Abortion

Monomoy Regional High School

The Importance of Decriminalizing Abortion and its Effect on 

Gender Equality:

A Comparison of El Salvador and Cuba 

Jaymie Buffington 

Global Studies Program 

Mr. John Dickson  

May 2020 

Introduction 

Access to safe abortion upon request is a human right, which governments bare the responsibility of protecting. Nations that work to decriminalize abortion will be closer to social equality between men and women than countries which prohibit abortion under any circumstance. The importance of bridging gender gaps through the decriminalization of aboriton is demonstrated through several international frameworks and backed up with legal precedent. Two nations at opposing ends of the spectrum, Cuba, which permits abortion upon request, and El Salvador, which prohibits abortion under any circumstance, display the effects that the legal standing of abortion has on the gender gap in each country. 

Around the world there is varying levels of access to abortion procedures. Each nation has their own laws regarding the practice and different circumstances in which the procedure may be performed. Limitations to the practice often are differentiated between five categories. A few countries prohibited altogether, which exists in few nations today, but includes El Salvador. Some allow it only to save a woman’s life, while others permit it in order to preserve the health of a woman, physically or mentally. Other nations allow it based on social or economic grounds. This is a broad standard with variations dependent on each nation. It is determined based on the environment a woman lives in, including her financial capacity to care for a child and the impact of her pregnancy and child care. Finally, the least restrictive, which has the highest number of countries, including Cuba, is performed upon request. Theoretically, this allows women to have the procedure for any reason, with most nations having a common gestational limit of twelve weeks. 

Cuba is representative of advanced policy that rallies behind women’s right to autonomy and respecting abortion practices as a human right. By doing so, the nation has moved forward in the effort to establish gender equality. El Salvador, on the other hand, has regressed from this philosophy, and therefore displays little to no respect towards women’s autonomy and human rights. El Salvador is therefore preventing equality between men and women.    

Access to Safe Abortion Procedures On Request is a Human Right 

The pro-choice mentality supports a woman’s right to have an abortion. Whether the decision stems from economic factors, health issues, sexual assault, or simply not wanting a child, there are no circumstances in which this human right should be impeded. 

To understand the necessity of abortion procedures being readily availible, it is imperative to understand the plethora of reasons women decide to terminate a pregnancy. A primary reason behind this choice stems from socioeconomic conditions (Crane, 2020). In the United States, the average cost of a delivery is $4,500, even with insurance, as of 2015 (Khazan, 2020). The expenses then expand to formula, clothing, diapers, bottles, cribs, car seats, day care, and beyond. This is a price that is not affordable for many working women. Beyond this, women who work full time to support themselves, and possibly more children, they simply do not have the time to care for a newborn child or cannot afford to take maternity leave. Many women also are in the process of continuing their education. Not only does a full course load not leave much time to care for a newborn, but the steep cost of tuition and everyday expenses makes it much more difficult. 

Another barrier between women and keeping a pregnancy are health factors. In some cases, keeping a pregnancy would negatively affect a woman’s mental or physical health. Prior existing conditions and chronic illnesses threaten the well-being, and extreme cases, life, of a woman if she chooses to carry out a pregnancy. The health factors also extend to the fetus as well. Women also chose to terminate a pregnancy if the child will be born with birth defects. These can include physical, intellectual, and developmental defects. For example, severe heart defects will impact the quality of life of the baby and cause the child to endure high levels of pain before suffering a premature death. Some women choose to terminate a pregnancy to save a child from suffering through this pain. 

Finally, another driving force behind the decision to terminate a pregnancy is that it was the result of rape or incest. As of 1996, 32,101 pregnancies in the world resulted from an incedent of rape each year (Holmes). Whether it be from a current or former partner, a colleague, friend, or unknown perpetrator, women in this circumstance should not be forced to bear the responsibility of carrying out the pregnancy. Women pregnant as a result of incest, also need the option to terminate a pregnancy. These women often come from low socioeconomic conditions and/or an abusive household (Karbeyaz, 2016). 

Whether women with an unplanned pregnancy lack financial means to carry out a pregnancy, have conflicting health concerns, or were the victim of sexual assault or incest, the option of abortion needs to be readily availible in order to protect women’s right to chose, privacy, and respect their bodily integrity and autonomy. 

