Cuba’s Abortion Culture: A Consequence of the US Embargo
by Megan Bridges
The following article originally appeared in The Spectrum:
Pope John Paul II addressed 100,000 Cubans present during the first mass of his 1998 Cuban tour in Santa Clara, just east of Havana. He spoke against Cuba’s high abortion rate and its “anti-birth mentality,” which he attributed to a false sense of freedom and limited access to resources. His speech highlighted a serious abortion trend pervading Cuban society.
In 1996, there were 59.4 terminated pregnancies for every 100 births in Cuba and an average abortion rate of 2.3 abortions per woman. Nearly two decades later, abortion remains prevalent. According to official reports, 60.2 percent of all pregnancies are terminated. Furthermore, researchers at the University of Western Ontario found that most Havana residents know at least one woman within their immediate social network who has terminated a pregnancy, and nearly all have been aware of abortion since childhood.
Although the Cuban government does not officially encourage abortion, its normalcy is indicative of a larger abortion culture. Abortion culture is a term used to describe the nonchalant attitudes the general population and medical practitioners hold toward abortion. They view abortion as comparable to contraceptive use to avoid births. In Cuba, abortion is the primary means of fertility control, although intrauterine devices (IUDs) and oral contraceptives are widely used.
While abortion is commonplace in contemporary Cuba, this has not always been the case. The Social Defense Code of April 1936 restricted abortion to women who were victims of rape or experiencing health complications due to pregnancy. The law, however, was not heavily enforced and women in pre-revolutionary Cuba had access to affordable abortion procedures through private medical providers.
Following the Cuban Revolution in 1959, the government more stringently enforced its antiabortion law. Additionally, 3,000 physicians emigrated from the island. As a consequence, women found it increasingly difficult to access skilled doctors to perform the abortions they sought, so they began to rely on unskilled medical practitioners. This led to increased rates of abortion mortality.
The Cuban government reevaluated its interpretation of the Social Defense Code in 1964, resulting in greater access to abortions provided through the national health care system. Since 1965, women are eligible for abortions up to 10 weeks into gestation. Abortions can be performed after that period, but patients must seek approval by the director of a hospital or their obstetrician-gynecologist. As opposed to restricting abortion access, the government has elected to improve abortion safety.
Cuba’s liberal approach to abortion does not exist in a vacuum, but instead coincides with the US embargo against Cuba. In 1960, the United States imposed its first sanction against Cuba by suspending the importation of sugar cane from the Caribbean nation. This sanction was a reaction to Cuba’s public-ownership of foreign property and businesses. Just two years later, President John F. Kennedy interrupted all trade with Cuba, including the importation of medical supplies.
Cuba was hit hard, especially its population. Between 1959 and 1961, 75 percent of Cuba’s trade was with the United States. Therefore, Cuba lost a major trading partner and began to rely more heavily on the Soviet Union for financial support. Not only was the embargo deleterious to Cuba’s economy, but it also had damaging and long-lasting effects on citizens’ health.
For example, water became unsafe to drink because Cuba cannot import the parts needed to repair US-built water sanitation devices. Furthermore, PET/CT scanners are impossible to purchase because their manufacturers are unauthorized to trade with Cuba, and HIV/AIDS patients do not have access to new antiretroviral drugs due to the sanction on US-patented goods.
Pertinent to the discussion of the proliferation of abortion, the embargo caused a severe shortage of contraceptives because Cuba could no longer import them from its largest suppliers. Cuba responded by subsidizing female sterilization and manufacturing IUDs locally. The contraceptive devices, however, were often low quality and problematic. Therefore, women typically dislike IUDs because they associate the contraceptives with negative experiences. Unfortunately, the Cuban government delayed action to counter contraceptive shortages until the mid-1970s, further complicating matters.
Unlike the United States, contraceptive use in Cuba is not considered the responsibility of both sexes, but falls primarily on women. Therefore, condoms are unpopular and are frequently out-of-stock in pharmacies. Since condom use is not a likely alternative to IUDs, women turn to abortion procedures for fertility control since the public perceives abortion as low-risk, effective, and mundane.
Although the embargo against Cuba helped to fuel female reliance on abortion, an abortion culture continues today due to poverty, limited access to high-quality birth control, and widespread ignorance regarding the effectiveness of contraceptive methods. The Cuban government has responded to international criticism of the prevalence of abortion by emphasizing the role men play in family planning through sexual education programs beginning in preschool, as well as by utilizing interpersonal communication to encourage contraceptive use.