The decision states: “The filing of a complaint or the existence of a credit and/or a formal indictment is not required. It will be sufficient for a woman who goes to a public or private health centre for the purpose of performing an abortion, because the pregnancy is the result of a crime, to communicate this situation to the competent authority, and in this way the professional doctor who will perform the abortion has explicit proof that he will justify doing so. “The Constitutional Court declares the criminalization of consensual abortion enforceable, in the sense that the crime is not configured if the conduct is performed before the 24th week of pregnancy, and without subjecting this limit if the grounds given in the C-355 judgment of 2006 are set out. The practice of induced abortion is not limited to a population of a certain age. In this sense, 17% reported having performed an induced termination of their pregnancy between the ages of 13 and 19, half between the ages of 20 and 29 and a third between the ages of 30 and 39.  The judgment allows the application of the penal code to abortion in non-criminal cases and removes any doubt as to the obligation of guarantee of the State, in particular of the health services. On the other hand, it provides an opportunity to open a debate on the decriminalization of abortion in broader terms than those currently contained in the Penal Code. And on the other hand, this judgment removed the legal obstacles that, until then, required judicial approval to carry out the procedure, since they “… incompatible with the right to physical, psychological and sexual integrity, not to be tortured and not to be subjected to cruel, inhuman, degrading and degrading treatment, to physical health and dignity, to the free development of women`s personality and autonomy. enshrined in the Constitution. This criminalization of induced and unauthorized abortion leads to a clandestine practice of people of dubious education and in unhealthy and uncertain conditions that delimit the responsibilities of those who practice it. Despite the existence of constitutional judgment 0206/2014, social pressure from religious groups and the stigma associated with abortion in public often make access difficult, even in cases provided for by law.
Clandestine abortion is the third leading cause of maternal death in the country.  Health professionals who express their obstacle to the execution of the procedures of legal termination of pregnancy must immediately inform the head of the service and / or the director of the health service in order to ensure that the procedure of termination of pregnancy is carried out within the first 2 hours in accordance with the mandatory nature of the sanction. The Court provides that, in cases where abortion is permitted, the doctor`s performance cannot be classified as a criminal offence. The court recognizes that there is a legal practice of abortion. Law No. 21.030, promulgated on 14 September 2017 regulating the decriminalization of voluntary abortion for three reasons, amended, inter alia, the Health Act, replacing its article 119 and adopting articles 119 bis, 119 ter and 119 quarter. In this context, the Conscientious Objection Ordinance is approved by Decree No. 67 of 2018, in accordance with the provisions of Article 119 ter of the above-mentioned Code. It is common ground that a surgeon who is required to terminate the pregnancy for one of the reasons described in Article 119(1) of the same legal person may refrain from carrying out the pregnancy if he has expressed his conscientious objection in writing and in advance to the director of the health institution. Similarly, the same command guarantees the rest of the health workers responsible for carrying out their duties in the surgical pavilion during the procedure just described.
Finally, this legal norm stipulates that an institution may invoke conscientious objection. Notwithstanding the above, the Office of the Auditor of the Republic in its Opinion No. 11.781 of 2018 stressed that some health institutions cannot be conscientious objectors, including private health institutions that are considering obstetric and gynecological services, which by their nature include care in the pavilion and have signed the agreements subject to the provisions of the decree with the force of Law No. 36. from 1980 from the Ministry of Health. If the woman needs immediate and urgent assistance and invokes the reason of No. 1 of the first paragraph of article 119 of the Health Code (“The woman is at vital risk, so that the termination of pregnancy avoids a danger to her life”), the institution that expressed a conscientious objection to military service, do not excuse the implementation of termination of pregnancy. Abortion in Bolivia, which refers to induced abortion, has been regulated in Bolivia since 1973.  It is legal to prevent damage to the woman`s health or in cases of rape.
In another case, the abortion has a penalty for both the pregnant woman and the person performing it. Constitutional Decree 0206/2014 stresses that pregnant women have access to abortion without the need for judicial approval, which was the norm until then. The reasons for access to abortion increased in 2018.  The possibility of using the procedure to prevent current or future risks to the life and general health of pregnant women, malformations incompatible with life, whether as a result of non-consensual assisted reproduction, rape or incest, and in the case of girls and adolescents or when they are dependent on older adults, has been added – with a disability or other minors or are students.  The director or service provider, as the legal representative of the health service, may under no circumstances invoke conscientious objection. As an institution and not as an individual representative, it must guarantee that the legal termination of pregnancy will be carried out within the first 24 hours. Abortion in Bolivia is the third leading cause of death for pregnant women, and there are even departments like Cochabamba where abortion is the leading cause. You should know that these deaths are preventable if you have less restrictive laws and if the procedures are performed by properly trained health workers and in appropriate sanitation facilities.
Article 153 does not decriminalize abortion, which is what many organizations and activists who are part of the September 28 campaign and the National Pact for the Decriminalization of Abortion in Bolivia want, but it does elaborate on the causes for which a woman will have access to a legal and safe abortion. This is essential in a country with one of the highest maternal mortality rates in all of Latin America and the Caribbean, where abortion is the third cause and where it is estimated that about 200 women abort every day in secret places (remember that Bolivia currently has 11 million inhabitants). Abortions performed under conditions of secrecy and uncertainty, in poorly ventilated and dirty rooms and, in many cases, by people who lack the necessary professionalism. Abortions that take women`s lives and leave many others in situations of disability. Article 153 extends the conditions under which abortion is already permitted, namely rape, incest, legal rape and the risk to the health of the mother; and includes the cause of life-incompatible fetal malformations, assisted reproduction, to which the woman has not consented, and in cases where the pregnant woman is a girl or adolescent girl. In a country where, according to the United Nations Population Fund, 10 teenage pregnancies were recorded every hour, many life projects are interrupted by unwanted motherhood, often the result of sexual violence. In 2014, the Bolivian Constitutional Court issued judgment 0206 of 2014, which means progress that you should be aware of. This constitutional judgment makes it clear that the requirement for access to abortion is the consent of the woman (girl, adolescent, adolescent, adult), which is why it can be confirmed that every woman, regardless of age, has the right to have an abortion in these circumstances. However, the Bolivian Population and Health Survey shows that about 40% of pregnancies in Bolivia are unwanted and, according to serious estimates by the United Nations Population Fund (UNFPA), it is estimated that about sixty thousand abortions are performed in the country each year.