‘Outside the law’

IN 2003, more than 1,000 women in Portugal were forced to go to hospital due to complications following botched illegal abortions, according to a recent report published by the Divisão de Saúde Materno-Infantil e dos Adolescentes of the Direcção-Geral da Saúde (DGS). The report registers 1,019 cases for 2003 – a much higher number than the previous year, in which only 123 ‘illegal’ abortions were reported.

Those responsible at the National Department for Health did not explain the discrepancy between the two years but it is believed that the huge rise is due to the fact that abortion cases can only be classified as ‘illegal’ if evidence exists that an illegal action took place.

Many doctors show sympathy

The Director General of the DGS, Pereira Miguel, has indicated that the majority of abortion cases that are treated at hospitals are classed as involuntary, and there were a total of 6,741 of these cases registered last year. However, this figure could also include some abortions that were intentional, as some doctors choose to protect their patient and register the case as spontaneous. “There could be doctors who, wishing to help the women, take the humanitarian side and register an abortion as an interrupted pregnancy,” admitted Pereira Miguel.

Of those women who were treated after having abortions ‘outside the law’ in 2003 (Portuguese law does not punish abortion if the foetus is malformed, if the pregnancy implies a physical or mental risk for the mother, and in the case of rape), most (704) were classed as having had an ‘incomplete’ pregnancy,– the medical term for when the foetus is dead but not expelled from the body. There were also 76 cases of infection and sepsis registered. The remaining numbers were recorded as ‘unspecified’.

Real number could be much higher

Experts believe that these statistics represent only a fraction of the illegal abortions that take place in Portugal, as women only go to hospital if they are experiencing complications that obliges them to seek emergency help.

The Director General and High Commissioner for Health points out that the DGS only receives data compiled by the hospitals with the identity of the patients omitted. He also says that he prefers to use the expression ‘outside the law’ rather than the word ‘illegal’, as he considers the first to “cause less stigma”.

The situation is causing so much concern that a memo exists (circular nº 3 da Divisão de Saúde Materna e dos Adolescentes, 2001), which explains how hospitals should proceed in these sorts of cases. It suggests that the case must be properly recorded on paper but that the identity of the patient should not be noted. The report should remain in the hospital and is only sent to the DGS for statistical purposes. The Direcção-Geral da Saúde “never recommends that doctors or nurses report abortion cases, or undertake any initiative of the kind,” stressed the Director General.

Some abortions are reported

Despite this advice, there are instances when some health professionals do report illegal abortion cases to the police. Between two and five out of 10 of these reported cases end up in court each year – usually when a patient’s personal details have been revealed while they are being treated after a botched abortion. However, in the recent case of a girl aged 21, who took a miscarriage-inducing medicine and was treated in Sintra hospital after suffering from internal haemorrhaging, the case was thrown out of court within 45 minutes due to an apparent lack of evidence.