How Attitude Towards Abortion Is Formed 

The stigma towards abortion, both for and against, is influenced heavily through many different factors. An individual’s culture, religion, and stability of the nation they live in all play an important role in shaping the attitude towards abortion. 

A primary cause of an overall population’s attitude towards abortion is the level of industrialization. Industrialized nations have a stronger economic and political stability. Due to this, the nation as a whole does not have a centralized focus on trying to obtain physical and economic security. The focus of the nation has the capacity to move towards developing self expression and modern values. Nations that are more industrial tend to have more liberal attitudes towards abortion. 36% of women who are of reproductive age live in nations with the most liberal abortion laws, which are performed on request (The World’s Abortion Laws, 2020). 

Underdeveloped nations, on the other hand, have a central focus on obtaining or maintaining stability either economically or politically, or both. In these nations, where citizens are struggling to obtain resources to survive, self expression is not a priority. Citizens in the nations facing significant levels of poverty or an unstable government will often stand by traditional ideals and values, which is unfavorabletowards access to abortion. 5% of women of reproductive age, which is about 90 million women, live in the 26 nations with the most restrictive access to abortion: prohibited altogether (The World’s Abortion Laws, 2020). Of the 26 nations that have the most restrictive abortion laws, all classify as underdeveloped or developing nations. Almost every one of these nations is facing significant levels of poverty. 1 in 2,800 women will die from pregnancy complications in industrialized nations while 1 in 61 women will die in developing nations from the same pregnancy complications (Crane, 2020). 

Opinion towards abortion is also drawn from religious participation. Most major religions, including, but not limited to, Christianity, Islam, Buddhism, and Judiasm, support traditional family structures, and therefore support a traditional view on gender roles. Mostmajor religions disaprove of abortion. Religious people often draw from their beliefs to form personal opinions. Many Christians, especially in El Salvador, turn to the Bible for clarification. For example, Jeremiah 1:5 in the Bible quotes, “Before I formed you in the womb I knew you, before you were born I set you apart; I appointed you as a prophet to the nations.”  Excerpts such as these lead believers to regard a fertilized egg as a gift from God, and see termination of a pregnancy as an act of murder. Therefore, many people who have negative attitudes towards abortion tend to have a stronger religious background than those who have a more liberal attitude.

88.2% of the people in El Salvador identify as Christian. 11% of people are unaffiliated. This is a much stronger devotion to religion compared to Cuba, where 59.2% of people identify as Christian, and 23% of people are unaffiliated (Religions in El Salvador). In this instance, the nation with the stronger religious devotion completely outlaws abortion. Cuba, which makes abortion readily availible, demonstrates a less strong affiliation with religious practices.

Cultures that are also shaped through means of self expression and progressive agendas are less confined to traditional gender roles. Progressive agendas work towards a more modern society, incorporating environmental activism, gender equality, a commitment to a good education, and more. People within these cultures are more likely to be accepting of gender equality and hold a pro-choice stance. Cultures that are focused on religious participation will maintain tradional family stuctures, support archaic gender roles, and hold a pro-life attitude. 

Overall, less developed nations tend to stick to more traditional values, opposing abortion practices. With this, individuals with a stronger religious background generally oppose the practice as well. As exemplified with El Salvador and Cuba, many underdeveloped nations seem to have stronger religious ties and a stronger opposition of abortion. 

Legal Precedent and Commitment From International Frameworks 

Many of the prominent international frameworks, such as the United Nations and the World Health Organization support the idea that abortion is a human right. In addition, the United States, a world leader on several fronts, has backed this right through legal precedent over the previous decades. 

