Defending the Sexual and Reproductive Health and Rights of Women in Panama

Quote by Dr Ruth de Leon

In Panama, the fundamental and basic rights of women and girls – such as education, work and political participation – continue to be violated. These violations extend to rights in sexual and reproductive health, which should allow women and girls to access services such as prenatal control, contraception and, in specific cases and as permitted by Panamanian law, safe and legal abortion services. The scale of violence against women, adolescent pregnancy and maternal mortality in Panama undoubtedly reflects the existence of a public health problem, which has been exacerbated dramatically by the COVID-19 pandemic.

According to gynecologist and obstetrician Ruth De León, former president of the Panamanian Society of Obstetrics and Gynecology (SPOG) and Focal Point of the Advocating for Safe Abortion Project (ASAP), SPOG remains concerned about the potential risks that the pandemic poses to women. Although care services are open, restrictions could continue to be a trigger for gender-based, domestic and sexual violence, which can cause unplanned pregnancies, as well as possible induced abortions. These, when performed in unsafe environments, could result in the death of the woman or girl.

"As a medical-scientific grouping, SPOG focuses its efforts primarily on the prevention of morbidity and maternal mortality – a situation that may be influenced precisely by the adequate or limited access to these sexual and reproductive rights," says De León.

Protecting SRHR during COVID-19

Deaths from complications associated with pregnancy continue to be one of the most dramatic indicators of health inequity. In Panama, this overwhelmingly affects the poorest women in the country, for whom being mothers is often a life risk.

De León points out that during the COVID-19 pandemic in Panama, sexual and reproductive rights were not directly limited by the authorities, but the measures imposed by authorities to reduce contagion had an indirect impact. Gender mobility, total quarantine, transfers of control and consultation services to other public institutions or facilities, temporary closure of private care services, supply chain impacts and fear of contagion all impacted women and girls’ access to prenatal control and contraception services in Panama.

"The pandemic should not affect the sexual and reproductive health and rights of Panamanian women and girls. Therefore, we must do everything we can to provide them with the information necessary to enforce those rights, as well as the care they need or want, when they need it, without distinction," she emphasises.

SPOG promotes and urges women to use long-lasting contraception for better family planning, which at the moment represents a good option, given the pandemic and its impact. It further ensures that every teenage girl or grand multiparous woman (a woman who has had more than five births) who has had an abortion is discharged from health facilities with a long-lasting contraceptive method, provided she has given her informed consent; in order to prevent any pregnancy-related complications that may be life-threatening. SPOG also conducts communications and teaching activities on contraception (including emergency) and access to safe abortion, which include actions that can be taken to reduce preventable maternal mortality and disability.

De Leon states that,

"Ensuring the comprehensive sexual and reproductive health and rights of women and girls means prioritising measures that ensure access and improve the quality of care, uphold access to sexual and reproductive health services for adolescents, and reduce the serious impact of unsafe abortion. These measures also aim to ensure that preventable maternal mortality and disability is treated as an issue of public health and social justice, until it is eradicated."

Building alliances to challenge and fight 

"The violation of the human rights of women and girls in Panama is evident and occurs by omission, both because of lack of knowledge and lack of compliance with institutional and state policies, as well as prejudice and stigma. Perhaps the most serious issue is the state’s own indifference in their duty to ensure and guarantee these rights," says De León.

Through official statements, SPOG has sought collaborative advocacy and intervention with the health care professions and has urged authorities to take steps to reduce such violations. Likewise, SPOG remains alert to the adoption of laws that revictimise the victims and survivors of rape, or violate other fundamental rights of these women and girls.

For SPOG, fighting to curb violence against women is everyone's responsibility. Under this premise and through the ASAP project, SPOG has formed a solid and collaborative network of communication and teaching, which brings forward information aimed at raising awareness about violence against women and its impact on society, as well as ensuring the claim and defence of the sexual and reproductive health and rights of women and girls in Panama. This partnership includes media, such as Nex TV and the printed supplement Revista Ellas, medical societies, and other non-governmental organisations.

In a collaborative alliance with La Asociación Panameña para el Planeamiento de la Familia (APLAFA) since November 2020 and under the hashtag #JuevesdeDerechosSexuales, SPOG holds monthly teaching days suitable for college and university students, as well as for other health care professionals working with victims of violence or with those seeking guidance in sexual and reproductive health.

SPOG has also created an integral care protocol for female victims of violence, for which SPOG works with government institutions such as the Ministry of Health, the National Institute of Women and the Ministry of Social Development. SPOG was also instrumental in ensuring the inclusion of the proposal "Review and Modification of the Theoretical Framework of Sexual Education in Schools" in the platform for citizen participation AGORA.

Continuing to advocate for safe abortion in Panama

In April 2019 , SPOG launched ASAP, with the support of FIGO, the Ministry of Health and the Social Security Fund. Through their work within ASAP, SPOG seeks to publicise the risks of unsafe abortion, as well as the circumstances allowing access to legal abortion services in Panama, and consequently the paths to safe abortion.

Abortion in Panama is restrictive and is only permitted under certain grounds. The Criminal Code of the Republic of Panama under articles 141 to 143, sets a penalty of up to eight years in prison. However, there are limited situations in which it is not considered a crime – following rape (up to 8 weeks of pregnancy), or if a pregnancy may cause serious health risks for the mother or fetus.

"Even during the pandemic, we will continue to emphasise comprehensive health for women and girls, promoting in this context the full validity of sexual and reproductive rights as human rights – pushing for the body to be seen as a territory of autonomy and freedom of choice."

– Dr Ruth De León.