Through hotlines and clinics, activists and health experts are trying to change the stigma associated with abortion.

Tegucigalpa, Honduras – At 22 years old, Ana Padilla was certain of one thing: she did not want to be a mother. So when she found out she was pregnant six years ago, she frantically called a friend to see if she knew how to get an abortion, which is illegal under all circumstances in Honduras. The friend calmed her nerves and gave her the phone number of someone she knew who clandestinely sold mifepristone and misoprostol, pills used for at-home abortions.

“I was desperate in that moment,” says Padilla, adding that the experience of buying the pills was “mysterious”, like a drug deal.

“Anything that would have helped me to not be pregnant, I would have taken,” she tells Al Jazeera.

Honduras is one of six countries in Latin America with a total abortion ban. But reproductive rights advocates say the bans do little to stop women like Padilla from having an abortion, and instead push more to do so through drastic, life-threatening means.

In Honduras, there are an estimated 50,000 to 80,000 clandestine abortions each year, according to the Honduran-based Center for the Rights of Women.

With a legislative assembly that skews conservative and lacks the political will to bring decriminalisation to a vote, Honduran women have started to take other measures to reduce the risks of abortion, by forming informal networks to spread accurate information and improving post-abortion care at hospitals. But stigma and misinformation persist.

Misoprostol pills are taped inside an envelope and shipped to women in Honduras who then distribute them to those seeking to have an abortion [Cristina Baussan/Al Jazeera]

Through education and training, feminist activists hope that they can reduce the country’s maternal mortality rate and fight the stigma surrounding abortion while they wait to be able to make headway on their long-term goal of decriminalisation.

The hotlines

Since 2017, a group of feminist activists have manned “La Linea” (the line), a phone line that Honduran women can call anonymously to ask about abortions, emergency contraception and other issues related to reproductive health.

In high schools and colleges, few qualified professionals talk to young women about sexual education, prompting many young women who become pregnant to seek out clandestine abortions, activists say. So La Linea volunteers focus on young women and adolescents, by posting fliers around college campuses and high schools.

“We want to reach young women because we know that they don’t have anywhere else where they can find this information,” says one of the founders of the line who wished to remain anonymous because of the sensitivity of their work.

Callers often want to know about birth control, abortions and the morning-after pill, which is also banned in Honduras. Many callers ask for misoprostol or other abortion services, but the hotline doesn’t help women get these pills, because doing so is illegal and could cause the line to shut down. Instead, it focuses on sharing accurate information and promoting body autonomy.

190627184711541

“Here, women still don’t believe that they can decide about their own bodies. There’s still a stigma around telling people that they can decide,” the founder says. “And the right to decide involves many things: the right to decide about your sexuality or the right to decide to have a child.”

But La Linea isn’t the only hotline looking to providing information to women who are questioning whether to end their pregnancies.

An ad in various Honduran newspapers for a different hotline reads, “Are you pregnant and don’t know what to do?” in big block letters next to the silhouette of a pregnant woman. It’s unclear from the ad who runs the line.

Upon calling, a woman or adolescent reaches a volunteer from Provida, an anti-abortion rights organisation based in Tegucigalpa. The group is against abortion in all cases, as well as the morning-after pill. It only promotes natural birth control methods.

Women who call the Provida line speak to a volunteer who tells them about what the group considers to be the risks of abortions. The volunteers also often try to set up an appointment for women to come into the office.

At Provida’s office, where a series of graphic pictures of fetuses at each stage of pregnancy lines the wall, the women and girls are shown a video called, Life in the Womb, which is about the process of pregnancy and childbirth. Then, they listen to their fetus’s heartbeat. The whole process aims to persuade pregnant teens and women against having an abortion.

Ad for the Provida hotline [Anna-Cat Brigida/Al Jazeera]

“Most of them are young women who are uncertain and afraid and all they need is that someone extends a hand,” says Michelle De Idiaquez, president of Provida. “Our goal is to give them support and ensure that these women carry their pregnancies to term.”

If a woman ultimately decides to enroll in the programme, she has the option of being attended during her pregnancy by a network of volunteer doctors, all free of cost, but she is not helped after the birth due to limited resources, De Idiaquez says.

“Most of the women decide to have their babies and in general they are very happy and content,” says De Idiaquez, who also questions government and rights groups data showing high levels of sexual violence in the country. During the past 10 years, more than 50,000 Honduran women have reported being victims of sexual assault, and more than 17,000 of those women were minors, according to government data.

