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1 ETHICAL AND LEGAL ISSUES IN REPRODUCTIVE HEALTH

2 The evolution of Mexico City's abortion laws: From public morality to

3 women's autonomy

4 Alejandro Madrazo

5 Centro de Investigacin y Docencia Econmicas (CIDE), Mexico City, Mexico

6

7

a b s t r a c ta r t i c l e i n f o

8910

11 Keywords:

12 Abortion regulation

13 Decriminalization of abortion

14 Law reform

15 Public health policy

16 Public morality

17 Women's autonomy

18 Women's health

19Before 2000, Mexico City's criminal laws prohibited induced abortion to maintain public morality. The

20Criminal Code considered abortion by accident or in cases of rape not criminal, and criminal but excusable

21and therefore not punishablein certain cases not endangering public morality, such as medical necessity to

22save the woman's life. In 2000, the Criminal Code was reformed expanding exceptions from criminal liability,

23particularly in cases of danger to a woman's health or where fetal survival was at risk. In 2004, Mexico City

24enacted its own law, effectively decriminalizing consensual abortion in cases of rape, fetal malformation, and

25risk to the woman's health. A 2007 reform further decriminalized all consensual abortion within the

26rst 12 weeks of pregnancy, and required public hospitals to provide abortion and family planning services.

27In August 2008, the Supreme Court of Mexico ruled Mexico City's 2007 liberalization of abortion law

28constitutional.

29 2009 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.

3031

32

33

34 1. Introduction

35 Over the last few years, the transformation of abortion laws in

36 Mexico City has been profound. Until recently, Mexico City had the

37 most restrictive abortion legislation of all Mexican states, permitting

38 abortion onlyin cases of rape and when the woman's life or the fetus's

39 life were at risk. The law was expressed in the rhetoric of honor and

40 public morality. In contrast, legal reforms were enacted in 2007 by

41 Mexico City's Legislative Assembly, allowing for abortion on request

42 during therst 12 weeks of pregnancy, and mandating that the health

43 service be provided free of charge in public city hospitals. The new

44 regulation of abortion was explicitly intertwined with the language of

45 sexual and reproductive rights, education, equality, dignity, and auto-

46 nomy. In the late summer of 2008, Mexico's Supreme Court conrmed

47 the constitutionality of this new law.

48 Between these two extremes lies a string of legislative reforms

49 (2000, 2004, and 2007) and two constitutional challenges before the

50 Supreme Court (20002002 and 20072008). There are probably few

51 examples of such Copernican shifts in abortion regulation through52 widely publicized democratic legislative channels. This article aims to

53 track the path of this change, eshing out the legal and conceptual

54 shifts that took place in this period.

55 This gradual change reects two different underpinning concep-

56 tions of the values that should guide abortion laws. These two

57 differentconceptionsare best captured by the2000 reformknown as

58 the Ley Robleswhich expands exceptions to a criminal law prohibi-

59 tion of induced abortion, increasing the number of socially accepted

60reasons why a woman should be allowed to terminate a pregnancy;

61and the 2007 reform, which openly decriminalizes abortion during

62the rst trimester. In the rst conception, the law came to be more

63

liberal, incorporating health

even mental distress

as acceptable64reasons for society not punishing abortions. In the second conception,

65it is no longer society that is to decide when the termination of a

66pregnancy is acceptable, but each individual woman deciding about

67her own pregnancy. These two conceptions are diametrically different

68yet, as we shall see, the former paved the way for the latter to provide

69the guiding notions for the law governing abortion.

702. Public morality and the woman's role as wife and mother

71Legislative change regarding abortion began soon after Mexico City

72acquired the authority to determine its own laws. Until the late 1990s,

73Mexico City was under direct control of the Federal Government in that

74the President appointed its Governor and the Federal Congress enacted

75its laws. The standing statute governing criminal law was the Federal

76Criminal Code (CPF, for its initials in Spanish), enacted by Congress in

771932. Its abortion clauses had remained unaltered since then.

78Before 2000, abortion was treated as a matter of public morality

79under the Federal Criminal Code. Under the CPF (which remains the

80statute applicable under federal jurisdiction) abortion is dened as

81the death of the product of conception at any moment during

82pregnancy [1]. The CPF establishes that the crime of abortion is not

83punishable when the result of imprudence (i.e. accident) or in cases

84of rape [2]. Furthermore, criminal sanctions are not to be applied

85when the woman or product risked death in the concurring opinion

86of two doctors (time permitting, otherwise one will sufce) [3]. The

87difference between these two exceptions is subtle but important. In

International Journal of Gynecology and Obstetrics xxx (2009) xxxxxx

CarreteraMxico-Toluca3655 Col.Lomasde Santa Fe,c.p. 01210, Mxico,D.F. Mexico.

