By Heather Sayette and Paulina Ponce
Abortion rights campaigns in Latin America have the potential to profoundly transform women’s health across the region.
Ecuador is a country of vibrant change. In the last five years, it has experienced sustained debate and profound transformations in relation to sexual and reproductive health and rights. As Argentina celebrates the legalization of abortion — after a decades-long push — there will undoubtedly be regional repercussions.
In 2018 and 2019, Ecuador’s unicameral National Assembly debated reforms of the criminal code, and abortion was a central topic. This open debate on the decriminalization of abortion — in the event of rape or a fatal fetal diagnosis — prompted a diversity of voices to come out in favor of changing the law to guarantee health and justice for girls and women victims of sexual violence. The tone of the debate, for the first time ever, changed markedly in favor of abortion rights. The vote came in late 2019, and the proposal fell just shy of passage (Argentina had also seen an abortion legalization bill fail in 2018, before passage ultimately occurred in 2020). Now the decriminalization of abortion for rape and other situations is currently in the hands of Ecuador’s Constitutional Court.
But people’s opinions about abortion have already been changing. Opinion studies show that 73% of Ecuadorians believe that a woman should not go to jail for having an abortion. This burgeoning public support may be the basis for the long term structural changes needed to start acting on abortion care as a public health issue.
Women’s rights groups in Ecuador have also been fueled by evidence showing the need for abortion law reform. Ministry of Health data demonstrates the cost burden of not investing in sexual and reproductive health services, including the impact of sexual violence and forced motherhood on young girls.
What the data says
Each year in Ecuador, 2 out of every 3 pregnancies are unplanned. One in four of these unplanned pregnancies occur among adolescents, according to a study published by the Ministry of Health, UNFPA and other institutions, with support from Planned Parenthood Global.
Despite the fact that abortion is legal in Ecuador to preserve a woman’s life and health, and for women with a mental disability who have been raped, public medical facilities still do not fully guarantee access to abortion, which generates a high cost in terms of people’s lives, and also in burdening the health care system.
According to the government’s own statistics, Ecuador loses 448 million dollars each year by failing to provide timely sexual and reproductive health services. 68 million of that are health system dollars spent directly on the care of unplanned pregnancies.
The other 380 million dollars are the social costs to society accrued by the increase in maternal deaths, spikes in teen pregnancy and girls dropping out of school, which leads to lower-wage jobs. Studies show that girls who make it out of their teen years without giving birth are 6% more likely to finish primary and secondary education and 11% more likely to reach a higher educational level.
For every dollar invested in sexual and reproductive health programs, Ecuador would save $17, and every dollar invested specifically to prevent unintended pregnancy, Ecuador would save $5.40. However, in 2020 public funding to prevent pregnancy among adolescents was lower than previous years.
Children, Not Mothers!
Concern has been growing in the region, particularly in Ecuador, about sexual violence directed at young girls. In 2015, Planned Parenthood Global published “Stolen Lives”, a multicountry study that documents the unique and severe impact of sexual violence and forced pregnancies on the health of girls. We know that the lockdown measures to confront COVID19 have also now left girls and women especially vulnerable, stuck at home with their abusers.
The campaign #NiñasNoMadres (Girls, Not Mothers) has shed light on the epidemic of these cases across Latin America, like Norma, an Ecuadorian girl and survivor of sexual violence. Starting at age 12, Norma was repeatedly sexually abused by her father. Doctors told her she wasn’t allowed to have an abortion, and her father was never arrested. In 2019, Norma’s case was brought to the United Nations Human Rights Committee by Planned Parenthood Global, the Center for Reproductive Rights and Surkuna Ecuador. There are thousands of girls and women in the same situation as Norma. The outrage has mobilized young people like never before, adding more and more voices all over the country.
This concern about forced pregnancy has been echoed by international human rights bodies and special rapporteurs, who have implored the Ecuador government to guarantee access to sexual and reproductive health and to decriminalize abortion in cases of rape and other reasons.
To stem an additional pandemic of unplanned pregnancies, it is essential to finance and implement preventive policies and laws, to invest in contraceptive methods and education, and to guarantee access to preventive health care with a gender perspective. These should be central issues for the candidates in Ecuador’s elections this year.
Unless Ecuador expands legal abortion and adequately invests in sexual and reproductive health services, the increase in teen pregnancies and maternal mortality will not stop. Not investing in health care will cost the government even more. Sidelining women’s health is a losing proposition.
The tireless work of activists and organizations to shine a light on sexual and reproductive rights and the impact of restrictions on the access to abortion has built a drumbeat in Ecuador. The sea of green handkerchiefs in Ecuador in favor of the women’s bodily autonomy has turned abortion into a pivotal issue in the country. The revolution is just starting.
Heather Sayette is Latin America Regional Program Director for Planned Parenthood Global.
Paulina Ponce is Ecuador Program Officer for Planned Parenthood Global.