The women seeking abortions turned away by doctors in Chile By Grace Livingstone

BBC Santiago, Chile Published duration 1 August 2019

image copyright Getty Images image caption The total ban on abortions in Chile was lifted in 2017 after much campaigning by women's rights groups

When Adriana Ávila Barraza was 12 weeks pregnant, she received some upsetting news.

Her foetus's head was malformed, and the prognosis was not good, her doctor told her. The diagnosis was confirmed by an x-ray when she was 16 weeks pregnant - part of the skull was missing, so the brain could not develop. The foetus would not survive.

Since then, abortions have been allowed under three strict conditions: if a mother's life is at risk, if a woman has been raped and if the foetus is unviable.

Turned away

Knowing that the foetus had no chance of surviving to term, Adriana asked her doctor for a termination. But he refused.

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He was one of the hundreds of doctors in Chile who describe themselves as "conscientious objectors" because they refuse to carry out abortions.

"He gave me two options," says Adriana - to wait until the foetus died or "to pray".

At a loss, Adriana went to a public hospital in the capital, Santiago. But staff seemed to have no knowledge of the abortion law, she says, even though the legislation had been passed several months earlier. They would not carry out an abortion.

She went to a second hospital in Santiago, and again, was turned away.

It was only when she went to a third hospital that medical staff agreed to carry out a termination.

However, they said they needed a diagnosis from her original doctor. He refused, causing several more weeks delay.

In desperation, Adriana contacted Chile's ministry of health, which finally arranged for her to have an abortion.

By this time she was 26 weeks pregnant. Adriana was induced and had to endure a 24-hour labour, giving birth to a dead foetus.

'Serving life'

Adriana's doctor is not an exception. When the law decriminalising abortion was passed by the centre-left government of President Michelle Bachelet, a clause was included allowing doctors to refuse to perform terminations on grounds of personal conscience.

Two years on, a fifth of obstetric doctors in public hospitals say they will not carry out abortions even if a woman's life is at risk,

There are many more "objector" doctors in private clinics and hundreds of paramedics and anaesthetists also refuse to assist terminations.

Dr Luis Jensen is one of the "conscientious objectors" working in a private clinic in Santiago.

image caption Dr Luis Jensen says he will not perform abortions

"I studied medicine 40 years ago," he says. "I learnt at medical school that doctors were meant to serve life, to restore health and cure illnesses. We were never taught to give treatments designed to kill," he says.

Dr Jensen says that if a mother's life was at risk, he would perform an early Caesarean, as that, in his view, would not constitute a termination because the aim of the operation would not be to destroy the foetus.

If a woman had been raped or her foetus was unviable, he would encourage her to continue with the pregnancy. This would be better than "living with the knowledge that you have killed your own child," he argues.

Camila Maturana is a lawyer for the non-governmental rights group Corporación Humanas and represents several women who have been denied terminations.

She says that the current conservative government of President Sebastián Piñera has made it harder for women to access their legal right to an abortion.

The Piñera government introduced new rules in 2018 making it easier for doctors to become "conscientious objectors".

Public hospitals, for example, no longer have to ensure that there are always medical staff available to terminate pregnancies.

image caption Debora Solís says women are being forced to opt for risky backstreet abortions

The government also recently won a constitutional court ruling that enables private hospitals and clinics which refuse to carry out abortions to continue to receive state funds.

Debora Solís, a director of the Chilean Association for the Protection of the Family, which runs sexual health clinics across the country, says the state's failure to provide access to legal abortions is forcing thousands of women and girls to opt for illegal backstreet abortions, effectively putting their lives at risk.

'I felt so alone'

Pro-government Congressman Guillermo Ramírez is one of those who defends doctors' right to refuse to carry out terminations. "My personal opinion is that conscientious objection is a liberal principle that we must defend at all costs," he says.

image caption Congressman Guillermo Ramírez believes doctors should have the right to be "conscientious objectors"

He says that with limited resources, the priority should not lie in providing abortions in every hospital. "Chile has many medical shortages. We don't have a cardiologist in every hospital, so why should we have doctors who carry out abortions in all hospitals?" he argues.

He says that if the first hospital a woman goes to will not provide an abortion, she will just be taken to another one that does.

But Adriana Ávila, who was turned away by a private clinic and two public hospitals says the experience was traumatic.

"I was in despair, I didn't know where to turn. I knew that the foetus was going to die so why did I have to go through this torture?" she asks.

"I felt so alone."