E-mail address: [email protected].

IJG-06312; No of Pages 4

0020-7292/$ see front matter 2009 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.

doi:10.1016/j.ijgo.2009.05.004

Contents lists available at ScienceDirect

International Journal of Gynecology and Obstetrics

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Please cite this article as: Madrazo A, The evolution of Mexico City's abortion laws: From public morality to women's autonomy, Int J GynecolObstet (2009), doi:10.1016/j.ijgo.2009.05.004
mailto:[email protected]://dx.doi.org/10.1016/j.ijgo.2009.05.004http://www.sciencedirect.com/science/journal/00207292http://dx.doi.org/10.1016/j.ijgo.2009.05.004http://dx.doi.org/10.1016/j.ijgo.2009.05.004http://www.sciencedirect.com/science/journal/00207292http://dx.doi.org/10.1016/j.ijgo.2009.05.004mailto:[email protected]


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cases of imprudence or rape, when the abortion is not punishable, the

criminal character of abortion disappears. In contrast, in case of

medical necessity to save the woman's life, the act remains criminal,

but is considered excusable and thus not punished. The fact that rape

eliminates the criminal character of the conduct reveals the moral

orientation of the statute, for it reveals that the legislator is most

concerned with the woman's conduct leading up to pregnancy.

More revealing of the underpinning public morality is the language

of the Federal criminal law statute. Justice Fernando Franco pointed tothis fact at the SupremeCourt deliberations on August 27, 2008. TheCPF

establishesreduced punishment for the mother if threecircumstances

concur: (1) that she does not have a bad reputation; (2) that she kept

the pregnancyconcealed until the abortion; and (3) that the pregnancy

is the fruit of a legitimate union [4]. Speaking ofthe mother rather

than thewoman reveals assumptions the legislators made concerning

theproper role of a pregnant woman.Further, thecrime is deemedlesser

if circumstances occur that acknowledge the damage that abortion

causes to public moralitynot the fetusby the woman's discretion in

concealing the pregnancy and its termination, and the pregnancy

occurring within marriage.

3. From public morality to health: The Ley Robles

The rst in a chain of legislative reforms regarding abortion was

enacted in 2000. It consisted of the following changes to the CPF.

(1) It eliminated the alternative sanction that allowed diminished

punishments in case of concurrence of the woman's good

reputation, concealed pregnancy, and legitimate union. This

change was key in moving away from the public morality thrust

of the law, focusing instead on the well-being of the fetus. As will

become clearer in this section, this shift in the good protected by

the legislationfrom public morality to the fetus itselfis central

to the Ley Robles, and instrumental in the reform strategy that

was to be carried out in 2007.

(2) It made the crime of abortion punishable only if successfully

carried out, excluding failed attempts from punishment. This

change reects a shift from focusing on criminal intentto harmfulresult, again moving the legislation away from damage to moral-

ity and into the eld of damage to the fetus.

(3) It concentrated all exceptions to the ban on abortion under the

category ofsanctions not to be applied. This is consistent with

the shift in focus from the morality of the conduct (in which the

conduct leading to pregnancy is relevant in assessing the

sanction) to a uniform focus on result (in which conduct leading

to abortion is relevant, but not conduct leading to pregnancy).

(4) It incorporated several new exceptions to the ban on abortion,

namely:

(a) When a woman is articially inseminated without her

consent. The infrequency of such cases leads one to think

that, rather than dealing with a pressing social problem,

the reform aimed to signal that the woman's consent wasdeterminant in allowing for interruption of pregnancy. In

this, we can see the second crucial shift in the legislative

history of abortion in Mexico City: while still nascent, the

notion of women's autonomy is now visible.

(b) When there is a threat to the woman's health. This exception

replaced threat to the life of a woman or product of

conception, and was to be interpreted to include cases

when the woman's life was threatened. Importantly, this

eliminated the threat to fetal life as a relevant question,

emphasizing the woman's well-beingin her physical body,

not as a moral agentas the emerging concern of the law.

(c) When there are adverse genetic and congenital conditions

affecting the fetus which may result in physical or mental

damage, to the extent that they put the product of

151conception's survival at risk [5]. The inclusion of this

152exception is particularly important when coupled with the

153elimination of the risk to the life of the fetus exception.

