Mexico’s Supreme Court greenlit abortion. Will doctors and nurses listen?

As soon as the nurse found out that she had an abortion at home, Fernanda García knew she was in danger. The nurse began yelling that she was a criminal, that what she had done was wrong, that she would be sent to jail.

“She told me that they were going to report me, that I was going to face charges,” said García, who went to the hospital last month after experiencing pain and bleeding. “I’ve never felt so scared in my life.”

When García tried to leave, she said the medical staff refused to return her belongings. She said that she snatched her things and ran out, but that she still shakes every time the doorbell rings, convinced the police are coming to arrest her. She says she has thought about killing herself many times since then.

Now, Mexico’s Supreme Court has ruled that abortion is not a crime, setting a national precedent that puts the country on the path to becoming the most populous nation in Latin America to allow the procedure. Thousands of people have faced criminal investigations in recent years for ending their pregnancies, and the court’s unanimous decision last week should enable them to get any charges dropped, legal experts said.

But cases like García’s show how out of sync the nation’s top judges are with the views of the conservative majority in Mexico, where polls indicate that most people don’t believe abortion should be legal.

As an emboldened women’s rights movement increasingly took to the streets in Mexico, the country edged toward broader access to abortion, with several states decriminalizing the procedure before the Supreme Court ruling. But as in Argentina, which legalized abortion last year only to have many doctors refuse to provide the procedure on moral grounds, those changes have created sharp divisions in a country with one of the world’s largest numbers of Catholics.

In fact, lawmakers in Mexico enshrined a doctor’s right to refuse to perform any procedure that goes against his or her personal beliefs in 2018 — a contentious issue that the Supreme Court is expected to take on this week that could ultimately determine how widely available abortion is in practice.

The court is considering whether to require that public hospitals have medical professionals on staff who are willing to perform abortions, or that patients must be transferred to facilities that do. The justices are also deciding whether to prohibit medical professionals from harassing or preaching to women who want abortions, a move that could fundamentally change the way doctors and nurses are allowed to treat people who seek to end their pregnancies.

“A lot of health and medical workers are trained on the issue of abortion with a very traditional perspective, even influenced by religious values,” said Roberto Castro, a health researcher at the National Autonomous University of Mexico. “When you ask if they would perform an abortion, we have many doctors saying they are conscientious objectors, because they will not kill a human being.”

Despite the Supreme Court ruling last week that having an abortion is not a crime, the procedure remains extremely difficult to obtain. Before abortion becomes legal across Mexico, the many state laws that outlaw it must first be challenged in court, unless local legislatures vote to change them on their own.

Even in the few parts of the country that have already made abortion legal, the backlash has been significant, with medical professionals at times refusing to perform the procedure. Doctors and medical researchers say they expect a similar reaction to the Supreme Court ruling, making its next big decision — on the right of doctors and nurses to refuse to perform the procedure — all the more important.

“The next challenge now is to take on that conscientious objection,” said Dr. Magali Rosas Rosales, deputy director of Tepetlixpa Hospital in Mexico state. “New generations of doctors are already more adapted to the change, but older doctors struggle a lot with their morals.”

Doctors and nurses in Mexico have long informed on women for having illegal abortions. Federal law requires them to report any crimes they’re aware of, so one of the most common ways women end up in the hands of the police is that they suffer complications from abortions at home, head to the hospital bleeding and are soon reported to the authorities.

Martha Patricia Méndez Manuel said that before a nurse turned her over to the authorities, she was told to repent for what she had done. Méndez said that she arrived at a hospital in Veracruz bleeding heavily after taking an abortion pill, but that the staff made her wait for hours before being seen by a specialist.

When she woke up from a procedure to remove the remaining fetal tissue, she said, a nurse brought her a bundle wrapped in a sheet.

“She told me, ‘Ask it for forgiveness, because you killed it,’” Méndez recounted. “I felt like the worst woman in the entire world.”

The same nurse wheeled her hospital bed into the maternity ward, she said, so she could watch mothers receive their newborns. “It was torture,” she said. Then, she said, the nurse drove her directly to the local prosecutor’s office so she could be prosecuted.

Méndez, a college student at the time, got a lawyer, but the ordeal continued, eliciting broad public attention and, often, anger. “Everyone pointed a finger at me,” she said.

She said she lost her friends, eventually dropped out of college and moved out of the state, far from her family. She spent years fighting the charges against her until prosecutors dropped the case in 2019, her lawyer said.

Experts say that medical education in Mexico generally does not include extensive training about how to provide safe abortions, which have long been legal in certain cases, like rape. Some universities “may be against abortion or decriminalization” altogether, said Amado Nieto Caraveo, a professor of medicine at the Autonomous University of San Luis Potosí.

As advocates have widened access to abortion across the country, their efforts have at times prompted a revolt among some doctors and nurses. When Mexico City legalized abortion in 2007, many health workers would not perform the procedure. In Oaxaca, which legalized abortion in 2019, a group of doctors fought, unsuccessfully, to get the law repealed.

The backlash has extended to state legislatures as well. Two of the nation’s most powerful political parties added clauses to the constitutions of 19 states that emphasized the government’s commitment to protecting life from the moment of conception.

The move didn’t add any new penalties for abortion, but it was a powerful tool to signal that anyone who failed to report abortions in those states “would be making a grave mistake,” said Martha Lamas, a feminist activist. “It had an impact in the minds of many people.”

In a separate pivotal ruling last week, the Supreme Court declared such clauses unconstitutional as well. By vowing to protect unborn life, “implicitly, what they’re doing is imposing limits on the human rights of other people, in this case of women,” said one of the justices, Luis María Aguilar.

García says she is still afraid, despite the court’s actions. She lives in Guanajuato, a stronghold of the conservative PAN party, where local politicians came out forcefully against the decision to decriminalize abortion.

More immediately, García lives with conservative relatives and fears they will kick her out.

Before she left the hospital, García said she was told to undress for an examination. Then a social worker came into the room and demanded her home address and other personal details so the hospital could report her to the authorities.

Since the emergency room visit, she says, she hasn’t been able to sleep through the night.

“It’s a daily anguish,” she said. “As soon as my dogs start barking, I start shaking, I start thinking it’s them, that it’s done, that I’m going to face the charges.”