Illegal Abortion in the Wake of Democracy: Abortion Referral and Provisioning in Highland Bolivia, 1982–2010

In a 1994 study on pregnancy and abortion among Bolivian market workers, one indigenous woman reported that, in desperation at becoming pregnant again, she had fallen out of the back of a truck in order to induce a miscarriage. Abortion in Bolivia is illegal in most circumstances, and although an estimated 115 illegal abortions occur in the country each day, this fact has sparked few serious efforts to curb the practice—as of 2004, only two cases concerning the procedure ever made it to trial.    

Based on personal medical records and interview data, this paper traces a broad history of illegal abortion in the highland cities of La Paz and El Alto between 1982 and 2010. In it, I argue that women’s consistent demand for abortion coalesced with broader sociopolitical and legal processes following the 1982 return to democracy to spur the development of a remarkably stable network of illegal abortion providers in the region.  Chief among the processes contributing to the development of the network are the lack of availability of legal abortion, growing national and international concern over high rates of maternal death due to illegal abortion, and increasing public support for women’s rights in general. While the existence of this network, I argue, has contributed to the reduction of maternal mortality rates due to botched abortion, it has also, ironically, slowed efforts to legalize the procedure.  The stakes of abortion’s illegality for women, in turn, remain high, and include social stigma, medical complications, and in some instances, death.  In exploring the interactions between policies on, debates about, and the lived experience of unwanted pregnancy and abortion, this chapter reveals how concerns with fertility and reproduction engage with broader ideas about women’s roles in society across different historical periods.