Fury over Paraguayan authorities’ refusal to allow an abortion for a 10-year-old rape victim is expected to bring unprecedented numbers of pro-choice protesters to the streets of the country’s capital, Asunción, this week.

The case has prompted outcry around the world and prompted a national debate about the prevalence of child abuse and underage pregnancies.

But that debate has focused more on adult violence than on child health. And while many have called for tougher penalties for adults who abuse minors, few expect any change in the Catholic country’s strict abortion laws.

Despite a plea from the girl’s mother, Paraguayan authorities have ruled that the 10-year-old who is now 25 weeks into the pregnancy must give birth, unless she develops complications that put her life in danger. A medical panel is monitoring her condition.



Pedro Pablo Guanes, a gynaecologist based in Asunción, said the authorities are likely to release a tentative date for the birth soon. One option is for a cesarian section to be carried out in the next few weeks to avoid the biggest risk, which is that the girl’s body may not yet be developed enough to accommodate a fetus in its final stage.

On average, two girls under the age of 16 give birth each day in this country of 6.8 million, according to local media reports which have reflected fears that the rape of minors has become “normalised”.



Congressmen have proposed raising the maximum sentence for the rape of a minor to 30 years in prison, up from 10 years. But attempts to raise awareness over the issue of sexual abuse have been modest: the government has urged people to wear green ribbons on the National Day Against Child and Adolescent Sexual Abuse on 31 May.

A day earlier, hundreds of demonstrators are expected to attend a march from the Plaza Uruguaya to El Panteón in the capital with banners declaring “My body, my territory, not for use or abuse”. Similar small rallies have been staged every year, but organisers expected double the usual number of marchers this year because of the commotion caused by the 10-year-old’s pregnancy.

“Her case is emblematic and motivates many people,” said Rosana Ríos of the Grupo Luna Nueva, which is one of the participating organisations in the protest. “We are marching against the inaction of the state in the face of this problem.”

A child holds a sign that reads in Spanish: ‘Sexual child abuse never again, screams without voice,’ at a demonstration in front of the attorney general’s office in Ciudad del Este, Paraguay, Monday 11 May. Photograph: Peter Prengaman/AP

Petitions have been sent to the Ministry of Children demanding the government stop treating this problem as “normal” and asking for the establishment of a medical board to evaluate the options for the girl’s well-being. The global online campaigning organisation Avaaz presented a petition to the Paraguayan congress with half a million signatures calling for the decriminalization of abortion for women under 15 years of age.

This coincided with a public hearing in Asunción on whether to reform the nation’s abortion laws. Feminist and pro-choice groups argued that decriminalisation was long overdue because more than 50,000 illegal abortions are carried out each year for those who can afford them, while the poor have no choice but to bear the health and economic risks associated with an unwanted pregnancy.

The situation in Paraguay reflects that across Latin America, where abortion is illegal or severely restricted in most countries. Nicaragua, Chile and El Salvador ban abortion completely, even if the pregnancy threatens the life of both the mother and the foetus.

The World Health Organization has said botched abortions are a leading cause of maternal death worldwide, and in 2008 accounted for 12% of all maternal deaths in Latin America and the Caribbean.

But the strong influence of the Catholic church in the region makes reform unlikely. Earlier this week, Peru’s congress rejected a bill to decriminalise abortion in the case of rape. In Paraguay, a recent survey suggested that 87% of the population is opposed to abortion.

Many local doctors say it is unnecessary. The hospital Clinicas recently reported almost 400 pregnancies of girls under 16 years old that went to term without complications. The gynaecologist in charge of the 10-year old’s case said in a press release that he was surprised at the latest fuss because last year a nine-year-old girl gave birth.



“This shows how the situation here has become normal, at least to those who work with these cases,” said Cecilia Caniza, a psychiatrist based in Asunción. “Everyone needs to understand that this is not normal. Just because there are lots of cases does not make the situation OK.”

International research suggests the potential hazards for very young mothers are considerable: even though a 10-year-old may be able to conceive, her pelvis is not fully developed, raising the likelihood of complications during birth.

“One big study in Bangladesh showed a five-fold increase in risk of death among 10- to 14-year-olds compared to women aged 20 to 24,” said Dr Mickey Chopra, Unicef’s global chief of health.



“Even if the mother doesn’t die, the physical complications of pregnancy can be quite severe, running from prolapses to being physically disabled,” said Chopra.

Young girls who become pregnant also experience higher rates of pre-eclampsia – dangerously high blood pressure – which can be life-threatening for mother and baby.

And even when rape is not an issue, adolescents can have difficulty adapting to motherhood when they are still growing up themselves, said Daghni Rajasingam, a consultant obstetrician and spokesperson for the Royal College of Obstetricians and Gynaecologists in the UK.

According to Unicef, the teen and adolescent birth rate in Paraguay is 63 per 1000 girls aged 15 to 19. In the UK, which has one of the highest rates in Europe, the rate is 25 per 1000 and in the US, which has the highest rates in the OECD, it is 39.



Religion is not the only factor. Some Catholic countries do not have high teenage pregnancy rates – in Italy it is seven per 1000 and in Ireland it is 16. “Access to abortion is obviously important, but it is also about social norms,” Chopra said.

Additional reporting by Shanna Hanbury

