Activists in the Dominican Republic Are Fighting the Country’s Abortion Ban

Dominicans are unable to access safe abortions, even in cases where a pregnancy is life-threatening. Activists in the country are creating a playbook for abortion rights advocacy from which American activists may soon want to take a page.

Chrislevi Ramirez is an activist fighting for abortion rights in the Dominican Republic. (Courtesy of Jaclynn Ashly)

The Dominican Republic is one of few countries in the world which has a complete ban on abortion, even when a pregnancy is life-threatening, unviable, or the result of rape or incest. Scores of Dominican women, and those who can get pregnant, die each year from botched abortion attempts.

Earlier this year, the country’s total ban on abortion once again came under public scrutiny. The Dominican Congress has begun work on reforming the country’s 1884 criminal code, which imposes prison sentences of up to two years on women and girls who have abortions and up to twenty years for medical professionals who provide them.

Activists have demanded that tres causales be included in the criminal code. This would permit abortion in cases when the pregnancy is the result of rape or incest, it endangers the life or health of the mother, or if the fetus will not survive.

Activist Hardships

In April, two gift-wrapped boxes of brownies were delivered to a protest camp outside the presidential palace in the Dominican Republic’s capital Santo Domingo. In March, dozens of abortion rights activists occupied the area for seventy-three days to demand that tres causales — the three exceptions to the country’s total abortion ban — be included in the country’s reformed criminal code.

A note on the gifted brownies expressed words of encouragement and was addressed to a specific person: Sergia Galván Ortega, one of the country’s most prominent feminist activists. Ortega happily accepted the brownies, ate some herself, and passed them out to share with others at the camp. It did not take long, however, for those who ate the brownies to become dangerously sick.

Sergia Galván Ortega. (Courtesy of Jaclynn Ashly)

“My head started to hurt and my heart was beating very fast. I began shaking,” Ortega recounts. About eleven other people were affected by what was later found to be spiked brownies. The activists believed they had been poisoned. Some began vomiting, hallucinating, and became severely paranoid. Around seven people, including Ortega, wound up in the hospital. Ortega spent fourteen hours at the hospital, while others were hospitalized for days.

Ortega is no stranger to harassment. The sixty-six-year-old veteran activist has been a prominent fighter for abortion rights for decades. In a country in which most of the population is Roman Catholic and deeply conservative, being a vocal abortion rights activist comes with a social cost. But this was the first time she truly felt scared.

“It was one of the most difficult moments of my life,” Ortega tells me, sitting on a couch at her apartment, decorated with various framed protest posters, in the capital Santo Domingo.

That was the worst thing I had experienced as an activist. I was very worried because it was not just an attack on me, but it affected others. I was worried they were going to die because some of them were much worse than me. I just ate a small amount.

“I tried to appear strong in front of everyone,” she says.

But I could not sleep peacefully after that because I couldn’t stop thinking something might happen to the activists. We were left completely exposed at the camp. It was the first time in my life that I felt scared for the lives and well-being of the activists.

But the activists carried on, even expanding their encampment to outside the Palace of Congress during the first reading of the criminal code. The first night outside Congress, however, was disrupted by a swarm of police. During the raid, police destroyed the tents with knives and sprayed the demonstrators with what activists described as a “powder-like gas” that made them extremely itchy. The young activists nevertheless continued their protest — sleeping on the cement with only blankets wrapped around them — for two more days.

On May 23, after nearly three months demonstrating and sleeping outside the presidential palace, the activists crowned their protests with the largest march for women’s rights in the country’s history. Thousands of green-clad protesters — the color symbolizing abortion rights throughout Latin America — took over the streets. “We started the march from the camp so that we could lift up the camp and move the struggle to the streets,” explains Ivanna Molina Peña, a human rights lawyer who works with the Dominican ministry of women. “That was the whole symbolism of the march.”

Despite their protests, on June 30, the lower house of Congress approved the criminal code without the inclusion of tres causales. In response, activists point out that, even if the battle in Congress has been lost, the fight for abortion rights in the Dominican Republic has made gigantic strides.

Young women, from both the countryside and the city, are on the frontlines of this battle, tirelessly challenging the orthodoxy of their communities. The encampment and march represented a turning point in the decades-long fight for abortion rights in the country, they say. Despite facing harassment, these women are determined to see the decriminalization of abortion in their lifetime.

Policing Women’s Bodies

The lower house of Congress approved the criminal code that excluded tres causales, but the upper house was unable to reach a vote on the penal code before legislative adjournment in August. Consequently, the bill has been sent back to the beginning of the legislative process. Even so, Peña says activists have little hope that tres causales will be approved by the legislators — the current Congress is the “most conservative we’ve had in recent history.” This conservatism comes in spite of President Luis Abinader’s Modern Revolutionary Party’s (PRM) majority government. Last year, the PRM bucked sixteen years of the center-left Dominican Liberation Party (PLD).

