A report* produced in 2001 as a collaboration between the World Bank, the Inter-American Development Bank, and the Pan American Health Association addressed the dire need for effective women's health care in Latin America and the Caribbean. One of their conclusions was:
"To improve the health status of women, given tight budget constraints, countries... should focus resources on improving basic reproductive health conditions. The interventions required are relatively low-cost, in general, and yet have major pay-offs in health conditions and human welfare. Providing appropriate family planning methods to women who want to control their fertility, providing early and reliable prenatal and essential obstetric care, fostering good nutrition, and developing specially targeted services for women at high risk for sexually transmitted diseases should all be very high on the public priority list."
According to the sources cited, Cuba has met some of these needs through their Mother and Child Plan, but with a slight edge over the rest of its neighbors in Latin America and the Caribbean: legalized abortion since 1965.
The 2001 World Bank report states that "[i]n most Latin American countries, between one-quarter and one-third of women 18 years old or younger are pregnant or have already had a child... Up to half of the pregnancies in young women are unplanned"(emphasis added). Currently, abortion is illegal or highly restricted in Latin America and the Caribbean, thus many women seek clandestine abortion. A 1996 study found that "[e]stimated rates of [clandestine] abortion are highest in Peru and Chile (each year, almost one woman in every 20, aged 15-49 has an induced abortion), intermediate in Brazil, Colombia and the Dominican Republic (about one woman in 30), and lowest in Mexico (approximately one in 40)." The World Bank believes "an estimated one-fifth of maternal deaths are attributed to [clandestine] abortion-related conditions, and an estimated 40 percent... experience serious complications."
In 1990, a study in Bolivia, Colombia, Peru and Venezuela, "found that the vast majority of hospitalized [clandestine] abortion patients [due to complications]...half (51%) had two or more children." Several other studies have shown that "the majority of... patients appear to be married women who already have all the children they feel able to care for. The difficult social and economic conditions facing many millions of families in Latin America's poor rural areas and vast city slums spur the desire of couples to have fewer children."
These desires, with the help of other available contraception, have expressed themselves in the overall decrease of fertility rates in Latin America and the Caribbean over the years, yet it is mainly in the urban sectors, leaving the rural poor with higher fertility rates and higher maternal mortality rates.
According to the Alan Guttmacher Institute, "[t]he developing areas of the world, where 79% of the world's people live, account for 64% of legal and 95% of illegal abortions..."
*The World Bank, Inter-American Development Bank, and Pan American Health Association. (2001). The Health of Women in Latin America and the Caribbean. Washington DC: The World Bank.