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BUENOS AIRES – For the first time in over a century, women in Argentina can legally have abortions, but this historic change in the law may do them little good in hospitals like the one in the northern province of Jujuy where all but one obstetrician have a simple answer: No.

Opponents of abortion are reeling after a measure legalizing the procedure was enacted in December, but they have barely given up. They have filed a lawsuit arguing that the new law is unconstitutional. And they’ve made sure doctors know they can refuse to terminate a pregnancy, a message that’s adopted by many in rural areas.

“The law is already a reality, but that doesn’t mean we have to stand still,” said Dr Gloria Abán, a general practitioner and abortion opponent who travels through the remote Calchaquí valleys of the province of Salta to see patients. “We have to be proactive.”

In the neighboring town of Jujuy, 29 of the 30 obstetricians at the Hector Quintana Maternity and Children’s Hospital declared themselves conscientious objectors, as the law allows. The same goes for almost a handful of the province’s 120 gynecologists, said Dr Rubén Véliz, head of the obstetrics department at Hector Quintana.

“We are really up against the hurricane,” he said.

Argentina’s abortion law marked a big change for reproductive rights in Latin America, which has one of the strictest abortion laws in the world, galvanizing movements to expand access to safe abortion in Colombia, Mexico and Chile.

But even officials in the administration of President Alberto Fernández, who introduced the bill, admit that hard work remains to ensure that women can access the process. “Activists will have to play a key role,” said Elizabeth Gómez Alcorta, Argentina’s Minister for Women, Gender and Diversity, in an interview.

The law, which came into force on January 24, allows for termination of pregnancies during the first 14 weeks. Previously, abortion, which was prohibited when Argentina adopted its first penal code in 1886, was only legal in cases of rape or if the pregnancy threatened the health of the mother.

In recent days, anti-abortion activists – who have fought unsuccessfully as lawmakers debated the measure – have turned to the courts, filing lawsuits in at least 10 provinces to have the new law declared unconstitutional.

They won a first skirmish in the northern province of Chaco, where a judge issued a preliminary injunction preventing the law from coming into force late last month. But abortion rights activists expect to prevail in court.

“Some sectors were expected to make the decision to go to the judges to try to block the law,” said Vilma Ibarra, the president’s legal secretary, who drafted the abortion bill and played a key role in its adoption.

One of the cases is also expected, she said, to reach the Supreme Court and uphold the law: “We have no doubts.”

But the courts are not the biggest obstacle.

The law faces widespread opposition among doctors in rural areas, particularly in the northern provinces where Catholic and Evangelical churches have considerable influence.

“In my hospital, around 90% of healthcare professionals are conscientious objectors,” said Dr Mirta Gisela Reynaga, gynecologist. in the province of Tucumán who is an anti-abortion activist.

Abortion rights activists say federal and state officials have been slow to develop plans to put the new law into effect, especially in conservative areas. This, they say, has given the upper hand to their opponents.

“Those who are against this law are much faster than the ministry, and they pressure people to register as conscientious objectors,” said Dr Cecilia Ousset, a gynecologist in Tucumán, a conservative province known for its restrictive policies on termination of pregnancy.

Dr Ousset was involved in the abortion wars in Argentina in 2019 after helping an 11-year-old girl who was raped but was denied an abortion. The baby was delivered by cesarean section but died soon after. The case ignited passions across the country.

Officials say opposition from doctors will have limited impact as the vast majority of abortions in the first 14 weeks of pregnancy are performed with pills and do not require a medical procedure. Even when a procedure is needed, they said, there will be ways to bypass roadblocks.

“The practice is guaranteed, because if a hospital does not have professionals who are not conscientious objectors, we will transfer the patient,” said Dr Claudia Castro, who heads the women’s health department in the division of maternity and early childhood of the Ministry of Health of Jujuy.

In rural areas, however, it can be difficult for women to seek help in the first place.

María Laura Lerma, a psychologist from Quebrada de Humahuaca, a remote mountain valley in Jujuy, said doctors often try to scare pregnant women into having abortion. Healthcare workers, she said, “will often tell young women that her fetus will turn into an elf.”

“This is one of the many popular beliefs that are part of the collective imagination,” said Lerma, who belongs to a coalition of health care providers for the right to abortion.

Recently, Ms Lerma said, a woman in her twenties came to see her and said she was terrified of having an abortion because a gynecologist told her it would cause cancer. .

As they work to improve access to abortion in rural areas, activists are also seeking to clear the criminal records of hundreds of women who have been charged with abortion-related crimes in recent years. The Center for Legal and Social Studies, a human rights group that campaigned for the legalization of abortion, said that from 2012 to 2020, there were more than 1,500 directly related lawsuits. abortion and 37 for “obstetric events”, which generally refer to miscarriages. .

The first category may be easier to manage. Since abortion is now allowed, all outstanding cases can be dismissed, although “it won’t be so automatic,” said Diego Morales, an attorney for the legal center.

Activists want to ensure that even cases that have not resulted in convictions are cleared.

“The sentences are very low, but the criminal process works like a punishment because of the stigma,” said Soledad Deza, a lawyer from Tucumán who has represented many women accused of having abortions.

The biggest challenge is with charges related to so-called obstetric events, filed after women report late miscarriages or stillbirths. Some prosecutors have treated these cases as murders.

Victoria Tesoriero, a senior Interior Ministry official, said this was part of a “misogynistic” justice system strategy to “hide the situation” that women were indeed being prosecuted for miscarriages.

Natalia Saralegui Ferrante, a law professor at the University of Buenos Aires, was the co-author of a book published last year that shed light on how common these lawsuits have become. Sometimes, she said, women said they didn’t even know they were pregnant – “but no one believed them.”

“There should be a presumption of innocence in our justice system,” said Ms Saralegui Ferrante, “but in those cases it was the other way around, there was a presumption of guilt.”

A woman, Rosalía Reyes, who was placed under house arrest after being sentenced to eight years. She says she miscarried when she was seven months pregnant.

The judges declared him murder.

As a mother of four, judges ruled, Ms Reyes should have known how to cut the umbilical cord, even though she lost so much blood that she passed out, her lawyer, Fabiana Vannini, said.

Ms Vannini hopes that now she can have a way to reopen the case. The new law, she argues, does more than legalize abortion.

“It also changes the paradigm of who a woman is, and who has control of her body, her womb,” the lawyer said.

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