Abortion in Cuba is not “as easy as pulling teeth.” Let’s examine what the abortion process in the island is really like.
By Kiana Anandra
HAVANA TIMES – Abortion in Cuba is not “as easy as pulling teeth”, as journalist Camila Acosta claimed in an article published in ABC.es in July.
Let’s examine what the abortion process in Cuba is really like:
The Ministry of Public Health regulates the legal termination of pregnancy, so the procedure relies on medical discretion rather than the pregnant woman’s choice.
According to the Ministry of Public Health’s guide for the voluntary termination of pregnancy, a diagnosis of certainty of pregnancy is required, which must be proven by clinical, immunological, imaging or other scientific forms of diagnosis recognized in the National Health System.
This is the first step for those who wish to have an abortion and it is done only under referral by the family doctor, a specialist in gynecobstetrics or other professionals of the National Health System in the different accredited institutions that serve pregnant woman.
Up to 12 weeks, except in cases where the mother is at risk
The guidelines also state that voluntary termination of pregnancy can only be performed up to 12 weeks of gestation counted from the first day of amenorrhea (not the 14 weeks mentioned by Dr. Oscar Biscet in Acosta’s article). Moreover, the only ones qualified to make decisions about the medical, psychological, and social consequences derived from either the continuation or termination of the pregnancy are medical specialists.
After 12 weeks, the termination of pregnancy may be carried out only in exceptional cases, specifically due to health problems that endanger the health or life of the pregnant woman or the fetus. Such cases require the authorization of a hospital commission for voluntary termination of pregnancy (said commissions are appointed by the director of each hospital).
Menstrual regulation, medical induction or surgical abortion
Health professionals are also the ones who decide on the method: menstrual regulation, medical induction or surgical abortion.
Menstrual regulation consists of manual aspiration, indicated for the first weeks of gestation (up to 45 days) and is usually performed without anesthesia, which makes it extremely painful.
Before this procedure is performed, a diagnosis is done to determine how far along the pregnancy is, along with a series of blood tests (including one for HIV-AIDS, although that test result is not tied to authorization of the procedure).
Pregnant women are given an informed consent form that they must sign at the time the procedure is scheduled. Patients have up to 72 hours to confirm their decision from the moment they are given the information and the procedure is performed.
Medication induction is performed with misoprostol. Due to the economic crisis and the difficulty the country has in obtaining drugs, it is the least widely used, though its use is on the rise.
This procedure also requires informed consent and mandatory complementary medical examinations (including blood work) prior to the procedure.
Finally, surgical abortion, usually curettage, is indicated when medical induction fails. However, the lack of misoprostol may result in it being more frequently performed from the second month of pregnancy onwards.
The scarcity of resources and the difficulty of accessing abortion services in more remote areas forces many pregnant women to resort to informal monetary transactions within the health system. In addition to difficulties in accessing abortion services, there are problems linked to women’s educational levels, activism by conservative anti-abortion groups, malpractice, the limited availability of contraceptive methods and various types of violence that may arise during the abortion process.
The phrase “Abortion in Cuba is a practice ‘as easy as pulling teeth'” was attributed to Gabriela López Díaz, an undergraduate student whom ABC.es described as a researcher, although academic search engines do not provide any reference to scientific publications by her.
According to Acosta, the phrase was taken from Lopez’s thesis for her degree in Social Communication Journalism at the Pontificia Universidad Javeriana, in Bogota, Colombia. However, in the thesis itself she notes that this phrase actually corresponds to an interview, published on Youtube in 2011, with Dr. María Concepción Morales Peralta, president of the pro-life movement of the Cuban Catholic Church.