154Taken together, these two moves indicate that it is the

155emotional distress of the woman in cases such as anence-

156phaly that concerned the legislator, not the risk to the fetus's

157life.

158(5) Importantly, it replaced the term mother by theterm woman,

159signaling a distancing from the previous assumptions about the160expected roles of women. This is the only conceptual change

161thatwas undertakenby theLeyRobles.It was, however, important

162in signaling future changes to come.

163(6) Finally, the Ley Robles included a new procedural regulation for

164authorizing abortions in cases of rape and involuntary insemina-

165tion, putting a time limit of 24 hours for authorities to consider

166authorization once the rape and pregnancy were demonstrated.

167What needs to be clearly understood aboutthe Ley Robles of 2000in

168contrast to the 2007 decriminalizationis that its logic remained within

169the concept that privileges socially accepted reasons for abortion over a

170woman's capacity to decide over her own pregnancy, that is, her auto-

171nomy. It includes aspects that raise the issue of a woman's autonomy

172most notably the inclusion of nonconsensual articial insemination as a

173case deserving special regulation, and also replacement of the word

174mother by womanyet it still advances the liberalization of abortion

175through socially acceptable exceptions to a general bancongenital

176malformations and risk to the health of themother. It was not until 2007,

177with full decriminalization, that a woman's capacity to decide becomes

178the premise underlying abortion law.

179The Ley Robles was challenged by a minority of conservative local

180congressmen before the Supreme Court of Mexico, on grounds that

181authorizing abortions in cases of genetic or congenital conditions of the

182fetus violated the fetal constitutional right to life. The Court ruled in

183 January of 2002 in favor of the constitutionality of the reform,

184recognizing the right to life of the fetus, but deeming that the reform

185does not authorize the taking of the life of the product of conception,

186but rather it merely contemplates the possibility that once the criminal

187act takes place no sanction be applied [6]. Because of the special type of188procedure under which the challenge was brought, the Court's holding

189wasnonbindingas precedent.However, it recognized a right to life of the

190fetus, and it implied thatthe constitutionality of the2000 reformlaw lay

191in maintaining the criminal natureof theoffense. In this sense,the Court

192seemedto rule in favor of liberalization because thelegislationremained

193within the concept that allows for abortions only when socially

194acceptable reasons, previously established in law, are satised, which

195is a far cry from allowing abortion on grounds of respect for women's

196autonomy.

1974. From no sanctions to no crime: The 2004 reform

198Six months after the Supreme Court's ruling, in Juneof 2002, Mexico

199City nally published its ownNew Criminal Codefor the Federal District200(NCPDF). The clauses regulating abortion remained fundamentally

201unaltered from the Ley Robles reform. One change worthy of notice,

202insignicant from a normative perspective at the time, but relevant in

203retrospect, was a slight alteration in the denition of the crime of

204abortion. The new code replaced the word preez with the word

205embarazo, both synonyms meaning pregnancy, but the former

206considerably outof usein the21stcentury[7]. Thenew code'sregulation

207of abortion was revised shortly thereafter, in December 2003, and was

208published in January 2004.

209Continuing down the path timidly laid out by the Ley Robles, the

2102004 reform advanced the notion that the woman's consent must be

211regarded as central in abortion legislation. It raised the punishment

212for abortion without the woman's consent, which had been for a term

213of 3

6 years' imprisonment, to a term of 5

8 years. Furthermore, it

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214 undertook a major shift in the legal character of permitted abortions.

215 Article 148 abandoned the language that stated that in some cases

216 sanctions were not to be applied and replaced this language by

217 stating that rape, congenital malformation of the fetus, risk to the

218 woman's health, and unwanted articial insemination were all to be

219 considered reasons to exclude criminal responsibility. This meant

220 that abortion under the specied circumstances was no longer consi-

221 dered excusable yet criminal conduct, but rather that the conduct lost

222

its criminal character altogether. This represented a gargantuan shift223 in the underlying assumptions of the regulation of abortion. Abortion

224 was effectively decriminalized for the rst time, if only in limited

225 socially sanctioned cases.

226 In decriminalization, this reform risked falling outside the scope of

227 the 2002 Supreme Court ruling, which justied nding the Ley Robles

228 constitutional because the criminal character of the conduct had

229 remained. However, the 2004 legal reform was not challenged in

230 court.In fact, it was approvedby allparties in theLegislative Assembly,

231 including the National Action Party, a staunch opponent of the

232 liberalization of abortion law and a historic ally of the Roman Catholic

233 Church, because it allowed for conscientious objection on the part of

234 the health service provider [8].

