Mariana Iglesias
02/13/2021 15:04
Clarín.com
Society
Updated 02/13/2021 15:04
There are those who still present themselves with shame, their faces down, their hands clenched.
But there
are
also
already very high fronts that with a firm voice claim their right.
The professionals who make up the health teams that are in charge of legal abortions are experiencing situations that came from the hand of the new law.
And a transcendent fact that - they assure - changes everything:
it is not necessary to investigate more women as if it were a judicial interrogation
.
The law of
Voluntary Interruption of Pregnancy (IVE)
, voted at dawn on December 30, 2020, after twelve hours of debate in a Senate that seemed elusive but ended up giving 38 votes in favor, allows abortion until week 14 After that period the interruption is allowed, but for reasons:
rape, risk of life, health problems
.
"The law of voluntary interruption of pregnancy comes to respond to a very serious public health problem, clandestine abortion.
More than 3,000 women have left their lives there since we recovered democracy.
Today we come to repair this," said 14 January Vilma Ibarra, moved to tears at the act of promulgation of the law.
That day, the Legal and Technical secretary also said;
"The State answered with jail, now we change this paradigm and
the State is going to receive women and treat them with dignity and respect
",
Vilma Ibarra hands President Alberto Fernández a pen at the act of promulgation of the law on January 14 at the Bicentennial Museum.
(AP Photo / Marcos
Law 27,610 entered into force on January 24.
The
0800 222 3444
of the National Directorate of Sexual and Reproductive Health doubled the calls.
There you can not only make inquiries but also report if a health center denies care.
There is also an email from the ministry:
saludsexual@msal.gov.ar
.
"There is a flood of inquiries, the demand is very important. The 0800 is overflowing,"
Viviana Mazur, responsible for access to the ILE and IVE in the City of Buenos Aires
, explains to
Clarín
.
"Among those who consult there
are
also
people who were not users of the public system, but of prepaid and social works,
and who even before the law resolved these issues in a particular way," says this doctor who is also part of the
Network of Access to Safe Abortion of Argentina (Redaas)
.
It is a network of health and law professionals linked to public and community health services in Argentina.
Formed in 2011 - at the initiative of the Health, Economy and Society Area of the
Center for State and Society Studies (CEDES),
which was later joined by the
Latin American Justice and Gender Team (ELA)
-, since then they accompany and attend to women in legal abortion situations to ensure that this right is fulfilled.
The doctor Viviana Mazur in Congress, speaking in favor of the Voluntary Termination of Pregnancy
"They call as soon as they have a delay and take the test," says the doctor.
Sometimes it is about four weeks, then they advise to wait another week, and
confirm the pregnancy with an ultrasound
.
But the most important change -detail- is in the attitude: "To
ask for
an interruption before was shameful, it
was asked in an apologetic tone, with shame,
now there are women who speak differently, they know that it is their right."
"The relief we feel from
not having to question anyone is enormous,
" says Mazur, who speaks of "super heterogeneous" when defining the profile of those who ask for the interruption: women of different ages and socioeconomic situations.
He says that
there are still those who do not dare to pronounce the word "abortion"
and speak of "that new law."
Also that there are other women who ask many times if they can really do it because
they cannot believe that it is free in the hospital
.
A handkerchief to claim for legal abortion.
Photo José Almeida
The truth is that less than 15% of the interventions are carried out in the hospital, the
vast majority are done with pills
that professionals prescribe to use in their own homes, that is, on an outpatient basis.
There are still no IVE figures in Caba, but it is one of the few jurisdictions in the country where the ILE protocol was complied with: in 2020 there were 10,000 legal interruptions.
Uneven country
"The demand exploded this last month,"
Marianela Sierralta, 39, a gynecologist
, tells
Clarín
.
She has worked since 2006 in a provincial hospital in Salta, where
only two professionals from obstetrics and gynecology services are "non-objectors
.
"
In total there are 55 professionals: 25 in gynecology and 30 in obstetrics.
It is the most important public maternal and child hospital in the province.
Marianela Sierralta in the Salta hospital where she has worked since 2006.
"Salta is
a very hostile, archaic place,
where everything costs twice as much," says Marianela, who until recently was the only one who carried out pregnancy terminations.
Now - and thanks to his insistence - a young woman who has just finished her residency and is not an objector has entered the hospital.
Marianela is training her.
"We can't cope. Even my personal cell phone doesn't stop ringing, because people kept passing my phone, but
I can't be the only person who complies with the law
, because we already have the law but that's not how we are enforcing it", says the doctor, who is overwhelmed, because in addition to her cell phone, the hospital line phone rings and the guard is also full of women.