According to Peña, PRM is “completely divided” on tres causales.

After 16 years of the ruling party in power, you have people who came together not because they see politics in the same way, or because they have a similar vision for what the Dominican Republic should look like  — it’s because they saw an opportunity to gain power. So you have people in PRM that are liberal and progressive and then you have the worst of the worst — literal neo Nazis — in the same party.

On the campaign trail, Abinader expressed his support for tres causales. Activists felt that he was their last and best hope to send the criminal code without tres causales back to Congress. However, since gaining the presidency, Abinader has failed to take any vocal stance on the matter. Eliciting the disdain of activists, he has instead claimed abortion rights is a “religious matter.” According to a 2018 survey conducted by Untold Research, a large majority of Dominicans are in favor of tres causales.

The police, meanwhile, tested the spiked brownies for marijuana, opium, and cocaine. But they only tested positive for marijuana, Peña says. This does not ring true for the activists, who, based on their reactions to the edibles, believe there were other substances present. According to Peña, the police arrested the delivery culprit. Surprisingly, it was a fellow activist. In the Dominican Republic, there are fringe activists who believe the fight for tres causales is too reformist and are staunchly opposed to the movement.

CONAMUCA’s center with a tribute to historic Dominican feminists. (Courtesy of Jaclynn Ashly)

“In the Dominican Republic, every activist will tell you that of course we believe in full abortion rights, but we also understand the political and social context of the country,” Peña tells me. “I have not seen any country move from a complete ban on abortion to full legalization.”

The inclusion of tres causales in the criminal code could quite literally save their lives. About twenty-five thousand women and girls are treated for complications from miscarriage or abortion in the Dominican public health system each year. Failure to treat incomplete abortions can lead to serious infections, sepsis, and even death. In the Dominican Republic, complications from abortion or miscarriage account for at least 8 percent of maternal deaths.

One of the most high-profile cases in recent years was that of sixteen-year-old Rosaura Arisleida Almonte Hernández who was suffering from acute leukemia and needed urgent treatment. She was seven weeks pregnant at the time and her doctor recommended she have a therapeutic abortion so she could immediately begin treatment. At the time, both Rosaura and her mother repeatedly voiced their agreement that the pregnancy should be terminated.

However, because of the abortion ban, administrators stopped the procedure and delayed her chemotherapy because it would put the fetus at risk of termination. Twenty-four days after being hospitalized she was eventually allowed to seek treatment. But about three weeks later Rosaura suffered a miscarriage. Rosaura herself died the following day.

Almost every Dominican woman has stories of a friend or relative who has experienced an abortion going wrong or pregnancy complications. Daniela Javier, twenty-nine, remembers when her friend a few years ago called her in a panic. The then eighteen-year-old had drunk a tea made from herbs and plants — the most common way women terminate pregnancies in the villages.“She was in a lot of pain and bleeding a lot,” says Javier, who is from the town of Dios Dirá in the San Cristóbal province, just south of Santo Domingo.

The doctors just left her there and said inappropriate things, like “if you don’t want to be pregnant then why did you have sex?” She wasn’t offered any medicine or treatment for hours. They made her suffer as punishment for having an abortion. She thought she was going to die there.

Benita Cordero is a forty-six-year-old veteran abortion rights activist and advocacy coordinator for Confederación Nacional de Mujeres Campesinas (CONAMUCA), a feminist organization promoting the rights of women in the villages. Cordero says that Javier’s friend’s experience is common in the Dominican Republic.

“We have gotten a lot of reports of women going into the hospital, whether from a miscarriage or an abortion, and being denied treatment from the doctors because they are against abortion,” Cordero says. This typically happens at the public hospitals, where women who cannot afford treatment at the private clinics seek treatment.

Because of the antipathy toward abortions, even women who experience miscarriage complications are eyed suspiciously by nurses and doctors. About a decade ago, Cordero herself, unknowingly three weeks pregnant, suffered an unexpected miscarriage.

“All the nurses and doctors thought I had provoked an abortion,” Cordero tells me. “And they just left me. I arrived at the hospital at 7 am but it wasn’t until 4 pm that I received treatment. And that was only because I called the head of the hospital.” Others have reported that doctors will punish patients for ending pregnancies — commonly refusing to provide pain relief in the event that uterine tissue removal is required as part of treatment.

Benita Cordero. (Courtesy of Jaclynn Ashly)

Cordero says that it is an “unspoken” yet widely known secret that in rural areas women rely on tea concoctions. In the cities, meanwhile, women tend to use Cytotec, or misoprostol, which is a medicine typically used to prevent ulcers. Cytotec also comprises one part of the medical abortion process, following an initial dose of mifepristone.

