Colombia’s progressive abortion laws can stop the spread of Zika-linked microcephaly. But the conservative opposition has other plans.

Bogotá, Colombia — On a brisk, rainy day in late March, eight determined protesters held a seemingly endless vigil outside Santa Ana Parish on Calle 33A. With all the solemnity of a requiem, they directed their prayers at an off-white building across the street. I approached them curiously, and one woman shuffled over to me. “They perform abortions over there,” she whispered out of the corner of her mouth.

Anti-abortion protesters like those on Calle 33A regularly stage vigils in front of clinics across Colombia. They have been accused of spreading disinformation that could dissuade pregnant women from taking advantage of the country’s globally progressive abortion laws.

Amid the Zika virus outbreak, this long-running debate has taken on a new dimension with a particularly alarming twist. Zika has already hit the country hard: Confirmed cases of women infected with the Zika virus have exploded from 24,000 to 64,839 in about two months, making Colombia the most affected nation in the world after Brazil. Cases of pregnant women with Zika have more than tripled in the same timespan, jumping from 3,100 to over 11,776, according to the latest figures released by Colombian National Health Institute.

But despite an impressively well-established system, Zika poses a daunting threat. On April 7, the WHO declared that there is now a “scientific consensus that Zika virus is a cause of microcephaly,” a generally rare neonatal malformation of the skull, usually the result of abnormal brain development in the womb. This “consensus” was affirmed by the U.S. Centers for Disease Control and Prevention (CDC), which announced on April 13 that the Zika virus does indeed cause severe birth defects such as microcephaly.

Before 2006, Colombia was one of three countries in the region that completely banned abortion. But that year, a group of human rights lawyers won a hard-fought constitutional battle, and the country’s Constitutional Court overturned the ban. The decision extended abortion exceptions to cover late-term pregnancies that, according to the court, “may at times cause severe anguish or even mental disorders.”

But thanks to a byzantine bureaucracy, judicial delay, conservative opposition, and many doctors’ refusing to perform abortions or offer referrals, Colombian women in need of pregnancy termination have been prevented from understanding their legal options. As a result, many — due either to misinformation or fear of religious shaming — seek clandestine abortions. Such procedures, conducted at illegal clinics, constitute the vast majority of abortions in Colombia. “There are still many women who don’t know that there is no time limit to perform an abortion in Colombia,” said Marta Royo, executive director of the privately run Profamilia, Colombia’s largest family planning organization. “Even many public employees have no idea. There is a lack of information.”

Colombia’s Gordian knot, then — amid an unprecedented public health crisis — lies not in establishing a legal precedent but in “socializing” laws that are already on the books. Now that the WHO has declared Zika virus an epidemic, Colombia’s chasm between policy and implementation promises to prevent women from understanding their legal right to abort a fetus that may be born with cranium deformations.

Colombia’s relatively liberal laws allow abortions not only for pregnancies resulting in “malformations incompatible with life,” but also those that “risk the physical, mental, or social health” of a woman. Pregnant women with Zika should be able to receive legal abortions, since the risk of giving birth to a deformed baby would be considered damaging to their mental health, as defined by the law.

“Women can request an abortion when any of the possible consequences of Zika — or potential Guillain-Barre or other disease that affects brain development of the fetus — threatens their well-being,” said Monica Roa, the Colombian women’s rights lawyer who won the case to legalize abortion and the vice president of Women’s Link. “This is, of course, a very subjective decision. What is unbearable to one woman can be well tolerated or even received by another.”

Colombia is on the progressive vanguard when it comes to pro-choice rights in Latin America. Prohibition for abortions, except if they are deemed to save a woman’s life, exist in Venezuela, Panama, Guatemala, and Mexico. Meanwhile, reproductive rights groups list El Salvador, Nicaragua, Haiti, Honduras, Suriname, and the Dominican Republic as having the strictest anti-abortion laws. In these countries, the practice is completely outlawed, without exception. In Ecuador, Bolivia, Argentina, Costa Rica, the Bahamas, and Grenada, abortions can be legally preformed only to save a women’s life or if the pregnancy threatens her physical health. In a historic development, Chile this month removed an abortion baninstated by former President Augusto Pinochet.

But in Brazil, where the WHO estimates that over 2,500 babies will be born with microcephaly over the next year, abortion is illegal unless it threatens the life of the woman. Yet demand for abortion is high, and thousands of women are forced to resort to procedures that incur health and legal risks: If a woman is caught carrying out a clandestine abortion in Brazil, she faces up to three years in jail. What’s more, Brazil is looking to increase that penalty to up to four and a half years for microcephaly cases.

