Abortion in Peru

Abortion is a prevalent health care need in Peru despite its strict legal restrictions and existing stigma. However, healthcare providers can legally perform abortions if the pregnant person’s life is at risk. The uncertain and restrictive conditions lead abortion seekers toward unsafe abortions [2].

In Peru, abortion laws are stringent, permitting the procedure solely in cases where the life of the pregnant individual is at stake. This framework severely limits sexual and reproductive autonomy. Any deviation from this criterion, whether by the pregnant person seeking the procedure or those involved in its provision, can result in imprisonment [1].

Despite the restrictions and stigma surrounding abortion in Peru, in 2014, a national guideline for how to legally approach abortion was issued; this resulted not only in the training of thousands of doctors and midwives,  receiving training on how to perform abortions but also in a shifting perception on the legitimacy of abortion as a healthcare service, and the recognition of health benefits of safe abortions [2].

The Peruvian law prohibits and criminalizes anyone involved in an abortion: the pregnant person and the person performing the procedure. Chapter II of the Peruvian Criminal Code (1991) establishes that abortion is not permitted in any of its modalities and is cause for the deprivation of freedom. The only exceptions to this are cases where the pregnant person’s life is at risk.

However, such exceptions are granted solely for abortions performed within the 22nd week of pregnancy. Beyond this timeframe, abortion is punishable by law.

Despite there being situations whereby legal abortions can be performed, such as the one mentioned above, it is still a practice that is severely punished and blamed. Abortions in cases where the pregnancy is a result of sexual rape or non-consensual insemination are currently illegal. 

The “National Technical Guide for the Standardization of the Comprehensive Care Procedure for Pregnant Women in the Voluntary Interruption due to Therapeutic Indication of Pregnancy under 22 Weeks with Informed Consent within the framework of the provisions of Article 119 of the Penal Code.”

In 2014, the Peruvian Ministry of Health issued the National technical guide for the standardization of the Comprehensive Care procedure for pregnant women in the Voluntary Interruption due to Therapeutic Indication of Pregnancy under 22 weeks with informed consent, a framework for providing abortions legally under article 119 of the penal code. The goal of this mechanism is to look after the health and well-being of pregnant persons and to reduce maternal mortality rates since abortion-related complications and lack of medical support have been the second leading cause of maternal mortality in the country for two decades before 2014 [3]. Unsafe abortions and their complications continue to remain a significant cause of maternal mortality in Peru [4].

The Guidelines provide a framework that intends to help healthcare professionals offer integral attention and care for abortion legally. In such cases, “the pregnancy puts in grave risk of permanent damage to the woman, the interruption of pregnancy, only when this is the only way to save her life or avoid her going into grave or permanent health damage” [3]. This type of abortion is named therapeutic abortion.

The objectives of The Guideline not only promote integral attention to pregnant persons who require an abortion before 22 weeks of pregnancy but also attempt to guarantee the right to access healthcare, reproductive and sexual rights, as well as the dignified treatment of pregnant persons whose lives are at risk. The guideline seeks to guarantee quality standards and attention for healthcare professionals so that they can act without encountering barriers that make their work difficult or impossible.

It is essential to highlight that among the mechanisms intended to regulate abortion, there is also the General National Health Law [5], which makes it mandatory for healthcare professionals to report cases of abortion to authorities for investigation. Now, within the Criminal Code and the national legal instruments, the concept of ‘criminal abortion’ is not defined within the Criminal Code and national legal instruments. Therefore, although healthcare professionals are mandated to report instances of abortion to authorities, prosecutions under the concept of ‘criminal abortion’ cannot be pursued.

Abortion Environment Rating

This evaluation uses a 1 to 5 scale for each criterion, where 1 indicates a hostile environment for abortion rights, and 5 indicates a friendly environment for abortion rights.

Law and policy (2)

2) Abortion is mostly criminalized with few exceptions; many legal barriers exist, minimal protection of SRHR, and few provisions for marginalized groups.

Accessibility (2)

2) Limited access, significant waiting times, expensive for most income levels, facilities are poorly geographically reachable.

Provider Training (2)

2) Providers have limited training in WHO-recommended methods, training programs are infrequent or insufficient, and frequent use of outdated methods, with limited implementation of modern methods.

Public Opinion (2)

2) Abortion is generally stigmatized in public opinion, and public discourse on abortion is largely driven by moral judgments and misinformation.

Support Services (2) 

2) Limited information is provided, with some inaccuracies. Counseling is rarely available or not offered. There is weak linkage to additional care or services, with significant gaps.

