How Is Criminalization Experienced?
What Can I Find on This Microsite?
On this microsite, you will find information about the different ways in which abortion is criminalized. It explores the stigma around abortion—rooted in legal frameworks, institutional practices, and sociocultural contexts—that continues to permeate health care settings and examines how the inclusion of abortion in criminal codes affects the lives of women and other people with the capacity to gestate.
Drawing on an analysis of cases accompanied by GIRE, the microsite shows that criminalization extends beyond the opening of criminal investigations or the formal justice system itself. Here, you can explore how treating abortion as a crime—even when it does not lead to formal criminal proceedings—has social, institutional, and community-level consequences that hinder access to healthcare, reinforce prejudice, and perpetuate discriminatory practices.
Additionally, the microsite presents the different forms of criminalization—both direct and indirect—as well as the mechanisms through which stigma is transformed into surveillance, generates fear, and imposes structural barriers on the free exercise of rights.
Methodology
This study is based on case files of women accompanied by GIRE, and in particular on the notes recorded by accompanying staff from the opening to the closure of each case. Through qualitative analysis of these materials recurring patterns and dynamics were identified that reveal how criminalization and stigma operate within health care services.
Supported by qualitative analysis software, an initial set of observations was developed which made it possible to identify emerging themes as the project advanced. This, in turn, allowed for the identification of criminalization related practices that are discussed in greater detail below; namely, the imposition of facts, medical negligence, keeping people in a state of uncertainty, the distortion of clinical information, the initiation of criminal proceedings, and violations of due process—as well as the phenomena of construction of culpability and construction of defensive responses.
Taken together, these findings made it possible to define what GIRE refers to as a criminalization protocol, i.e., institutional dynamics structured around the stigma associated with abortion as a crime, which affect both service users and those who accompany them. This approach not only made it possible to confirm that stigma is reflected in concrete practices within health care settings, with direct impacts on those who seek medical services; it also revealed a broader phenomenon of social criminalization.
While the cases analyzed primarily reveal these practices within health care settings, they are by no means confined to them. The home, the family, and the broader community also continue to be spaces where judgment, control, and discrimination persist, reinforcing and perpetuating these patterns.
Similar research has been conducted in other Latin American countries using an approach comparable to the one presented here. Examples include, La crueldad hecha rutina: Criminalización del aborto en Perú, 2012-2022, La criminalización por aborto y otros eventos obstétricos en la Argentina, La criminalización del aborto en Colombia, and Del hospital a la cárcel. Consecuencias para las mujeres por la penalización sin excepciones de la interrupción del embarazo en El Salvador, 1998-2019. This study is thus situated within a broader regional effort to document abortion criminalization, showing that the patterns identified here are not anomalies, but rather consistent and recurring dynamics across Latin America.
Stigma and Access to Abortion
When a stigma takes hold, your perspective shifts without you even realizing it. You enter the consulting room wearing your white coat and with years of training under your belt, yet something else seeps into your decision-making—something not found in medical textbooks. The mere presence of abortion in criminal codes acts as a vague but persistent shadow, capable of shaping medical practice even without a criminal investigation on the horizon.
Suddenly, medical practice is no longer limited to care, support, and clinical judgment; it becomes entangled with fears, prejudices, and doubts that have been learned and internalized. In this way, stigma turns a health care need—abortion—into an object of guilt and suspicion. It alters the questions asked, deepens hesitation, and fosters a posture of constant surveillance, even in settings where abortion is legally permitted.
There is no need for a formal criminal investigation to exist. The mere fact that abortion is classified as a crime taints medical consultations, disrupts relationships with those seeking care, and erodes the trust that should guide every clinical decision. When stigma becomes embedded in medical practice, it harms those who need the service and also distorts how health care personnel understand their own duty to provide care.
How Is Stigma Related to the Criminalization of Abortion in Criminal Codes?
Stigma begins not when a criminal investigation is opened—that is, when a formal accusation is brought before a justice institution—but much earlier.
It stems from the way the law, particularly criminal law, defines abortion and establishes the conditions under which it may be accessed. Although abortion has been decriminalized in three quarters of Mexico’s federal entities, this decriminalization is limited either to a certain number of weeks or to specific legal grounds. If a person seeking an abortion does not meet the criteria in force in their state or federal entity—even though their need for medical care may be identical to that of someone in another entity—the law penalizes their decision. This blurred and often poorly understood legal boundary fosters fear, hesitation, and self-censorship among those seeking care.
In ruling on Action of Unconstitutionality 148/2017, the Supreme Court of Justice of the Nation recognized that criminalizing abortion without exception violates the human rights of women and other people with the capacity to gestate.[1] In its decision, the Court explained that a total ban on voluntary abortion nullifies the right to decide, which encompasses everything from comprehensive sexual education to the possibility of continuing a pregnancy or terminating it under the best available conditions.
