Adopted by the 60th WMA General Assembly, New Delhi, India, October 2009,
and revised by the 70th WMA General Assembly, Tbilisi, Georgia, October 2019
In 2006, Nicaragua adopted a penal code that criminalises abortion in all circumstances, including any medical treatment of a pregnant woman which results in the death of or injury to an embryo or fetus.
According to the UN Population Fund (UNFPA), despite improvement of national sexual and reproductive health indicators, Nicaragua continues to have one of the highest teenage pregnancy and maternal mortality rates in the Americas region, in particular in lower income rural population groups.
- Has a negative impact on the health of women in Nicaragua resulting in preventable deaths of women and the embryo or fetus they are carrying.
- Places physicians at risk of imprisonment if they carry out abortions, even to save a pregnant woman’s life, unless they follow the Nicaraguan Ministry of Health’s (MINSA) 2006 Obstetric Protocols designed for high emergency care alone.
- Requires physicians to report to police, women and girls for suspected abortions, in breach of their duty of confidentiality towards patients and placing them in a conflict between the law and medical ethics.
The WMA Statement on Medically-Indicated Termination of Pregnancy (October 2018) provides that: “National laws, norms, standards, and clinical practice related to termination of pregnancy should promote and protect women’s health, dignity and their human rights, voluntary informed consent, and autonomy in decision-making, confidentiality and privacy. National medical associations should advocate that national health policy upholds these principles.”
The WMA reiterates its Resolution on Criminalisation of Medical Practice (October 2013) recommending that its members “oppose government intrusions into the practice of medicine and in healthcare decision making, including the government’s ability to define appropriate medical practice through imposition of criminal penalties.”
THEREFORE, the World Medical Association and its constituent members urge the Nicaraguan government to repeal its penal code criminalizing abortion and develop in its place a legislation that promotes and protects women’s human rights, dignity and health, including adequate access to reproductive healthcare, and that allows physicians to perform their duties in line with medical ethics and particularly medical confidentiality.