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Catholic World News News Feature

Girded for Battle August 01, 2004

Debates over the legal distribution of the abortifacient “morning-after pill”—also known as the “emergency oral contraceptive”—are no longer a matter of merely scientific interest in Latin America. Rather suddenly, this issue has become a key battle all across the continent in the struggle to protect the dignity of human life.

The drug known as Levonorgestrel, and marketed in Latin America as “Plan B” or “Postinor 2,” has cropped up in the center of public debates within the last six months in Mexico, Brazil, Argentina, Peru, and Chile.

The near-simultaneous emergence of this hot political topic in several different countries is “certainly not by chance,” says Carlos Polo, a representative of the Population Research Institute in South America. According to Polo:

There is a similar pattern used to introduce the “morning-after pill” in the countries of the region. First, a government decree is passed to include the drug in public health programs—thus avoiding the debate in congress. Then its abortifacient effect is blatantly denied. And finally the whole concept of abortion is redefined to move the country one step closer to its legalization.

DISPUTING THE FACTS

Dr. Raúl Cantella, one of Peru’s top research physicians and a pro-life leader, sees a prime showcase of this process in the person of Pilar Mazzetti, Peru’s minister of health. “Mazzetti expresses perfectly the ‘baby steps’ abortion promoters are taking in the region to legalize abortion,” Cantella says.

In March 2004, Mazzetti said it was “indispensable” to provide distribution of the morning-after pill through state-run public health programs, because she claimed that “experts”—mostly feminists and pro-abortion advocates—strongly recommended the drug as a way to prevent teen pregnancy.

But the Catholic Church and pro-life organizations in Peru immediately argued that distribution of the drug would be unconstitutional. Peru’s constitution is one of the most specifically pro-life documents in the region, since it declares that the protection of human life should begin at the moment of conception. The morning-after pill works by preventing the buildup of the lining of a woman’s uterus, which is necessary to sustain a pregnancy; if conception has already taken place, the fertilized ovum is unable to implant itself in the uterus, and the unborn baby dies. Mazzetti responded to this objection by saying that she would consult with more experts, and await the results of a study on the drug by the US Food and Drug Administration (FDA). But when the FDA report confirmed that the prevention of implantation is “one possible effect of the morning after-pill,” the Peruvian health minister changed her approach, suddenly announcing that she had “more modern, up-to-date information” allegedly “confirming” that this abortifacient effect, confirmed by the FDA, was not real.

In Chile, too, the country’s constitution forbids abortion. But since the Chilean document makes no explicit reference to conception as the moment when human life begins, promoters of the morning-after pill made no attempt to hide the fact that the drug prevents implantation. Still, in order to avoid use of the term “abortifacient,” they relied on the World Health Organization’s definition of abortion as “the interruption of a pregnancy, which does not begin until implantation.” Since implantation can take place up to several days after conception, this definition opened a window of opportunity for the use of the morning-after pill under conditions that would cause the destruction of the fetus, but would not qualify legally as abortion.

A THREAT DEFERRED

“So, while in Peru the strategy was to deny the anti-implantation effect of the pill, in Chile it was to deny that such an effect was an abortion,” Cantella observes.

The Peruvian Bishops Conference (CEP) reacted energetically to the health minister’s skewing of the scientific debate, denouncing Mazetti’s “double speak,” and condemning “the malicious manipulation of language, employed by international and national lobbyists that support the distribution of these population control methods in the Third World.” The bishops warned that:

It is obvious that this strategy seeks to roll back the protection of the unborn and deny them their rights. At the same time, however, this distortion also seeks to alter the concept of “abortion,” because it would no longer mean the elimination of a new living being from the moment of fertilization, but rather from the moment of implantation in the uterus.

Then, just as Mazzetti was about to release an order for the government’s purchase of the pill, a pro-life leader made public his discovery that the “more up-to-date studies” cited by the health minister actually amounted to just one investigation, dating from 2002, carried out in Sweden by scientists from the Department of Health for Women and Children of the Karolinska Hospital in Stockholm. The study, which had been provided to Mazzetti by the Peruvian gynecologist Luis Tavara, who works for the UN Population Fund, is thus older and less extensive in scope than the study that had been undertaken by the FDA.

At this point Bishop Hugo Garaycoa, the president of the CEP, called upon all political and social organizations in the country to force the heath minister to engage in a public debate about the issue. Under pressure, Mazzetti accepted the challenge, at least insofar as she promised to delay any final decision about the pill until later this year.

In Chile, meanwhile, distribution of the drug was also approved by a decree from the ministry of health, which required all city councils to receive and distribute the morning-after pill on demand; the directive also stipulated that the pill should be provided to teenagers who requested it. The health minister, Pedro Garcia, said that any local officials who resisted the distribution of the drug would be legally prosecuted.

That threat sparked a wave of protest from pro-life mayors, and after the Chilean bishops announced that they would support any mayors who engaged in civil disobedience by challenging the directive, the health ministry was forced to back down. In fact, vice minister Antonio Infante said in early July that “after several days of uncertainty and analysis in the ministry, the possibility of applying sanctions against mayors has been lifted.”

A LEGAL VICTORY

But the campaign for legal approval of the drug’s distribution in Chile was about to suffer another, more damaging blow.

A group of Catholic college students had put together a legal case, showing that the morning-after pill had an abortifacient effect and that its use was therefore unconstitutional. They presented their case before a federal court, and in July the tables were turned decisively against the government. Judge Silvia Papa issued a ruling prohibiting the sale and the marketing of the morning-after pill, arguing that the drug’s “anti-implantation mechanism qualifies it as abortifacient under Chilean law.”

In her 40-page ruling—which, she took pains to point out, was based “on legal rather than moral grounds”—Judge Papa nullified the health ministry’s authorization to market the drug. The ruling means that authorities must remove Postinor 2 from the market immediately, as well as any other product that contains Levonorgestrel, even if it is given out free of charge or by order of the government.

The director of Chile’s Institute of Public Health, Rodrigo Salinas, announced that he would appeal the decision, but acknowledged that if the Supreme Court rules against legalization of the drug, the government will abide by that decision.

In Argentina, too, a federal judge has ruled that distribution of the morning-after pill would violate the pro-life provision of that country’s constitution. The Argentine judge actually went further, finding that any drug or device that prevents implantation—such as the IUD—falls under the same prohibition, and insisting that the government must refrain from distribution of such contraceptives. There, too, the court’s decision has been appealed, by both the government and feminist groups, and it is very likely that the case will end in the country’s supreme court.

A LONG FIGHT

In each of these countries—and in the other Latin American nations where the dispute has come recently to the fore—these legal and political battles are likely to continue for months if not years.

According to Carlos Beltramo of the Institute of Bioethics Studies of the Autonomous University of Puebla, Mexico, “it is clear that there is still a long fight ahead. Each country in which the morning-after pill has been proposed is in the first round of this battle.”

Because both sides are now fully engaged in this battle, and fully aware of the implications, the final result of disputes about legal marketing of the morning-after pill could have much broader implications, involving the legal definitions of abortion and of human life, and the government’s commitment to protect the unborn. Beltramo concludes: “What both sides know now is that this battle will be decisive in defining what will happen in the region—in matters of life and family—in the near future”

[AUTHOR ID] Alejandro Bermúdez is the director of the ACI-Prensa news agency, based in Lima, Peru, and a regular CWR contributor.