The Caribbean Initiative on Abortion and Contraception
School of Medicine of the University of Puerto Rico

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Caribbean Initiative on Abortion and Contraception

Saludpromujer, Department of Obstetrics and Gynecology, School of Medicine,
Medical Sciences Campus, University of Puerto Rico

University of Picardie Jules Verne, Amiens, France, and University of Paris 8/CNRS

(National Center for Scientific Research)

The Caribbean Initiative on Abortion and Contraception conducts research, training and education with health practitioners, women’s groups, policy-makers, professors and scientists in the Caribbean. The Initiative builds cross-border and interdisciplinary networks for improving women’s access to quality sexual and reproductive healthcare services and provisions. Anguilla, Antigua and Barbuda, Barbados,Guadaloupe, Guyana, Jamaica, Martinique , Puerto Rico, Saba, St. Eustatius, St.Maarten, St. Martin, St. Kitts and Nevis, St. Lucia, and Trinidad and Tobago have participated in network activities. The Caribbean Initiative was founded in 2000 by

Yamila Azize-Vargas and Gail Pheterson who have since co-directed the project from their respective university bases, Department of Ob-Gyn at the University of Puerto Rico Medical School, the University of Picardie Jules Verne and the Paris Center for Sociological and Political Research (CRESPPA), University of Paris 8/CNRS (National Center for Scientific Research). For information you can contact Yamila Azize Vargas at yazizevargas@gmail.com and Gail Pheterson at gpheterson@gmail.com.

Research on Abortion

From 2001 to 2004, the Caribbean Initiative conducted a field investigation of abortion laws, policies and cross-border service delivery systems in five island countries of the northeast Caribbean. A working paper in English, French and Spanish, a condensed English publication and a more elaborate sociological publication in French reveal the complexities of abortion realities in the region and the need for improvement in services to assure the autonomy and health of women. Following the study, research participants including health professionals, women’s groups, family planning personnel and health authorities joined the Initiative and participated in a series of expert meetings.

See: Pheterson, Gail and Azize, Yamila. Abortion practice in the Northeast Caribbean: ‘Just write down stomach pain’.” Reproductive Health Matters. 1 (26): 44-53, November 2005; Pheterson, Gail and Azize, Yamila. “Avortement sécurisé hors la loi dans le Nord-Est des Caraïbes. Sociétés Contemporaines, no. 61, pp. 19-40, 2006.

Expert Meetings and Regional Conferences:

The Expert Meeting on Abortion and Contraception: Europe and the Caribbean, September 2003, took place at the University of Picardie Jules Verne in Amiens, France, for health practitioners, government health authorities and research clinicians from St Martin, Sint Maarten, Anguilla, St Kits and Nevis, Antigua and Barbuda, France, England, Spain, Netherlands, United States, and South Africa. The European venue was deliberately chosen to provide practitioners and policy-makers from restrictive legal environments in the Caribbean an opportunity for inter-island networking away from home and for networking with practitioners and policy-makers from other world regions in a context of liberal abortion laws and institutionalized abortion practice. The meeting mobilized a committed network of local actors, international consultants from global organizations, and university medical experts with facilities for educational and clinical training. Participants formulated objectives including improved access to services, liberalization of laws, curriculum change in medical education, training protocols for professionals, and ongoing clinical and political collaboration between Caribbean countries and between the Caribbean network and global reproductive health centers.

Abortion in the Caribbean: From Law to Practice

In May 2005, the Caribbean Initiative organized a large expert meeting in Antigua–Barbuda. Caribbean of organizations (family planning offices, women and gender programs) , health professionals (physicians, nurses and social workers), activists and government officials. This event had the support of The Population Council, Gynuity Health Projects, Ibis Reproductive Health and Ipas. Participants came from 14 Caribbean countries: Anguilla, Antigua–Barbuda, Barbados, Curaçao, Dominica, Guadeloupe, Guyana, Jamaica, St Eustatius, Sint Maarten, Puerto Rico, St Kitts–Nevis, St Lucia, and Trinidad–Tobago. The meeting focused upon legal and clinical issues, and culminated in a Declaration of Health Professionals, Scientists and Advocates For Decriminalization of Abortion in the Caribbean.

Caribbean Nursing Summit on Sexual and Reproductive Health

A Nursing Summit was held in Sint Maarten, April 2009, as a training workshop for nurse practitioners and educators committed to innovative programs in nurse and midwife educational institutions. This Summit culminated in the formalization of a nurses’ network, signatures of nurse participants from 10 Caribbean countries onto the Declaration for the Decriminalization of Abortion in the Caribbean, and development of several island projects related to clinical education and practice, (continuing) education and advocacy for legal reform. .A follow up meeting was held in Puerto Rico in April 2010.

Working Groups:

CARIWONET. The Caribbean Women’s Network for Sexual and Reproductive Health and Rights was organized to assure communication between women and their service providers. The network included 14 Caribbean countries held regular meetings with individual activists and organizations representing Caribbean civil societies and government gender affairs offices.

A Physician’s Working Group first convened at the Expert Meeting in Amiens, France, 2003, as a loose network of general practitioners, ob-gyn specialists, health officials and medical researchers interested in improving access to quality contraception and abortion in the Caribbean region. This network began on the 5  islands of the original research, expanded to include international researchers of the Amiens meeting, and extended to practitioners on a total of 14 Caribbean countries convened at the Antigua conference. Since one of the recommendations of the network was to develop continuing education opportunities for practicing health professionals and residents/students in training at Caribbean university centers, expert medical consultant Dr. Marijke Alblas was engaged by the Caribbean Initiative to conduct educational activities in the region. Several clinical training activities were organized with the support of the World Population Foundation. Dr. Alblas visited 10 islands of the network during three one month periods from 2004 to 2005. She trained manual vacuum aspiration and use of local anesthesia in hospitals, and conducted educational sessions for doctors, nurses, family planning staff, women’s groups, high schools students and policymakers. Those sessions helped meet pressing needs and outline future programs for additional clinical, educational and research activities.

Clinical-Medical Training. The first formal meeting of the Physician’s Working Group took place in June 2006 in New York with the support of Planned Parenthood New York City, Margaret Sanger International Center and Mt Sinai Medical Center. One of the most outstanding results of this meeting was designing and getting authorization for a hands-on clinical training program for Caribbean physicians. Three Caribbean physicians from Antigua, Dominican Republic and St. Kitts went to New York for this training. In addition, a course was designed at Mt. Sinai Medical School permitting Puerto Rican medical students from the University of Puerto Rico to go to New York for family planning training. So far we were able to support 5 fellowships.

Medical and Nursing School Curriculum Project.

Throughout this decade we were able to identify faculty at medical and nursing schools

interested in sexual and reproductive health issues. A number of meetings were organized that culminated in a Caribbean Regional Curriculum Transformation Projects supported by The Ford Foundation.

Caribbean Nurses Network: Following the Regional Nurses Meeting in Sint Maarten, a Nurses’ Working Group was constituted that met in Puerto Rico April 2010 with representatives of the 5 founding islands of the network plus a representative of Dominican Republic. Participants were committed to developing local research and action projects within their educational institutions.

A Decade of the Caribbean Initiative: Meeting in Sint Maarten, August 2015: Assessment of progress and ongoing challenges in assuring abortion and contraception access  in the Caribbean. In progress…