Because of privacy concerns, Al Jazeera was not able to contact any of the adolescents and women who have gone through Provida’s programme to speak to them directly about their experience.

But critics argue that Provida’s hotline is just another example of Honduran women’s lack of control over their own bodies. Considering the lack of sexual education, limited knowledge of contraception, and high rates of sexual violence, “it’s unbelievable that they do this,” says the founder of La Linea, who adds that she has seen the postings for the hotline in the bathrooms of the Olympic Village in Tegucigalpa, the same place where La Linea’s fliers are regularly taken down.

“It seems like they are only putting women in a more vulnerable situation and making women feel like they are to blame,” she adds. “And obviously, they are not promoting the right to decide, but rather the complete opposite. It’s a shame really that women have to hear once again that they can’t make the decision for themselves.”

Health risks

Despite efforts from anti-abortion rights groups to stop the procedure, tens of thousands of Honduran women like Padilla still have abortions every year. When they do, they risk life-threatening complications if not treated properly.

Women do not have fewer abortions in countries with more restrictive abortions laws, according to a 2017 report by the Guttmacher Institute, a US-based reproductive health research and policy organisation. In countries with more restrictive laws, a higher percentage of abortions are considered unsafe.

Ana Ligia Chinchilla, a doctor at a post-abortion clinic in Tegucigalpa, treats women with complications from abortions. Many women arrive hemorrhaging or in extreme cases, with a perforated uterus from a botched abortion. In these cases, doctors usually have to remove the uterus completely, meaning that the woman will not be able to have children in the future.

190707003702255

One in 23 maternal deaths in Honduras in 2017 was the result of an abortion, according to data from the health secretary. But the number could be even higher given that women often try to hide their abortions for fear of the legal consequences, according to a recent Human Rights Watch report.

“Because it’s illegal, many women have abortions in unsafe conditions and die and we don’t know about it,” Chincilla says.

I have friends who have had babies because of this stigma of not wanting to be a bad person or a bad woman, but it's important to get rid of this idea that we've always been told and that we've learned. Ana Padilla

Padilla was too scared to go to the hospital when she started experiencing heavy bleeding after taking an abortion pill at home. Her partner encouraged her to go to the hospital, but her sister disagreed. Padilla made the final decision.

“I remember I said, ‘No matter how much pain I’m in, we’re not going to leave here,'” Padilla says. “I was more scared that they would [put me in jail].”

Under Honduran law, women in Honduras can be sentenced to three to six years in prison for having an abortion. Any person who helped induce the abortion, including doctors and nurses, can receive a sentence of between three and 10 years depending on whether the women consented. In Honduras, dozens of cases have been opened against women suspected of having abortions and medical professionals who have been accused of carrying out the procedure

Padilla’s heavy bleeding was not life-threatening, but she realises now that she was lucky that medical attention was not necessary. If abortion had been legal, she might have sought help from the hospital instead.

“If it weren’t illegal, it would make the whole process easier,” she says.

The post-abortion clinic is trying to reduce maternal mortality by getting rid of the stigma surrounding abortions among healthcare professionals, who often turn women away when they suspect they have had an abortion, either for religious reasons or for fear of prosecution under the country’s abortion law.

Now the focus is on medical attention, rather than judgment.

“The situation has improved a lot because the hospitals attend to women without asking what happened,” Chinchilla says of the select hospitals where the programme has been carried out. “We give attention to women, independently of whether she has induced the abortion. We are not interested in knowing. We are just interested in saving her life.”

Women gather at a protest for the International Day of action for women’s health in Tegucigalpa, Honduras [Cristina Baussan/Al Jazeera]

Padilla recalls that the experience of having an abortion was filled with paranoia and shame.

“It’s because of the ban that you feel that way, because it’s prohibited,” she says. But she hopes that views are changing so that Honduran women won’t have to go through what she went through.

“I have friends who have had babies because of this stigma of not wanting to be a bad person or a bad woman, but it’s important to get rid of this idea that we’ve always been told and that we’ve learned,” Padilla says.

“So many women and girls don’t have access to birth control, they are raped and they end up pregnant. Even then, they don’t have the right to say, ‘You know what? I don’t want a baby. And I’m not a bad person for not wanting it.'”

With additional reporting by Vienna Herrera in Tegucigalpa.

This article is part of a multi-part series examining reproductive health in Honduras. Also read:

In Honduras, women fight for access to the morning-after pill

Honduran women demand protocol for survivors of sex abuse

This series was supported by the International Women’s Media Foundation’s Reproductive Health, Rights and Justice in the Americas.