas reports that helpless doctors had referred these patients from one hospital to another. The number of indirect victims is probably much higher. “Pregnant women no longer have anyone to talk to in the public hospitals,” the legal adviser explains. “The doctors feel so unsure that they generally avoid pregnant patients, and don’t do medical check ups.”

According to Unicef, Nicaragua already had one of the highest maternal mortality rates before the law was changed, with over 200 deaths per 100,000 births. CEPS, an independent agency for social studies, estimates that this ratio will now rise by about a third in the long run.

Social impact

The new regulation particularly affects disadvantaged communities in urban slums and rural areas. The elite in politics and business continue to have abortions in modern clinics in the USA or in Cuba. But according to official statistics, three quarters of Nicaraguans must make do with less than two dollars per person and day. Only in rare cases can these people afford trips abroad.

Nicaracua’s average level of education is low; in 2005 the official rate of illiteracy was 18.4 %. Short-term survival strategies take priority among the poor. Birth rates are high, and pregnancies involving risks are quite common. Experts maintain there are approximately 80 cases a day in Nicaragua in which a woman’s body spontaneously rejects the embryo or foetus. From a medical perspective, quick intervention is essential.

However, the new law does not take such emergencies into consideration. Nor does it deal with the treatment of tubal pregnancies, which can have fatal consequences without adequate intervention. In these cases, the question of protecting the unborn life does not arise at all, as the foetus is still unable to survive.

Furthermore, many Nicaraguan mothers raise their children without any support from the fathers. Since the state does not guarantee any basic social welfare, the new law is profoundly unsocial: if the mother, as main breadwinner, is no longer able to provide because of medical mistreatment, the support for entire families collapses.

So why was Nicaragua’s abortion law, which had been in force for over 100 years, tightened so radically? First it must be stated that, in contrast to Europe, America is a religious continent. For many Nicaraguans, religion is a central part of life; it ties them into social networks and binds them to spiritual leaders.

Nonetheless, the reactionary reform cannot simply be attributed to a faith-induced shift in values. The majority of Nicaraguan members of parliament – let alone the population – does not support the view that, in doubt, the protection of the foetus is more important than the life of a pregnant woman. Rather, Nicaragua is an example for the ability of religious dogmatists to suppress serious debate on a subject, by mobilising people in their hundreds of thousands with the help of professionally run campaigns.

Emotionalised campaign

Church representatives began their mass rallies in the middle of the election campaign: “Yes to life – no to abortion!” With the support of the conservative media, the spin doctors reduced a complex ethical matter to a simple yes-or-no decision. They cleverly positioned it in the context of children’s rights and family responsibility. Written on the stomach of pregnant demonstrators was the desperate plea: “Mama, I want to get to know you.”

The political parties came under such pressure that they quickly adopted the legal reform that was being demanded. A parliamentary commission was set up to debate the sensitive matter, but it did not even meet once. Members of parliament were simply not prepared to tackle such an explosive subject at the end of their term.

So far, only a small minority of the people is aware that, by implementing the total ban, their country has adopted an extreme position shared only by Chile, El Salvador, Malta and the Vatican. Internationally, special provisions on abortion are the norm if
– the life or health of the expectant mother is at risk,
– the pregnancy is the result of rape, or
– the foetus shows severe deformities.

None of these scenarios were mentioned in public discussion in Nicaragua. The strategy of reducing the issue to a matter of black or white succeeded, not least because in the eyes of many people, the old regulation for “aborto terapéutico” had been abused. Officially, the law allowed pregnancies to be terminated only in order to save the lives of women, and three doctors had to agree on the diagnosis. In practice, however, well coordinated teams of doctors often satisfied demand rather than worried about the law.

For all practical purposes, people felt that pregnant women had the freedom of choice, and that did not conform to the moral beliefs held by many voters. This wide-spread perception played into the hands of those campaigning for the general ban on abortion. In that sense, protest by women’s rights activists, some of whom seemed quite foreign, backfired. With slogans like “Yo decido!” (I decide!), they were not advocating the medically necessary abortion option that had legally existed before. Instead, they were campaigning for a pro-choice rule.

Only around 40 % of women throughout the world can have legal abortions without having to state reasons, according to UN statistics. The comparative figure for Latin America is only five percent. For half of Latin America’s people, the right to an abortion is still denied even in the case of health risks resulting from pregnancy complications. In the face of the particularly restrictive Latin American laws, approximately four million women in the region seek out illegal abortion clinics every year. More often than not, these clinics are unable to offer adequate medical standards.

With all forces available, the churches are resisting attempts by progressive politicians to relax the relevant paragraphs. A “massacre of the innocent” must not be allowed, said the archbishop of Rio de Janeiro, after the Brazilian health minister had proposed reopening the discussion on abortion from a public-health perspective. Reacting to the introduction of a pro-choice law in the Mexican capital, Pope Benedict XVI emphasised that life is to be respected in every instance “from the moment of conception until natural death”. According to him, supporters of the new law excommunicated themselves.