The United States, a world leader on many fronts, has made strides at the federal level in protecting women’s right to access safe aboriton practices. A monumental Supreme Court Case, Roe v. Wade (1973) established that “states have legitimate interests in seeing that abortions are performed under? circumstances that insure maximum safety for the patirent, the right to privacy”, that women’s right to privacy includes their decision whether or not to terminate a pregnancy, and the definition of “person” under the Fourteenth Amendment of the US Constitution does not include an unborn, and that of fetuses which are viable, a state cannot prohibit abortions which are conducted to preserve the life or health of the mother (Hartman, 2007). While this court case outlined federal guidelines for abortion laws, it recognized that “a woman’s right to terminate her pregnancy is not absolute” and that state legislatures may impose further restrictions on the practice after the first trimester. While this landmark Supreme Court Case was a significant step in the right direction, the broad majority opinion leaves states with leeway to impose restrictions on abortion practices and strict guidelines. 

Nineteen years later, in Planned Parenthood v Casey (1992) reaffirmed the previous decision from Roe v. Wade. This case determined to which extent a state could restrict access to abortion. The outcome of this case maintained that “the Due Process clause of the Fourteenth Amendment prevents states from unduly interfering with a woman’s right to abort a non-viable fetus.” (Planned Parenthood, 2020). It also maintained that after viability, a state may impose restrictions on whether an aboriton can be performed, unless it endangers the health or life of the mother. It also confirmed that states have a legitimate interest in protecting the health of a pregnant woman and the fetus’ life. It also confirmed that Pennsylvania's requirement for spousal approval was unconstitutional. While this case reaffirmed the core values of the Roe decision, the court remained divided under other aspects of abortion regulations, such as the trimester framwork and undue burden standards. 

Beyond the boundaries of the United States, the world as a whole has been overall progressing towards liberal abortion laws over the past 50 years. With this, there has been a world wide drop in aboriton rates. “Almost 90% of abortions in countries with liberal abortion laws are considered safe, compared with only 25% of those in countries in which abortion is banned.” (Abortion Law, 2019). The expansion of rights to abortion procedures results in a higher quality and safer abortion practice, which will overall lead to a higher maternal survival rate. Several international frameworks have established that access to safe abortion is a human right. These include, but are not limited to, UN Human Rights Committee, European Court of Human Rights, Inter-American Court of Human Rights, and the World Health Organization, which was the first to recognize this right in 1967  (Abortion Law, 2019). However, there are still 26 countries that prohibit abortion all together (The World’s Abortion Laws, 2020) and 125 that impose varying levels of restricitions. Third world nations, which often have the most restrive abortion laws, often structure their laws after their former European colonizers, which have liberalized their own laws since colonization (Crane, 2020). 

When governments criminalize abortion, or impose undue restrictions, it negatively reflects the way a government respects a woman’s autonomy, privacy, bodily integrity, and her right to raise a family. Forcing a woman to carry out a pregnancy is forcing a woman to serve the government’s interest through carrying an unwanted child, denying her dignity, and abusing her reproductive rights. Women in impoverished nations are more likely to have to turn to unsafe abortion methods, threatening their own lives. This danger highlights how closely related social and economic justice correlates to abortion practices. Women have a stronger ability of maintaining their overall health, productivity, and contributions to society when given accessibility to safe abortion procedures. A lower population growth, which correlates to abortion accessibility and a prioritization of reproductive health care will help a nation. It will allow women to continue to contribute to the economy, facilitate economic growth, and reduce poverty in the nation (Crane, 2020). 

Prevention of Maternal Mortality 

Access to safe abortion procedures is imperative in order to reduce maternal mortality. Providing access to such procedures demonstrates the government’s interest in protecting the health and well being of women. 

The World Heath Organization estimates that three-quarters of a million women have died since 1994 due to unsafe abortion complicatons. According to WHO, 97% of unsafe abortions are in the devleoping world, where there are poor health and economic conditions. In the year 2000, 3,700,000 unsafe abortions were performed in Latin America and the Carribean, which resulted in 3,700 maternal deaths (Crane, 2020). Between 10 to 50% of the women who undergo unsafe abortions, 20-30% get reproductive tract infections. Of that population, 20-40% of those resulted in “pelvic inflammatory disease or bilateral tubal occlusion and infertility” (Crane, 2020). Women who turn to unsafe abortion procedures are often without access to good health care, and these conditions worsen without medical attention. According to WHO, 8% of maternal deaths worldwide were the result of an unsafe abortion. 

