Abortion in Mexico: legal, safe and free?

For more than a decade, the slogan ‘legal, safe and free’ has been used in the fight to decriminalize abortion. It has flooded the streets and been the center of conversation and controversy. Mexico is currently positioned as one of the countries with the most progressive abortion legislation in the region. However, in practice, the list of pending issues that stand in the way of abortion truly being legal, safe and free, and crucially, accessible, is still long and complex.

More than 15 years ago, Mexico City introduced the right for women and people with gestational capacity to terminate a pregnancy.

This step was followed by other states just a couple of years ago.

This has served as a milestone so that women and people who are carrying an unwanted pregnancy can now access free abortions in public hospitals. But as in many human struggles, the victory was partial because state legislation is not unified with national legislation.

There are three main health systems in Mexico:

o Ministry of Public Health: where legal modifications to abortion access have an immediate impact. These health services can be accessed by anyone, but preference is given to those who do not have access to the other two health systems, and sometimes even denied care if they already belong to them.

o Instituto Mexicano del Seguro Social (IMSS): provides health and social security services to private workers.

o Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE): provides health and social security services to people who work for a government agency.

The complex web of different health care systems and legal hierarchies has resulted in obstacles to accessing legal abortions in Mexico.

Although both IMSS and ISSSTE also subsist on national public resources, they operate as independent institutions and are therefore governed by national rather than state laws. So, although there have been advances in state laws and penal codes, neither IMSS nor ISSSTE provide this service because at the national level, the laws have not kept pace.

This means that in the same state, for example Hidalgo, abortion is a right if it is performed under the State Health Secretariat and a crime under the IMSS or ISSSTE.

What is most frustrating is that, so far, neither institution has initiated any real attempt to sensitize and/or train their staff on this issue. There is also a lack of formal data on how many requests they have received for abortion services or follow-up on where people went for procedures.

The cost of having an abortion, in our prejudiced society, is not only monetary, but also social.

In a context where access to abortion is still not guaranteed despite its (already confusing) legality, people have to contend with a public health system that is not unified, that is full of obstacles and where they continue to be mistreated due to stigma.

The easiest and quickest solution for those who can afford it is to go to private abortion services within their state (if they exist) or to travel to Mexico City. For those who do not have the money and do not have more information about the use of Misoprostol or about feminist accompaniment networks, the options become even narrower. They can either try an unsafe procedure, or resign themselves to continuing the pregnancy.

For the people campaigning for accessible abortion care, the legal victory was short-lived. Just a few days later activists still needed to demand services from medical personnel as well as to accompany and support those seeking abortion medication because of the gaps in State provision.

So the ‘Green Wave’ continues the struggle and our slogan is still valid: Legal, safe, free, but also loving and accessible.

In Hidalgo, the third Mexican state where abortion was decriminalised, Di RAMONA joins our partner Abortistas MX to push for the legal modifications necessary so that safe abortion is available for all.

Tireless and strong, activists from all over the country have joined this strategy, each one from their own territory. Because none of them stop, because the stories they hear drive them to defend dignified lives and the freedom to decide about their own bodies.

Sonora, Veracruz, Oaxaca, and Baja California are some of the states that have already begun to work on legal protection. We have one shared goal in mind – one day, all of Mexico will be safe territory for women and people with gestational capacity to decide about their lives, protected by the law and under the care of all health systems.

By Sonia Rueda Olvera and Di RAMONA.

Di RAMONA is a SAAF grantee partner based in Hidalgo, Mexico with a focus on access to abortion, stigma-free lives for people living with HIV, prevention of child sexual abuse, and mental health for LGBTIQ+ people.

Sonia Rueda is a journalist based in Hidalgo who writes about various issues on the local feminist agenda, including access to free and legal abortion.

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