BOGOTA (Thomson Reuters Foundation) - When Paula went to a public hospital in Bogota for an abortion she was entitled to by law, a nurse showed her baby dolls and photos of newborn babies and asked her what she felt looking at them.
“I was judged. Doctors and nurses were always trying to talk me out of it,” she told the Thomson Reuters Foundation. “One doctor said I was committing murder if I went through with it.”
Paula’s experience is common in Colombia, where abortion is legal on paper but in practice out of reach by women dissuaded or deterred by bureaucratic hurdles, dangerous delays and stubborn attitudes, advocates say.
Colombia, a nation of 48 million people, allows abortion in cases of rape, incest, fetal malformation, if the fetus is at risk and if the health, both physical and mental, of the mother is at risk.
Its abortion law is liberal and broad, compared with most of its Latin American neighbors, including three countries in the region that ban abortion completely.
Yet despite the partial decriminalization of its total ban on abortion a decade ago, millions of women have sought illegal abortions rather than legal procedures, according to one estimate.
Obstacles to a legal abortion are placed in their way, campaigners say.
“Colombia has some of the strongest constitutional and legal protections for women’s rights in Latin America,” Catalina Martinez, regional director for Latin America at the Center for Reproductive Rights, said in a statement.
“But they cannot be allowed to exist on paper alone,” she said.
In Paula’s case, she was pregnant with her second child three years ago at age 31 and studying at university.
Already a single mother, Paula, who did not want her surname used to protect her identity, was adamant she did not want another child.
She was referred to three psychologists, two of whom found she qualified for an abortion on grounds that the pregnancy posed a risk to her mental well-being.
For weeks Paula was passed from one doctor to another, from one hospital to another. At every turn, there was a setback, she said.
“Sometimes I was told there were no beds available. Other times that there were no trained doctors who could carry out the procedure,” said Paula, who filed a lawsuit against the health service provider.
She won the case, but it was too late. She was 22 weeks pregnant and doctors refused her an abortion, calling it a health risk even though Colombia’s abortion law places no specific limit on the number of weeks of pregnancy.
Paula gave birth to a girl in 2013.
Colombia’s health providers have carried out about 50,000 legal abortions since the law was changed in 2006.
Yet around 400,000 women in Colombia undergo illegal abortions each year, according to estimates in a 2011 study by the U.S.-based Guttmacher Institute.
Monica Roa, a lawyer who brought the case before Colombia’s constitutional court in 2006 that changed the law, says she sees progress in abortion being seen more often as a woman’s right.
“The debate has completely changed,” said Roa, vice president of strategy at Women’s Link Worldwide, a global women’s rights group.
“Today no politician will go against abortion in public for fear it will come with a political cost,” she said.
But women, especially from poor backgrounds in rural areas, often do not know their rights and there is confusion among doctors over when the procedure is allowed, particularly in terms of mental health, she said.
“Many doctors still interpret risk to a women’s health in just physical terms and when there is a threat to life,” Roa said. “Abortion is not just for when a woman is about to die.”
Another obstacle is doctors refusing to carry out abortions, often citing conscientious objection.
Doctors have that right but are legally obliged to refer a woman to a colleague who they can guarantee will do an abortion. Abortion advocates say in fact that does not happen promptly or at all.
It is common as well for a doctor to insist on convening a special medical committee to decide, said Viviana Bohorquez, a lawyer at the Women’s Life and Health Committee, a reproductive rights group.
“There’s absolutely no need to do this. In Colombia, you only need the permission of one doctor,” Bohorquez said.
“This only causes delays and means women wait days, if not weeks, for a decision,” she said. Past 20 weeks of pregnancy, it is nearly impossible for a woman to get an abortion, she said.
In the last decade, Bohorquez’ rights group has handled about 1,000 cases involving women who faced hurdles getting an abortion or were denied one altogether.
Thirteen cases have gone all the way to Colombia’s constitutional court.
One recent case involves a 14-year-old indigenous girl, pregnant after being raped. She was unable to find a doctor who would perform an abortion in the Amazon rainforest where she lived, forcing her to travel to the capital.
Another case seeks financial compensation for a woman who was carrying a malformed fetus. She sought an abortion but the healthcare provider took 84 days to decide to turn her down.
She gave birth to a child with severe disabilities.
Colombia could take steps to allow better access, campaigners say.
Lawmakers are considering a bill to allow women to have an abortion up to 24 weeks of pregnancy without any restrictions.
Another bill expected to be introduced in July would allow abortion up to 14 weeks without restrictions and seek better access to contraception and school sex education.
Reporting by Anastasia Moloney, editing by Ellen Wulfhorst. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women's rights, trafficking, property rights and climate change. Visit news.trust.org