Lack of abortion care is a threat to women’s health in Latin America

In 1994, the International Conference on Population and Development established a groundbreaking framework recognising reproductive rights as human rights.1 This framework prioritised people and human rights in development—rather than population control. Thirty years on, stark inequalities in sexual and reproductive health and rights persist across national, regional, and global levels. Poor access and restrictions on abortion are contributing to maternal mortality in Latin America and the Caribbean.

In many contexts, women have limited autonomy and decision making power over their health, exacerbating poor health outcomes. Unsafe abortion is a serious public health problem and poses a particular risk to women’s health—especially in countries where abortion is clandestine and often dangerous. The impact of unsafe abortion is particularly severe in young, impoverished, and less educated women. Studies on clandestine abortions in places where abortion is highly restricted show that women with higher incomes have a greater chance of accessing safer abortion methods than those with lower incomes.2 Legislative restrictions, inadequate social support, limited family planning services, and under-resourced healthcare infrastructures contribute to this issue. Complications from these abortions further strain local health systems because of the need for emergency and long term care.

When women are faced with unintended or unplanned pregnancies in Latin American and Caribbean countries with restrictive abortion laws, they are confronted with a difficult choice: giving birth to a child they may not be prepared to support or seeking an abortion. Until 2020, 97% of women of reproductive age in Latin America lived in countries where abortion access was severely restricted.3 Pursuing an abortion in these countries involves stigma and secrecy, leading to delays in obtaining help, resorting to unsafe methods, or relying on unqualified people. In countries where abortion is legally permitted, however, it is a safe, low risk procedure.

These inequalities result in avoidable deaths of women from pregnancy related causes, while healthcare professionals experience frustration over the legal inability to provide care to women who need it.4 The weighted average maternal mortality rate in countries where abortion is legally restricted is three times higher than in countries where abortion is legally permitted.5 The Montevideo consensus, an advanced regional agreement on Population and Development in Latin America and the Caribbean,6 highlights the high rates of maternal mortality. This is largely because of difficulties accessing sexual and reproductive health services or unsafe abortions. Many experiences in the Latin American region have shown that the penalisation of abortion leads to higher rates of maternal mortality and morbidity and does not reduce the number of abortions. Maternal mortality has become a strong concern in Latin America and the Caribbean, where in 2020, one woman died every hour from pregnancy related complications.5 This alarming statistic represents a setback of two decades in terms of maternal mortality ratio, exacerbating inequalities and deepening the crisis in access to sexual and reproductive health services and rights in the region.7

Reducing maternal mortality and inequities in sexual and reproductive health and rights requires urgent action at multiple levels. In June 2024, director of the Pan American Health Organisation, Jarbas Barbosa, issued an urgent call to action to reduce maternal mortality in Latin America by implementing strategies to reduce situations of vulnerability and challenge “gender norms and roles.”8 The G20 health working group announced the approval of the health declaration in October, stressing the need to tackle long standing inequalities, promote public health, and ensure equity in access to healthcare in all countries. These calls should serve as a platform for action on sexual and reproductive health and rights.

The Montevideo consensus recommends that governments in Latin America and the Caribbean must prioritise the expansion of equitable healthcare access, particularly for marginalised communities. Removing legislative barriers to safe abortion, investing in high quality maternal healthcare, and bolstering family planning services are essential steps to improve outcomes for all women, regardless of income or geographical location. Policies must focus on the root causes of maternal mortality, such as restrictive abortion laws, inadequate family planning resources, and poor healthcare infrastructure.4

At a global level, organisations and policy makers must work together to ensure that the foundational goals of the International Conference on Population and Development and the sustainable development goals are fully realised. This includes increasing funding for maternal health services, supporting community based interventions, and ensuring that women everywhere have the autonomy to make informed decisions about their reproductive health. Lessons can be learnt from Uruguay in South America, where maternal mortality from abortion has drastically reduced since legislative changes.9 The Voluntary Interruption of Pregnancy Law created a legal framework that supports the protection and exercise of human rights within the scope of sexual and reproductive rights.10

The inequalities that persist in maternal health and sexual and reproductive rights in Latin America and the Caribbean serve as a stark reminder that much work is still to be done. By investing in comprehensive, inclusive, women centred, and accessible reproductive healthcare, we can make meaningful strides towards a future where no woman dies from preventable pregnancy related causes and where sexual and reproductive health and rights are truly realised for all.