One of the walls in Alba Nely Peña’s front room is adorned with graduation photos of her children. She gave birth to three boys and three girls, but only five smiling faces are on display in her house on the outskirts of Santo Domingo, the capital of the Dominican Republic.
“My youngest one died. I took her photo down because I can’t bear the pain,” she says, before going into a back room and digging out a framed collage of photos of her daughter. On it are written the words: “We will always remember you, Rossa.”
Rossa Nelly Aquino died in June 2013, aged 20, a couple of days after getting an abortion in an illegal clinic not far from where she lived with her mother. She kept the procedure a secret from her family and only revealed what had happened to her sister, Heidy Valoy, moments before she died.
“What my sister did in that clandestine clinic was to leave us, her family, with a laceration for the rest of our lives. Our family is incomplete,” says Valoy. “I want the medical community to pay more attention to these clinics and to dismantle them.”
Abortion in the Dominican Republic is illegal in all circumstances, including rape and incest. Abortions are not allowed to save a woman’s life or when the foetus can’t survive outside the womb. The law has been in effect since 1884. Women face up to two years in prison for having an abortion, while the penalties for doctors or midwives range from five to 20 years.
Despite the law, there is a thriving and profitable business in providing abortions. In towns across the country, there is usually at least one clandestine clinic known to offer abortions in secret. These clinics are often disguised as medical centres offering ultrasounds, for example. Others have no signage at all, like the one sandwiched between an ice-cream shop and a sports centre, and painted in bright colours with flower murals on the walls, in a town in the middle of the Caribbean country.
Women are usually charged from 5,000 (£67.81) to 13,000 (£175.75) Dominican pesos, a significant amount for much of the population. Abortions are offered immediately after a woman requests one, with few questions asked, according to women’s rights campaigners. The procedure is often carried out in unsanitary conditions.
Faby Espinal, a member of Aquelarre RD, a grassroots feminist collective in the city of Bonao, says: “[Abortion] is a blatant and total business. There is a double standard and a hidden market that capitalises on women’s ovaries and extracts money from them.”
Although women have had successful abortions at these clinics, there have also been horror stories, like that of Rossa Nelly. On the morning of her death, she complained of stomach pains to her mother, before seeking medical attention from the man who had performed her abortion two days earlier. Her sister went to visit her and remembers the clinic was “not clean” and “an unsuitable place for this type of practice”. By the time Valoy found out what had really happened, it was too late to save her sister’s life.
In 2020, the body of a 24-year-old woman who had two children was found in a bin after she died in the middle of an abortion in a clandestine clinic. There are accounts of women who go to these clinics and endure immense pain while undergoing surgical procedures without anaesthetic, as well as those who suffer serious health complications.
Women’s rights campaigners argue that the country’s total abortion ban forces people to resort to unsafe methods that threaten their health and lives. They say the law is incompatible with the country’s international human rights obligations. Evidence shows that restricting access does not reduce the number of abortions that take place and that women and girls from low-income and rural areas are disproportionately harmed.
The rate of maternal mortality in the Dominican Republic is 107 for every 100,000 live births, above that of the average for the Latin America region, which is 88 maternal deaths for every 100,000 live births. Abortion is the third leading cause of maternal death in the country, according to the International Planned Parenthood Federation. Figures from the Ministry of Public Health quoted in a 2018 Human Rights Watch report state there are an estimated 25,000 hospitalisations for abortion or miscarriage in the public health system each year, many involving a clandestine abortion.
In February last year, after 20 years of campaigning, a proposal to decriminalise abortion in three cases – when the pregnancy is the result of rape or incest, if the woman’s life is at risk, or when the foetus becomes incompatible with life – was not passed. In the same week, 16-year-old Esmeralda Richiez bled to death in her bathroom after her maths teacher, with whom she became pregnant, allegedly gave her abortion pills.
Esther Giron, co-founder of Aquelarre and a member of the UN Girl’s Education Initiative feminist network, believes that “deeply religious beliefs”, the far right and a growing and powerful evangelical movement that originated in the US are “guiding society” in the country.
She, and her colleague Espinal, advocate for abortion to be legal in all cases, but say other changes need to happen, including improving the public health system. Many of the women they come across understand abortion is prohibited but know nothing about what the law says or efforts to get it changed.
Methods used to terminate pregnancies vary. “Abortion in this country is a matter of privilege,” says Giron. “If you have a better economic status, you leave the country or go to a private, good clinic.”
Otherwise, women buy pills known to bring about abortions from pharmacies, insert sharp objects up their vagina, throw themselves down the stairs, drink a herbal concoction or visit a clandestine clinic.
Faced with deeply rooted sexism, high rates of violence against women, poverty and teenage pregnancy, a lack of sex education, which means adolescent girls don’t know how their menstrual cycle works, and a prohibitive law, demand for unsafe abortions will continue.
A decade after Rossa Nelly’s death, Valoy and her mother still don’t understand what led her to seek an abortion. As she lay dying, Valoy remembers, the doctor left saying he wanted to get a drink. “He didn’t feel bad at all. It was like he was making fun of me as I came in and touched her face, calling her by her name,” she says.
He never returned and spent five years on the run. He was arrested near the border with Haiti and sentenced to 20 years in prison.
Valoy and her mother believe Rossa Nelly was wrong to seek an abortion and they don’t want the law to change. However, Valoy says: “Abortion is not going to stop because there are many methods available. Women seek them out thinking they are finding a solution to their problem.”
