On August 28, Mexico’s Supreme Court by an 8-3 vote upheld as constitutional the decriminalization of abortion.

The law, passed in 2007 by the Mexico City Legislative Assembly, decriminalized abortion in the first 12 weeks of pregnancy. The law also defined a pregnancy as beginning upon implantation and required public health centers in Mexico City to provide abortion information and free services, with an opt-out for doctors with a conscientious objection. With this law, Mexico City joined Puerto Rico, Cuba and Guyana in the Hemisphere as having decriminalized abortion in the first trimester.

The law was immediately challenged by the pro-criminalization forces in Mexican society, as violating the right to life as set forth in the Mexican Constitution. The decision, finding that it did not, was a constitutionally limited one, unlike the broader Roe v. Wade decision from the U.S. Supreme Court in 1973. The Roe decision found that in the U.S. Constitution there was a right to privacy that required that abortion be decriminalized before fetal viability. The Mexican Court held that the Mexican Constitution permitted, but did not require, the state legislatures of the nation to decriminalize, or criminalize, abortion. One judge said, “It is not up to the Supreme Court to legalize or criminalize abortion.” With this decision as precedent, other states in Mexico can decriminalize abortion should they choose to do so.

The Mexico City abortion law addresses a catastrophic public health problem: unsafe abortion. There are estimates that there are between 500,000 and 1 million unsafe abortions a year in Mexico, with approximately 100,000 annual abortion-related hospital admissions. From 1990 to 2005, 21,646 women in Mexico died of maternal related causes, with abortion accounting for 537. These figures are probably understated given the illegality of the procedure. Since the decriminalization, there has been one death from abortion in Mexico City.

Additional maternal deaths in the past were in no doubt caused by lack of access to family planning services, which would have delayed pregnancies until the woman was older, spaced out a woman’s pregnancies and reduced the absolute number of pregnancies, thereby reducing the risk of death in childbirth. It was heartening to see that 58% of women seeking abortions in Mexico City ask for an IUD after their abortion to prevent their next pregnancy. Abortion decriminalization must be part of a broad public health plan to bring reproductive health care services to young, poor, indigenous, rural and uninsured women, who otherwise do not have access. About 40% of pregnancies worldwide are unintended. It is these pregnancies that result in unsafe abortion and maternal mortality and morbidity. This can be prevented only by simultaneously attacking gender inequality, gender violence, lack of information and access to contraceptive services, lack of an appropriate contraceptive method for every woman at every stage of her reproductive life, and, finally, the stigma that women face in many cultures in trying to control their bodies and their lives. A big agenda, but Mexico has shown that we can tackle it.