Universal access to safe and legal abortion care: the missing link to guarantee the sexual and reproductive rights of adolescent women in Mexico

By Biani Saavedra and Blair G. Darney

Mexico is made up of 32 states, each with the autonomy to establish their own laws. Abortion is regulated via state penal codes and thus a woman’s rights to legal and safe abortion is tied to her place of residence. In 2007, Mexico City decriminalized abortion up to 12-weeks gestation, and in 2019 the state of Oaxaca, one of the poorest in the country, followed suit. The remaining 30 states of Mexico include exemptions in their penal codes to permit (or not prosecute) termination of pregnancy; for example, all 32 states allow abortion in the case of rape and 16 states include exemptions for the health of the woman or for fetal abnormalities. Unfortunately, only 2 states include an exemption for socio-economic reasons. However, implementation of exemptions is practically non-existent and thus millions of women live in contexts with extremely restrictive abortion laws.

Approximately 20% of the 126 million inhabitants of Mexico are young people aged between 10 to 19 years old. Of the 2 million births each year in Mexico, about 20% are to adolescent women. Compared with other countries in the Latin American region, Mexico has amongst the highest adolescent fertility rate, with 70.5 births per 1,000 adolescents aged 15 to 19 years old, and the highest adolescent fertility rate amongst OECD countries.

Although not all adolescent pregnancies are unwanted, our study ‘Preventing first births among adolescents in Mexico City’s public abortion programme shows that adolescents who seek abortion services in Mexico City are likely to be nulliparous and seeking abortion in order to prevent their first birth, compared with adult women who are more likely to be multiparous and seeking to space or limit their fertility. The study contributes to the body of evidence in Mexico about the role of abortion in helping women to achieve their reproductive goals in the case of unwanted pregnancies, and the barriers to accessing legal abortion services, especially for adolescents.

In light of the high adolescent fertility rate, reduction of adolescent fertility has been a priority topic for the Mexican government under different administrations. This national strategy has focused on preventing adolescent pregnancies via 5 key interventions: i) sexual education, ii) adolescent-friendly health services, iii) free contraceptive methods, iv) mass educations campaigns, and v) social policies to encourage school retention and labor force participation. In particular, challenges to accessing modern contraceptive methods persist. Many young women enter the health system only after a pregnancy has occurred and thus only receive effective contraception after their first birth.

In addition to the above 5 interventions, legal and safe abortion is a key intervention to reduce unwanted births in adolescents and as such should be part of public policy discussions that seek to improve adolescent health and well-being. Mexico has made important progress towards such reproductive freedom; the decriminalization of abortion in Oaxaca is a prime example of this progress. However, public policy that seeks to enable adolescents and all women to achieve their life plans and reproductive goals must use a human rights lens and include wider access to legal and safe abortion.

 

Read more: Preventing first births among adolescents in Mexico City’s public abortion programme

Biani Saavedra has a master’s degree in health systems research and is currently a Ph.D Student in Public Policy at the Center for Research and Teaching in Economics (CIDE), Mexico. Her main topics of interest are women’s sexual and reproductive health, particularly access to abortion and contraceptive care.

Blair G. Darney is a reproductive health services researcher who works in the US and Latin America. She is an Assistant Professor at Oregon Health & Science University Schools of Medicine and Public Health, US, and is affiliated with the National Institute of Public Health/Instituto Nacional de Salud Publica (INSP), Mexico.

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