When abortion is treated as a crime rather than as an essential health service, the effects of criminalization manifest preemptively. The consequences of including abortion in criminal law are evident even in the absence of formal legal proceedings. These effects become apparent, for example, when a person arrives at a hospital fearing social judgement, being reported to the authorities, or interrogation; when a health professional hesitates to provide comprehensive care out of concern about potential criminal liability; or when the mere act of seeking information about abortion services is perceived as a risk.
In this way, stigma rooted in the criminal framework becomes a barrier to accessing abortion, impacting care even before any clinical assessment takes place. The following section examines the components of this stigma: how it is constructed, how it is reproduced within institutions and communities, and how it shapes the experiences of those seeking to exercise their right to reproductive health.
How Does Stigma Around Abortion Manifest in Health Care Settings?
Stigma has no single face: it is expressed through the actions, decisions, and value judgments of health care personnel toward those[2] in their care. In the cases analyzed by GIRE, various practices were identified that do not always lead to the opening of a criminal investigation, yet nonetheless transform medical care into a space of surveillance and criminalization. Practices such as imposing a particular version of the facts, engaging in medical negligence, keeping service users in a state of uncertainty, or distorting clinical information constitute what GIRE refers to as symbolic criminalization. Although these practices do not carry direct legal consequences, they generate profound feelings of guilt, constant scrutiny, and a sense of vulnerability. By contrast, the initiation of legal proceedings and violations of due process amount to criminal prosecution—the most explicit and severe form of institutional persecution.
This section explains how these forms of criminalization manifest within health care services. By means of illustration, it features a ball of yarn with interactive points representing the different types of criminalization identified in the cases analyzed. By clicking on each point, you can explore examples of symbolic criminalization and criminal prosecution, along with reconstructed testimonies that illustrate how these experiences are lived.
When I arrived at the hospital, I felt that from the very first moment the personnel had already decided what had happened to me. Even though I had only taken diclofenac, they were convinced that I had used abortion pills and began treating me as if I’d committed a crime. They didn’t provide care; instead, they accused me and called the Prosecutor’s Office, which sent agents who interrogated me insistently and aggressively. I felt blamed for something that wasn’t true.
Imposition of Facts
This form of symbolic criminalization occurs when health care personnel assume—without any clinical evidence or dialogue with the service user—that a criminal act related to abortion has taken place. It is a practice rooted in stigma, whereby any symptom, complication, or prior event is interpreted as proof of an induced abortion, even when this is not the case, such as in the event of a miscarriage or the use of medication without the intention of terminating a pregnancy.
Under this logic, health care personnel construct a narrative of guilt even before conducting a complete medical assessment. If a person reports having taken a pill for pain, it is presumed to have been misoprostol; if they present with bleeding, it is assumed to be the result of a deliberate act. This imposition transforms the medical consultation into a space of suspicion rather than care, marking the service user as “responsible” for a crime without any supporting evidence.
Imposing a predetermined narrative not only undermines medical care, but also paves the way for further repercussions, including interrogation, denial of services, threats, and other practices that infringe upon individuals’ dignity and health. It represents an early form of criminalization.
I arrived at the hospital extremely frightened because of my hemorrhage, but the staff left me waiting for hours without relieving my symptoms. Nearly a month passed before I was given an appointment in the gynecology unit, and it was a family member who finally managed to get me seen. Before the procedure, I was left without food for almost 30 hours. Afterwards, while I was still recovering, they interrogated me. It felt as though everything was intentional, as if I deserved to be treated that way for what they believed I’d done.
Medical Negligence
This is a form of symbolic criminalization that takes place when, in response to the suspicion that an abortion has occurred, health care personnel delay, deny, or provide incomplete care to a person in need of medical attention. It is not an isolated oversight, but rather an institutional response shaped by prejudice and by the deeply entrenched social belief that certain behaviors must be punished. As a result, the service user is left in a situation of heightened vulnerability and without adequate protection.
In these cases, health care personnel may minimize symptoms, delay necessary interventions, deny pain relief, make moralizing comments, or subject individuals to degrading treatment. In this way, the suspicion of an induced abortion functions as an informal justification within the institutional setting for delivering substandard care, in direct contravention of medical ethics.
Medical negligence can occur even in the absence of evidence of an induced abortion or any formal complaint, and may nonetheless cause serious harm. When stigma intervenes, the right to health becomes subordinated to the moral judgments or presumed legal considerations of health care personnel, and the quality of care ceases to be determined solely by individuals’ medical needs.
