Tegucigalpa, Honduras – Emilia* had just started college in Tegucigalpa, Honduras in 2015 and she didn’t want anything to get in the way of her plans to graduate. She knew having a baby would make it more difficult to finish her university studies, which was why she was careful to never have unprotected sex with her boyfriend. But when a condom broke one night four years ago, 18-year-old Emilia began to worry.
Although the morning-after pill is banned in Honduras, Emila had heard that she could buy the emergency contraception clandestinely at a local pharmacy. But when she arrived, the pharmacy was out of stock.
“I got mad in that moment and thought, ‘Why can’t I have Plan B in my country?’,” Emilia told Al Jazeera.
For 10 years, Honduran women like Emilia have been unable to legally and easily buy the morning-after pill (also referred to as the day-after pill), a form of contraception that the World Health Organization (WHO) considers a human right. And so, women – including rape survivors – have been unable to prevent unwanted pregnancies in a safe way. Instead, Honduras has one of the highest rates of teen pregnancy in the region and women who want to terminate an unplanned pregnancy have to take risky measures to do so that could even cost them their lives.
As Honduras marks 10 years since the coup that led to the ban on the morning-after pill, a coalition of feminist organisations is working to raise awareness about the effects of the ban on Honduran women. They hope to gain enough momentum to eventually convince the health ministry to overturn the ban.
The coup, the ban and the effect on reproductive health
In 2009, Honduras became the only country in Latin America to ban emergency contraception, also known as PAE for the Spanish acronym. Since then, Honduran women like Emilia have had to turn to clandestine networks – underground pharmacies and friends of friends of friends – to buy the morning-after pill.
In April 2009, the Honduran Congress approved a bill to ban the use of the morning-after pill. But then-President Manuel Zelaya quickly vetoed the bill on the grounds that it violated women’s rights.
On June 28, 2009, the Honduran military overthrew the democratically-elected President Zelaya in a coup. A de facto government took power in the following months until scheduled elections in November 2009.
The coup had profound effects on the Honduran political system – and on women’s reproductive rights – that are still felt today.
Since the coup, the criminalisation of protests and social movements has increased and religious interests – both Catholic and Evangelical – have continued to gain traction within the political system.
“The impact of the coup on women is reflected in our bodies and the lack of access to reproductive health,” said Marcela Arias of the Center for the Rights of Women. “What happened after the coup was that the few opportunities that we women had for reproductive health were restricted more.”
In October 2009, the interim minister of health, Mario Noe Villafranco, issued a decree banning the “promotion, use, sale, distribution and purchase” of the morning-after pill, a decision that remains in place 10 years later.
The decree was based on a ruling issued by the Honduran Medical College that said the morning-after pill induces abortions. Villafranco had issued the ruling when he was the head of the Honduran Medical College.
According to the WHO, emergency contraception can prevent pregnancies when effective, but does not cause abortions.
Reproductive rights advocates also point to other health conditions that result from the ban on the morning-after pill.
Honduras has one of the highest rates of teen pregnancy in Latin America, with more than 30,000 pregnancies among girls and adolescents under 20 in 2017, according to government data. These pregnancies run a higher risk of maternal mortality during childbirth because their bodies are not fully developed for childbirth. More than 800 of these births were to girls ages 10 to 14, most likely the result of the rape of young girls who are too young to consent to sex.
In 2017, more than 80 percent of the pregnant women attended by Doctors Without Borders in Honduras said their pregnancy was a result of rape. These women and girls are denied the morning-after pill which could prevent an unwanted pregnancy after a sexual encounter they did not consent to.
Additionally, not allowing women to prevent unwanted pregnancies can make them more likely to seek a clandestine abortion, not the other way around, said Piedad Huerta Arneros, the in-country representative in Honduras for the WHO. Each year, there are between 50,000 and 80,000 clandestine abortions in Honduras, according to a report by the Center for the Rights of Women.
Rural vs urban divide
Just how dire the consequences of the ban depends on where a woman lives and her socioeconomic class.
Cintia*, a 24-year-old university student, went looking for the morning-after pill in San Pedro Sula, an industrial city in northern Honduras, after having unprotected sex with her boyfriend. She had heard of a pharmacy that sold it and was able to buy it for about $12. Her boyfriend helped her pay for it, but for many Honduran women, the price would be out of reach even if they could find the pill.
