OMISSION AND INDIFFERENCE REPRODUCTIVE RIGHTS IN MEXICO ABORTION / CONTRACEPTION / MATERNAL MORTALITY / OBSTETRIC VIOLENCE / WORK AND FAMILY LIFE / ASSISTED REPRODUCTION OMISSION AND INDIFFERENCE REPRODUCTIVE RIGHTS IN MEXICO ABORTION / CONTRACEPTION / MATERNAL MORTALITY / OBSTETRIC VIOLENCE / WORK AND FAMILY LIFE / ASSISTED REPRODUCTION 5 / INTRODUCTION / Director / Regina Tamés Noriega Coordinators / Ximena Andión and Rebeca Ramos Research and Texts / Ximena Andión, Alma Luz Beltrán y Puga, Fernanda Díaz de León, Marisol Escudero, Isabel García, Mariana García, Rebeca Ramos, Brenda Rodríguez, Itzel Silva, Martín Vera, and the National Lawyers Network for Reproductive Choice (RADAR 4th). Editing / Sara Gómez Translation / Benton & Asociados, Sara Gómez, Celorio Morayta, Jennifer Paine, and Fionn Petch Design / María Carral ACKNOWLEDGMENTS Chapter Review / Lourdes Motta (Assisted Reproduction and Contraception) Raffaela Schiavon (Maternal Mortality) Support for Case Registry and Documentation / National Alliance for the Right to Decide; Network for Sexual and Reproductive Rights in Mexico (DDESER); Meritxell Calderón Vargas and Pysche Calderón Vargas of the Ibero-American Network for Human Rights; Abraham Cortez Bernal and Julieta Hernández of Yes, There are Women in Durango. Board of Directors / Lucero González, Marta Lamas, María Consuelo Mejía, Patricia Mercado and Sara Sefchovich Advisory Board / Gerardo Barroso, Luisa Cabal, Roy Campos, Karla Iberia Sánchez, Francisca Pou, María Luisa Sánchez Fuentes, Roberto Tapia, Rodolfo Vázquez, Ana Francisca Vega, Jenaro Villamil and José Woldenberg. GIRE’s work, including this report and related activities, are supported by various donors, including two anonymous donors; the Erik E. and Edith H. Bergstrom Foun- dation; the Embassy of the Netherlands in Mexico; the Ford Foundation, Office for Mexico and Central America; the John D. and Catherine T. MacArthur Foundation; the Sigrid Rausing Trust; and the Stewart R. Mott Foundation, among others. 6 / INTRODUCTION / TABLE OF CONTENTS 2.3.4 EMERGENCY CONTRACEPTION (HORMONAL POST-COITAL CONTRACEPTION), OFFICIAL MEXICAN NORM 046-SSA2-2005, INTRODUCTION 12 DOMESTIC AND SEXUAL VIOLENCE AND VIOLENCE AGAINST WOMEN 60 2.3.5 STATE REGULATION ON CONTRACEPTION 61 2.3.6 INFORMED CONSENT 62 1. SAFE AND LEGAL ABORTION 15 2.3.7 ACCESS FOR ADOLESCENTS 63 1.1 INTRODUCTION 16 1.2 SITUATION IN MEXICO 16 2.4 IMPLEMENTATION OF THE LEGAL AND POLICY FRAMEWORK 64 1.3 LEGAL AND POLICY FRAMEWORK 18 2.4.1 EMERGENCY CONTRACEPTION 64 A. States 68 1.3.1 FEDERAL PENAL CODE 18 2.4.2 INFORMED CONSENT 69 1.3.2 STATE PENAL CODES 18 2.4.3 ACCESS FOR ADOLESCENT 70 A. Map of Legal Indications 19 A. Federal and State Ministries of Health 70 B. Sanctions 21 1.3.3 REGULATION IN MEXICO CITY 23 1.3.4 PROCEDURES AND GUIDELINES FOR TERMINATION OF PREGNANCY RESULTING FROM RAPE 24 2.5 CONCLUSIONS 72 1.4 IMPLEMENTATION OF THE LEGAL FRAMEWORK 25 2.6 RECOMMENDATIONS 73 1.4.1 FEDERAL LEVEL 25 2.6.1 LAW AND POLICY 73 1.4.2 STATE LEVEL 26 2.6.2 IMPLEMENTATION OF LAW AND POLICY 73 A. Mexico