When we think of the worst circumstances women and girls worldwide must endure, we sometimes go too far down the map. In reality, very close to home, millions of people of reproductive age are living through hell. The Dominican Republic, for example, is one of only four Latin American nations that criminalizes abortion without exception.

To no one’s surprise, this coincides with the Dominican Republic being the only country with a Bible on its flag.

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In the Caribbean country, women face prison sentences of up to two years for having an abortion. For doctors or midwives who facilitate abortions, penalties range from five to 20 years.

And this is just the tip of the iceberg.

A woman holds a placard reading “Abortion is a Debt of Democracy” during a demonstration in support of the decriminalization of abortion in three circumstances, in front of the National Congress in Santo Domingo, on October 6, 2020. Credit: Getty Images.

The scenario is draconian in the Dominican Republic

Although President Luis Abinader promised in his presidential campaign there would be a change in women’s rights in the country, very little has changed.

The total abortion ban established in 1884 remains in place. According to Human Rights Watch, it “threatens the health and lives of pregnant women.” Worse, it is incompatible with international human rights obligations assumed by the Dominican Republic.

In the Caribbean country, abortion is illegal even when the pregnancy poses a risk to life, is unviable, or is the product of rape or incest — also known as “the three circumstances.”

Although in a new legislative bill, the law speaks of “exonerations” for health care providers who facilitate abortion, according to health professionals, it changes absolutely nothing.

“This does not give the pregnant person the ability to make the decision whether to continue a pregnancy or not. It only gives power to medical personnel in an extreme situation, when death is imminent,” Natalia Mármol, part of the coordination of the Coalition for Life and Women’s Rights, told the newspaper “El País.”

However, abortion is not impossible, but it can have serious consequences

Even though there are many ancestral medicine alternatives to terminate pregnancies, the options for Dominican women are very few.

As explained by the “Los Angeles Times,” there are medical personnel in the cities who manage to provide medications such as misoprostol.

Likewise, there are networks of volunteers, according to well-known activist Sergia Galván.

And if it is a spontaneous abortion, the situation in public hospitals “is extremely delicate,” according to nurse Francisca Peguero of the Dominican Medical Association.

“We even see deaths of adolescents in the emergency room because the doctor is faced with a dilemma: if he pays attention to them, he can be penalized,” she added.

The nurse recounts stories of adolescents who “introduce things because it is penalized legally and by the parents.” 

In other cases, it is the parents themselves who denounce the girls, even if the pregnancy is the result of rape.

An alleged priest holds a sign during a pro-abortion demonstration in front of the National Congress in Santo Domingo. Credit: Getty Images.

Anti-abortion legislation backed by religious wings

Since the beginning of the 20th century, the Dominican Republic has been a deeply Catholic country. After the fall of the dictatorship of Rafael Trujillo, the fear of the emergence of a communist movement, as well as the many rural messianic figures (Liborio Mateo, Elupina Cordero, Juanita García Peraza), rooted the Faith in the Dominican collective unconscious, to the point of being inseparable from governmental affairs.

Undoubtedly, thinking about abortion rights, sex education, or LGBTQ+ rights is virtually impossible.

Although President Luis Abinader also promised to support educational measures around reproductive health, the Dominican state motto, “Dios, Patria, Libertad,” seems to weigh more heavily.

Add to this the fact that since 1954, the government has had a concordat with the Vatican, and the chances of a breakthrough on sexual education issues are virtually impossible.

Even if many people’s lives depend on it.

For Rosa Hernandez, in the Dominican Republic, “After God, there are the doctors.”

As she told the “Los Angeles Times,” her 16-year-old daughter Rosaura had leukemia and was pregnant. Doctors delayed her treatment so as not to affect the fetus, which was no more than a month pregnant. Within weeks, Rosaura died in August 2012.

“They destroyed my daughter,” Hernandez said during a recent meeting organized by the Women’s Equality Center. “They came to put her on the treatment when she no longer had life. One month of pregnancy was more important than her 16 years.”

Rosa Hernandez, who lost her daughter Rosaura Almonte in 2012 for being denied treatment for her leukemia due to being pregnant, poses at her house in Santo Domingo on March 16, 2021. Credit: Getty Images.

In the Dominican Republic, teenage pregnancy and child marriage figures are shocking

In the Caribbean country, for every 1,000 girls between the ages of 15 and 19, 42 will become mothers by 2023, according to the United Nations Population Fund.

As of 2019, the year UNICEF released its latest report on child marriage, more than one-third of Dominican women were married or in union before the age of 18, NBC News reported.

Although Dominican laws have banned child marriage since 2021, community leaders say such unions remain a common and normalized practice, as few people are aware of the law.

“In my 14-year-old granddaughter’s class, two of her younger friends are already married,” activist Marcia Gonzalez told “NBC News.” “Many mothers give the responsibility of their younger children to their older daughters so, instead of taking care of little boys, they run away with a husband.”

The Dominican Republic has one of the highest rates of maternal mortality, largely associated with clandestine abortions performed in unsafe conditions -the third cause of maternal death- and which mainly affects women living in poverty. Credit: Getty Images.

Activists keep fighting against all odds

According to the 2019 Americas Barometer, 61% of Dominicans agree with abortion when the mother’s health is at risk or when it is established that the fetus is unviable due to malformations.

However, as “El Pais” continued, the growing evangelical force in the country joined the Catholic one to lobby inside and outside the chambers.

“We women in this country don’t matter at all,” says Liliam Fondeur, a Dominican obstetrician-gynecologist. “It is clear that women who want to have an abortion will continue to do so, but without guarantees. These will continue to be reserved for those who have money. The women who die in the attempt do not matter to those who make the decisions; the poor ones do not matter to anyone”. 

The doctor stresses that it is also crucial to promote sex education, which is non-existent in all educational curricula. No child in the country hears about contraceptive methods, consent, or sexually transmitted diseases during their school years. 

Moreover, no contraceptives are sold in the country’s public pharmacies, where products are subsidized by the state and are more accessible.

For their part, organizations such as the National Confederation of Rural Women (CONAMUCA) have launched their own adolescent clubs. Each group meets for two hours a week and hosts up to 25 participants between the ages of 13 and 17.

As NBC News explained, the clubs bring together 1,600 girls in 60 communities. The issues they study vary from one region to another. But among the recurring ones are teenage pregnancy, early unions, and femicide.

“CONAMUCA was born to fight for land ownership, but the landscape has changed, and we have integrated new issues, such as food sovereignty, agrarian reform, and sexual and reproductive rights,” said Lidia Ferrer, one of its leaders.