Women have always used various methods to interrupt their pregnancies. There is a wide array of abortive methods, knowledge of which is handed down from generation to generation by women themselves, folk healers or traditional physicians and health professionals or by people close to those who abort, such as friends and relatives (McLaren, 1990; Guillaume, 2004). There is also a wide range of formal networks that provide information and undertake actions of dissemination and prevention concerning available methods (Sanseviero, 2003). The conditions for resorting to abortion and the methods proposed to women depend on the legal status of this practice in each country, conditions of access to health services available for performing legal abortions, and the formal or informal supply of abortions when they are prohibited by law. Moreover, women’s socio-economic status and levels of autonomy are crucial factors for these purposes.
In Latin America, there is a fairly broad spectrum of abortive methods, ranging from the traditional ones that pose the greatest risks, to the more modern methods that ensure greater safety, although this also depends on the sanitary conditions in which abortions are performed and the professional training of those that use these methods (Encuentro de Investigadores sobre el Aborto Inducido en América Latina y el Caribe, 1994). Abortive methods have evolved over time on the basis of technological and medical advances, although the availability of the fruits of these advances is closely linked to the legality or illegality of this act in a given place. Whereas in countries where abortion is legal, new and modern methods are introduced and used, in those where it remains illegal, women continue resorting to sometimes archaic methods, with serious health consequences. Even in countries where abortion is considered illegal, however, there is a “medicalized abortion market” that is either risk-free or entails less risk.
Even when abortion is considered legal, access to services for interrupting pregnancies is sometimes difficult for certain women to obtain (Billings et al., 2002), a fact that largely explains the persistence of clandestine abortions using risky methods. These difficulties in access have also been documented in Cuba in the case of adolescents (Azize Vargas, 1994). The above arguments illustrate that restrictions, whether material, moral, religious or legal, explain the practice of abortions with such varied methods, as well as the fact that they are performed on both the formal and the informal market.
Sometimes restrictions to access are the result of doctors’ reluctance to perform abortions, due to their personal convictions. At other times, doctors fail to respect doctor-patient confidentiality, which leads them to denounce women that are the victims of abortion complications, as happens in El Salvador (McNaughton et al., 2004).