Latin America.

IN HER ARTICLE, "LATIN America's Abortion Battles" (Autumn 2005), Joanne Mariner highlights many of the opportunities and challenges facing advocates for women's health and rights who are working to end unsafe abortion in Latin America.

In Brazil, more than a million women risk their lives and health every year to end a pregnancy with an unsafe abortion. As a result, unsafe abortion is one of the leading causes of maternal mortality here. It comes at a high cost not only for women and their families, but for the health system as a whole: Last year, the public health service spent $15.5 million treating women with complications from unsafe abortion. This is an expense that we simply cannot afford.

Although Ms. Mariner writes that "[t]here is little societal support for abortion generally," it is clearly an experience shared by millions of Brazilian and Latin American women. Why do societies allow an experience that is common to so many women remain so stigmatized and dangerous? Every day, these women's rights to health, life and equality are ignored and trampled.

No woman with an unwanted pregnancy should have to risk her life or health because she has no other option. Experiences from Romania, South Africa and other countries that have liberal abortion laws clearly show that making safe, legal abortion available to women saves lives and protects women's health. Latin American nations must act now to invest in the lives of our citizens rather than succumbing to the pervasive anti-woman religious dogma that encourages our governments to maintain damaging and unfair abortion laws.

DR. LEILA ADESSE

Director, Ipas-Brazil

JOANNE MARINER PRESENTS a revealing picture of the multifarious efforts of the Catholic hierarchy to resist the advancing movement to flee women from the burden of unwanted pregnancies.

But there is another important player in this drama that the article fails to mention: The administration of George W. Bush and his fundamentalist minions. Although their impact may be less direct and immediate than direct pressure by Catholic prelates, there is no question that the US administration's imposition of its antichoice agenda abroad is having, at minimum, a "chilling effect" on the fight for sexual and reproductive rights in Latin America. At worst, these pernicious policies have impeded progress toward safe, legal termination of unwanted pregnancies, and thus contribute to illness and death from botched clandestine abortions.

The principal case in point is the "Global Gag Rule," prohibiting foreign recipients of US assistance for reproductive health services from relating in any affirmative way to abortion, including referrals to legal abortion providers and advocacy for abortion-law reform. Since most aid recipients have no practical choice, they have been helpless to counsel women about alternatives to unsafe abortion and barred from openly joining the movement for decriminalization.

In other instances, domestic US policies can in themselves create a ripple effect across the region. The vacillation by the US Food and Drug Administration over dispensing emergency contraception over the counter may well have emboldened conservative forces in Latin America to challenge liberalization of access to EC in their own countries, as is happening in Peru, Ecuador, Mexico and elsewhere.

And pressure from anti-choice types is not limited to the executive branch of the US government. Abortion-obsessed members of Congress regularly intervene directly with Latin American legislators. In one notorious instance, Representative Chris Smith (R-NJ) appealed directly to members of the Uruguayan Senate to vote against a pending bill to decriminalize abortion. The measure failed by a margin of three votes.

The lesson of all this is that the struggle to defend reproductive rights in the United States has significant ramifications throughout the Western Hemisphere. The foreign impact of a reversal of Roe v. Wade by a John Roberts-led Supreme Court is frightening to contemplate.

CARMEN BARROSO

Western Hemisphere Regional Director

International Planned Parenthood Federation