The correlation is strong between liberal abortion laws, safer abortion practices, and a lower maternal mortality. There are 126 nations in the world which impose restrictions on abortion procedures at varying levels. Laws which allow abortions under “risk of serious harm to health” is a guideline that many nations follow. However, the ambiguity of this law presents many questions. Laws like these often do not define what constitutes a risk. They also leave out who is responsible for deciding if the risk is present or not. Furthermore, they often do not outline the procedure needed to authorize an abortion. This lack of clarity places health care professionals in a confusing situation. It leaves health care professionals with no proper training on safe and proper abortion procedure practices. By not regulating it furrther, abortions can be expensive. Without financial resources to pay these fees, women are forced into a position where they turn to unsafe and secret abortion methods that risk their health and life. According to the UN Population Fund, “addressing the unmet need for family planning would both considerably reduce maternal mortality and reduce abortion by up to 70 percent in the developing world” (Abortion Law, 2019). 

Countries with more restrictive abortion laws do not have lower abortion rates. In fact, legalizing abortion and making birth control access easier results in a lower abortion rate. For example, in Switzerland, a developed nation, where abortion is legal for the first 12 weeks, 5 in 1,000 women undergo aboriton procedures (Fox, 2018). 

Countries with vague laws are often more restrictive in their practices. This is due to the fact that there are no clear ways to meet guidelines for a legal abortion. 

El Salvador 

El Salvador has been going the opposite direction as the majority of the world in making their laws regarding abortion more restrictive. Up until 1997, abortion was permitted if the health of the mother was at risk, their child was malformed, and in instances in which the mother was raped.  On April 20, 1998 the government eliminated any allowance for abortion. In January of 1999 Article 1 of El Salvador’s constitution was amended. It now recognizes that from the moment of conception the fetus is recognized as a human person and therefore receives the same rights a person outside of a womb would receive. The campaign to illegalize abortion was headed by religious and conservative leaders in El Salvador. The constitutional amendment was ratified on February 3, 1999. In 2014 84% of adults were raised as Catholic in Latin America. There is a clear, strong correlation to the religious beliefs and political beliefs of the Salvadoran population (Brando, 2019).  

Women who have complications with their pregnancies, resulting in a misscarriage, are often wrongly accused of aborting a child. Under Salvadoran law, health professionals are required to report women to the police whom they suspected attempted  or had an abortion. According to Agrupación Ciudadana, a Salvadoran organization that works to decriminalize abortion practices and promote sexual health, between January 2000 and March 2011 there were 129 women prosecuted for abortion related crimes. Generally, the women are charged with abortion. Upon lack of evidence, prosecutors often change the charge to varying degrees of homicide against their children. Of the 129 women, 68 were prosecuted for consensuel and self-inflicted abortion, while 60 were charged with aggrivated homicide (Center for Reproduce Rights, 2014). 

The court system is constructed of prejudice, poor representation, and unfair trials. From the very beginning of the trial, these women are tried on the presumption of their guilt. 56 of the women tried were forced to go to a detention facility where they were grossly mistreated, directly after birthing a stillborn. There, they had little to no communication with their defense attorney. In many cases, their own lawyers were incompetent or were prejudice against their own clients. Lawyers would fail to provide exculpatory evidence and testimony, fail to challenge prosecution’s evidence and testimony, and even failed to appeal homicide convictions in most cases (Center for Reproduce Rights, 2014). The blatant errors from attorneys and judges in the court system goes to prove that the stigma of abortions and injustice towards women accused of them does not escape the courtroom. 

49 of the 129 prosecuted were convicted, 23 of them for abortion and 26 of them for varying degreees of homicide. This statistic does not include the multitude of accusations that were dismissed before prosecution, but does include plea bargains in order to avoid harsher prosecution. It also does not include minors, as the Protection of Childhood and Adolescence Act does not allow data to be released about the number of minors charged (Center for Reproduce Rights, 2014). Of the 26 cases resulting in homicide convictions, they resulted in harsh, extensive sentences of 12-35 years in prison. Of these 26 cases, only 12 appeals were filed, again showing the incompetence of the public attorneys appointed to the poor women. Two of these cases were convicted despite autopsies not being able to determine the actual cause of death of the fetus, and in one case an autopsy confirmed that perinatal asphyxia was the cause of death. It is abundantly clear that these women are presumed to be guilty the very moment they are charged, and failing to give them a fair trial is a clear violation of their human rights. 

