Dr. celestino lajonchere and the provision of abortion services in early revolutionary Cuba

The paper examines Cuban experience in providing abortion services normalized within a national system of comprehensive health care. This experience is viewed through an appreciation of the life of an outstanding leader in this effort, Dr. Celestino Lajonchere. In 1959, Lajonchere was a popular physician among working people and progressive sectors of Havana, practicing at the Clínica Antonetti, one of Havana's most prestigious private clinics. La Clínica Antonetti was one of several private clinics offering services both on individual fee-for-service basis and via “mutualismo” (a popular Cuban form akin to U.S. pre-paid group practice). At the triumph of the 26th of July Movement in 1959, the new minister of health, Dr. Ramón Machado y Ventura, asked Dr. Lajonchere to head the nation's program of maternal health, charging him with the mission of extending to all Cuban women the high standard of care set by the Clínica Antonetti. One of Lajonchere's first initiatives was to study the distribution and causes of maternal mortality in Cuba, finding a large proportion of maternal mortality associated with improper abortion. Lajonchere responded to these findings by including abortion care in medical education and extending abortion services to most, if not all, general hospitals in the nation. Together with expanded prenatal care, rural birthing homes, improved neonatology, and post-natal sercices, the provision of normalized abortion services contributed to Cuba's much acclaimed achievement in reducing maternal mortality to one of the lowest in the world.