Honduras has legalized the morning-after pill to prevent pregnancy. But only after a sexual assault?

Honduras’ first female president promised to ease restrictions on women’s reproductive rights. Now many of her former supporters say they have been betrayed.

One year ago, Honduras’ first female president, Xiomara Castro, was elected, promising to change the country’s strict restrictions on women’s reproductive rights within her first 100 days in office. And now, exactly one year later, Honduras has legalized the morning-after pill – a contraceptive a woman takes after sex to prevent pregnancy. True, only in cases of rape.

In Tegucigalpa, the capital of Honduras, which has the strictest reproductive regulations for women, we meet Laura, a 25-year-old who is two months pregnant and not ready to have a child. “Two months ago, I spent the evening away from home and met someone. I was careless and got pregnant,” the girl says, wrinkling her forehead. “It is difficult for me, I live alone and there is no one to support me.

“Morning-after pills were banned in the country in 2009, and abortion can carry a six-year prison sentence, even in cases of rape and incest. But Laura has heard that prescription pills for stomach cancer can be used to terminate a pregnancy – when administered vaginally, they cause severe uterine bleeding and miscarriage. Now the girl plans to buy these pills from a drug dealer named Jose, who she says is well known to people her age in Tegucigalpa.”

Laura (right) knows that illegal abortion pills carry serious health risks.

In the evening, we go to the pharmacy with Jose to pick up medicine for another client. The smell of his perfume fills the car. Jose says that his ex-girlfriend, who works at the hospital, writes the prescriptions. We explain quickly, simply, and clearly what happened, why it matters, and what happens next.

Jose sets the price based on the client’s financial ability – his most expensive deal was for 7000 Honduran lempiras (about $280), but Jose sometimes drops the price to 1500 lempiras. He says he has a steady stream of customers. “Students, young women just starting their sexual lives, mature and elderly mothers, women who got pregnant after an affair,” Jose says of his clients, naming several high-profile individuals. “Mostly they are women. Men often don’t take responsibility. Jose says he also sells contraceptive pills, but there are far fewer buyers for them. According to him, there is a pharmacy in Tegucigalpa that is known to sell pills illegally, and we confirm this by going there and buying them for 230 lempiras (about $9).

Last year, the UN Working Group estimated that between 51 and 82 thousand unsafe abortions are performed in Honduras each year. Jose admits that his business is illegal and that he has no medical training, but he believes he is providing a service that his clients trust. Sometimes, he says, they even ask him to insert tablets – they have to take two tablets orally and insert two vaginally, and women prefer someone who knows how to do it and ask him for a favor. He also provides clients with rehydration salts to help them recover from bleeding.

Jose admits that he has no medical training. The Escuela Hospital in Tegucigalpa, the largest hospital in Honduras, often receives women with complications from underground pill abortions. These pills are sold to them by Jose and other black market dealers. Each week, about 60 women are treated here after experiencing pregnancy loss, either through induced abortion or miscarriage – no separate record is kept at the hospital. Many 15- to 17-year-old girls also come to take pregnancy tests. Honduras has the highest teenage pregnancy rate in Central America, nearly double the world average, according to UN data from 2020.

Doctors admit that it is very discouraging for them because they cannot help women with unwanted pregnancies, even if the pregnancy is a threat to the mother’s health. Jinna Rosales, of the youth advocacy group Youth Action, says the cause of many of these pregnancies, and sometimes risky abortions, is poor sex education and the prevalence of gender-based violence. “If a woman has an abortion in Honduras, it’s not her fault, it’s the fault of the state, because it doesn’t provide the means to prevent such situations,” she says. Rosalie says she understands that in a country where 43% of the population identifies as evangelical Christians and 38% as Catholics, there is serious opposition to abortion. However, she believes that birth control pills, which are recognized by the World Health Organization as a form of contraception, should be less controversial.

Young activists from the online group Generation Celeste, which describes itself as a movement “for life, for family, for freedom in Honduras,” disagree. Jorge, who we meet in the café along with his colleague Alma, is convinced that the morning-after pill is essentially an early abortion because it works in three ways, two of which are contraceptive and the third prevents the implantation of the already fertilized egg in the uterine wall. “Abortion is not a right, Alma adds. – It contradicts the most important fundamental right – the right to life.

Doctor Jose Manuel Mateu: “Those who have irresponsible sex should suffer the consequences”

In November 2021, Honduras held its first democratic elections since the 2009 military coup. Xiomara Castro won the elections and became the first female president of Honduras, promising to legalize abortion in certain cases, including rape and threats to the life of the mother. And make contraceptives legally available to all women. She promised to do it within 100 days of taking office in January this year. But women’s rights groups have told the BBC that although they have been invited to negotiate with the president, there is still no sign of changes to abortion laws. The promised change regarding “morning pills” has also not been implemented.

On December 6, the Honduran Ministry of Health announced that for the first time since the 2009 coup, these pills would be legal again, but only in cases of rape and only if prescribed by a doctor in a hospital. Tess Hewitt of Médecins Sans Frontières in Honduras called it “an important step in providing access to life-saving and emergency care for thousands of women in Honduras,” but added that it was not limited to victims of sexual violence. “The next immediate steps should be to ensure the availability of emergency contraception to everyone who needs it,” added Hewitt.

President Xiomara Castro refused to be interviewed by the BBC, but her government’s health minister, Dr. Jose Manuel Mateu, agreed to speak to us. “We are not going to promote the ‘morning-after pill’ as a contraceptive to prevent sexual promiscuity,” he said. “I am using precise words. We will allow the morning-after pill only for victims of rape. Those who engage in irresponsible sexual activity should suffer the consequences.”

Women like Laura, who have become pregnant as a result of consensual sex, but would have difficulty caring for the child alone, do not have the right to the morning-after pill. She says she understands the risks of taking a pill she bought from Jose. “They say that (illegal) abortion is three times more painful than normal childbirth,” the girl says, shaking. “I can’t be sure that I won’t die, but I have no other way out. I know that abortion is illegal, but if I have the chance, I will take it. The names Laura and Jose have been changed.

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