Organizing for Women's Sexual and Reproductive Rights : The Case of the Latin American Consortium for Emergency Contrace

1. Organizing for Women's Sexual and Reproductive Rights:The Case of the Latin American Consortium forEmergency Contraception Angeles Cabria Pacific Institute for Women’s Health

2. Expanding Contraceptive Choice: Emergency Contraception (EC) as a Woman’s Right • EC, commonly known as the “morning-after pill,” is a female-controlled method of contraception that prevents pregnancy after unprotected sexual intercourse. • EC– as pills or the IUD-- is the only form of post-coital contraception. • EC increases women’s autonomy and decision-making power related to fertility

3. Why Is EC So Critical for Women in Latin America (LA)? • Reducing unintended pregnancy is one of women’s highest priorities, especially where abortion is legally restricted • EC has the potential for preventing a large number of unsafe abortions • LA has the world’s highest percentage of maternal deaths due to unsafe abortions • EC is particularly relevant for rape survivors and youth

4. What are the principles that frame our approach? • Women’s rights and sexual and reproductive health rights are human rights. • The right of women to control all aspects of their health is central to empowerment. • Ultimately, sexual and reproductive rights are imperative to ensure justicefor all members of society.

5. More principles that guide our approach • The establishment and enforcement of laws and policies that protect and advance these rights are essential. • Guidelines must secure women’s access to a wide range of contraceptive methods, including EC and protect the freedom to decide whether and when to have children. • Denial of female-specific medical care is a form of discrimination against women.

6. What is today’s EC status in Latin America? • EC is widely available in pharmacies and reproductive health clinics (Yuzpe regimen) • The number of countries where a dedicated EC product is available is growing: Argentina, Brazil, Colombia, Chile, DR, El Salvador, Peru, Mexico, Nicaragua, Paraguay, Uruguay and Venezuela • Other countries, such as Ecuador, have products registered but not available

7. However… • There is limited access to health care services that provide EC • Many providers are not familiar with EC, and some harbor paternalistic attitudes or fears of being punished for EC provision • Women don’t know about EC so cannot ask for it and demand their rights • The public sector (Ministries of Health) are reluctant to incorporate it in their official norms on family planning and/ or sexual violence and youth

8. Other socio-cultural barriers to EC in Latin America • Perception of EC as “micro-abortion” • Opposition from the Catholic Church and conservative groups • Low-level recognition of sexual and reproductive rights • Conservative attitudes towards sexuality • Lack of sexual education from and for parents and in schools • Mystification of maternity

9. In summary…. EC is not yet accessible to most women who need it!

10. What are the Needs for EC Promotion in the Region • Policies: Advocate for the inclusion of EC in the official norms, protocols and working documents in both the public and private sectors • Service delivery: Expand availability of and broaden access to information about EC • Information, education and communication: Inform the general public about the method, correct misinformation and disseminate relevant study and survey results in the region

11. A Unique Approach to Fostering Networking and Collaborations Worldwide • The International Consortium for Emergency Contraception • The Latin American Consortium for Emergency Contraception

12. In the Beginning… • A group of activists pushed ahead on different fronts, mainly in the U.S. and Europe* • North-to-South action needed to make EC known and available in developing countries • In 1995 lead agencies involved in EC formed the International Consortium for Emergency Contraception • Partnership among public sector organizations and private industry was created in order to make EC available to women worldwide * The Concept Foundation, International Planned Parenthood Federation, Pacific Institute for Women’s Health, PATH (Program for Appropriate Technology in Health), Pathfinder International, Population Council, World Health Organization, Special Program of Research, Development and Research Training in Human Reproduction

13. LATIN AMERICAN CONSORTIUM FOR EMERGENCY CONTRACEPTION

14. The Latin American Consortium for Emergency Contraception -LACEC (CLAE in Spanish) is a network of non-governmental, governmental, private, and public organizations and institutions that work in the areas of health, education, and sexual and reproductive rights. * The Pacific Institute for Women’s Health has been coordinating LACEC since its inception in 2000

15. LACEC Mission Statement The Consortium seeks to contribute to the overall improvement of the population’s health and to the reduction of unintended pregnancy, maternal mortality and unsafe abortion in Latin America through advocacy, promotion, information dissemination and access to emergency contraception within the context of sexual and reproductive rights.

