February 21, 2023 Profamilia – an IPPF Member Association and a leading organization in the defense and guarantee of Sexual and Reproductive Rights in Colombia – celebrates the first year of the Constitutional Court decision that allowed the decriminalization of abortion in Colombia up to 24 weeks of gestation. This represents a historic step for the guarantee of the rights of women and pregnant people in the country and Latin America, as well as a transcendental advance towards the recognition of their autonomy and full citizenship. Thanks to the ruling, those who are faced with an unwanted pregnancy and decide to have an abortion will not be prosecuted or criminalized for accessing what is now considered a health service and a matter of social justice.
Similarly, the organization recognizes the issuance of Resolution 051 of 2023, with which the Ministry of Health regulates comprehensive care to provide abortion services throughout Colombia. This resolution recognizes that both women and pregnant people (transgender men, trans masculinities, non-binary people, among others) can access the service without restrictions and reiterates that abortion is an essential and urgent health service that must be guaranteed and not suspended.
Since its enactment, Profamilia has guaranteed the implementation of Ruling C-055 of 2022 in its network of more than 53 clinics specialized in sexual and reproductive health nationwide. In this sense, the Organization shares with public opinion an analysis of what has been evidenced in the first year of the Sentence, as well as recommendations to move towards a society that respects and guarantees the application of the current jurisprudence in favor of the rights and reproductive autonomy of women and pregnant people in the country.
The Positive side: Decriminalization increases access and engagement
Women, trans men and non-binary people who decide to terminate their pregnancies do so early. During this first year, 97.2% of the abortions performed through Profamilia were performed before the 16th week of gestation and of these, 86% before the 12th week and only 1.1% of the procedures were performed after 24 weeks, under one of the grounds of Ruling C-355 of 2006.
After Ruling C-055, access to safe abortion has improved. The Organization recorded a 65.9% increase in procedures. This information coincides with evidence from other countries (Uruguay, France, Portugal, Spain, Mexico City, Mexico) in which, after the legalization of voluntary interruption of pregnancy, there is no long-term increase in procedures, but rather an initial increase that then stabilizes and even decreases.
Profamilia has strengthened its MIA service, which accompanies and performs self-managed abortions up to 12 weeks of gestation through telemedicine. This service has reached women who wish to terminate their pregnancies in hard-to-reach municipalities such as: Leticia, in Amazonas, Bahía Solano, in Chocó, San Vicente del Caguán, in Caquetá, Dibulla, in La Guajira, among others.
Different authorities have fulfilled their obligations and reiterated their commitment to abortion rights. In August 2022, the National Government, through the Ministry of Foreign Affairs, communicated that Colombia officially withdrew from the Geneva Consensus Declaration – recognized for seeking to undermine reproductive autonomy and family diversity – and reiterated that the country recognizes, respects and protects the sexual and reproductive rights of women and girls and that, in accordance with the Political Constitution and the jurisprudence of the Constitutional Court, the right to legal and safe abortion is an integral and indivisible part of sexual and reproductive rights and health.
Resolution 051 of 2023 of the Ministry of Health guarantees the service for migrant women in Colombia and recognizes this right as an essential and urgent service that can never be suspended. It also eliminates co-payments and moderating fees in EPS and medical centers. It reaffirms that minors under 14 years of age may decide autonomously about an abortion, without their parents’ permission and even when their decision is contrary to their parents’. The resolution urges to modernize the protocols as an advance for the welfare of women and pregnant people.
On February 2, 2023, the Council of Bogota approved Agreement 023, which aims to guarantee the right to abortion without barriers and promote knowledge and access to information on rights and prevention of early motherhood and fatherhood, which not only impacts the right to health, but also strengthens the sector and becomes a benchmark for other cities in the country in the commitment they must make to ensure access to abortion as a health service.
The National Development Plan for the period 2022-2026 included the guarantee of the right to abortion (Voluntary Interruption of Pregnancy) in the framework of the formulation and implementation of the National Policy on Sexuality, Sexual and Reproductive Rights that must be updated for the next 10 years, with this it is possible to ensure resources to promote the materialization of all measures and actions to ensure the guarantee of the right to abortion in Colombia.
Still concerning: Barriers and violence persist
Despite Ruling C-055 of 2022, Profamilia has received users, with less than 24 weeks of gestation, who report having encountered barriers in health professionals who have limited the right and service of abortion.
On the other hand, Profamilia’s statistics on the provision of IVE (Voluntary Interruption of Pregnancy) services in its network of clinics throughout the country reveal a worrying increase in sexual violence against minors under 14 years of age, with an increase from 47.3% in 2021 to 2022. This data coincides, unfortunately, with the report of the National Institute of Legal Medicine and Forensic Sciences which indicates that there was a 23% increase by 2022 of sexual crimes against minors, compared to previous year.
The legalization of abortion in Colombia has shown limitations in the quality of services, it is essential to eliminate all forms of discrimination and violence, training and sensitization of health personnel, the elimination of curettage as the main technique and the definitive closure of sites where unsafe procedures are practiced.
What are the challenges?
It is necessary to fully comply with the orders of Ruling C-055 of 2022. That is why it is essential to support the approval of legislative and public policy initiatives that seek the implementation and strengthening of Comprehensive Sexuality Education in all educational institutions in the country, in order to prevent gender-based violence, promote the safe and responsible exercise of sexual and reproductive autonomy, knowledge and empowerment in rights, effective and timely access to contraceptive methods, as well as the search for a society with gender equity.
With the management of abortion as a public health issue, the country has the possibility of ending the preventable death of 70 women who lose their lives each year due to unsafe abortions, as well as reducing and avoiding 132,000 complications derived from this type of procedure. The legalization of abortion represents the opportunity to place the protection of the health and lives of girls and women at the center as the main objective of all public health policy.
The elimination of barriers to access to safe abortion services should be a priority for local health authorities, who are responsible for the inspection, surveillance and control of the health system in their jurisdictions. It is necessary to implement intersectoral mechanisms for follow-up and monitoring of barriers and technical accompaniment of health care providers to ensure an orderly and systematized implementation of the jurisprudence of the Constitutional Court and the regulatory norms that have been issued.
Territorial entities, at all levels, must take the initiative and leadership to make sexual and reproductive rights a reality in their jurisdictions. The example of the Bogotá Council and its agreement on the elimination of barriers to safe abortion is an example of how local measures can be adopted to facilitate the implementation of constitutional and regulatory mandates on abortion with actions.
“After one year it is possible to see the progress, the country has made in terms of reproductive autonomy and rights for women and pregnant people. However, we must move from text to action, ensuring that Ruling 055 of 2022 is implemented. Profamilia’s commitment will always be to provide comprehensive, humanized and safe services that allow free and informed decision making, and we reiterate this today,” said Marta Royo, Executive Director of Profamilia.
“Colombia has set a standard for the region, women and pregnant people deserves to choose the best decision for them and their families. In IPPF we are committed to grow the green wave to ensure that all the countries have equal rights for all, especially in Central America and the Caribbean “said Eugenia López Uribe, Regional Director of IPPF for the Americas and The Caribbean.
REF: https://acr.ippf.org/news/1-year-anniversary-historic-decision-decriminalize-abortion-colombia