‘I Can’t Bear the Pain’: Mourning the Lives Lost to the Dominican Republic’s Abortion Ban

OOne of the walls in Alba Nely Peña’s front room is decorated with graduation photos of her children. She gave birth to three boys and three girls, but in her home on the outskirts of Santo Domingo, the capital of the Dominican Republic, there are only five smiling faces.

“My youngest passed away. I deleted her photo because I can’t stand the pain,” she says, before going into a back room and pulling out a framed collage of photos of her daughter. On it are written the words: “We will always remember you, Rossa.”

Rossa Nelly Aquino died in June 2013 at the age of 20, a few days after having an abortion at an illegal clinic not far from where she lived with her mother. She kept the procedure a secret from her family and only revealed what happened to her sister, Heidy Valoy, just before she died.

‘What my sister did in that clandestine clinic was to leave us, her family, with a tear for the rest of our lives. Our family is incomplete,” says Valoy. “I want the medical community to pay more attention to these clinics and dismantle them.”

Abortion in the Dominican Republic is illegal under all circumstances, including rape and incest. Abortions are not allowed to save a woman’s life or if the fetus cannot survive outside the womb. The law has been in force ever since 1884. Women can be jailed for up to two years for having an abortion, while the sentences for doctors and midwives range from five to 20 years.

Despite the law, there is a thriving and profitable business providing abortions. In cities across the country, there is usually at least one known clandestine clinic offering abortions in secret. These clinics are often disguised as medical centers that offer ultrasound scans, for example. Others have no signage at all, like the one sandwiched between an ice cream parlor and a sports center, and painted in bright colors with flower murals on the walls, in a city in the middle of the Caribbean country.

Women typically pay between 5,000 (£67.81) and 13,000 (£175.75) Dominican pesos, a significant amount for a large part of the population. According to women’s rights activists, abortions are offered immediately after a woman requests them, with no questions asked. The procedure is often performed under unsanitary conditions.

Faby Espinal, member of Aquelarre RD, a grassroots feminist collective in the city of Bonao, says: “(Abortion) is a blatant and total issue. There is a double standard and a hidden market that capitalizes on women’s ovaries and makes money from them.”

While women have had successful abortions at these clinics, there have also been horror stories, like Rossa Nelly’s. On the morning of her death, she complained to her mother of stomach pain before seeking medical attention from the man who had performed her abortion two days earlier. Her sister went to visit her and remembers that the clinic was “not clean” and “an unsuitable place for this kind of practice”. By the time Valoy found out what had really happened, it was too late to save her sister’s life.

In 2020, the body of a 24-year-old woman who had two children was found found in a bin after she died during an abortion at a clandestine clinic. There are stories of women going to these clinics and enduring immense pain while undergoing surgical procedures without anesthesia, and of women developing serious health complications.

Women’s rights activists claim that the country’s total abortion ban forces people to resort to unsafe methods that threaten their health and lives. They say the law is incompatible with the country’s international human rights obligations. There are indications that access is being restricted does not decrease the number of abortions taking place and that women and girls from low-income and rural areas are disproportionately affected.

The percentage of maternal mortality in the Dominican Republic it is 107 per 100,000 live births, above that of the average for the Latin America region, which is 88 maternal deaths per 100,000 live births. Abortion is the third leading cause of maternal death in the country, according to the International Planned Parenthood Federation. Figures from the Ministry of Health, cited in a 2018 report by Human Rights Watch, show that there is a an estimated 25,000 hospital admissions for abortion or miscarriage in the public health system every year, often involving clandestine abortion.

In February last year, after twenty years of campaigning, a proposal to decriminalize abortion in three cases – when the pregnancy is the result of rape or incest, when the woman’s life is in danger, or when the fetus becomes incompatible with life – was not adopted. The same week, 16-year-old Esmeralda Richiez bled to death in her bathroom after her math teacher, from whom she became pregnant, allegedly gave her abortion pills.

Esther Giron, co-founder of Aquelarre and member of the UN Girls Education Initiative feminist network believes that “deeply religious beliefs,” the far right and a growing and powerful evangelical movement that originated in the US are “leading society” in the country.

She and her colleague Espinal advocate for abortion to be legal in all cases, but say other changes need to happen, including improving the public health system. Many of the women they encounter understand that abortion is illegal, but know nothing about what the law says or efforts to change it.

The methods used to terminate pregnancies vary. “Abortion is a matter of privilege in this country,” Giron said. “If you have a better economic status, you leave the country or go to a private, good clinic.”

Otherwise, women buy pills in pharmacies that are known to cause abortions, insert sharp objects into their vaginas, throw themselves down the stairs, drink a herbal mixture or visit a clandestine clinic.

Faced with deep-seated sexism, high rates of violence against women, poverty And teenage pregnanciesDue to a lack of sex education, which means that adolescent girls do not know how their menstrual cycle works, and a prohibition law, the demand for unsafe abortions will continue.

Ten years after Rossa Nelly’s death, Valoy and her mother still don’t understand what drove her to have an abortion. As she lay dying, Valoy recalls, the doctor left saying he wanted to get something to drink. “He didn’t feel bad at all. It was like he was making fun of me when I came in and touched her face and called her by name,” she says.

He never returned and spent five years on the run. He was arrested near the border with Haiti and sentenced to twenty years in prison.

Valoy and her mother believe Rossa Nelly was wrong to want an abortion, and they don’t want the law to change. However, Valoy says: “Abortion will not stop because there are many methods available. Women seek them out thinking they will find a solution to their problem.”