Reproductive rights in Chile: An analysis of abortion legislation in one of the world's most restrictive legal contexts

Chile is one of only four countries globally where induced abortion is not permitted by law for any reason. Recent momentum in several South American countries could inspire liberalization of abortion laws in Chile. In order to capitalize on this opportunity, understanding of factors influencing abortion legislation in Chile is crucial. I systematically reviewed peer-reviewed publications, popular literature, human rights statements, and grey literature identified through English- and Spanish-language searches and conversations with stakeholders during a month-long visit to Chile in 2013. The review revealed various factors, including the legacy of the Pinochet dictatorship that ended legality of therapeutic abortion, influence of the Catholic Church, constitutional rights afforded at conception, and lack of discussion of abortion in public and professional spheres. Maternal mortality from unsafe abortion is estimated at 1.2/100,000 live births though data are scarce given the illegality of the procedure. Discordance between law and practice exists: abortion is performed by doctors when the pregnancy threatens the pregnant woman's life, though protocols do not exist and doctors may fear punishment. Maternal deaths did not increase after therapeutic abortion was outlawed in 1989. Potential annual demand for therapeutic abortions in cases of life endangerment and fetal unviability is estimated at 300. Public opinion studies show majority support for legal abortion in cases of life/health endangerment, fetal unviability, and rape. United Nations human rights committees have called on Chile to modify its extreme abortion law. This analysis of available public health and socio-political information reveals various potential arguments for legal change.