For every 100,000 births, there are 160 maternal deaths in the Dominican Republic. The deaths are fueled in part by clandestine abortions. Abortion policies in Dominican Republic are very tough for women. The law prohibits abortions when the life of mother or child is in danger, and even in case of rape. Many women with severe preeclampsia and eclampsia are dying in hospital emergency room because the hospital cannot perform safe abortions. The recent constitutional amendment brought by article 30 has even make the situation worse. More women will continue to dies because they are barred from accessing critical reproductive health services. There is need to focus the effort in pressuring the lawmakers to respect the rights of women. This will make it possible for women to have access to safe abortions especially when their life is at risk. This will reduce the rate of maternal death.
Nature and Magnitude of the Problem
Unlike other Latin countries, Abortion is illegal under all circumstances in the Dominican Republic. The Dominican law prohibits women from abortion even the life of woman and the child is in danger. With such stiff policies in place, thousands of women induce abortions themselves or visit underground hospitals to perform abortion. Many young women are putting their health and live by choosing clandestine abortions.
Because abortion is considered illegal, it is hard to calculate correct statistics on abortions. Dominican Republic Officials assumes that abortions don’t take place. But staffs in many public hospitals, which have to deal with cases of post abortion complications gives different information. There are an estimated 90,000 abortions perfumed every year in the Dominican Republic. This makes abortions a major cause of maternal death. Most women induce abortion by taking pills that stimulate uterine contractions. This method leads to expulsion of the fetus. In some cases, women take an overdose of these pills leading to severe hemorrhaging. Most women experiencing severe hemorrhages prefer visiting ill equipped clinics, which makes the matter even worse. Due to lack of proper equipment, the cleaning of women uterus is performed poorly. This leads to uterus infections and/or perforation which lead to complications in future reproductive. This conditions leads to death in some case.
Who is affected?
Maternal mortality mostly affects Dominican Republic women and girls because the law prohibits them from abortions. This makes access to efficient reproductive health impossible. The law strictly limits the availability and access of safe abortions even when a woman has complications that threaten her life. Women suffering from HIV/AIDS, malaria and cancer are not exempt from this law. This group of women need of special treatment that is not compatible with pregnancy.
Women and girls who have unwanted pregnancies as a result of rape are also affected by maternal mortality. Doctors’ ability to provide effective and timely treatment for women suffering from pregnancy complications is limited. Pregnant Single mother, already burdened with responsibility of raising children on their won are also affected by maternal mortality. And since they don’t have access to qualified health services, they result to underground abortions, which in most cases results to more suffering.
Risk Factors
One of the main factors that contributing to the high rate of abortion related maternal death is the Dominica policies on abortion. The law prohibits women from abortion even when the life of the mother is at risk. Women and girls with unwanted pregnancies are also barred from abortions. The recent amendment to the Dominican Republic constitution will deny women right to access contraceptives. Use of Intra Uterine Device (IUD) and emergency contraception like morning after pills are now considered a violation of article 30. Restriction to access and use of IUD and contraception limits the ability for women to plan their reproductive lives. This is going to escalate the issue of maternal death as women continue to seek abortions in underground clinic.
Lack of sexual reproduction education is another factor contributing to the high rate of abortion related maternal deaths. Most women and teenage girls do not have access to the right information on reproductive health. This results to high rate of unwanted and teen pregnancies even when contraception has been used. Minors between ages 13 and 17 constitute 30% of child birth in Dominican Republic.
Economic and Social Consequences of Maternal Mortality
In the Dominican Republic, women play dominant roles in providing for the families. Women contribute to the community cohesion and overall social structure. According to Duran, Maternal and Infant Mortality, women makes up over 40% of the active labor force in the Dominican Republic economy. They contribute $35 billion to the countries GDP. As such, any death of a woman or girl cause ripples the Dominican Republic economy. Every pregnancy in Dominican Republican can lead to the death of mother. Women who opt to visit underground clinic for abortion procedures are at a risk of serious health issues that affect their physical health and overall contribution to the community.
Underground abortions clinics do not have set fee for abortion procedure. How much a woman pay depends with the woman’s ability to pay. It is estimated that the cost of abortion ranges from $6 – $58 in underground clinics while private clinics operated by private medical doctors charge between $120 and $1,000. In most case, poor women opt for low cost doctors, who operate poorly equipped clinics. In such situation, the overall cost usually escalates due to further complications. Women who are better of economically prefer highly skilled doctors, who charge them exorbitant fees.
Recommendation to Address Abortion Related Maternal Mortality Rate
In order to reduce the rate of abortion related maternal deaths; there is need for both legislative, education and social reforms in Dominican Republic. The law is very restrictive on women rights to abortion. These force women, majority of who are poor to seek unsafe abortions. In this regards, Dominican Republic law maker must be compelled to change the law so that women whose life is in danger can access safe abortion procedures. In case of unwanted pregnancies resulting from rape, women should be able to seek legal and safe abortion too.
Behind every abortion in Dominican Republic, there are unwanted pregnancies. This is because women and teenage girls do have access to information on reproductive control and health. To reduce the rate of abortion in Dominican Republic, there is need to introduce and improve access to reproductive information for women and teenage girls. This coupled with access to family planning resources will reduce the rate of unwanted pregnancies and ultimately lead to decreased rate of maternal mortality caused by abortion.
Reference
Amnesty IInternational. (2009). Changes to Dominican Republic Constitution will put women’s lives in danger. Web.
Buettner, B. E. (2009). Abortion in the Dominican Republic. Web.
Camp, S. (2009). A Dangerous Trend: Dominican Republic Adopts Draconian Abortion Restriction. Web.
DRI. (2010). Abortion in the Dominican Republic. Web.
Duran, A. M. (2008). Maternal and Infant Mortality: A Global Snapshot. Web.
Singson, S. (2009). Dominican Republic Passes Complete Abortion Ban. Web.