“I can’t even imagine how it would be for a woman who didn’t have all the privileges that I had in that moment,” Cintia said. “She wouldn’t even have a choice. Her destiny would be to be a mother.”
Alexa Pineda said many Honduran women living in rural areas know all too well what the bans mean for their health. They often can’t find these pills at all. If they can, they can’t afford them at prices that range from $7 to $12, which is roughly equivalent to one day’s expenses for some families in Honduras.
From Choluteca, a southern Honduran city near the border with Nicaragua, Pineda recalled receiving a text message from her friend when they were in high school.
“Ale, I’m screwed,” her friend wrote her. “I had sex and the condom broke,” Pineda said her friend texted.
The pair went to every pharmacy in Choluteca’s urban centre, where a worn-down church stands at the central plaza, a symbol of the enduring presence of the Catholic church, asking if they sold the morning-after pill. They were turned away time and time again until they reached the last pharmacy in town, which finally sold it to Pineda’s friend.
“Being outside of the capital drastically changes our possibility of having access to the [PAE],” said Marcela Villatoro, a 23-year-old member of the feminist organisation Network of Young Women in Choluteca.
“It’s still illegal, but there is much more information, support and organisations in Tegucigalpa than we have here,” she told Al Jazeera.
“None of the women in our group decided to be mothers,” she said, adding that they didn’t have any other choice because of the prohibition of the PAE and abortion.
‘Hablemos lo que es’: A change in public opinion?
But advocates say if a new campaign to address stigma and change public opinion is successful, motherhood will always be a choice in Honduras. The campaign, called Hablemos Lo Que Es (Let’s talk about what it is), which launched in April, has worked to debunk the misinformation surrounding the PAE – that it induces abortions and causes cancer.
The campaign aims to reach the entire country, including Choluteca. A billboard with a black and white image of a young woman with long, black hair, head resting on her hands, stood on the way to the winding road from Choluteca to Tegucigalpa with the words “Hablemos Lo Que Es”.
The effort to change Hondurans’ opinions and misconceptions about the PAE has been met with an equally strong backlash from anti-abortion rights groups, according to members of the Strategic Group for the Legalization of PAE.
“It’s a farce. It’s a lie,” Michelle de Idiaquez, president of Provida Honduras, an anti-abortion rights organisation based in Tegucigalpa, told Al Jazeera of the campaign. She claimed that the morning-after pill is abortive and that the campaign should not suggest otherwise.
The decision [to lift the ban], like many decisions in Honduras, is one that is not in the hands of the people, but rather in the hands of the authorities. But it’s a basic right that shouldn’t be negotiated.
Natalia Lozano, national coordinator for Rights Here and Now
Headway on the political front has also stalled. The current Health Minister, Alba Consuelo Flores, told Al Jazeera that she is reviewing the decree, but would not say clearly whether she would consider issuing a new decree to allow the sale and use of the morning-after pill in Honduras.
But public opinion is slowly changing. According to surveys conducted by feminist organisation Rights Here and Now (Derechos Aqui y Ahora), part of the Strategic Group for the Legalisation of PAE, more than half of Hondurans are in favour of allowing the morning-after pill to be bought and sold in the country.
“The decision [to lift the ban], like many decisions in Honduras, is one that is not in the hands of the people, but rather in the hands of the authorities,” said Natalia Lozano, the national coordinator for Rights Here and Now. “But it’s a basic right that shouldn’t be negotiated.”
Meanwhile, Honduran women like Pineda, Emilia, and Cintia still have to scour pharmacies worried about whether they will be able to find the pill that will allow them to prevent an unplanned pregnancy.
“Access to the PAE in the case of a mistake or the failure of another form of contraception should be a plan B – another option,” said Pineda. “[Having access to the PAE] is about the right to decide what to do with your sex life, the right to decide about motherhood and the right to decide about your life. That’s why Honduran women should have free access to PAE: because it’s our right to decide what to do with our bodies.”
*Names have been changed to protect the individuals’ identity due to the stigma surrounding the morning-after pill in Honduras.
This reporting was supported by the International Women’s Media Foundation’s Reproductive Health, Rights, and Justice in the Americas.