Abortion in Ecuador

Ecuador regulated abortion in 2021. The law establishes that abortion is decriminalized in all cases of rape, so anyone who has suffered sexual violence can access abortion care without legal punishment.

According to the Ministry of Public Health, between 2013 and 2017, 109 696 abortions (spontaneous, medical, unspecified) were registered. The same report states 61 people have abortions every day in Ecuador; 26 are under 24 years of age [6]. Based on data collected by Statista, between 2014 and 2018, 29 cases of voluntary abortion were prosecuted on the Coast, 74 in the Sierra, and 31 in the Amazon between 2014 and 2018 [11].

Although the government decriminalized abortion in case of rape, the Ecuadorian environment is still very restrictive towards abortion. The context affects the health and rights of women, girls, and queer people.

What does the law say in Ecuador?     

Abortion Rights in Ecuador

“Abortion performed by a physician or other qualified health professional, with the consent of the woman or her spouse, partner, intimate relatives or her legal representative, when she is not in a position to give it, shall not be punishable in the following cases: 1. if it has been practiced to avoid a danger to the life or health of the pregnant woman, and if this danger cannot be avoided by other means. 2. If the pregnancy is a consequence of rape in a woman who suffers from mental disability.”

Código Orgánico Integral Penal Integral, COIP, in Art.150

Induced abortion is still considered a crime under the COIP, Article 150, and has a minimum of one year of detention; there are only two cases in which a person can access abortion services without being sanctioned:

  • The life or health of the pregnant person is at risk (which is known as “causal health” or “therapeutic abortion”).
  • When the pregnancy is the result of rape [2].

In Ecuador, it is possible to access legal abortion through public or private health services, which must analyze the case and provide a resolution within six days; this means that legal abortion based on either of the two recognized grounds is a free procedure that the National Health System is obligated to guarantee [7].

On April 28, 2021, the Constitutional Court of Ecuador took a ground-breaking step by decriminalizing abortion in all cases of rape. This decision acknowledges the human right of anyone pregnant due to rape to access non-punishable abortion care and ensures that they cannot be criminalized for terminating the pregnancy [4]; this is an important landmark pronouncement for the country and the region.

How many abortions are performed in Ecuador?

Data and numbers of abortions in Ecuador

According to the most recent statistics from the National Institute of Statistics and Census (INEC), there were 911 reported cases of legal abortion in 2019 [2]. However, records from the Ministry of Public Health of Ecuador indicate that in the same year, 21,939 people sought medical treatment for an abortion (spontaneous, medical, other, or unspecified), and 42% were people under 24 years of age [4]. Such statistics may indicate people choose to avoid seeking medical attention due to the fear of criminalization for abortion.

Abortion numbers with accompanying organizations

Abortion escort organizations have been essential in increasing the number of safe abortions in Latin America, including Ecuador. The Latin American Coalition Against Unsafe Abortion (CLACAI) estimated that in 2017, 16,380 safe abortions were performed with the support of abortion escorts; The data was gathered from a research study that had consulted seven abortion organizations, and the figures were based on estimates given by the escort group coordinators, as they did not have official records. The first organization reported 60 abortions, while the second, third, and fourth reported 72, 156, and 420, respectively. The fifth and sixth organizations reported 1,200 and 14,400 abortions, respectively.

 What do people in Ecuador believe?              

Opinion on abortion in Ecuador

One month after the Supreme Court of Ecuador decriminalized abortion in case of rape, in May 2021, Statista Research Department carried out a survey in which 69% of participants supported legal abortion in case of rape; and 76% disagreed with individuals being jailed if they obtain an abortion [6] [12].

Who are the people who have requested abortions?          

Abortion seekers in Ecuador

There is limited research regarding the demographic profile of abortion seekers; however, an analysis conducted by Sukurna, a support organization that assists sexual violence victims in accessing abortion care, found that all sexual violence victims who contacted them encountered barriers to accessing abortion care, despite meeting the requirements. In addition, 27.3% of those supported by the organization were under the age of 14. The report also found that 91% of those accompanied by Sukurna were ethnically mixed-race, while 9% were indigenous. [13]

Surkuna
It is a feminist organization founded in 2014 as a response to the criminalization of women for abortion and the demand of the feminist movement to have a legal organization that works for access to justice for women and girls in Ecuador.