Women were interrogated by police or doctors without the presence of an attorney, and the interrogation is often conducted while receiving medical treatment and some will still be under the effects of anesthesia. Doctors in El Salvador are clearly violating medical ethics, breaking a doctor’s duty to maintain confidence. Throughout investigation and trial, women face clear discrmination and beyond unjust treatment. 

While in prison, the basic procedural guidelines are not respected. There are multiple accounts of physical and sexual assault. They are denied basic medical services in jail. In one instance, this resulted in the death of a woman while in prison named Manuela who was wrongly convicted of an aboriton crime after suffering from miscarriage (Provost, 2014). Women in jail for abortion related crimes face insults and beatings from other inmates, due to the strong negative stigma towards abortions. They are subject to vaginal and anal inspections from prison officials, who fail to use new disposable gloves, showing no regard for these women’s basic personal hygeine. The treatment they receive stems from gender stereotypes, which determine that women have the sole job of being a mother or that they are “easy” for having conceived out of marriage. 

Most of the women who were prosecuted were impoverished. They did not have money to afford clinical care, or travel to a clinic, and did not have medical treatment to aid their complications (Rutherford, 2020). According to the UN, the average woman in Latin America works 25 hours more per month than the average man. But only about 50% of Latin American women are employed due to the wage gap. Men make on average 10.2% more than women (Center for Reproductive Rights, 2014). Because of this wage gap, which is going to deter economic growth, women are more often than not going to take on the role at home. This is influenced by gender identity, where women are taking more “feminine” occupations, such as a stay at home mother, than men, who take part in more “manly” occupations (Brando, 2019). Perpetuating the gender stereotypes in the underdeveloped nation runs parallel with the negative stigma towards abortion, as it sees that it is a woman’s duty to carry and raise children.   

Many women in El Salvador take on this role at an early age. 89 of 1,000 women will be pregnant between the ages of 15 and 19. This is tied for the highest adolescent pregnancy rate in all of Latin America (Center for Reproductive Rights, 2014). Of the pregnant adolescents, a majority of them will not be enrolled in school, instead taking on the role at home, perpetuating the feminine stereotype. 

Whether women have a partner or not, a large portion of the nation faces extreme poverty. About 30% of families in El Salvador are run by a single mother (Rutherford, 2003). According to the 2011 Multipurpose Home Survey, or MHS, 41% of households are in poverty. In rural areas, this number rises to 50%. Of the rural areas, 32% live in relative poverty while 18% live in extreme poverty (Center for Reproductive Rights, 2014).

Of the 129, women who were prosecuted, 95 of the women did not have a partner for their relationship. 66 women did not have their own income, 49 performed unpaid domestic labor, 41 women who did work were making minimum wage or less and 17 were students when they became pregnant (Center for Reproductive Rights, 2014). Single women are more susceptible to being reported for an abortion related times. Women who do not have sufficient funds, who are impoverished, are also often targeted for abrotion related crimes. They do not have money to even travel to a clinic to receive care, nevermind afford a private attorney to support them. 

According to the Global Health Council in 2002, an estimated 246,275 abortions took place in 1995 to 2000. 11.1% of these resulted in the death of pregnant women. Unfortunately, without much reliable data relating to illegal abortion practices, it makes it difficult to determine the exact effect the criminalization of abotion has on women’s health in El Salvador. 

The restrictive laws in El Salvador are detrimental not only to women’s freedom, but their health and economic well-being as well. By failing to decrmininalize abortion, El Salvador is impeding the development of society and failing to reduce the frequency of abortion within the nation. 

Cuba 

Cuba’s abortion law is much more liberal compared to El Salvador. In Cuba abortion is completely legal, performed on request, and readily availible since 1965. Beyond this, the negative stigma towards abortion that is seen in El Salvador is absent and abortion and sexual and reproductive health is much more openly discussed. There is “a rate of nearly 30 abortions for every 1,000 women of childbearing age, according to 2010 data compiled by the United Nations” (Ahmed, 2015). Behind the decision to abort for many women is that many families have a low income, cannot afford a child, and do not want to subject a child to a life of poverty. 

