GUANAJUATO, Mexico — The woman came into the hospital, bleeding, scared and barely out of her teens. But before anyone would treat her, the authorities had to be called.
Doctors believed that she had had an illegal abortion, so first, a man from the prosecutor’s office had to arrive and ask her about her sexual history. Then, after she was treated but still groggy from the anesthesia, another investigator showed up and took her statement.
The investigation is still open two months later. Prosecutors are seeking medical records to determine whether they will charge the young woman, who asked that her name not be used, as well as the person they suspect helped her.
Here in the state of Guanajuato, where Roman Catholic conservatives have controlled government for more than 15 years, it is standard procedure to investigate suspected cases of abortion. But Guanajuato is no anomaly, women’s rights advocates and some health officials say, since a broad move to enforce antiabortion laws has gained momentum in other parts of Mexico.
One reason is a backlash against Mexico City’s decision three years ago to permit legal abortion to any woman in the first 12 weeks of pregnancy. After the Supreme Court upheld that law in 2008, 17 states passed constitutional amendments declaring that life begins at conception, even though abortion was already illegal everywhere but Mexico City, except in cases of rape or to save a mother’s life.
“It is a political response,” said Pedro Salazar, a legal scholar at the Institute of Legal Research of the National Autonomous University of Mexico. “This is a well-coordinated initiative. It’s not a spontaneous decision.”
Lawyers contend that rather than tightening existing antiabortion legislation, the state amendments are aimed at preventing future state governments from possibly following Mexico City’s lead and legalizing abortion.
There is also opposition in some quarters to emergency contraception. About 300 doctors working for public hospitals in Guadalajara, Mexico’s second largest city, and the state of Jalisco sought protection from the Supreme Court last year against a federal policy allowing patients to get the morning-after pill. The court has yet to decide the case.
The enforcement of the antiabortion law here in Guanajuato has created what critics call a climate in which any pregnancy that does not end with a healthy baby raises suspicions about the mother.
The fear of being investigated means that even some women who want to be pregnant but have complications or lose the baby “have to think twice about going to a hospital,” said Nadine Goodman, who runs a school for midwives in the Guanajuato town of San Miguel de Allende.
Dr. Luis Alberto Villanueva, adjunct director of maternal health for Mexico’s Health Ministry, said he was concerned that antiabortion enforcement could scare many women around the country away from seeking health care.
“The intentional search for ‘proof’ in women with bleeding in the first half of pregnancy diverts health workers from their task,” he said, “and drives women away from medical facilities, even at the risk of placing them in conditions of high risk to their health or their life.” He added that poor women, who rely most on public hospitals, were particularly vulnerable.
State prosecutors here in Guanajuato have opened 166 investigations for abortion in 10 years, according to women’s health advocates. Most of them do not reach a judge, but nine women have been convicted for having abortions. They were sentenced to jail, but paid a bond to finish their sentences on parole.
In states where antiabortion laws are strictly enforced, there can also be a fine line between charging a woman with abortion and sentencing her for killing a newborn.
In the gulf state of Veracruz, the state women’s institute found this year that eight women serving sentences for homicide — killing their babies after they had been born alive — had either had abortions, which has a much lighter penalty, or had miscarriages or stillbirths. They have since been released, according to the institute’s departing director.
Eight women in Guanajuato have also been jailed on homicide charges in recent years, stirring a debate over whether the authorities have used the crime as a way to pursue tougher sentences against women who had had abortions, or perhaps simply lost a baby during pregnancy.
When the cases were publicized last month after one woman was released on appeal, the national news media descended on Guanajuato and the women gave jailhouse interviews. Some contended that they had been forced to sign confessions after they gave birth to babies who were stillborn or premature. Their lawyers argued the medical evidence in their cases was too shoddy to determine whether the babies had actually been born alive.
“The women went into labor alone,” said Javier Cruz Angulo, a lawyer who runs the legal clinic at CIDE, a Mexico City university, which won the first appeal. “There were no health services.”
The cases created such a furor that the State Congress changed the women’s sentences and applied them retroactively. This month, the women, who had been serving terms of 25 to 30 years, were freed but not absolved.
Yolanda Martínez, 25, who had been in jail for almost seven years, walked out with her fist raised. “This state is too tough,” she said as she emerged. “They accuse you of crimes that you never committed.”
Other complex cases have come to light. Earlier this year, an 11-year-old girl in the state of Quintana Roo was found to be pregnant after she was raped by her stepfather. Because the girl was ashamed to tell her mother, her pregnancy was discovered at four months — too late, under a recently tightened state law, to give her the option of an abortion. The case fueled a debate over the unintended consequences of tightening abortion laws.
The federal government is opposed to legalizing abortion, and Guanajuato has long been one of the most reliable strongholds of President Felipe Calderón’s National Action Party. Still, the situation here has raised alarm among some health officials like Dr. Villanueva.
Concerned that other states are following Guanajuato’s lead, he sent a letter to state health secretaries objecting to viewing women with health problems as potential suspects and warning against “trying to use health workers in this process.”
But state health officials in Guanajuato say that they are required to uphold the law and notify authorities in cases of suspected abortions. The situation is no different, they say, from calling the police when someone turns up with a gunshot wound or injuries from a beating.
“We treat any patient in any type of gynecological or obstetric situation without distinction,” said Dr. Héctor Martínez, director of health services for the State Health Ministry. “If we suspect that there is something, we inform the authorities. We don’t accuse. We don’t investigate.”