Abortion in Costa Rica is severely restricted by criminal law. Currently, abortions are allowed in Costa Rica only in order to preserve the life or physical health of the woman. Abortions are illegal in almost all cases, including when the pregnancy is a result of rape or incest and when the foetus has medical problems or birth defects. Both social and economic factors have led to this legal status. It remains unclear whether abortions are legal to preserve the mental health of the woman, though the 2013 United Nations abortion report says Costa Rica does allow abortions concerning the mental health of a woman.
Under the Carlos Alvarado Quesada administration, the discussion of the "Technical Norm" to regulate the already legal therapeutic abortion is a hot issue, as the Evangelical parties (who have a large bloc in the Legislative Assembly) vigorously oppose it.
Legal issues
The Costa Rican Penal Code in its article 121 establishes that no abortion performed to protect the life or health of the mother, carried with the consent of the woman and participation of an authorized physician or obstetrician, can be punished. This is known as "abortion with impunity". However, the lack of a regulatory norm makes application difficult.
Article 93 allows the judges to grant judicial pardon to a woman who has caused her own abortion as a consequence of rape. Articles 118, 119, 120 and 122 punish different types of abortion from three months to ten years of prison depending on the circumstances. In all cases the law increases the penalty if the foetus had more than six months of development.
Induced abortion is classified as a crime in the Penal Code of 1970, included in the crimes against life. Doctors who suspect that a woman has had an abortion are obligated to report them to the Organization of Judicial Investigation (Organizacion de Investigacion Judicial). Punishment varies depending on whether the woman consented or not to the procedure and whether the foetus had reached six months' gestation at the time.
Although the United Nations Human Rights Council recommended in 1999 that Costa Rica should introduce more exceptions to the prohibition of abortions, the actual Costa Rican legislature intended to increase penalties for abortions due to their Roman Catholic background. Laura Chinchilla, strictly opposed to the legalisation of abortion, was president of Costa Rica from 2010 to 2014, during which reforms to the law were not expected.
Therapeutic abortion Therapeutic abortion refers to the termination of a pregnancy for medical reasons aimed at protecting the health or life of the pregnant person. This type of abortion is performed when continuing the pregnancy poses a significant risk to the physical or mental well-being of the pregnant individual.
According to the Center for Reproductive Rights (translated from Spanish), therapeutic abortion is legal according to Article 121 of the Penal Code. Although it might be technically allowed, public hospitals, where the majority of Costa Ricans seek medical treatment, generally decline to provide the procedure unless a woman's life is on the line, such as in the situation of an ectopic pregnancy.
Adequate measures have not been taken to guarantee this right. Specifically, there are no specialised protocols or guides that tell health care workers how to proceed with an abortion if the life or physical or mental health of the woman is at risk. There are also no effective judicial or administrative mechanisms through which this procedure can be demanded to be performed."
Carlos Alvarado On December 12th 2019, Costa Rica's President Carlos Alvarado issued a technical decree that allowed for therapeutic abortions in the Central American nation, despite opposition from religious and conservative political groups. The measure outlined clearer requirements for medical professionals and enabled the first therapeutic abortions to be performed within six months at public hospitals. Private clinics were also allowed to perform the procedure.
Health Minister Daniel Salas said in a statement in 2019 therapeutic abortions could be performed if three requirements were met:
1) If there is no other medical alternative;
2) If the woman gives consent;
3) After mandatory evaluation by three medical professionals.
Fourteen days prior to this, Costa Rica witnessed a gathering of thousands, marching in support of "Yes to Life!" These demonstrators urged Carlos Alvarado not to bypass the legislative chambers, where lawmakers advocating pro-life positions had the potential to obstruct a new abortion legislation.
Fabricio Alvarado, leader of the opposition, actively participated in the protest and accused the government of attempting to enforce "unlimited abortion" in defiance of the majority's wishes.
Ricardo Salazar, Pastor of the Abundant Life evangelical church, asserted, "Costa Rica is a nation that values life, a country built on the belief in life. Suddenly, through deceitful means, there's an attempt to supplant a law that truly reflects the sentiments of Costa Ricans with an unnecessary one that could legalize abortion."
Bishop José Manuel Garita Herrera of Ciudad Quesada spoke out against the decree and urged respect for both lives- that of the mother and of the child in her womb.
"To doctors, my call is also that, faithful to the principle and vocation to which they have consecrated themselves, allow them to place their gifts at the service of the mother and her son," Bishop Herrera said.
Rodrigo Chaves Robles Rodrigo Chaves Robles is Costa Rica's current President and has played a pivotal role in shaping the country's approach to therapeutic abortion.