235 A sister reform added two articles to Mexico City's Health Law.

236 Article 16 bis 6 stated that public health institutions run by the city

237 government were under an obligation to perform abortions free of

238 charge, in cases permitted by the criminal law. It also mandated that

239 women be provided with information regarding their alternatives to

240 abortion and the possible consequences to health of abortion, again

241 strengthening the importance of the woman's capacity to decide.

242 Importantly, it set a time limit of 5 days after a petition was submitted

243 for performing legal abortions. Article 16 bis 7, on its part, established

244 a right to conscientious objection for health service providers, but

245 carved out an exception if the life or health of the woman is in danger.

246 Finally, if a health provider conscientiously objected to perform an

247 abortion, the provider had the obligation to refer the patient to a

248 doctor who did not object.

249 In short, the 2004 reform maintained the law within the rationale of

250 allowing abortion only in cases that are socially acceptable, but it

251 advanced the notion of a woman's autonomy by highlighting informa-252 tion. Importantlyalthough this cannot be heralded as the moment

253 when autonomy prevailedit reclassied the socially acceptable

254 exceptions as not criminal, and not merely excusable.

255 5. The 2007 reform: Decriminalization during the rst trimester

256 The Mexican Constitution does not allow for immediate re-election

257 of elected ofcials, so allmembers of legislative bodies arerenewedwith

258 each election. Accordingly, a new administration and a new legislature

259 came into power in Mexico City in late 2006. A new reform to abortion

260 laws was soon proposed, with full decriminalization of consensual

261 abortions during the rst trimester. The months that followed this

262 proposal for reform of the law saw a heated debate in the media, with

263 surprisingly little public mobilization on the streets, despite energetic264 efforts on the part of both women's rights groups and the Catholic

265 Churchand its alliesto mobilize their bases of support. In April 2007, the

266 reform was approved by an overwhelming majority of the Legislative

267 Assembly. Opposition to the reform was incapable of gathering the

268 legislative support required to challenge the reform before the Supreme

269 Court. The specic type of constitutional procedure for a direct con-

270 stitutional challenge before the Supreme Court required the support of

271 at least 33% of the legislative body to grant them standing, but this

272 volume of opposition to the law was not present.

273 The2007 reform represents a shift in conceptions that underliethe

274 liberalization of abortion law. Instead of widening the socially accep-

275 table exceptions to the prohibition of induced abortionone option

276 proposed by women's groups was to include the earnest pursuit of a

277 woman's life plan as a cause for the exclusion of criminal responsi-

278bility for an abortionthe Legislative Assembly redened the crime of

279abortion itself. Abortion is now dened as the interruption of a

280pregnancy after the 12th week. This leaves untouched the bases of

281exclusion of criminal responsibility for abortion beyond the 12th

282week, while eliminating the crime of abortion from the books before

283the 12th week of pregnancy. Within the rst trimester, it is now for a

284woman to decide freely on her continuation of pregnancy, indepen-

285dently of what is deemed socially acceptable.

286

Furthermore, the reform de

ned pregnancy as the process of287human reproduction starting with implantation of the embryo in the

288wall of the uterus, making emergency contraception fall outside the

289denition of both pregnancy and abortion. A parallel crime was

290inserted of forced abortion, which was dened as the interruption of a

291pregnancy without the woman's consent at any moment during the

292pregnancy, with increased penalties in cases of physical or psycho-

293logical violence. This last inclusion underlined yet again the woman's

294consent as the centerpiece of the emerging regime on abortion.

295In addition to the redenition of the crime of abortion, the

296sanctions applied to women for post-12th week abortions were sub-

297stantially reduced, allowing for an alternative between a short prison

298term of 36 months or a ne of US $400 to US $600 (still a signicant

299amount, considering the daily minimum wage is set at about US $4.00).

300A sister reform, made to the Health Law of Mexico City, explicitly

301claries that all women are entitled to free legal abortions in city

302hospitals, even if they are covered by private or other public healthcare

303systems. The clause is largely redundant, but seems designed as a

304guarantee against restrictive interpretations on the part of the admi-

305nistration, that could conceivably contrivenancial barriers to frustrate

306a woman's access to safe and timely abortion. More importantly, it

307provides a clear message, thatnot only is a woman to be allowed to make

308her decision, butshe must also be provided with the means to make her

309decision effective.

