RIO DE JANEIRO, Brazil — From the outside, the white, two-story building set back from a quiet, middle-class street doesnt attract much attention. No sign advertises its purpose. The large, tinted windows out front give no clues.
Yet for more than three decades, hundreds of women have come here and paid as much as $1,600 each to get abortions, even though the practice is illegal in Brazil in nearly every circumstance.
Latin America has the highest abortion rate in the world, according to a recent study by the World Health Organization and the U.S.-based Guttmacher Institute research group. That's despite the fact that most Latin American countries ban abortions except when a womans life is at risk or after a rape, and some ban it under any circumstance.
Nevertheless, in 2003, 31 out of every 1,000 Latin American women had abortions, the study found. Africa and Asia ranked second at 29 abortions per 1,000 women. North Americas rate was 21 per 1,000 women.
The locations of supposedly clandestine abortion clinics are common knowledge.
Theres really no secret about what happens at these places, said a 39-year-old Rio de Janeiro woman who's had two abortions. She asked not to be identified for fear of prosecution. Even the police know where they are, but they dont want to crack down.
Its a long-standing contradiction in this heavily Roman Catholic region where religious and social values clash with reality, said Gleyde Selma da Hora, a Rio de Janeiro state womens rights coordinator who supports legalizing abortion during the first trimester of a pregnancy.
She said that middle-class women often pay thousands of dollars for abortions at professional clinics, while poor women resort to dangerous home remedies such as inserting pills that provoke hemorrhages and other foreign objects into their uteruses.
An estimated 2,000 Brazilian women die every year due to complications from illegal abortions.
Easing abortion laws, however, remains taboo in Latin America, and proposals to do so have drawn prompt condemnation across the political spectrum.
Earlier this year, Brazilian President Luiz Inacio Lula da Silva and his health minister stirred controversy by calling abortion a public health issue and inviting more public discussion about it.
Catholic leaders quickly rebuked the government.
In Chile, President Michelle Bachelet drew harsh criticism for permitting the free distribution of emergency contraception, the so-called morning-after pill, to girls as young as 14 without requiring that their parents be notified.
Chilean abortion opponent Elizabeth Bunster said she fears more changes are on the horizon and blamed international pressure to loosen restrictions. She leads a Catholic group that counsels pregnant women not to get abortions.
Its not just the policy of our government thats the problem, Bunster said. Lamentably, the world doesnt recognize the child in gestation as another human being. And many women are confusing their liberation and rights with the rights of their babies to live.
Despite such opposition, some Latin countries are gradually loosening restrictions.
Last year, legislators in Mexico City legalized abortion through the first 12 weeks of pregnancy, while Colombias Supreme Court permitted a few exceptions to the countrys abortion ban.
Nicaraguan legislators, on the other hand, removed the few exceptions their countrys abortion ban allowed. Chile and El Salvador also dont permit abortions in any cases.
Only three nations — Cuba, Puerto Rico and Guyana — permit abortions under any circumstances during the first trimester.
While Latin Americans must deal with conflicting messages on the abortion issue, they dont seem to be demanding major reforms. About two-thirds of Brazilians, for example, think the countrys abortion laws should be left alone, according to a poll by the research firm Datafolha.
Abortion is so common that people dont even think about the laws anymore, said Brazilian legislator Marina Maggessi, who supports loosening abortion laws. Women are getting abortions despite what the law says.