Natalia Acevedo, a lawyer in charge of advocacy at Profamilia, said that since Colombia legalized abortion, conservative lawmakers and Catholic clergy have directed efforts against the progressive agenda, and in defense of the rights of the unborn. “Colombia is progressive in terms of constitutionality, but we have a really conservative Congress,” Acevedo said. “We are facing constant challenges and threats coming from the legislative side or even the executive side. The [abortion] ruling is not settled.”

President Juan Manuel Santos has said little on the matter. And when it comes to the question of abortions and Zika, other members of the government have generally towed the same line as the human rights community: The laws are available for Colombian women in need.

With Zika on the rise, the obfuscation and stonewalling of Colombia’s anti-abortion bloc may exacerbate the crisis. One of the biggest threats to the public’s right to information about abortion, according to Profamilia, is 40 Days for Life, a U.S.-based, international anti-abortion organization that has become known for holding 40-day vigils outside abortion clinics from Bogota to Bucharest. In Bogota, of course, the law is not on their side. Yet the enduring influence of Catholic norms and purported disinformation campaigns make Colombia’s liberal victories pretty on paper but generally misunderstood by the public.

Conservative opposition to pro-choice legislation in Colombia has been repeatedly accused of deterring women from seeking abortions or receiving drugs like misoprostol, which causes early contractions in the womb and is ideally taken within the first 12 weeks of pregnancy. Unlawful interference in such cases, however, is “very difficult to prove,” Roa said.

40 Days for Life regularly updates its Colombia Facebook page with announcements for vigil schedules and news that supports its mission. “Abortion is an industry that generates large amounts of money, and it is clear that this will be the first option offered to women who come to these sites looking for advice on this particularly vulnerable time in their lives. Fortunately, there are people and places that give them comprehensive advice that respects their dignity and the lives of their children,” one recent post read.

Recent incidents between Profamilia and 40 Days for Life could provide a case for legal action that could greatly affect the spread of Zika in the country. “This pressure is 100 percent real,” Royo said. “It seems the more we speak about what the constitution says to inform the public, the more opposition we find. Most of the time, that opposition happens in the terms of barriers that they put in front of women.”

In February, Profamilia’s Medellin branch recorded three incidents where employees or prospective clients were confronted by 40 Days for Life protesters. Carlos Mesa, regional manager of Profamila for Antioquia and Santander, recounted one case involving a father who was entering the clinic with his 12-year-old daughter. Members of the movement allegedly attempted to dissuade her from asking for an abortion. His daughter eventually went through with the procedure. The case could be used to prove that such protesters are obstructing women’s rights to lawful abortions, with much greater implications during this time of outbreak.

The most vocal anti-abortion advocate in Colombia is Alejandro Ordoñez, a public attorney who oversees an office in charge of supervising the ethical conduct of public servants. He fiercely opposes gay marriage, and has lost lawsuits filed against him for dishonest campaigning. In 2011, over 1,200 women successfully sued himfor violating their right to obtaining accurate, reliable, and complete information regarding their reproductive rights after proving that he had spread wrong or misleading information.

“Alejandro Ordoñez is an embarrassment to Colombian public servants,” Roa said. “He has used his position and disciplinary powers shamelessly to dissuade public servants from ensuring reproductive rights are available to all women.”

Pro-choice triumphs in the Colombian court may be exportable. “Health exceptions offered under the Colombian constitution provide the best model to follow in the region, not only to face the Zika outbreak, but to ensure therapeutic abortion” — that is to say, procedures that take into account the mental and emotional health of the woman — “as the minimum that states must grant women,” Roa said.

Royo recognizes that the best way to confront the Zika outbreak is to march in lockstep with public institutions to bridge the information gap across Colombia — by organizing mobile clinics and a public information campaign to reach and inform far-flung coastal villages where few have access to television and Zika poses the greatest threat of spreading. “I believe that an alliance is a possible solution,” Royo said. “Originally it was hard to get public institutions and decision-makers to meet with us, but now almost all invitations to our meetings are accepted.”

Now with the Zika database up and running, the onus is on the Ministry of Health to take care of women in need. The Zika outbreak may then be capable of exposing the areas of the country where Colombians are ostensibly covered by the health system, but in reality lack adequate access to facilities and reliable information. It will likely prove to be a disease that underscores the fissures in the system along poverty lines.

“Zika tells us a lot about the socioeconomic conditions of the population,” Acevedo said. “It reveals problems with access to water, electricity, and health institutions. This outbreak will be a test whether or not our public services and provisions are working.”

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