City 26 2.6.3 GENERATION OF INFORMATION AND STATISTICAL DATA 73 B. Access to Abortion after Rape 28 B.1 EMBLEMATIC CASES 30 C. Access to Abortion for other Legal Indication 33 3. MATERNAL MORTALITY 76 D. Criminalization of Women for Illegal Abortion 34 3.1 INTRODUCTION 77 D.1 EMBLEMATIC CASES 37 E. Regulation Regarding Conscientious Objection 41 3.2 SITUATION IN MEXICO 78 F. Doctor-Patient Confidentiality vs. Obligation to Report 42 3.3 LEGAL AND POLICY FRAMEWORK 81 G. Impact of the Reforms that Protect Life from the Moment of Conception 44 3.3.1 GENERAL HEALTH LAW AND ITS REGULATIONS 81 1.5 CONCLUSIONS 45 3.3.2 OFFICIAL MEXICAN NORM 007-SSA2-1993, CARE OF WOMEN DURING PREGNANCY, DELIVERY AND THE POST-PARTUM PERIOD, AND OF NEWBORN CHILDREN 82 1.6 RECOMMENDATIONS 46 1.6.1 LAWS AND POLICY 46 1.6.2 IMPLEMENTATION OF LAW AND POLICY 46 3.4 IMPLEMENTATION OF THE LEGAL AND POLICY FRAMEWORK: ACCOUNTABILITY AND ACCESS TO JUSTICE 82 1.6.3 GENERATION OF INFORMATION AND STATISTICAL DATA 47 3.4.1 COMMITTEES FOR THE PREVENTION OF MATERNAL AND CHILD MORTALITY 83 3.4.2 ADMINISTRATIVE COMPLAINTS IN HEALTH INSTITUTIONS 84 3.4.3 ADMINISTRATIVE PROCESSES AGAINST PUBLIC OFFICIALS 84 CONTRACEPTION 55 3.4.4 PECUNIARY RESPONSIBILITY OF THE STATE 84 2. 3.4.5 PENAL PROCESSES AT THE STATE LEVEL 85 2.1 INTRODUCTION 56 3.4.6 HUMAN RIGHTS COMMISSIONS 85 2.2 SITUATION IN MEXICO 56 3.4.7 EMBLEMATIC CASE 85 2.3 LEGAL AND POLICY FRAMEWORK 57 3.4.8 MEDICAL ARBITRATION COMMISSIONS 87 2.3.1 GENERAL HEALTH LAW AND ITS REGULATIONS 58 3.5 CONCLUSIONS 87 2.3.2 GENERAL POPULATION LAW AND ITS REGULATIONS 58 2.3.3 CONTRACEPTION. OFFICIAL MEXICAN NORM 005-SSA2-1993, FAMILY PLANNING SERVICES 59 3.6 RECOMMENDATIONS 87 4. OBSTETRIC VIOLENCE 93 6. ASSISTED REPRODUCTION 128 4.1 INTRODUCTION 94 6.1 INTRODUCTION 129 4.2 SITUATION IN MEXICO 95 6.2 SITUATION IN MEXICO 129 4.3 LEGAL AND POLICY FRAMEWORK 99 6.3 LEGAL AND POLICY FRAMEWORK 130 4.3.1 OBSTETRIC VIOLENCE 99 6.3.1 SURROGATE MOTHERHOOD 132 A. Definition of the Crime of Obstetric Violence 100 6.4 CONCLUSIONS 134 4.3.2 OFFICIAL MEXICAN NORM 007-SSA2-1993, CARE OF WOMEN DURING 6.4.1 ADEQUATE CONTENT FOR COMPREHENSIVE LAW AND POLICY ON ASSISTED REPRODUCTION 135 PREGNANCY, DELIVERY AND THE POST-PARTUM PERIOD, AND OF NEWBORN CHILDREN 100 4.3.3 FORCED STERILIZATION 101 6.5 RECOMMENDATIONS 135 4.4 IMPLEMENTATION OF THE LEGAL AND POLICY FRAMEWORK 105 4.4.1 CARE DURING DELIVERY 105 APPENDIX 138 A. Care during Delivery: Situation in the States 106 REQUESTS FOR ACCESS TO INFORMATION 140 4.4.2 OBSTETRIC VIOLENCE 108 A. Obstetric Violence: Situation in the States 109 B. Sanctions 111 4.5 CONCLUSIONS 111 4.6 RECOMMENDATIONS 112 4.6.1 LAW AND POLICY 112 4.6.2 IMPLEMENTATION OF LAW AND POLICY 112 5. WORK AND FAMILY LIFE 115 5.1 INTRODUCTION 116 5.2 SITUATION IN MEXICO 117 5.3 LEGAL AND POLICY FRAMEWORK 118 5.3.1 REFORMS TO THE FEDERAL LABOR LAW (2012) 120 5.3.2 GAPS AND DEFICIENCIES IN CURRENT LAW AND POLICY 121 5.4 IMPLEMENTATION OF THE LEGAL AND POLICY FRAMEWORK 121 5.4.1 EMBLEMATIC CASE 123 5.5 CONCLUSIONS 124 5.6 RECOMMENDATIONS 125 5.6.1 