All requests for access to IVE in the province are derived from her service, because except for her and the resident,
non-objectionable professionals
, such as the Cafayate clinic
,
are counted by hand
, but only attend first trimester interruptions.
Marianela says that the social works deny any request, that
only the public system is working:
"Nothing is going well, in Salta we always see everything that is wrong."
In Salta, he marches in favor of the legalization of abortion, in front of the legislature, with the presence of Lucrecia Martel.
Marianela -also part of Redaas- attends the interruptions office every Monday.
Until before the law I saw about five patients per day and now there are more than ten, twelve per day.
"The demand is much higher, luckily
with the information, women approach before
, as soon as they find out about the pregnancy, and it can be resolved on an outpatient basis and with pills. But
in Salta there are still many situations of abuse,
much shame, much vulnerability, high pregnancy in girls and adolescents, which are factors that delay consultations ".
Luciana Hita is a gynecologist at a hospital in the capital of Neuquén.
There the panorama did not change so much because in the province the legal interruptions were already being carried out: "What is happening is that the procedure is expedited because if it is before week 14, you
do not have to be investigating the causes
. And yes, there was more demand, we will see if it is something from the first month or if it is sustained over time, "he tells
Clarín
.
Luciana Hita and the team of doctors she accompanies in the voluntary interruptions of pregnancies at the Neuquén hospital.
In the hospital where he works,
only a third of the professionals in the gynecology and obstetrics services guarantee the interventions
, the rest are objectors.
But it highlights an important link with the nursing sector, which often also functions as an obstructor.
And it confirms what happens in other places:
most of the interventions are with pills and outpatients
and that complicated cases have to do with abuse, girls, adolescents and situations of greater social and economic vulnerability.
Alejandra Zorzoli is a social worker, she has been in a provincial hospital in Rosario since 2005. There, the ILE was also implemented in a timely manner, but the big change is in the first talk.
"
We no longer have to ask women almost anything
, that is a huge satisfaction, because we had to be practically investigating them to have to justify and explain the reasons," he tells
Clarín
.
Alejandra Zorzoli is a social worker and attends a provincial hospital in Rosario
He also talks about the collapse of 0800, the increase in consultations, and something that seems like progress: "Adolescents came accompanied by their families. It is seen that
more information is circulating, people know more, they are
beginning to know their rights and it is because the issue from the law is becoming much more visible ".
It repeats the trend of drug and outpatient interventions and
the clear vulnerability of those who just show up in the second trimester
: "They are the people who have less access to everything," says Alejandra, who emphasizes the lack of contraceptives.
But she ends with what for her is the great revolution: "
Going from asking for explanations to talking about rights
in a counseling room."
The number of the Ministry to make inquiries or report the impediment to access to legal abortion
"The scenario is in the process of reconfiguration and that is foreseeable and necessary. Each actor is attentive to the new responsibilities.
The health teams that guarantee access feel the impact of the support and legitimacy that the law gives them.
This comforts them and strengthens their ethical and professional commitment ", assures
Clarín
Silvina Ramos, Cedes and Redaas specialist.
Ramos explains that the Ministry of Health is updating the protocol according to the new standards set by law and the latest scientific advances: "ANMAT has authorized misoprostol for outpatient and inpatient use for various indications, including legally permitted termination of pregnancy. The public laboratory in Santa Fe produces this drug with assured quality standards and it will be a key supplier in the policy of assurance of supplies of the National Directorate of Sexual and Reproductive Health ".
In any case, Ramos admits,
complying with the law "will be a process that is not without difficulties
, as happened in other countries in the early days. But the legitimacy of the law, the consensus and the political will that led to its approval and the solid commitment of those who have been supporting access to safe abortion in Argentina will help to overcome them ".
The specialist poses two major challenges for these months: "On the one hand, the proper understanding and implementation of the regulation of conscientious objection on which the law is so clearly expressed. And also, the presentations in court requesting precautions for to leave without application the law ".
Misoprostol
To strengthen the implementation of the public policy of access to ILE, during 2020 the National Directorate of Sexual and Reproductive Health of the Ministry of Health of the Nation
bought 35,000 treatments
of misoprostol, the drug used to interrupt pregnancies.
The Laboratorio Industrial Farcacologico (LIF) of the province of Santa Fe produces misoprostol. Forum: José Almeida.
By 2021, more than double what was planned in 2020 was incorporated into the annual purchase plan:
80,000 treatments.
In turn, provincial jurisdictions also purchase misoprostol from provincial ministries or through direct purchases from hospitals.
The medication is distributed through
the Remediar program
to provincial Sexual and Reproductive Health programs and directorates and to health centers that require direct delivery.