In 2022 President Rodrigo Chaves Robles took part in a significant meeting with members of the Catholic Episcopal Conference. The discussions centred around the topic of abortion, particularly the therapeutic interruption of pregnancy.This commission, composed of subject experts, representatives from the Ministry of Health, the Costa Rican Social Security Fund (CCSS), medical professionals, and other stakeholders, concluded its assessment on June 20, 2022.
Following the meeting, the newly appointed Minister of Health, Joselyn Chacón, announced a forthcoming review of the technical standard concerning therapeutic abortion. Chacón emphasised that this review, scheduled for June 2022, aimed to ensure that the regulations accurately reflect the government's commitment to prioritising the life of the mother.
Chacón stated that the revision process would involve a commission and comprehensive studies on the subject. She emphasised the alignment of this initiative with the requests made by the bishops during the meeting with President Chaves Robles. Chacón reiterated that the government's stance is not in favour of pro-abortion policies but is steadfast in safeguarding the mother's life.
President Chaves Robles articulated his position on the revision of the technical standard. He highlighted that the primary objective of this review is to eliminate any potential loopholes that might arise. He reiterated his unwavering commitment to ensuring that the standard serves the explicit purpose of regulating situations where a pregnancy jeopardizes the life of the mother.
Chaves Robles acknowledged his limited expertise on the matter but emphasised that any deviations from the core objective of protecting the mother's life would warrant careful examination.
The technical standard, initially signed in December 2019 by then-President Carlos Alvarado, holds paramount importance in the landscape of abortion regulations in Costa Rica. It establishes the framework for the application of therapeutic abortion within the country, outlining the necessary regulations and procedures.
Griselda Ugalde, former president of the College of Nurses and a participant in the commission's work, conveyed that the commission found no need for changes to the document. However, any further progress or action regarding the technical standard is contingent upon the decision of Joselyn Chacón, the Minister of Health.
Griselda Ugalde highlighted the persistence of patriarchal, homophobic, and misogynistic attitudes in Costa Rican society. She acknowledged that despite progress, there may be limited support for therapeutic abortion.
The lack of implementation of the existing norm posed questions about the necessity of the review process. The challenges surrounding personnel training and evaluation processes were noted as factors contributing to the limited application of the standard.
The consensus reached by the commission was that modifications to the technical standard were unnecessary given its evaluation. Larissa Arroyo, a representative for individuals who were compelled to carry unviable pregnancies to term, pointed out that while the technical norm might not be ideal according to international standards, it represents progress within Costa Rica's legal framework.
The possibility of a review process raised concerns about resource allocation and accountability.
Catholic church The country has a state religion, Roman Catholicism, meaning the Catholic church has an especially prominent place in public institutions like schools and hospitals. The church regularly intervenes in public debates around a variety of issues — like in vitro fertilization, euthanasia, same-sex marriage and abortion.
For example, in 2017 a girl's life story gained attention when her mother publicly revealed the sexual violence the girl had endured from her father. Following this disclosure, Andrea's mental state deteriorated significantly, with her expressing a desire to not continue living due to the trauma. Andrea's mother highlighted her daughter's depression, reduced appetite, severe pregnancy-related nausea, and her adamant unwillingness to proceed with the pregnancy.
Instead of urging the enforcement of Costa Rican abortion law, the media provided a platform for religious figures to express their viewpoints. The public discourse regarding Andrea's case is not framed within a medical or legal context, but rather through a Christian lens. Religious institutions and anti-abortion groups approached Andrea and her mother to discourage them from considering pregnancy termination. Paola Vega, a deputy in the Costa Rican parliament and one of only three openly pro-choice elected officials, said:"The whole conversation has become radicalized. People actually argue that if a woman is dying while she's in labour, she has to give birth no matter what happens because it's God's will. She has to give birth, and if she dies and if the baby dies, well, it's God's will. The whole discussion has gotten so much worse, so much more radical."
Catholic Church Responds to UN Observations on Abortion in Costa Rica Following a comprehensive 10-day visit to Costa Rica, UN Special Rapporteur on health rights, Tlaleng Mofokeng, has emphasised the country's potential to overcome challenges and achieve truly universal healthcare. During her visit, Mofokeng engaged with a range of stakeholders, including government officials, civil society, healthcare professionals, and marginalised groups.
She underscored the need for a holistic approach to healthcare, focusing not only on access but also on addressing underlying determinants. Mofokeng called for the full recognition of the right to health in Costa Rica's constitution and expressed concerns about the criminalization of abortion, which she deemed to be in violation of human rights standards and medical protocols.
Mofokeng's recommendations include the decriminalisation of abortion, highlighting that such laws restrict autonomy, hinder the patient-doctor relationship, and perpetuate gender discrimination. She proposed a moratorium on enforcing abortion laws and commended Costa Rica for its effective COVID-19 strategies, urging ongoing stakeholder involvement in health policymaking.