Visit Surkuna website

What abortion services are available in Ecuador? 

Abortion Methods

LEGAL METHODS AVAILABLE
OTHER METHODS

Abortion with Misoprostol

Pfizer Cytotec 200 µg is the only brand of Misoprostol marketed in Ecuador. These pills are available in pharmacies with a prescription. However, stigma and lack of knowledge of proper protocols for the correct use of the drug hinder access and generate misinformation. The official cost of prescription pills in 2015 was US$12, 0.50 cents per pill [8].

Which abortion pills are available in Ecuador?

Misoprostol

Cytotec – 200 mcg – Pfizer Ltdt

In-clinic abortions

During the first trimester of pregnancy, manual aspiration (MVA) and dilatation and curettage (D&C) abortions are available in Ecuador’s public and private health centers. These assessments can range from $60 to $3,000, depending on where they are performed (clinics, hospitals, or private clinics); this information is based on 2015 and may have changed since then.  [7].

Legal restrictions on abortion create obstacles to accessing safe abortion methods. In Ecuador, people in need of abortion are forced to seek private clinics that offer clandestine purchases or use of traditional folk methods that are not recognized by the WHO (World Health Organization).

Abortion with pills and Telemedicine

In Ecuador, it is possible to obtain information about abortion through telemedicine, a safe and effective method. Las Comadres is a feminist network of accompaniment to safe abortion in Ecuador. They share information about abortion with pills and accompany women before, during, and after abortion.

How does the context affect abortion in Ecuador?              

Context and abortion

The indices used to measure the context in Ecuador reveal that there are still significant gaps in inequality that need to be addressed. Access to basic drinking water, reduction in hunger and undernourishment, and enhanced respect for human rights are some areas where progress needs to be made.

This data is essential to determine whether the population has the minimum social conditions necessary to live a healthy and happy life. Consequently, the information helps to understand the context in which people decide whether to continue or terminate the pregnancy. For example, in many instances, people would like to continue their pregnancy, but their social system doesn’t support them. Similarly, people would want to interrupt their pregnancy, but the system does not allow them or prosecutes them for it. 

Systematic inequalities significantly contribute to the decision of whether to continue with a pregnancy, the ability to access safe abortion care, and the possibility of criminalization; this has been evidenced by research conducted by Human Rights Watch, which found that individuals tried in Ecuador for abortion are often from indigenous and Afro-descendant backgrounds, leaving them with few options but imprisonment, health problems, death, forced motherhood, or pregnancy [2].

What is happening to the girls in Ecuador?

Between 2013 and 2016, 8,677 girls gave birth due to rape. However, only 232 complaints of sexual violence were reported by healthcare centers, despite being a legal obligation, according to The Ministry of Health. In an analysis of the impact of abortion criminalization done by Human Rights Watch, in 2021, seven girls under the age of 14 gave birth in Ecuador every day, and 12% of the people criminalized for abortion were minors, many of which were from indigenous communities [2].

From 2009 to 2016, 17,448 girls under the age of fourteen gave birth in Ecuador. Even though they were victims of sexual violence, many of these cases were not registered as such. In this scenario, most girls cannot receive adequate care [1]. According to these statistics, Ecuadorian minors are not protected from sexual violence; this adversely affects the health and well-being of the underage population.

Women criminalized for abortion

Based on filings provided by Ecuador’s Attorney General’s Office to Human Rights Watch, from the beginning of 2014 until June 2019, the Prosecutor General’s Office filed charges for alleged consensual abortion in 286 cases [2]. 

The criminalization of abortion does not impact all people equally. For example, the cases Human Rights Watch analyzed found that all 100% came from economically marginalized regions, and 40% of the cases involved Afro-Ecuatorian people. In addition, the age of the people criminalized was 6% 30 to 39, 21% 25 to 29, 61% 18 to 24, and 12% under eighteen years old [2]. 

