Estefanía Cioffi is a doctor, a feminist activist and belongs to the Network of Health Professionals for the Right to Decide. For many years he dreamed of being able to guarantee voluntary interruptions of pregnancy for pregnant people without the burden of secrecy. For this reason, when he handwritten misoprostol prescribed for the first IVEs, protected by law 27,610 that came into force this Sunday, he celebrated it with a phrase that speaks of the fight that he carried out from the network and from the Health Center 20 in the Ricciardelli neighborhood of Bajo Flores, in addition to the Solano de Quilmes hospital: “Social justice is being able to decide.”
“The most exciting thing about those first recipes has to do with the will that is at the center of the scene. For the first time we stopped asking justifications from those people who turned to us looking for a safe abortion”, She excitedly told Page 12.
This week, Cioffi and his co-workers began to feel that paradigm shift., although they take into account that it is a process that has just begun and for which the public health system must be well prepared, protected by law but also accompanied by a State that ensures the availability of resources, mainly Misoprostol. Another fundamental role, according to the doctor, will play the feminist movement and organizations such as the Network, which will now have the task of acting as “observers” of this process, witnesses of the application of the law and builders of bridges to territorialize the practices.
Cioffi said that now pregnant people who come to the center do so “more strengthened”, despite the fact that the place was committed from the beginning with the dissemination of information about the ILEs. You can see that trust because they know that what they are doing “is within the framework of the law” and that no one is going to judge them for their decision. This is how a pregnant person, after being informed of all their options, chose to safely suspend their pregnancy.
“It is moving to know that we have been organizing for this moment for many years, that we have been changing paradigms as we move forward, from the guarantee of the ILEs to this, ”Cioffi celebrated. However, he stressed that “there is much to do collectively, because we must bear in mind that the reality is not the same in all cities and provinces.”
In the hospital where she works, and despite the fact that interdisciplinary accompaniment was always chosen with a perspective of reducing risks and damages in the face of unsafe abortions, the situation changed since December, with the sanction of the legalization project promoted by the Executive Power . From that moment, the teams began to be formed to guarantee the IVEs. “Before many professionals did not feel accompanied, but the legal framework now brings clarity. It gives us another peace of mind, ”he explains.
The debate in Congress, both this year and 2018, was very important for the Network because the members of the organization, who have been accompanying women and people with the ability to gestate since 2014, experienced a “massive coming out of the closet ”. “We were able to say you are counting on us,” said the doctor.
While the detractors of the IVE focused on the alleged impossibility of treating the project in the midst of the pandemic, in the face of a demanding health system, the health workers that make up the Network gave their point of view, from the hospitals. “We are the ones who put the body to the pandemic, we know what an emergency is and that is why we said that the IVE is, especially at a time when access to rights is restricted,” said Cioffi, who today celebrates that abortion is legal.
The need to territorialize IVEs practices
The Network tried to guarantee the ILEs in recent years in those provincial and municipal states that impeded their practice, outside the law. According to the doctor who is part of the organization, now the same must be done with the IVEs: “We demand that the national, provincial and municipal states have the political decision that this process becomes a reality.”
The legalization of abortion, according to Cioffi, must necessarily be accompanied by “the hand of the State.” “We urgently need training for health workersWe are providing information throughout the country but it needs to reach everywhere, above all to guarantee supplies, “he remarked.
Misoprostol is an elemental for the practice of IVEs, but it is essential that it be free, since a complete treatment costs between 6 thousand and 7 thousand pesos. In this sense, the law clarifies that social and prepaid works will be obliged to include it in the Mandatory Medical Program. In addition, it indicates that providers and objector provinces must guarantee quality sexual reproductive and non-reproductive health services, with a gender perspective and for all.
Misoprostol for all, but also mifepristone
Cioffi adds the need for the use of mifepristone, a drug that “makes abortion of much better quality”. “Misoprostol has a percentage of 89 percent, which combined with mifepristone reaches 97, 98 percent and also reduces the adverse effects, discomfort of the interruption, pain, and amount of bleeding”, highlighted the doctor, who indicated that it is essential that “we produce it in Argentina and that it be available.”
The member of the Network explained that in the health center the interruption method is carried out according to the number of weeks. Until week 13 inclusive, it is done with pills, fully accompanied and with precise monitoring. Then, the treatment known as MVA (manual vacuum aspiration) is performed.
“We need greater access to this practice, which today is taken as a second option and not as a choice, because in some places inadequate practices continue to be carried out, such as the curettage that the WHO stopped recommending years ago. Therefore, we need professionals are trained and have the tools to be able to guarantee it “, he stressed.
He indicated that for this to happen “the organizations have an important task ahead of them, which is to be observers of the application of the law and to territorialize our practices, to accompany, to be a bridge between people and health workers.”