Pass the Mic: Yanina and Carolina, Advocates for Safe Abortion Access 

Carolina Comaleras: Providing services before legal protection 

Carolina, a licensed midwife and one of the first people to join REDAAS, witnessed the complexities of providing safe abortion care long before it was legally protected. For years, she worked in a system where access to safe abortion was a matter of life and death for many women, and where secrecy and fear were the norm. Namely, abortion access was a grey area. 

“When I began to work, abortion was a taboo subject, and we handled it with a certain level of fear. There were no organised support networks or groups, just the desire to help the women who came to our clinics. We knew what we were doing was necessary, but we also knew that at any moment, someone could report us,” Carolina recalls. She remembers how midwives, nurses, and doctors would secretly seek advice from each other in hospital corridors on how to provide safe abortion services, and how many of them attended trainings on how to provide these services abroad because they were not available in Argentina.  

In 2018, Carolina was invited to speak before the National Congress in defence of the right to safe comprehensive abortion services. “I talked about what I did. I did not want to hide that, as a midwife, I had been performing abortions for years,” she recalls. Although the law was not passed then, the advocacy work continued. In 2020, Carolina returned to Congress when the law was finally approved. “It was a historic moment, but there was still much work to be done. Even today, there are people and institutions who hinder access to comprehensive abortion services.” 

“You need to know that it’s possible, and to be ready to fight for people’s right to decide what they want to do with their lives and bodies,” Carolina adds. She firmly believes that abortion is a human right. Although the 2020 law provides a legal framework, she insists that there is still a need for education and clear guidelines to ensure that services are provided without stigma or barriers. “We already have laws on respectful childbirth, now we need guidelines on respectful abortion care.” 

Yanina Miragaya: The strength of a supportive network

Yanina Miragaya, a licensed midwife with a master’s degree in epidemiology, found in REDAAS a space where she could practise her profession with freedom and safety. “I fell in love with my profession again thanks to REDAAS,” Yanina explains. “Before joining, I felt my role as a midwife was limited, especially around sexual and reproductive health. REDAAS gave me a new perspective on what we could achieve as a collective.” 

REDAAS, a network of midwives and other professionals, has been essential in strengthening the role of midwives in providing safe abortion services. Yanina highlights the importance of such networks, not only in safeguarding rights but also in supporting midwives. “Many times, midwives work in isolation, especially in rural areas where they are the only reproductive health providers. REDAAS has allowed us to connect and organise, creating a real impact in our communities.” 

Obstacles in Argentina: A struggle beyond legalisation 

Despite the approval of Law 27.610, which legalises abortion up to 14 weeks of pregnancy (and beyond that, under certain conditions), midwives in Argentina continue to face legal and social barriers to providing abortion care. The main challenge lies in the legal gaps at the provincial level. While the national ​abortion ​law includes midwives as health professionals authorised to perform​ such practices ​, many provinces have yet to update their​ professional​ regulations to reflect this change. This leaves midwives in an ambiguous position, without the full legal protection needed to practise. 

These legal gaps also extend to other essential sexual and reproductive health services, such as contraception provision. “We know how to insert implants and IUDs, how to provide safe abortion, but we don’t have the legal security to do so without fear of repercussions,” Yanina explains. In some provinces there have been significant advances, allowing midwives to prescribe medications like misoprostol. However, in most of Argentina, midwives still rely on doctors to sign prescriptions or authorise procedures. 

“It doesn’t make sense that a midwife can safely perform an abortion but doesn’t have the legal right to do so in the majority of provinces in Argentina,” Carolina points out. Despite these limitations, many midwives continue providing abortion services, knowing they are saving lives and ensuring women’s right to health services. “Women come to us because they know we are accessible and trustworthy. We do what we can, but we need the law to back us.” 

Essential competencies and legal support 

Midwives have the ​technical ​competencies to provide 90% of sexual and reproductive health services. However, as Carolina and Yanina explain, these skills must be supported by a legal framework that allows midwives to work autonomously. “We know how to provide safe abortion care. What’s missing is for the law to recognise us and give us the tools to practise our profession,” says Yanina. The ICM Essential Competencies for Midwifery Practice can provide a framework that is helpful to midwives, regulators and legislators, as it describes midwives’ role in providing contraception and comprehensive abortion services. 

In Argentina, a couple of provinces have updated its legal frameworks to allow midwives to prescribe misoprostol and mifepristone, the most common medications used for comprehensive abortion care. While this is a significant step forward, much work remains. Yanina points out that REDAAS has documented that more than 80% of midwives ​surveyed ​are already providing these services, even in the absence of an explicit legal framework. 

This legal support is crucial not only for abortion care but also for other vital sexual and reproductive health services, such as prescribing contraceptives and inserting IUDs.  

Advice for midwives in working in countries with restrictive laws 

Carolina and Yanina’s experiences offer valuable lessons for midwives in countries where abortion is still illegal or highly restricted. “Midwives have always been with women, at every stage of their lives. Abortion is just another event in the reproductive cycle, and we must treat it with the same respect and care as any other health service,” says Carolina. 

Yanina underscores the importance of organising. “REDASS taught us that together we are stronger. My advice to other midwives is to organise, support each other, and work for the recognition of your professional autonomy. Don’t be afraid to get involved, to discuss, and to debate for your rights.” 

Looking ahead: Legislation is fundamental 

Argentina’s experience demonstrates that the movement for safe abortion care does not end when legislation is passed. Legal and social barriers continue to pose significant challenges. However, thanks to the tireless work of women like Carolina and Yanina, progress is being made towards a future where midwives can provide women with the sexual and reproductive health services they need, without fear of legal repercussions or restrictions. 

“The law is just the beginning,” Carolina concludes. “We must keep fighting, not only for the right to abortion but for the full recognition of our autonomy as midwives. When the laws support us, real change will come. Until then, we remain steadfast, because we know that women depend on us.”