How did the pandemic influence abortion in Ecuador?

Impact of COVID-19

COVID-19 restrictions have directly impacted abortion access; Surkuna documented 12 cases of denial of sexual and reproductive health services due to the pandemic restrictions, including, among other barriers, denial of access to legal abortion services. In 2020, sixteen national and international human rights and women’s rights organizations called the Ecuadorian government to recognize and prioritize access to legal abortions and emergency obstetric care as essential health services [9][10].

Impact the COVID-19 in sexual health and reproductive rights

In a report made by different feminist groups from Latin America on Sexual violence, forced pregnancies, and access to health services in the context of the COVID-19 pandemic, they reported that in Ecuador, abortions decreased significantly in 2020, being 122 abortions performed compared to 2019, year in which 329 abortion were performed, this is clear evidence that the restrictions caused by the health crisis directly impacted the capacity and ability of individuals to access abortion and contraceptive services [9] [10].

The State Attorney General’s Office registered 17,163 sexual crimes in 2019, and 190 more pregnancies were recorded in girls aged 10 and 14 during 2020 compared to 2019. In addition, many cases of sexual violence go unreported not only due to the restriction to access the prosecutor’s offices in person because of quarantine but because many victims decide not to file a formal report [9]. 

What is the data gap in Ecuador?

What we don’t know

Although the health system has some data, NGOs provide more critical information. However, to draw a complete picture of the abortion situation in Ecuador, studies would require answering the following questions:

How many people are having abortions?
How many people are having unsafe abortions?
How many girls are forced to continue an at-risk pregnancy despite the law?
How many queer people are having abortions?
How many people know the abortion law?
How many people have their life projects affected by restrictions and barriers to abortion?

*This page presents abortion data only for women and girls since the information available is usually not separated by gender. However, AbortionData.org acknowledges this limitation.

 Where did we get the information?

Sources

[1] Acosta,A. and Aguilar, L. (2018) Revista Wambra.  [Online] Available at: http://clacaidigital.info/handle/123456789/1107

[2] Human Right Watch. (2021)Por qué me quieren volver hacer sufrir?”. https://www.hrw.org/sites/default/files/media_2021/07/ecuador0721sp_web.pdf

[3] Clacai. (2017) Mapeo “Uso y acceso a Misoprostol y

Mifepristona en tres países de América Latina: Argentina, Ecuador y Perú”.

[4] Wambra, R. (2019, 30 septiembre). Abortar en América Latina y el Caribe: acceso y obstáculos. Wambra Medio Comunitario. https://wambra.ec/abortar-en-america-latina-y-el-caribe/

[5] Cedatos. (2021). Opinan los ecuatorianos y hablan de las cifras oficiales. https://cedatos.com/2021/08/07/cedatos-opinan-los-ecuatorianos-y-hablan-las-cifras-oficiales/

[6] Wambra, R. (2019). Las 10 preguntas que te has hecho sobre el aborto. Wambra Medio Comunitario. https://wambra.ec/las-preguntas-que-te-has-hecho-sobre-el-aborto/

[7] HowToUseAbortionPill. (2015). Abortion in Ecuador costs & providers.

https://www.howtouseabortionpill.org/abortion-laws-by-country/ecuador/

[8] Women’s Link. (2020). Atención de emergencias obstétricas y acceso a abortos legales son servicios esenciales de salud, que se deben garantizar durante la pandemia de COVID-19.

https://www.womenslinkworldwide.org/informate/sala-de-prensa/atencion-de-emergencias-obstetricas-y-acceso-a-aborto-deben-ser-servicios-esenciales-de-salud-durante-la-pandemia-de-covid-19

[9] Clacai. (2021). Violencia sexual, embarazos forzados y acceso a servicios de salud en el contexto de la pandemia del COVID-19. 

http://clacaidigital.info/handle/123456789/1413

[10] Abortion in Ecuador | All you need to know about abortions. (s. f.-b). https://safe2choose.org/abortion-information/countries/ecuador

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