In the Dominican Republic, however, mifepristone is not available. Women instead consume about twelve pills, sometimes more, of misoprostol — which goes by the brandname Cytotec in Dominican pharmacies. This form of treatment is not as effective as standard medical abortions. Pharmacies also commonly force women to show prescriptions to purchase Cytotec, suspicious they may be using the medicine to induce an abortion.

“Since women have no rights to decide their own reproductive health, their fates are essentially left up to the personal views of the doctors, nurses, or pharmacists,” Cordero explains. “It amounts to the individual policing of women’s bodies and their reproduction.” Many people end up taking the risk of dealing with abortion complications on their own, fearing that if they seek treatment at a hospital the doctors or nurses could notify the police, Cordero says.

Violence Against Women

In the Dominican Republic, the threat of violence that attends the issue of reproductive health is largely normalized, Javier tells me. “Even I used to believe that women who got abortions were killers,” she explains. “I didn’t know anything else besides this.”

“Many women here are experiencing a lot of violence,” Javier continues. “Believe it or not, my own father, who raped me, could force me to have his child. Women are growing up thinking that this kind of violence is normal.”

Javier says it was only after she attended a meeting with CONAMUCA that she “started to understand the reality” of the violence inherent in restricting abortion access to people who can get pregnant. “I started to work to convince other women that this kind of violence we face, on the streets and within our own families, is not normal,” Javier tells me. “I don’t want women to experience this anymore. I want to do everything I can to stop the violence and the daily social problems in the community.”

Javier now heads a traveling choir with other youths around her village. The choir sings about the need for tres causales and tries to raise awareness about gender-based violence. This activism does not come easy, however — Javier says she is constantly the target of insults and harassment.

“I always feel a lot of discrimination from my family and community. People call me a murderer and accuse me of killing people. I just now received a text message from someone,” Javier says, glancing at her cell phone on the table. “It says ‘if you don’t want to get raped then don’t provoke men and if you don’t want to be pregnant then don’t have sex.’”

“Other people accuse me of being paid by the movement,” Javier adds.

But I don’t respond to these accusations. Nothing anyone says affects me because I know my rights as a human being and I know I’m not doing anything wrong. Women here in this country, we are fighting for our lives. So these words don’t affect me at all.

Chrislevi Ramirez, twenty-four, tells me that all the activists understand the sacrifices they will have to make as a result of their commitments to the abortion rights movement, including job discrimination. “It’s a challenge to be public and have my face visible in the movement because you’re going up against a social norm,” explains Ramirez, from the village of Niza in San Cristóbal.

Nowadays we have more freedom to express ourselves than our ancestors did. But we still see people who are not speaking up because they are scared to lose their jobs or face consequences from their communities.

“I’m not scared. But being visible in the movement can always make you a target of harassment or violence,” she adds.

But we have far less fear now and we are more willing to take risks to get our rights. I know that I won’t be considered for some jobs in the future because I’m visible in the movement. But these are sacrifices we have to make.

Ramirez, who joined the movement for abortion rights ten years ago, when she was just fourteen, says that the biggest obstacle activists currently face is a total lack of institutional support. There are not nearly enough politicians supporting tres causales in the Dominican Congress.

“Our government doesn’t represent the Dominican people,” Ramirez tells me. “We’re trying our best to educate people for the next elections [in 2024]. We need more people to fight for us.” Cordero says that CONAMUCA is in the process of convincing some of these young activists in the village to run for Congress themselves.

Ramirez says she believes she will see the inclusion of tres causales in the Dominican legal system in the next several years. “One of the most important aspects of this movement is to just keep talking about it,” she says. “We have to keep explaining and discussing it and changing peoples’ minds.”

Ramirez recounts an instance when her neighbor saw her on the news voicing her support for tres causales, and the neighbor subsequently stopped speaking to her out of anger. “But then I took the time to explain to her that we’re not trying to get everyone to agree on abortion,” she says. “We’re just talking about tres causales and to protect women’s lives. And after some time she started to understand and now she is supportive of tres causales.”

“Many people here don’t really understand what the issue is, so we have to just keep talking about it and then more people will support it,” Ramirez adds.

And that’s the most important part of our movement to continue being visible and talking about it. That’s my main goal — to transmit all the knowledge that I have to the people. And to keep discussing abortion and get people to understand — especially in the villages.

Ramirez adds that one of the most difficult aspects she faces in her advocacy is seeing women feel ashamed of themselves for seeking abortions. “This is something very painful to witness,” she says.

Women know they have to do it because they have no other choice. But then society makes them feel like they are doing something wrong. They make them feel ashamed for doing something they have to do. I try to make sure these women understand that having an unwanted pregnancy is not their fault and it is nothing to be ashamed about.