16. LACEC Goals • To advocate for the normalization of EC and its inclusion in the family planning/ reproductive health norms of ministries of health. • To disseminate information about and access to EC in its different forms, using a gender and human rights perspective, to all socio-economic levels of the population. • To expand social marketing initiatives for the commercialization and distribution of an EC dedicated product. • To defend EC as a sexual and reproductive right within the larger sphere of human rights, and to integrate EC into the context of human sexuality and the prevention of sexually transmitted diseases, and gender based violence.

17. LACEC Activities • Fostering collaborations, networks and coalitions • Facilitating information sharing among members and interested groups. • Leading Advocacy Strategies and collaborating with advocacy campaigns to integrate EC in norms of ministries of health • Convening and supporting networking and informational/educational meetings and conferences • Creating materials in collaboration with experts from the region • Fundraising for Consortium activities and to support EC initiatives in the region

18. LACEC Accomplishments • LACEC held in October 2002 in Quito, Ecuador, the largest Latin American Conference on EC in history “The Right To Emergency Contraception In Latin America And The Caribbean”. • 250 participants from 20 countries participated, including legislators, Ministry of Health officials, women’s and youth NGOs, researchers, health providers, human rights activists, youth, media.

19. Impact of LACEC Conference • Formation of new alliances, collaborations with participants • Increased LACEC membership • Advancement of the work plans developed during the conference, including new EC country networks or consortia • Initiation of policy changes, such as EC provision in service protocols for victims of sexual violence in Ecuador • Exchange of IEC materials and advocacy strategies • Greater mobilization of human resources and experts to support EC advocacy events • Greater participation of LACEC members in regional and international events • Involvement of grassroots groups and youth organizations in subsequent political debates

20. Organizing for EC Rights: LACEC Impact on Advancing Women’s Empowerment • In the two years of LACEC’s existence, women’s NGOs have contributed greatly to the formation of EC consortia in 4 countries (Bolivia, Ecuador, Peru and Chile) with several more in progress • Women’s groups in coalition with other sectors achieved integration of EC in the official norms of ministries of health in Ecuador, Argentina, Peru and Bolivia • More women are advocating and lobbying with decision makers and politicians about EC and other Sexual and Reproductive Rights

21. Organizing for EC Rights: Voices from the Field • “A representative from the Ministry of Justice was at the conference and he was absolutely sensitized by your presentation on comprehensive services for sexually abuse women, and it prompted him to propose to the Ministry of Justice that forensic doctors should not only inform about EC, but they should offer it as part of their services. I am sharing this with you so that you can see how your brilliant intervention helped to make progress in our country. Now we have this new challenge.” Conference presenter from Ecuador

22. Organizing for EC Rights: Voices from the Field • “In La Paz, I participated in a National Workshop with decision makers from different fields (mostly health and justice) to talk about services for victims of sexual violence. I tried to be convincing with the theme (it’s still a big problem in Bolivia), talking about the fact that EC is not an abortifacient, the need for a dedicated product, and the possibilities of introducing it according to costs. I tried to make them understand what is the damage done to women by the inexplicable resistance to normatize EC. The response was favorable. The Minister of the Supreme Court of Justice expressed his motivation for normatizing EC.” Conference presenter from Bolivia

23. Organizing for EC Rights: Voices from the Field • “Since I returned from the Quito conference, I have been working in my medical center with adolescent leaders on EC. They are very interested and it has been very helpful for them. It is important to create spaces where adolescents can freely discuss these themes. However, there are many institutions, people and health professionals here in Peru who find this difficult to accept. We are still struggling for information.” Conference participant from Perú

24. Conclusions • LACEC gets its strength from the vision, breadth of knowledge and experience of each of its members. • We have broadened our horizons, created innovative collaborations with new partners and grown as individuals while strengthening the whole collective. • In over two years of collaboration, we have documented and developed public health arguments that have allowed us to refute other points of view of a more moral or religious nature that attack EC and block efforts to defend the right to autonomy in personal decisions regarding women’s sexuality.

25. THANKS!