310To round off the new law governing abortion, a new article, 16 bis 8,

311was inserted into the Health Law, to explicitly mandate that sexual and

312reproductivehealthbe a priority of public health policies in Mexico City,

313specically invoking the constitutional right of all persons to decide the

314number and spacing of their children freely, responsibly, and in an

315informed manner. Article 4 of the Mexican Constitution states that all316persons have the constitutional rightto decidein a free, responsibleand

317informed manner the number and spacing of their children.

318Article 16 bis8 further lays outthe guidelines forthese policies,which

319merit extensive citation. The article calls for permanent, intensive and

320integral education and training campaigns promoting sexual health,

321reproductive rights, and responsible maternity and paternity, family

322planning, and contraception services aimed at reducing the number of

323abortions through the prevention of unplanned and unwanted preg-

324nancies, reducing reproductive risk,avoidingthe propagation of sexually

325transmitted diseases, and helping in the full exercise of sexual rights

326taking into account a gender perspective, and respect for sexual diversity

327in accordancewith the characteristics of the multiple populationgroups,

328especially girls and boys, adolescents and youths. TheArticle charges the

329city government with providing medical and social counseling regard-330ing sexual and reproductive health, permanently providing free services

331which include information, spreading awareness and orientation on the

332subject, as well as theprovision of allcontraceptivemethods of whichthe

333efcacy and security have been scientically proven [9].

334The 2007 reform puts the law governing abortion in Mexico City

335squarely on the side of privileging women's autonomy, shifting the

336focus from criminal repression of choice toward preventive services,

337education, and respect for women's self-determination and funda-

338mental rights. Within a month of enactment, however, the reforms

339were challenged by the President of Mexico's National Human Rights

340Commission (CNDH) and the Attorney General of the Federal

341Government. The President of the CNDH, a collegiate body, acted on

342his own authority, and half the members of the CNDH opposed the

343claim of unconstitutionality when appearing before the Supreme

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OFCourt. The current federal administration is headed by the NationalAction Party, which has historic ties to the Catholic Church.

The challenge was brought on several allegations of unconstitution-

ality, notably that the legal reforms violated the fetus's fundamental

right to life. The Supreme Court ruled in August of 2008 in favor of the

reforms being constitutional, nding that there were no constitutional

grounds to claim that a fetus has a right to life, and, more importantly,

that there was no constitutional obligation binding the legislature to

protect the fetus specically through criminal law. Furthermore, in its

incidental commentary, the Court found that the measure taken by the

legislature, to decriminalize abortion during the rst 12 weeks, was

ideal for safekeepingwomen's rightsthe objective explicitlypursued

by the legislature such as their freedom over their body, their physical

and mental health, and their lives, and that, even if the protection of the

fetus was pursued, criminalization did not ensure the proper develop-

ment of gestation given the social context, and that it did, in fact,

perpetuate discrimination against women [10].

6. The result: From public morality to personal autonomy

Eight years of gradual and continuouslegislative reform have moved

abortion laws in Mexico City far away from where they stood at the

opening of the 21st century. Consistent patterns emerging from this

trajectory include the gradual and constant exclusion of public morality

from the language and thrust of thelaw; theemergence of the woman's

consent as a determinant factorto be taken into account by the law; and,

equally important, having sexual and reproductive health and rights be

the center of the law regulating abortion, both criminal and adminis-

trative. The result, and the transcending signicance of the example of

Mexico City's new law, is not only decriminalization of abortion during

therst trimester, but also robust legislationenhancing family planning,

respect for sexual and reproductive rights and, importantly, prevention

of unwanted pregnancies.

A major achievement, of great relevance to the international public

health community, is the widely accessible program of abortion onrequest implemented by Mexico City's Ministry of Health. Table 1

provides some of the most salient numbers the Ministry of Health has

made public, but the experience of Mexico City should be recorded in

detail so that it can provide accumulated data for epidemiologists,

health policy makers and, in general, the public health community

around the globe. Few, if any, experiences in safe, accessible abortion

have been undertaken that can compare with that of Mexico City in

volumeand impactin a diverse, politically pluralsociety. Thedaunting

task of reorienting a health system, and mobilizing so many human,

material, and economic resources so quickly, has met with seemingly

surprising success and should be studied attentively.