“In the Dominican Republic, Poverty Has A Woman’s Face”

Vanessa Rodriquez, thirty, joined the movement for abortion rights in 2013. She says that most of the people in her village of Dios Dirá continue to be against tres causales. However, many who end up facing the decision personally — or within their own families — eventually end up supporting the movement.

“Everyone will say they are against abortion,” Rodriquez tells me.

But then if you ask what if your daughter gets pregnant and she’s going to die if she has that baby, would you support it then? And most of them will be forced to concede that they would. And even if they don’t answer me at that moment, they will continue to think about it.

“One of the big challenges for people in the Dominican Republic is that they need to overcome their two faces — these contradictory feelings,” she adds.

They have these moral feelings that make them against abortion, but then they also have a feeling of morality when they think about their own daughter facing this reality. There are two morals existing inside the same person in the Dominican Republic. And people need to reconcile that.

Rodriquez recounts how one person in her community who was staunchly opposed to tres causales came to change her mind. The woman in question experienced pregnancy complications that threatened her life. “She had to seek an abortion because she was scared she would lose her life. Now she is a supporter of the movement and an active abortion rights advocate.”

Vanessa Rodriquez. (Courtesy of Jaclynn Ashly)

Even Rodriquez’s own husband was against tres causales. However, he reconsidered his position a few years ago when Rodriquez experienced an anembryonic pregnancy. Such pregnancies occur when a fertilized egg successfully implants to form a growing embryonic sac, but the embryo fails to develop. “I was forced to abort because I would not have a baby anyway,” Rodriquez explains.

Why should I go through all this pain and trauma just because my government doesn’t think I have the ability to make my own health choices? After that my husband saw the importance of abortion rights and now supports the movement.

Most of the participants of the abortion rights movement in the Dominican Republic have framed their struggle using a secular, human rights vernacular. However, some in the country have also grappled with theological arguments around abortion. Christian churches are considered by many to be one of the biggest obstacles for obtaining abortion rights in the country.

“As a Christian, at first it was very difficult for me to reconcile my beliefs of abortion rights with my faith,” Rodriquez says. But she eventually joined a religious movement, called Alianza Cristiana Dominicana, which unites people from different Christian denominations in their shared belief in reproductive and sexual rights.

“I started to understand that no part of the Bible says you can exclude or discriminate against women or deny them sexual rights,” she says. “All of these prohibitions and restrictions are coming from men and designed by men. It’s not coming from the Bible or our religion. It’s just men who started all of this.”

Like all the other activists, Rodriquez believes in full abortion rights. “It’s a slow process to convince society of our full rights,” she says. “But I believe this struggle will get us there. We have to first get abortion rights for situations of necessity and then we can show people how all cases of abortion are for necessity.”

But the Dominican Republic is far from accepting full abortion rights for women. “We’re even far away from getting tres causales,” Rodriquez says.

But we’re progressing. Now it’s not just the feminists saying they support tres causales. Now we have a lot of people, in the cities and the villages, supporting the movement. So many women have suffered in silence, so now we are working to get the voices of women who have died and suffered pain because of this ban on abortion out into the world. And when more people hear these voices, the more people will support the movement.

The voices of those who have suffered from the country’s abortion ban come predominantly from poor women. It is the working class and poor who are left with no other options except to seek unsafe methods to terminate pregnancies or have children they are in no position to care for. Dominican women from higher classes, meanwhile, typically travel overseas to access safe abortions or are able to pay for under-the-table procedures at private clinics.

Molina Peña. (Courtesy of Jaclynn Ashly)

“It’s very clear this ban affects the poor women and the women in the countryside,” Cordero explains.

By not giving women access to abortion you are condemning them to poverty. You’re stripping them and their future generations of opportunities. The abortion ban ensures that women are constantly being pushed down in society. In the Dominican Republic poverty has a woman’s face.

Peña tells me that despite the challenges ahead, the movement has broken boundaries in their public fight for abortion rights in the capital. “Before this, abortion was a taboo topic,” she explains.

But for seventy-three days you would go to the little store on the corner and the radio spokesperson was talking about abortion; the newspapers were talking about abortion; every household in this country at one point or another talked about abortion.

“Many stories began to surface on social media,” she continues.

Many women who had never told their stories before began speaking up and talking about it. Congress may not approve the criminal code with tres causales, but we have made huge steps forward toward the social decriminalization of abortion.

Peña points to Argentina as an example of hope. In 1929, Argentina got tres causales approved and last year, a hundred years later, the country finally legalized abortion. “It has served for all of us around the region as an inspiration that maybe it takes you a hundred years, but you’ll find a way to claim your rights.”

Cordero, meanwhile, says she is “sure there will be a change coming soon” and that it is the young activists of this generation who are going to achieve it. “They have the power and the motivation,” she says. “I can see the fight in them. They won’t give up until they get it. This I’m certain of. I just hope that I’m still alive to be able to see it.”