LAW AND POLICY 125 5.6.2 IMPLEMENTATION OF LAWS AND POLICIES 125 TABLE OF CONTENTS 2.3.4 EMERGENCY CONTRACEPTION (HORMONAL POST-COITAL CONTRACEPTION), OFFICIAL MEXICAN NORM 046-SSA2-2005, INTRODUCTION 12 DOMESTIC AND SEXUAL VIOLENCE AND VIOLENCE AGAINST WOMEN 60 2.3.5 STATE REGULATION ON CONTRACEPTION 61 2.3.6 INFORMED CONSENT 62 1. SAFE AND LEGAL ABORTION 15 2.3.7 ACCESS FOR ADOLESCENTS 63 1.1 INTRODUCTION 16 1.2 SITUATION IN MEXICO 16 2.4 IMPLEMENTATION OF THE LEGAL AND POLICY FRAMEWORK 64 1.3 LEGAL AND POLICY FRAMEWORK 18 2.4.1 EMERGENCY CONTRACEPTION 64 A. States 68 1.3.1 FEDERAL PENAL CODE 18 2.4.2 INFORMED CONSENT 69 1.3.2 STATE PENAL CODES 18 2.4.3 ACCESS FOR ADOLESCENT 70 A. Map of Legal Indications 19 A. Federal and State Ministries of Health 70 B. Sanctions 21 1.3.3 REGULATION IN MEXICO CITY 23 1.3.4 PROCEDURES AND GUIDELINES FOR TERMINATION OF PREGNANCY RESULTING FROM RAPE 24 2.5 CONCLUSIONS 72 1.4 IMPLEMENTATION OF THE LEGAL FRAMEWORK 25 2.6 RECOMMENDATIONS 73 1.4.1 FEDERAL LEVEL 25 2.6.1 LAW AND POLICY 73 1.4.2 STATE LEVEL 26 2.6.2 IMPLEMENTATION OF LAW AND POLICY 73 A. Mexico City 26 2.6.3 GENERATION OF INFORMATION AND STATISTICAL DATA 73 B. Access to Abortion after Rape 28 B.1 EMBLEMATIC CASES 30 C. Access to Abortion for other Legal Indication 33 3. MATERNAL MORTALITY 76 D. Criminalization of Women for Illegal Abortion 34 3.1 INTRODUCTION 77 D.1 EMBLEMATIC CASES 37 E. Regulation Regarding Conscientious Objection 41 3.2 SITUATION IN MEXICO 78 F. Doctor-Patient Confidentiality vs. Obligation to Report 42 3.3 LEGAL AND POLICY FRAMEWORK 81 G. Impact of the Reforms that Protect Life from the Moment of Conception 44 3.3.1 GENERAL HEALTH LAW AND ITS REGULATIONS 81 1.5 CONCLUSIONS 45 3.3.2 OFFICIAL MEXICAN NORM 007-SSA2-1993, CARE OF WOMEN DURING PREGNANCY, DELIVERY AND THE POST-PARTUM PERIOD, AND OF NEWBORN CHILDREN 82 1.6 RECOMMENDATIONS 46 1.6.1 LAWS AND POLICY 46 1.6.2 IMPLEMENTATION OF LAW AND POLICY 46 3.4 IMPLEMENTATION OF THE LEGAL AND POLICY FRAMEWORK: ACCOUNTABILITY AND ACCESS TO JUSTICE 82 1.6.3 GENERATION OF INFORMATION AND STATISTICAL DATA 47 3.4.1 COMMITTEES FOR THE PREVENTION OF MATERNAL AND CHILD MORTALITY 83 3.4.2 ADMINISTRATIVE COMPLAINTS IN HEALTH INSTITUTIONS 84 3.4.3 ADMINISTRATIVE PROCESSES AGAINST PUBLIC OFFICIALS 84 CONTRACEPTION 55 3.4.4 PECUNIARY RESPONSIBILITY OF THE STATE 84 2. 3.4.5 PENAL PROCESSES AT THE STATE LEVEL 85 2.1 INTRODUCTION 56 3.4.6 HUMAN RIGHTS COMMISSIONS 85 2.2 SITUATION IN MEXICO 56 3.4.7 EMBLEMATIC CASE 85 2.3 LEGAL AND POLICY FRAMEWORK 57 3.4.8 MEDICAL ARBITRATION COMMISSIONS 87 2.3.1 GENERAL HEALTH LAW AND ITS REGULATIONS 58 3.5 CONCLUSIONS 87 2.3.2 GENERAL POPULATION LAW AND ITS REGULATIONS 58 2.3.3 CONTRACEPTION. OFFICIAL MEXICAN NORM 005-SSA2-1993, FAMILY PLANNING SERVICES 59 3.6 RECOMMENDATIONS 87 4. OBSTETRIC VIOLENCE 93 6. ASSISTED REPRODUCTION 128 4.1 INTRODUCTION 94 6.1 INTRODUCTION 129 4.2 SITUATION IN MEXICO 95 6.2 SITUATION IN MEXICO 129 4.3 LEGAL AND POLICY FRAMEWORK 99 6.3 LEGAL AND POLICY FRAMEWORK 130 4.3.1 OBSTETRIC VIOLENCE 99 6.3.1 SURROGATE MOTHERHOOD 132 A.