Data (2)

2) Sparse and incomplete data on abortion is available. Data updates are infrequent, and the information is not easily accessible.

International Standards (2)

2) No significant ratification of human rights documents mentioned.

Adherence to Health Standards in Abortion Care (2)

2) Abortion care practices deviate significantly from WHO guidelines, compromising safety, effectiveness, or accessibility.

Total Score for Peru 16|40

Since the government has not been collecting data accessible on national channels or platforms, various non-governmental organizations, feminist organizations, academic communities, and human rights groups have dedicated themselves to studying and acquiring data through polls and surveys among the civil community in Peru.

Despite investigations and official reports on matters such as sexual violence in minors, there is a massive void of up-to-date data about abortions in Peru. The Centro de Promoción y Defensa de los Derechos Sexuales y Reproductivos (The Center for the Promotion and Defense of Sexual and Reproductive Rights, Promsex), an NGO with the consultative status of the OAS, has been one of the organizations that has provided information about abortion. According to interviews conducted by PROMSEX in 2019, 19% of people with gestational capacity in Peru reported having had an abortion. According to the surveys, there is no significant difference between regions; however, the eastern region has the highest figures, with 26%, followed by the southern region with 21%, the central region with 19%, Lima-Callao with 17%, and finally the north with 14%.  In addition, 58% of people reported having gone to a health professional for an abortion [7]. PROMSEX only documents abortion data until 2019. 

Neither PROMSEX nor other researchers or organizations have released comprehensive and up-to-date abortion data since 2019, meaning there is a large gap and lack of significant advances in the data [8].

Finally, the platform OjoPublico estimated that approximately 350,000 abortions occur every year among women of reproductive age in Peru [13]. 

As for official data on abortion, the Peruvian National Center for Epidemiology, Prevention, and Disease Control Informative Bulletin reported in 2022 that abortion and associated complications ranked as the fourth leading cause of maternal mortality in the country [14].

The available information from the Ministry of Health of Peru is allusive to pregnancies and births among minors. Still, there is no specification of abortions performed in the country, within or outside the legal framework.

Peruvian society has a wide variety of opinions regarding abortion, including topics such as decriminalization or penalization. One global survey in 2023 found that:

• 12% of Peruvians believe abortion should be legal in all cases
• 29% of Peruvians believe that abortion should be legal in most cases
• 25% of Peruvians believe that abortion should be illegal in most cases
• 20% of Peruvians believe abortion should be illegal in all cases
• 15% were unsure of their opinion or declined to answer  

Other opinions gathered from this survey study showed that, based on the current legal framework, the majority of Peruvians polled believe that the woman who received the abortion (54%), the abortion provider (68%), and the person who coordinated the abortion (66%) should be penalized. In addition, the survey study provided data for when Peruvians believe the timeline for legal abortion under certain circumstances, such as the life of the pregnant person is at risk, should be.

From this data, we see that there is not a majority opinion on the decriminalization of abortion, penalization for people who receive or perform an abortion, or a timeline for legal abortions. Although abortion is a decisive issue in Peru, opinions on abortion differ by various circumstances and exceptions.

Even though both the freedom to choose and the sexual rights of pregnant people refer to similar areas of a person’s life, they each have their area of influence in terms of rights. Several initiatives, such as “Déjala Decidir” [10] (“Let Her Decide”), have been promoted in the Peruvian legislative bodies and entities. “Déjala Decidir” campaigns for the decriminalization of abortion “in pregnancies caused by rape, nonconsensual artificial insemination or egg transfer.” This campaign builds upon Peru’s legal abortions in circumstances where the pregnant person’s life is at risk. In 2022, one proposed bill considered situations including pregnancies resulting from rape, nonconsensual insemination, or nonconsensual egg transfer. It also introduced various factors into the context, such as the presence of ‘malformations incompatible with life’ in the pregnancy [11].

Although there have been several bills proposed regarding the decriminalization and legalization of abortion, there isn’t enough evidence that the section of the population that supports the decriminalization of abortion is well-represented in the legislative sector. Although civil organizations and groups have spoken up in favor of the regulation and legalization of abortion, Peru’s political context has not allowed the creation of a space where their efforts can be fruitful.

The Center for Promotion and Protection of Sexual and Reproductive Rights states that abortion is not present in just one sector of the population. However, 81% of the pregnant women who requested abortions in 2019 are part of socio-economic sectors with low incomes and low resources [7]. Furthermore, research reveals that as of 2019, 19% of Peruvian women between the ages of 18 and 49 report having had an abortion, and of this 19%, 58% sought assistance from healthcare professionals to terminate their pregnancies [7].

