Women’s health in Guatemala

Today has been an interesting day for learning about women’s health in Guatemala. The clinic I work at, as with all public clinics, have a family planning section. In this area they do pap smears and give information regarding sexual health. They also give, or advertise, all forms of contraception. It’s common to have women come in to get their birth control pills, or to have the depo-provera contraceptive shot (which is more convenient since it lasts for 3 months at a time). I think this is a wonderful thing.

Today, however, I learned that abortion is illegal in Guatemala, and what the consequences of that are. I’ll leave my personal views out of it, and just give you the jist of what I learned. So a woman comes into the clinic for a pregnancy test. Turns out, she’s pregnant. The woman was in tears – the father was not her husband (although I don’t know whether it was a case of rape or an affair…my spanish isn’t good enough that I could figure it out). She’s been having lots of problems with her husband already, and knows that he won’t care what she says. She insists that she cannot have the baby. She seemed to be saying (again, I’m not sure I caught everything) that she had already taken some kind of pill and gotten some kind of injection to try to get rid of it – which of course didn’t work. I felt horrible for her, she was so scared and was really stuck. She never went to school, couldn’t write, was poor and already had 3 children. Plus the problems with her husband…she was so deperate. And I desperately wanted to give her a hug!! The clinic ladies told her that there was nothing they could do – they aren’t authorized to give abortions. After the woman left, I asked them, if she wants an abortion, where does she go? They just shrugged their shoulders and said they didn’t know.

So this afternoon I asked my spanish teacher about whether abortion is legal in Guatemala. She said no. Of course this leads to the usual problems – women get themselves into super unsafe situations because they have no other choice if they feel they have to get rid of the baby. Often, it is inexperienced midwives that perform the procedure. These procedures are incredibly unsafe, and most of the women end up in the hospital anyways. Even worse is that once they get to the hospital, they are treated with little to no respect because of what they did. My spanish teacher told me that when she was in the hospital with one of her children, there was a woman next door who was there due to a botched abortion. When they did the procedure on her, obviously painful, they did it without anasthetic and she could hear her screaming. This was to supposedly teach her a lesson – not to try to abort her babies. She also told me of another time she was in the hospital, where a girl had come in from complications after taking some kind of medicine to try to abort her baby. When the nurse came to get her out of the waiting room, she just yelled out “where’s the *expletive* that wants to abort her baby?!”, then proceeded to verbally harass her in front of the entire room. Whatever your opinions on abortion are, I think there’s no doubt that this is totally unprofessional behaviour that would NEVER fly at home. Their views on patient autonomy and acceptance are obviously quite different here. Luckily, this morning the nurses at my clinic were really nice about the whole thing. If they hadn’t been, I’m not sure I could have taken it.

This lead into a discussion with my teacher about contraception and sex education in Guatemala. Apparently, it kinda sucks. When I pointed out how great the clinics are about advertising contraception, she explained that the information is only really available to women who already have kids – women who have come to the hospital or clinic for some reason and found out about it there. It is rarely taught in schools, or if it is, it isn’t done very much/well. Also, because of the power difference between men and women here, it is difficult to use proper preventative measures for both birth control and STIs. Women aren’t really “allowed” to ask a man to use a condom. It’s even worse for married women – if they ask their husband (most of whom also frequent prostitutes) to use a condom, the husband starts making assumptions about them sleeping with other men…which leads to other problems etc. etc.

I’m sad to say that I’m not surprised with the birth control situation. However, I was shocked and appalled to hear about how women who have abortions are treated. What happened to basic respect and decency? It’s a part of the culture here that I’m not sure that I will ever be able to understand fully. Maybe it’s a discussion for another day with my teacher. I tell-ya. She’s great. I love learning about this stuff, even if it is sometimes disturbing to hear.


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