Sex education is taught from primary school, including concepts such as consent and contraceptives. This educational program lowered teen pregnancy rates significantly (Gender Equality, 2011). In 2014, minors’ fertility rate younger than 20 years old was 51.6 births per 1,000 women. This represents more than 15% of Cuba’s total fertility (14ymedio, 2015). While this statistic is still substantial, it is compared to El Salvador, where 1 in 3 pregnancies are adolescents (Espinoza, 2018).  For every 100,000 births in Cuba, there are about 36 maternal mortalities as of 2017. This compares to El Salvador’s 46 maternal mortalities as of 2017. (Maternal Mortality Ratio, 2019). 

Cuba has been making strides to protect women from unsafe abortion practices and to prevent maternal mortalities from unsafe practices. The ministry of Public Health determined that the only circumstances in which abortion is illegal is if it it done against the woman’s will, it is performed outside the Cuban public health system, done by untrained personnel, or done for a fee (Gender Equality, 2011). These laws are protecting women from submitting to unsafe and life threatening abortion procedures and giving them to health care access they need. 

After the revolution in Cuba, the feminist movement also picked up momentum. Cuban’s constitution and laws reflect a goal of gender equality. A large part of this movement was putting women into the labor force. Between 1953 and 2017, the percentage of women who worked outside the house rose from 13.7% to 40%. The jobs changed from a majority working as maids or domestic servants, to including women in education, health, finance, and in every field of work (Hernández-Truyol, 2017). 

Today in Cuba, 43.6% of the legislature is female. This far surpasses female representation in Congress in the United States. Women still are not equally represented, but they are gaining numbers in previously male dominated fields such as science, technology, and mathematics. 

Cuban government is also working hard to break the still present gendersterotypes present in society. They are aiming to give mothers the support they need after giving birth. “In 2003, an FMC-proposed law revised the maternal leave law to allow both fathers and mothers the opportunity to take leave from work. Women are entitled to maternity leave with full pay beginning six weeks before the birth of a child and 12 weeks after giving birth. After that, either the mother or father is eligible for 40 weeks of parental leave at 60 percent pay.” (Gender Equality. 2011). 

Furthermore, “The World Economic Forum’s 2012 Global Gender Gap Report ranked Cuba 19th among 135 countries, up one notch from 2011, one of only two Latin American nations in the top 20 (Nicaragua was ranked ninth). By comparison, the United States fell to 22 from 17 in the survey, which measured the health, literacy, economic status and political participation of women.” (Lopez Torregrosa, 2013). Countires that have liberal aboriton laws, such as Cuba, are demonstrating much more effort towards gender equality than nations which prohibit abortion for any reason. 

Conclusion 

Access to safe abortion upon request is a human right, which government’s bare the responsibility of protecting. Nations that work to decriminalize abortion will be closer to social equality between men and women than countries which prohibit abortion under any circumstance. 

Nations which permit abortion on request demonstrate respecting the autonomy of a woman. It is a woman’s right to choose when she would like to raise children and how many, if at all. Restricting this decision shows no respect towards women’s bodily integrity. 

Furthermore, nations need to minimize any barriers that prevent a woman from having an abortion. These can include delays, waiting times, counseling and authorization requirements, spousal consent, and cost barriers. Conscience clauses, which allow health care providers to refuse abortions based on moral and religious convictions need to be outlawed as well. 

Encouraging conversations about abortions from a human rights perspective is imperative in progressing the movement of liberalization of abortion laws. Demanding reliable data from governments, throuroughly reviewing all cases regarding abortion is also of upmost importance. Due to the fact that abortions are criminalized in El Salvador, the estimations of abortion rates and maternal deaths due to abortions are not completely reliable. Cuba, on the other hand, is able to provide as accurate data as possible in relation to abortion rates and maternal deaths due to abotion complications. 

 

Governments have the necessity of making abortion readily availible to women. This is commonly misconceived with promoting the practice. Making abortion readily availible recognized what women have the right to decide what they want to do with their body and respecting their autonomy as a human right. 

Works Cited 

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