Furthermore, as per the latest report from the Guttmacher Institute, spanning from 2015 to 2019, there were a total of 1,080,000 pregnancies, with 69% reported as unwanted, leading to 48% resulting in abortions [12].

However, it is essential to mention that the existing data is alarming and covers child pregnancy—a condition that has been present in Peru for at least the last 25 years. The United Nations Population Fund (UNFPA) found that in 2022, over 1,600 girls aged 10-14 became mothers [9]. Findings reveal data related to maternal mortality and morbidity in pregnant people as young as 17 years of age. Despite this statistic, there have been no reports focused on teenagers or children, which indicates a void of information about the consequences of child pregnancy, which is mainly mortality.

Although there is some statistical information about abortion and sexual violence, there is not enough data available to determine the severity of the situation in Peru. The government has only focused on the regulatory outline, which has accessible content, but no information about how the guidelines are applied nor its impacts on the civil population.

Aborto

In Peru, topics that people researched related to “abortion” include “miscarriage risks” and “abortion in adolescents.” Questions and queries related to abortion include “risks of abortion at 2 months pregnant,” “What to do if I am pregnant and do not want to have the baby,” and “What is a spontaneous abortion without surgery?”. From these search questions, it is evident that pregnant persons in Peru are searching for information about miscarriages, abortions, and their ability to decide to carry a pregnancy, which are all topics related to sexual health and reproductive rights. 

Misoprostol

In Peru, search terms related to Misoprostol over the last 12 months (since May 2024) include the price of Misoprostol in 2023 and the proper dosage of Misoprostol. Other search questions related to Misoprostol include “When will a period return after an abortion with misoprostol?” and “What foods can I eat after taking misoprostol?”. Google Trends shows that 20 of the top 25 queries related to Misoprostol have grown 5000% or more over the last 12 months. 

Cytotec 

Cytotec is the brand name for misoprostol. According to Google Trends data, common queries related to “Cytotec” in Peru include looking for information about the dose and price. Although the search terms “Misoprostol” and “Cytotex” reached their peak popularity from May 2023 to May 2024 during August 2023 and September 2023, respectively, searches about the drug’s price and the proper dosage have grown exponentially.  

Peru has contemplated abortion as a motive for punishments such as deprivation of liberty (or community service or an alternative punitive punishment) in their Criminal Code in its multiple versions issued in 1863, 1924, and 1991. Congress has put the subject up for discussion many times. Still, it was not until 2014 that they created and approved an instrument or guidelines for cases considered exceptional where abortion was not considered a punishable act by the Criminal Code. 

The discussion around abortion in Peru takes many shapes. Despite being a secular nation, in legislative debates, Catholicism has influenced discussions, shaping and dominating discourses with religious orthodoxy. In addition, since 2018, the country has been through several political crises that have resulted in the removal of the head of State and, recently, the naming of a new Congress in the year 2022, along with the arrival of a new president [22]. These political crises have resulted in issues like abortion taking a backseat in terms of the legislative agenda priorities in the last 5 years. Following the resignation of Pedro Pablo Kuckynzki, the presidents that have exercised power up until today have not only neglected abortion legislation as a priority in their respective agendas but also represented political parties that identify themselves as “pro-life” or are strictly against legalizing abortion legalization.

n 2023, the Peruvian Congress approved Law 785 with 72 votes. This law proposes to amend the Civil Code to state that life begins at conception, which endangers pregnant people’s and adolescent’s rights to therapeutic abortions [24, 25]. It is important to note that this law goes against the right to therapeutic abortion for pregnant people whose lives are in danger. 

The current discussion about abortion is still ongoing, and there are significant gaps not only in the legal field but also in terms of regulation. The Guide (mentioned earlier in this document) is one of the few, if not the only, existing instruments intended to regulate abortion. There is also a lot of uncertainty for the future due to political instability in Peru, which has led to a lack of continuity in governance and policies because of the constant change in mandates. As a result, there has been no establishment of a political agenda that allows us to determine whether abortion will be a topic of discussion in the near future.

How did the pandemic influence abortion in Peru?

The pandemic brought a sanitary emergency around COVID-19, with isolation, social distancing, and a reconfiguration of Peruvian homesteads. In the matter of sexual violence, in the face of confinement, the People’s Defender reported the rise of risk for there to be sexual violence since most of these numbers are present in domestic households where victims inhabit with their aggressors and by being in confinement with them, the cases of sexual violence and rape raised. In addition to this, healthcare services and medical attention services were saturated because of the focus on the pandemic, which caused the healthcare services to disregard within its priorities the factor of sexual violence, resulting in the detriment of the right to access integral healthcare services [26]. 

