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Abortion of women in the Dominican Republic
– Reported, February 15, 2012
The statistics on abortion are almost impossible to calculate. In a country where the practice itself is considered illegal, it is officially assumed that abortions are not taking place; obviously, this couldnt be further from the truth. Just ask any employee at one of the countrys many public hospitals. They can tell you whether the law is succeeding in putting a stop to abortion in the Dominican Republic.
Dr. Milton Cordero began working with abortion in the countrys public hospitals with the arrival of an international organization named Engenderhealth in 1980. He was an integral part of the organization that focused its attention on improving the post- abortion services offered in the countrys public hospitals. These services were offered to women after an abortion had taken place and usually consisted of a general cleaning of the womans uterus. Afterwards, she was free to go home. With Engenderhealths assistance, post-abortion services were extended to treat women on both a physical and mental level. They now include emotional and psychological support, as well as family planning, and can be found at public hospitals throughout the country. Although abortion is illegal, these post-abortion services are permitted, since hospitals are only treating the women and not performing the abortions.
According to Dr. Cordero, some 90,000 abortions are performed in the Dominican Republic each year, making it the third leading cause of maternal death in the country. These abortions are either self- induced, or are performed by a backstreet practitioner. In either case, there are serious risks.
Dr. Cordero cites one common method women use to induce abortions, by taking over-the-counter pills that stimulate uterine contractions, leading to the expulsion of the fetus. He explains that women in the Dominican Republic take these pills themselves, often without knowing the proper dosage. An overdose can cause serious hemorrhaging, but the problem doesnt end there. These women suffering from hemorrhages then visit low-quality clinics, which could end up leading to further complications. In establishments such as these, the cleaning of the uterus is poorly performed and some women end up with a perforated or infected uterus, which can cause future reproductive problems, and in some cases, death.
With so many abortions being performed on a yearly basis in the Dominican Republic, the practice itself is obviously a lucrative underground business. Thousands of Dominican women put their physical health and life on the line in order to rid themselves of an unwanted pregnancy. The cost can be great, not only physically speaking but financially as well. According to Dr. Cordero, the cost of an abortion varies so greatly that it cannot be gauged. Effectively, the womans economic status often determines the price.
How much a doctor charges depends on the agreement he/she makes with the woman and her ability to pay, says Dr. Cordero. (The cost) can reach an enormous amount or a small amount. It depends on the clinic, the doctor, and the womans socio-economic status. A poor woman will have to go to an ill-equipped establishment and her health can be affected because of bad practice. In contrast, a better-off woman can go to someone with better training and skills, at a more appropriate establishment with lower risks of experiencing complications.
But what does a Dominican woman go through when she decides to have an abortion at one of these backstreet establishments? The stories about abortion clinics are interesting to say the least. They paint pictures of secret underground facilities where Dominican women sign contracts that release clandestine doctors of any liability, putting their life in the hands of someone who is considered a criminal in their country. In any case, these stories are hearsay, since they rarely come from women who have had an abortion: these women are much less likely to speak out.
Enter the Maternity Hospital of Los Minas in eastern Santo Domingo. This was one of the first hospitals Engenderhealth focused their attention on in the 1980s, and today the hospital sees one of the largest numbers of women seeking its post-abortion services in the country. With a little determination, DR1 managed to get inside one of these post-abortion rooms within the hospital. On this particular day, six women waited for medical attention inside a small room with three beds and no fan. The women were animated when they spoke about the hospitals service. One claimed there were too many patients for the doctors to handle along with a lack of supplies. Another woman, the mother of one of the patients, complained that her daughter was hungry since they had been waiting for some three hours without attention. Unfortunately, on the subject of abortion, no one was as forthcoming. The women denied any knowledge of the practice, and no one would discuss their experience before arriving at the hospital. Whether the truth was being told or not is impossible to prove, but one aspect remains persistent. People who perform abortions in the Dominican Republic are considered criminals, who if caught would face a stiff prison sentence, or at the very least, would be ostracized by their family and friends.
Surprisingly, the Dominican Republic has one of the highest rates of contraceptive use in Latin America as well as the world, at 70%. This high percentage is misleading, due to the lack of sexual education, which means that many people use contraceptives incorrectly, ultimately leading to many unwanted teenage pregnancies. Take for example Santo Domingos La Altagracia Maternity Hospital. More babies are born here than at any other hospital in the country. 30% of the women who give birth at La Altagracia are minors between the ages of 13 and 17. Dr. Cordero comments that many Dominican women do not know how to use contraceptives properly. He says that they do not understand that if contraceptives are not used each and every time when engaging in sex, getting pregnant is a strong possibility.
If the youth of our country had information on sex and reproduction in school, those young girls would know that if they have sexual relations with that boy from the neighborhood theyll get pregnant, he says. But since no one wants to talk about contraceptive methods, our women unfortunately become pregnant a high risk pregnancy that could kill her.
Sex education is not a brand new topic in the Dominican Republics public schools. According to Cristina Molina, Department Director of Counseling and Psychology at the Ministry of Education, the ministry produced the first sex education manual in 1979. It was used by psychologists who then offered the subject at their respective schools. The problem was a shortage of psychologists, which prevented sex education from reaching each school. It wasnt until 2002 that the Ministry of Education truly began to implement a structured sex education project. In that year, the Effective Sex Education in the Dominican Republic program was launched. This program trained teachers instead of psychologists in order to reach more schools. Mrs. Molina says that despite progressing at a slow rate, the program has been implemented at all Dominican high schools (grades 9-12) but it will take another two years to cover the elementary level (grades 1-8).
Were moving forward, but its a process working with the subject of sexual education is taboo, a subject that generates a lot of prejudice, says Mrs. Molina. Theres a cultural factor, a religious factor, and a factor of family upbringing thats being transferred from one generation to the next its a big job.
The Dominican Republics First Lady, Margarita Cedeño de Fernandez has implemented her own sex education project, called Bebé, Piénsalo Bien. The First Ladys Office launched the program last May (2006) as a pilot at the Community for Learning school in Santo Domingo. The project lends electronic babies to students for a weekend so they can experience the reality of caring for a newborn. The program has now been extended to Colegio Socorro Sanchez, which unlike the Community for Learning is a public school in one of the capitals poorer neighborhoods, Villa Duarte. According to Carolina Gordillo, Head of Childrens Projects at the First Ladys Office, the program will be launched in both private and public schools, as all students deal with the issue of pregnancy, an issue where education should begin at home.
We dont speak about sex with teenagers. Its embarrassing for a parent to speak about sex with their child so they dont want to deal with the topic, says Mrs. Gordillo. Before each program begins, we hold a meeting to explain that this is an important opportunity for them to speak with their children about sex. We ask that (the parents) speak about their own experiences of pregnancy with their son or daughter because it brings unity to the family.
Educational programs such as the ones mentioned are still in their infancy. Whether or not they help create awareness about sex and teenage pregnancy in the country still remains to be seen. The fact of the matter is that thousands of unsafe backstreet abortions are performed each year in the Dominican Republic. The laws are in place, but young Dominican woman continue to have abortions. With some 90,000 abortions being performed each year, the restrictions dont seem to be stopping women from aborting; but instead force them to visit ill-equipped facilities where their lives are put at risk.
Whats a woman whos got pregnant four times going to do with four children, alone? Whos going to take care of them? Asks Dr. Cordero. But since the country doesnt have legalized abortion and qualified services, the woman has to go to some witchdoctor where they are subjected to all sorts of procedures. In places where abortion is illegal, its the woman that suffers.
Credits: DR1.Com
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