On the five-hour bus ride from Guadalajara to this capital city, Rocio Medeles cried over her misfortune.
She was a 26-year-old single mother, pregnant by a man who was about to marry someone else. In the past, she would have been presented with a stark choice: Have the baby, or risk permanent damage to her health at one of Guadalajara’s many underground abortion clinics.
But in April, legislators decriminalized abortion in Mexico City’s Federal District, about 350 miles away. Since May, more than 3,400 women have received abortions at 14 of the capital’s public hospitals.
“If it hadn’t been for the option to go to the Federal District, I probably wouldn’t have risked a clandestine abortion,” said Medeles, who traveled to Mexico City for the procedure in September with her 6-year-old daughter. “I might have had the baby, although I probably would have given it up for adoption.”
Abortion remains illegal in the rest of Mexico, as it is in nearly all of Latin America. A group of activists, most of whom are Roman Catholics, routinely picket public hospitals here to condemn abortion.
But in Mexico City, legalization is bringing a profound, if quiet, change to the way thousands of women lead their lives. In a country where unwanted pregnancies often strip women of their independence and ambitions, the extraordinary number of legal abortions taking place every day is beginning to diminish the procedure’s considerable cultural stigma.
“When people think of abortion, they no longer think of a hidden, shameful, illegal, clandestine and expensive procedure that is full of risks,” said Marta Lamas, who founded Mexico’s leading abortion rights group in 1992.
Ana, a 22-year-old Mexico City law student, decided to have a legal abortion after much soul-searching and worry.
“I thought about being pregnant with my studies half-done, with my parents yelling at me, and my boyfriend desperate about money,” Ana, who asked that her last name not be published, wrote in an e-mail to The Times. “I thought, ‘I don’t want this for my life.’ ”
Ana’s experience at a Mexico City public hospital included pre- and post-abortion counseling sessions. Like most women undergoing abortions at public hospitals here, she paid nothing for the procedure.
City officials say a range of women and girls have had abortions at the city’s hospitals since May, including at least one 11-year-old. A quarter came from outside the city, officials said, some from as far as Baja California, more than 1,000 miles away.
Mexico’s Supreme Court is expected to rule early next year on a petition to have Mexico City’s law overturned on constitutional grounds. Abortion opponents are skeptical about their chances.
“It will be difficult, because attitudes are changing,” said Jorge Serrano Limon, leader of the National Pro-Life Committee, the leading antiabortion group here. “The pro-abortion current is growing tremendously. At the beginning, there was resistance in the medical community. Now there isn’t any.”
Serrano Limon fears that two Mexican states with leftist governments, Guerrero and Tabasco, might legalize abortion soon. Venezuela and Brazil could be next in the region to change abortion laws.
“This has been the bitterest battle because now we are seeing killing at a large scale,” said Serrano Limon, who formed the National Pro-Life Committee when Mexico’s Communist Party first proposed legalizing abortion in the 1970s.
Serrano Limon lashed out at Mexico City Mayor Marcelo Ebrard for signing the bill into law less than a day after it was approved by the city legislature, dominated by the mayor’s Democratic Revolution Party. Ebrard’s public health department has worked to make abortion available to any woman who wants one and whose pregnancy has not progressed beyond 12 weeks.
“The Aztecs sacrificed prisoners of war, but not even they killed as many people as Marcelo Ebrard is killing now,” Serrano Limon said.
The votes of eight of the 11 jurists on the Supreme Court would be needed to overturn the law on the grounds that it violates the rights of the unborn. But Serrano Limon and others count at least four jurists already in the abortion rights camp.
Legalization supporters say that with each day that passes, it is less likely that the court will overturn the law and drive abortion back underground.
Many of the old secret “clinics” that offered the cheapest and most dangerous surgical abortions, usually for about $400, have closed. Private hospitals that once charged as much as $2,000 for an illegal abortion have been forced to sharply reduce their prices, Lamas says.
“The aura of sin, fear and economic extortion is gone,” Lamas said.
Still, many of the women who have received the first legal, “on-demand” abortions in Mexican history are entering unknown emotional territory. Some say they approach the decision with dread.
“I hadn’t slept and I was afraid, even though I knew it was a safe place,” said Ana, the law student, describing the day she arrived at a public hospital for her abortion.
“I believe in God. And at that moment I asked him that nothing happen to me. I wanted to keep on living,” she continued. “If I had made that decision [to have an abortion], it was because I wanted to continue with my life goals, not to die.”
In the end, there were no medical complications. Ana recently completed her midterm exams.
“A lot of people can judge me for what I did . . . but I made the decision to be responsible,” Ana wrote. “If you decide to have a child it should be because you want to, and because you can offer him a decent life.”
Nearly all of the abortions at the public hospitals have been performed without complications, said Dr. Manuel Mondragon, the city’s top public health official. A quarter have been nonsurgical, with patients given abortion-inducing drugs.
“We know other countries are looking at us, and soon we will be publishing studies about our experience,” Mondragon said.
Abortion rights activists say Mondragon’s efforts to make abortions safe and widely available in Mexico City will be remembered as a landmark in Latin America’s reproductive rights movement.
Mondragon said making abortion legal was a crucial public health issue because of the high rates of death and injury caused by illegal abortions: According to one estimate, more than 3,500 women died from botched abortions each year.
“It hasn’t been an easy situation,” said Mondragon, 73, who says that he has received death threats and that protesters have distributed pamphlets labeling him a killer. “I am a Catholic, my family is very Catholic, and I have my personal beliefs. But when you’re in public administration, that’s one of the challenges.”
Abortion opponents launched a highly publicized campaign to persuade doctors and nurses at the clinics to be “conscientious objectors” and refuse to participate in abortions.
Serrano Limon, the antiabortion activist, said 22 doctors and about 60 nurses and social workers had declared themselves conscientious objectors. Mondragon said the activists’ efforts had not hindered the city’s abortion services.
Medeles, the single mother from Guadalajara, didn’t encounter any antiabortion activists in Mexico City. She said she met only doctors and nurses whose treatment of her was surprisingly professional.
“I had never seen a public hospital like that in Guadalajara,” she said. “All the people in Mexico City gave me a lot of support. The person who did my tests, the nurses, the social workers, the psychologist -- five or six people attended to me.”
Back in Guadalajara, her choices had seemed limited. Medeles remembered a 16-year-old classmate who bled to death at home after having an illegal abortion. “My friends in the barrio were telling me to go ahead and have the baby, that abortion would be worse,” she said.
But her friends at the university where she takes high school equivalency classes said abortion was a better choice. “They even gave me money so I could go to Mexico City,” she said.
Medeles came to Mexico City after her sister found the phone number for Catholic Women for the Right to Choose.
The Catholic women’s group got Medeles a hospital appointment in Mexico City. She made four visits to a city clinic over the course of seven days, meeting a few other women undergoing the same procedure.
One was a 14-year-old girl who also feared death. “I got to know her, and afterward we talked and everything went fine with her abortion,” Medeles said.
Another was a very poor woman not much older than Medeles, but with five children. “Her face was battered and bruised,” Medeles recalled. “She didn’t want any more children.”
On Medeles’ final visit, she met with a staff psychologist. Among other things, the psychologist wanted to know whether she had had any dreams with images of death. Medeles answered that she had not.
“I’m very thankful to them,” Medeles said. “They didn’t charge me one peso. . . . If any friend asks me for advice, I’d tell them to go to Mexico City because it went well for me. And you don’t run any risks.”
Cecilia Sanchez and Maria Antonieta Uribe of The Times’ Mexico City Bureau contributed to this report.