388A word should also be said about the political context that allowed

389this shift to happen, especially in a dominantly Roman Catholic

390country. First of all, the existence of an active, well-informed, and

391inuential critical mass of women's rights activists both ignited and

392guided the legislative transformation [11]. Second, when looking at

393patterns, the timing of reforms was consistently strategic. The 2000

394Ley Robles and the 2004 and 2007 reforms were undertaken soon

395after elections, in a less tense political atmosphere, and with enough

396

time before the next election for Catholic voters to forgive or forget. A397successful strategy was to position reforms at moments when politics

398were not dominated by potential presidential candidacies. The two

399most important reforms (in 2000 and the 2007 reform) were pushed

400through at times when the Mexico City Governor's potential

401presidential candidacy was not a central concern of legislators from

402his party. The third and last signicant circumstance was specic to

403the 2007 reform, the most radical in the sequence of reforms, namely

404theexistence,priorto andbeyond the abortion reforms,of a broad and

405stable more left-wing and liberal legislative coalition led by the

406majority party, which allowed for the marginalization of the right-

407wing party's position.

4087. Antiabortion backlash

409A note of cautionshouldbe soundedsincebacklashhas been quick to

410appear after the Supreme Court's August 2008 ruling. Several identical

411initiatives have been introduced in state congresses to reform local

412constitutions, ensuring that the right to life be protected from con-

413ception. Within less than a year of the decisionto March 2009four

414states have approved their constitutional amendments (Sonora, Baja

415California, Morelos, and Puebla). At least 7 others are in the process of

416being discussed. A similar amendment to the federal Constitution has

417already been introduced at the federal Congress. In January 2009,

418Mexico's President, Felipe Caldern, inaugurated a world forum in

419Mexico City, organizedby theCatholic Church,in defense offamily and

420life, the President acting in deance of Mexico's tradition of strictly

421secular government. Abortion has already reached the Supreme Court

422yet again. The local human rights defense organ challenged the Baja

423California amendment on claims that it affects the (federal) constitu-424tional rights of women. This year, two Supreme Court seats are eligible

425for renewal. So it seems thatMexico City's decriminalization of abortion

426is the beginning, not the end, of abortion politics in Mexico.

427The struggle between public morality and private autonomy may

428have only just begun.

429References

430[1] Cdigo Penal Federal, art. 329.431[2] Cdigo Penal Federal, art. 333.432[3] Cdigo Penal Federal, art. 334.433[4] Cdigo Penal Federal, art. 332.434[5] Article 334, Gaceta Ocial del Distrito Federal, Decreto por el que se reforman y435adicionandiversas disposiciones delCdigoPenalparael DistritoFederaly delCdigo436de Procedimientos Penales para el Distrito Federal, 24 de agosto de 2000: 1-2.

437[6] Diputados integrantes de la Asamblea Legislativa del Distrito Federal, Accin de438inconstitucionalidad 10/2000 (Suprema Corte de Justicia de la Nacin).439[7] Article 144, Gaceta Ocial del Distrito Federal, Decreto de Nuevo Cdigo Penal440para el Distrito Federal, 16 de Julio de 2002: 2-74.441[8] Marta Lamas La larga marcha hacia la despenalizacin del aborto en la Ciudad de442Mxico, ed. Eugenia Huerta, Conguraciones (Fundacin Pereyra), no. 26 (enero-443marzo 2008): 46-59.444[9] Gaceta Ocial del Distrito Federal, Decreto por el que se reforma el Cdigo Penal445para el Distrito Federal y se adiciona la Ley de salud para el Distrito Federal, 26 de446abril de 2007: 2-3.447[10] Opinion of the Court in Accin de inconstitucionalidad 146/2007 y su acumulada448147/2007.449[11] Lamas M. La larga marcha hacia la despenalizacin del aborto en la Ciudad de450Mxico, ed. Eugenia Huerta, Conguraciones (Fundacin Pereyra), no. 26 (enero-451marzo 2008): 46-59.452

Table 1

Abortion on request in Mexico City: Numbers after decriminalization. a

Applications for information regarding abortion: 36 709

Abortions requested in Mexico City public hospitals: 24 473

Abortions practiced in Mexico City public hospitals: 18 620

Number of city hospitals offering the service of legal abortion: 11

Procedures used:Misoprostol, manual vacuum aspiration,and/or dilatation and curettage

Number of doctors that practice abortions in public city hospitals: 21

Assistant personnel per hospital: 3 on average (2 nurses and 1 social worker)

Age range of patients: 1346 years

Casualties stemming from the procedure: 1 death due to performance of procedure

outside of protocol to a patient 16 weeks into her pregnancy.

Complications other than casualties: none

a Data were obtained using Mexico City's access to public information system and

reects data from the coming into force of the 2007 reform (April 27, 2007) up until

January 22, 2009.

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