The law on abortion in Mexico is formulated at the state level, and before this reform, abortions were only permitted under very limited circumstances such as rape, fetal malformations, or extreme circumstances such as a woman’s life or health. Even when they were legal, abortions were common even when they were legal.3,4 Nevertheless, abortions were widely practiced during this period. Based on one study, the incidence of induced abortions in Mexico in 2006 was 33 abortions per 1000 women aged 15 to 44 years, which is high by global standards.5 However, due to legal restrictions, the vast majority of abortions in Mexico took place clandestinely, often in unsafe conditions, resulting in severe health consequences for women. In Mexico from 1990 to 2008, 7.2% of all maternal deaths occurred as a result of abortion6. Another study estimated that 149 700 women were hospitalized as a result of complications following induced abortions in 2006.
It was difficult to obtain a safe abortion in Mexico due to inequity. In a study that analyzed data from the 2006 Mexican National Demographic Survey, poor women, those with low levels of education, and those belonging to indigenous groups had the highest risk of having an unsafe abortion. By departing from the restrictive abortion laws in the rest of Mexico, Mexico City has delivered a major victory for women’s reproductive rights in response to this public health issue.
THE DEVELOPMENT OF MEXICO CITY SINCE DECRIMINALIZATION
The MOH-DF established a public sector Clinica de aborto legal en CDMX program following the abortion decriminalization decision. Selected abortion clinics offer the service. Only the MOH-DF in Mexico City is legally obligated to provide abortion services, not the federal MOH or other state-funded institutions. Thus, if clients regularly use these facilities and want a public sector legal abortion, they must visit MOH-DF facilities.
More than 7000 women were treated for legal abortions under the MOH-DF program in its first year. A total of 89 510 abortions have been performed as of October 31, 2012. In contrast, there were only 62 legal abortions performed in Mexico City between 2001 and 2007. The majority of women who have obtained the services are adults between 18 and 29 Only 5.5% of the clients have been under the age of 18. Over half are married or in civil unions, and two thirds already have children. Eighty-two percent are Catholic.
DEVELOPMENTS AT STATE LEVELS SINCE DECRIMINALIZATION
Pro-choice activists and other progressives had hoped the Supreme Court ruling would lead to the passage of similar progressive abortion legislation in other states of Mexico, but this hasn’t happened and abortion remains highly restricted in every state. In all 31 states, abortion is legal only when a woman has been raped. A woman can obtain an abortion if her life is at risk in 27 states, if she has severe malformations of the fetus in 13 states, and if her health is at risk in 12 states, in addition to a few other minor legal provisions. Yucatan is another state in which abortion is permitted for economic reasons.
Additionally, there has been a conservative backlash in more than half of Mexico’s states following the passage of constitutional amendments recognizing a “right to life” that begins at conception. Following the abortion law reform in Mexico City, these amendments were passed in rapid succession. Researchers in 2008 found that only 23% of surveyed adults knew about their state’s reforms or initiatives, in eight states where amendments had recently passed or were being considered.