Political interests and faith issues

Since the change of government in 1990, the Catholic Church has always managed to position itself on the side of the candidate who went on to win the presidential election in Nicaragua. The church thus secured its socio-political influence. Cardinal Obando y Bravo supported the liberal-conservative camp for a long time. Ahead of the elections last year, however, he demonstratively sided with Daniel Ortega, the leader of the Sandinistas, who, after three defeats at the ballot box, was promptly elected to the highest public office. Hoping for additional votes, the former revolutionary leader presented himself as a God-fearing Catholic. He married his partner of many years, held out the prospect of numerous benefits for the church, and made sure a sufficient number of his party’s members of parliament joined the cross-party majority in favour of the restrictive abortion law.

Support from the church did not reverse the Sandinista leader’s long-term loss in popularity, but it contributed to thwarting the campaign of fear that was run against him. After an amendment of the electoral law and after the anti-Sandinista camp split, Ortega only needed 38 % of the votes to become president.

According to opinion polls, the Catholic Church enjoys the trust over 70 % of the Latin American people – that is significantly more than governments, parliaments and political parties can muster. Therefore, only few top politicians dare to engage in open debate with the clergy. Instead, they readily expand their political agenda to include religiously motivated objectives.

Right-leaning candidates like to emphasise conservative values, which works well in this context. On the other hand, in view of horrendous inequality and widespread poverty, Latin America’s heterogeneous left finds common ground in Christian social ethics. Their leaders jettisoned their historical role models’ criticism of religion. Today, they quote Pope John Paul’s stance on “predatory capitalism.”

Religious attitudes have a long tradition among the Sandinistas. Back in the 1980s, party founder Tomás Borge claimed to be a “disciple of Christ”, and demanded greater interaction between Christians and Sandinistas. Instead of driving back the religious influence per se, the revolutionaries supported liberation theology. When this movement increasingly lost its socio-political significance, party leader Ortega moved closer to the official church.

Today, even Venezuela’s controversial president Hugo Chávez refers to Jesus as the “first socialist” in human history. On the other hand, he calls George W. Bush a personification of the devil. Chávez thus exemplifies how politicians use religiously-charged rhetoric, rather than insisting on the separation of state and religion.

In the meantime, the number of practising Catholics in Latin American is declining, while some Evangelical denominations are experiencing strong growth. In 1995, 80 % of Latin Americans declared their faith in Catholicism; but according to Latinobarómetro, this number had fallen by nine percentage points by 2004. In the same period, with their decentralised “business model”, charismatic leaders and well filled mission boxes, Evangelical churches quadrupled their following, with 13% of the Latin American population professing their faith in them today.

In poverty-stricken Nicaragua, Evangelical preachers found a particularly fertile breeding ground. The Institute for Development and Democracy (IPADE) estimates their following at around 27 % of the population today.

To a large extent, the policy demands of Evengelical denominations coincide with those of the Catholic Church. Nonetheless, the formation of political-religious alliances is proving to be increasingly difficult in view of growing inter-church competition. In Latin America, political alliances are typically not limited to policy demands. Usually, they are also about access to scant state resources. Therefore, internal rivalry intensifies whenever the number of those involved in a coalition rises.

The Catholic Church can still claim to represent the vast majority of devout Latin Americans. It rests on long-established foundations, and its pronouncements carry a lot of social weight. By contrast, from a politics perspective, the Evangelical groups have the advantage of being more cohesive. They command disciplined and comparatively homogeneous voter blocks, which makes them attractive in the eyes of strategically-thinking politicians.

Prospects in Nicaragua

The tightened Nicaraguan abortion law was signed by Enrique Bolaños, president at the time. Back then, representatives of both Catholic and Evangelical churches attended the ceremony. Today, President Daniel Ortega consciously speaks in the plural of “the churches which give the country the hope it so urgently needs.”

Despite pressure from European donors, the challenge to quickly reintroduce a therapeutic abortion option has only a slight chance of success. As long as Nicaraguan voters are not made aware of the complexity of the matter and mobilised on a large scale against the total ban, Ortega will be on his guard not to get on the wrong side of the church hierarchies.

In principle, the abortion law could also be relaxed by Nicaragua’s Supreme Court of Justice, without parliamentary consideration. In Colombia, where some of the most restrictive abortion laws were in force for some time, the top-layer judges introduced a number of exemption clauses in 2006. With reference to ratified human rights agreements and other international obligations, they permitted abortions if there was a risk to physical or mental health, in the event of foetal deformities or if the pregnancy resulted from rape. The Colombian abortion law is now among the region’s most liberal ones.

In Nicaragua, however, a similar judgement is unlikely, because Ortega’s FSLN party controls the judicial sector. A relaxation of the new law would be attributed to him, and might weaken his political standing. Therefore, it is more likely that the wording of the tightened law will be qualified in judicial practice by drawing on other legal sources. Leading Nicaraguan parliamentarians and lawyers already take the view that a special legal provision “to act in an emergency” comes into effect, should an expectant mother’s life be at risk.

Furthermore, as part of an upcoming criminal law reform, other provisions could be put in place to make it easier to terminate pregnancies on medical grounds. However, in the foreseeable future, women and doctors will continue to be denied the legal certainty they deserve in Nicaragua.