Formally, pregnant people living in Peru during the pandemic should have had access to healthcare during and after pregnancy because of an order issued by the Peruvian Ministry of Health in 2020. However, preventative services were suspended [27]; this means that there was a decrease in the number of therapeutic abortions reported during the year 2020, which, according to the Peruvian Obstetric and Gynecologist Society [28], is related to the limitation of accessing the sexual and reproductive healthcare system, the difficulty for patients to access to appointments with the gynecologist specialty area and the lack of access to first level care, aside from the confinement conditions stipulated by the authorities that made it impossible for patients to mobilize themselves to healthcare facilities. The Society reported that during April, May, and July of 2020, there were no therapeutic abortions performed in the country. This total decrease in abortion numbers was estimated to be due to the impossibility of providing healthcare services and the incapacity of pregnant people to attend facilities and appointments with healthcare professionals in the matter of sexual health and therapeutic abortions.

Finally, there are significant information gaps, particularly regarding access to therapeutic abortion, and the COVID-19 pandemic has exacerbated these existing shortcomings. While state and governmental institutions as well as healthcare providers prioritized addressing the global health emergency, these gaps continued to widen even in the years that followed. There is still a lack of comprehensive reports on the status of abortion and its evolution over the past two years in Peru, despite the prevalence of sexual violence and gender-based violence.

Sexual Violence in Peru

Even though there are no official numbers about abortions in Peru in general, there is evidence that based on the available information on sexual violence, especially towards minors, it is common and one of the highest rates in Latin America. According to the Reporte de Igualdad y No Violencia (Equality and Non-Violence Report) presented by the Defensoría del Pueblo ( Ombudsman’s Office), 16 femicides were reported in the country during the first two months of 2023. There were also 292 reports of disappearances of girls and teenage women during January of 2023. These numbers show how violence is abundant in the country and how minors, underaged women, and other minorities are exposed to sexual violence [29].

There are also support mechanisms against sexual violence and gender violence in the country, including the Centro de Emergencias Mujer (Women’s Emergency Center; CEM for its initials in Spanish), Línea 100, and Temporary Refuge homes, among others. However, these mechanisms (free and accessible to access for the entire population) provide guidance and help in cases of violence. Still, they do not cover or mention information about abortion as any of their functions. There is also the initiative Rural Strategy that seeks to facilitate access to justice and attention and prevention of violence for rural communities (among which there are indigenous communities), but that, once again, doesn’t provide information about abortion in any way.

According to the Report on Attention to Pregnancies in Girls and Adolescent Girls, which collects information from different official sources, “throughout all of 2020, official sources reported 48,575 pregnancies where the mother’s age ranged from 0 to 19 years, with 11,179 (2.4%) childbirths in girls under 14 years of age and 24 childbirths in girls under 10 years of age.” [24]. These very alarming numbers indicate a worrisome phenomenon of sexual violence focused on underage girls. Thousands of girls are forced every year to take their pregnancies to term following the law, which does not contemplate regulated abortion for cases where pregnancy is a product of rape.

Even though the healthcare system does have certain data, it is NGOs that provide the most critical information. However, in order to have a wider picture of the situation of abortion in Peru, investigation should also approach the following questions:

*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.

[1] Código Penal de la República del Perú. (1991). Retrieved from https://oig.cepal.org/sites/default/files/1991_codigopenal_peru.pdf

[2] Ministerio de Salud del Perú. (2014). Guía técnica nacional para la estandarización del procedimiento de la atención integral de la gestante en la interrupción voluntaria por indicación terapéutica del embarazo menor de 22 semanas con consentimiento informado en el marco de lo dispuesto en el artículo 119 del código penal. Retrieved from http://www.diresacusco.gob.pe/salud_individual/dais/materno/NORMAS%20RTN/03/RM%20486-2014%20-%20GTN%20DE%20ABORTO%20TERAPEUTICO.pdf

[3] Ley 26842, Ley General de Salud. (2014). Retrieved from https://vlex.com.pe/vid/ley-26842-ley-general-578578938#:~:text=La%20salud%20es%20condici%C3%B3n%20indispensable,Estado%20regularla%2C%20vigilarla%20y%20promoverla

[4] Justicia Verde. (2021). Guía para acceder a una atención de aborto libre de violencia obstétrica en los establecimientos de salud. Retrieved from https://img1.wsimg.com/blobby/go/32e993c4-7164-4a9d-ba22-62eda718ec7e/Gu%C3%ADa_violencia_aborto-0002.pdf

