NYT, By JUAN FORERO
PAMPLONA, Colombia - In this tradition-bound Roman Catholic town one day in April, two young women did what many here consider unthinkable: pregnant and scared, they took a cheap ulcer medication known to induce abortions. When the drug left them bleeding, they were treated at a local emergency room - then promptly arrested.
Insisting that abortion was rare, Pamplona's conservative leaders thought the case was over. Instead, the episode reverberated throughout Colombia and helped to galvanize a national movement to roll back laws that make abortion illegal, even to save a mother's life.
Latin America holds some of the world's most stringent abortion laws, yet it still has the developing world's highest rate of abortions - a rate that is far higher even than in Western Europe, where abortion is widely and legally available.
Increasingly, however, women's rights groups across the region are mounting challenges in courts and on the streets to liberalize laws that in some countries ban abortion under any circumstances. At least one major case with implications for the entire region could be decided in the coming days.
So far, no country has dropped its ban. But the effort, spurred by the high mortality rate among Latin American women who undergo clandestine abortions, has begun to loosen once ironclad restrictions and opened the door to more change.
Although it may seem small by United States standards, it is a seismic shift for a region where abortion is readily available only in Cuba and a few other Caribbean nations. "There is a real trend for change, particularly in South America," said Marianne Mollman, a women's rights researcher for Human Rights Watch, which this year threw its support behind efforts to decriminalize abortion in Latin America. "I think it's the end of the realization that the criminalization of abortion doesn't lead to less abortion, but that it leads to a lot of preventable problems."
In Brazil, the world's largest Roman Catholic country, women's groups successfully pushed for new regulations earlier this year that permit a rape victim to get an abortion without providing a police report to doctors, as was commonly required.
The government of President Luiz Inácio Lula da Silva also created a commission this year that called for legalizing abortion up to the third month of pregnancy. The Brazilian Congress is now debating the plan.
In Uruguay, the Senate came three votes shy last year from legalizing abortion, setting the stage for future efforts by abortion rights advocates, while Argentina's Congress is debating about a half dozen bills to legalize abortion in some instances.
Women's rights groups from New York to Buenos Aires are also closely watching the outcome of a lawsuit filed by a Colombian lawyer, Monica Roa, with the nation's highest court. It seeks to legalize abortion when a mother's life is in danger, when the fetus is expected to die of abnormalities or when the pregnancy resulted from rape.
The central argument in the case - one that could set precedent - is that Colombia's anti-abortion laws violate its international treaty obligations, which require the nation to ensure a woman's right to life and health. Colombia's Constitutional Court is expected to rule on the case as early as next week.
The abortion rights movement in Latin American has come as women throughout the region are having fewer children and benefiting from once-improbable opportunities in the workplace and politics. Social mores are also changing. Largely gone, for example, is the social stigma unwed mothers once faced, as well as laws that offered few legal protections for women. Also, divorce is now legal across Latin America.
Emboldened, women's groups that advocate the legalization of abortion have taken to the streets of Buenos Aires, Santiago, Chile, and the Colombian capital, Bogotá, with some marchers publicly admitting they broke the law and underwent abortions.
Regional health officials increasingly argue that tough laws have done little to slow abortions. The rate of abortions in Latin America is 37 per 1,000 women of childbearing age, the highest in the world outside of Eastern Europe, according to United Nations figures. Four million abortions, most of them illegal, take place in Latin America annually, the United Nations reports, and up to 5,000 women are believed to die each year from complications from abortions.
In an interview, a doctor in Medellín, Colombia, said that while he offered safe, if secret, abortions, many abortionists did not.
"In this profession, we see all kinds of things, like people using witchcraft, to whatever pills they can get their hands on," said the doctor, who charges about $45 to carry out abortions in women's homes and who spoke on condition that his name not be used, because performing an abortion in Colombia can lead to a prison term of more than four years.
"They open themselves up to incredible risks, from losing their reproductive systems or, through complications, their lives," the doctor said, referring to women who have such abortions.
Such arguments have done little to sway an anti-abortion movement that is largely led by influential leaders of the Roman Catholic Church.
In Colombia, José Galat, the Catholic rector of the Gran Colombia University, has collected two million signatures against efforts to legalize abortion and has paid for full-page newspaper advertisements criticizing abortion rights advocates.
"If there is life, then it has all the rights and a mother cannot apply the death penalty," he said.
Public opinion polls and studies show that Latin Americans do not support the full legalization of abortion. But detailed surveys conducted in 2003 in Mexico, Colombia and Bolivia showed that a majority of Catholic respondents believed abortion should be permitted to save a mother's life, when doctors believe the fetus will not survive or when the pregnancy is the result of a rape.
Abortion rights advocates point to a Nov. 17 decision by the United Nations Human Rights Committee, which ruled that Peru had failed to comply with its obligations to an international rights treaty and violated the rights of a young woman by denying her access to an abortion in 2001. The decision may have wide repercussions in future cases.
The young woman had sought an abortion when she was 17 after doctors determined that her fetus was severely malformed. But a hospital in Lima, the Peruvian capital, denied her request, though abortion is legal under such circumstances in Peru. The woman was forced to have the baby, which died four days later.
"I hope that this does not happen to another young person," the woman, Karen, now 21, said in a telephone interview. She asked that her last name not be used. "I feel very satisfied because this was a long fight."
Like much of Latin America, the people here in Pamplona have, until recently, talked little of the abortions that have taken place behind the town's tranquil, button-down facade. Yet, 68 students, most of them from the University of Pamplona, sought emergency treatment at the local public hospital last year after having abortions, hospital records showed.
Several students said in interviews that the university's student body had a liberal attitude toward sex. Condoms are readily available, and the so-called morning-after pill is sold over the counter in pharmacies.
Still, sex education at the university focuses more on anatomy than behavior, and church and university officials preach abstinence. Shamed by the thought of having children without being married, many young women try to induce abortions by taking a drug called Cytotec, which is made for ulcers but also dilates the cervix.
Pharmacies in Pamplona are barred from selling the drug, but students can purchase it over the counter in cities nearby. It was Cytotec that the two young women took in April that left them bleeding and, ultimately, under arrest. But there have been others.
"I didn't know what to do," said one young woman, who had an abortion in February. "I'm sorry. I ask God for forgiveness and to give me another chance. I'll never do it again."
Mónica Trujillo contributed reporting from Bogotá for this article.