[5] Causa Justa: la agenda pendiente sobre aborto en Perú. A propósito del caso colombiano. (2022). Retrieved from https://idehpucp.pucp.edu.pe/analisis1/causa-justa-la-agenda-pendiente-sobre-aborto-en-peru-a-proposito-del-caso-colombiano/

[6] Causa Justa: la agenda pendiente sobre aborto en Perú. A propósito del caso colombiano. (2022). Retrieved from https://idehpucp.pucp.edu.pe/analisis1/causa-justa-la-agenda-pendiente-sobre-aborto-en-peru-a-proposito-del-caso-colombiano/

[7] PROMSEX. (2019). El aborto en cifras: Encuesta a mujeres en Perú. Retrieved from https://promsex.org/wp-content/uploads/2019/02/EncuestaAbortoDiptico.pdf

[8] Keogh, S., & Motta, A. (2021, April 1). Peru. Guttmacher Institute. Retrieved March 29, 2023, from https://www.guttmacher.org/regions/latin-america-caribbean/peru

[9] Díaz, C. (1970, May 11). Explicador: Lo Que Sabemos sobre las cifras diarias de aborto en el mundo. Ojo Público. Retrieved March 29, 2023, from https://ojo-publico.com/3477/lo-que-sabemos-sobre-las-cifras-diarias-de-aborto-en-el-mundo

[10] Search. MedAb. (n.d.). Retrieved March 29, 2023, from https://medab.org/search?field_brand_name_target_id=All&field_country_of_sale_target_id=214

[11] Abortion in Perú. All you need to know about abortions. (n.d.). Retrieved March 29, 2023, from https://safe2choose.org/abortion-information/countries/peru

[12]  How to use abortion pill staff. (n.d.). Abortion laws in Peru. HowToUse AbortionPill. Retrieved March 29, 2023, from https://amp.howtouseabortionpill.org/ru/abortion-laws-by-country/peru/

[13] Gallegos, J. (2020, September 28). Serena Morena: El Colectivo Que Acompaña a las mujeres que deciden abortar en el Perú. Salud con lupa. Retrieved March 29, 2023, from https://saludconlupa.com/la-vida-de-nosotras/serena-morena-el-colectivo-que-acompana-las-mujeres-que-deciden-abortar-en-el-peru/

[14] ¡Mi Cuerpo, mi decisión! DecidoYo. (n.d.). Retrieved March 29, 2023, from https://decidoyo.org/

[15] CDC MINSA. (n.d.). Retrieved March 30, 2023, from https://www.dge.gob.pe/epipublic/uploads/boletin/boletin_202213_29_141926.pdf

[16] S.A.S., E. L. R. (n.d.). Pedro Castillo Intentó disolver El Congreso y decretar Estado de Excepción. Diario La República. Retrieved March 29, 2023, from https://www.larepublica.co/globoeconomia/peru-anuncia-un-golpe-de-estado-despues-de-que-castillo-anuncia-cierre-del-congreso-3504829

[17] Informe sobre la supervisión de la atención integral en niñas y … (n.d.). Retrieved March 30, 2023, from https://www.defensoria.gob.pe/wp-content/uploads/2021/07/INFORME-DE-ATENCI%C3%93N-EMBARAZO-EN-NI%C3%91AS-Y-ADOLESCENTES-DP-UNFPA-PER%C3%9A.pdf

[18] Admin. (2021, June 4). Pandemia impactó en el acceso al aborto terapéutico. Proyecto SPOG FIGO ASAP. Retrieved April 5, 2023, from http://www.spog.org.pe/figo/proyecto/pedro-keiko-y-el-aborto-2/

[19] Swissinfo.ch. (2023, January 28). Dina Boluarte o el Reto de hacerse un hueco en el Eterno SISMO Peruano. SWI swissinfo.ch. Retrieved March 29, 2023, from https://www.swissinfo.ch/spa/per%C3%BA-crisis_dina-boluarte-o-el-reto-de-hacerse-un-hueco-en-el-eterno-sismo-peruano/48120264

Abortion in Peru

• 1What does the law say in Peru?     
• 2How many abortions are performed in Peru?
• 3 What do people in Peru believe?              
• 4Who are the people who have requested abortions?          
• 5What abortion services are available in Peru?    
• 6What information are people searching online regarding abortion in Peru?              
• 7How does the context affect abortion in Peru?              
• 8What is the data gap in Peru?
• 9 Where did we get the information?