During the days I was in the hospital, no one clearly explained what was happening to me, even though they ran many tests and asked me endless questions. My family received different versions: some staff members said everything would be fine, while others suggested that the medication I had taken was dangerous—almost like poison. We didn’t know what to expect. When the person accompanying me returned to request the follow-up appointment, they treated her well at first, but when they realized it was for me, they scolded her and told her that I had to come in myself, supposedly because of an emergency, but without explaining what it was. In the end, they just gave her a distant date for the appointment, ignoring the supposed “emergency” they had mentioned, and leaving us once again without clear answers.
Keeping Service Users in a State of Uncertainty
This form of symbolic criminalization arises when information about a service user’s health status is withheld, distorted, or conveyed in a fragmentary manner, generating confusion and distress for both the individual and their family members. Rooted in stigma and in the suspicion that an induced abortion has occurred, this practice undermines communication—one of the pillars of medical care—preventing it from fulfilling its role in guiding and accompanying the clinical process.
Instead of providing clear explanations about the diagnosis, potential risks, or next steps, information shared is often insufficient, contradictory, or inaccurate. This may occur even in emergency situations when a person presents with serious complications, whether due to the incorrect use of misoprostol or to a miscarriage requiring immediate medical attention. The resulting uncertainty—which arises from not fully understanding what is happening or what decisions are being made regarding one’s health—intensifies fear and vulnerability and reinforces patients’ perception of receiving care that does not adequately respond to their actual clinical needs.
Keeping service users and their close circles in this state of misinformation heightens both medical and emotional risks and therefore constitutes a form of institutional violence. In health care settings, the mere withholding of information can function as a tool of control, deepening mistrust and suffering in moments of profound vulnerability.
When I arrived in pain, they first told me the pregnancy was just over thirteen weeks, then they said it was fourteen, and in the end it became eighteen. Every time the number increased, it felt like everything became more complicated. They made my mother sign documents without explaining anything to her, and each step made me feel more guilty and confused.
Distortion of Clinical Information
This form of symbolic criminalization arises when a service user’s medical record does not accurately reflect the reality of their case, whether due to normalized clinical practices, clerical errors, or interpretations shaped by stigma surrounding abortion. A common example is the recording of an overestimated gestational age. Although it is not always possible to determine whether this variation is intentional or the result of routine procedures, its effects are significant, as it carries symbolic and moral weight, conveying the idea that the service user was in a “more serious” situation than was actually the case.
This alteration tends to occur in federal entities with legal frameworks that restrict abortion to specific gestational time limits. In this context, each additional week increases perceived legal responsibility and reinforces social perceptions of culpability, thereby encouraging more restrictive and stigmatizing treatment.
In these cases, the central issue is not verifying the precise accuracy of the data recorded, but recognizing that, when the legal model is structured around gestational limits, modifying that information—intentionally or otherwise—has consequences that directly affect medical care. The distortion of clinical information turns a medical datum into an instrument of stigma, reinforces a narrative of criminality, and fuels criminalization within a setting that should be governed by health criteria rather than moral judgements or criminal proceedings.
Three years after going to the hospital, I learned that there was a criminal case for abortion filed against me and that an arrest warrant had been issued. I was detained and brought before a judge, as if I’d committed a crime. I was sent to prison. I was only released after we paid the three thousand pesos that were set as bail to regain my freedom.
Initiation of Criminal Proceedings
The initiation of criminal proceedings is the most visible and aggressive expression of abortion criminalization. Unlike other more subtle or symbolic forms, it occurs when the suspicion that an induced abortion has taken place triggers the intervention of the justice system: a criminal investigation is opened, the public prosecutor’s office is notified, and the hospital ceases to function as a space of care, instead becoming the gateway to a criminal process.
In these cases, the person who arrives at the hospital seeking care—often in pain, experiencing bleeding, or facing a medical emergency—ceases to be treated as a service user and is instead regarded as a presumed offender. Extreme situations have been documented in which, even while in a state of vulnerability or under sedation, service users are handcuffed to hospital beds, guarded by police officers in inpatient areas, or interrogated without legal counsel or accompaniment. In other words, the priority shifts from safeguarding the person’s health to gathering information or evidence to substantiate a potential crime—even when no crime has occurred.
Criminal prosecution results in judicial proceedings and penal sanctions, but its impact begins much earlier. It starts the moment a logic of punitivism is activated within a space that should guarantee care, confidentiality, and dignity. This is the most evident and devastating manifestation of the stigma surrounding abortion—one in which criminalization abandons any pretense of subtlety and materializes in police intervention, restrictions on liberty, and penal consequences that permanently mark the lives of those who sought medical care.
When they took my statement at the hospital, no one asked for my consent or explained why they were doing it, and they took photos of me without telling me. They also did not inform me of my rights or that I could refuse to answer. Even though I was a minor, they did not contact anyone in my family, and there was no one there to defend me. Everything happened without any explanations, and I felt alone and scared.
Violations of Due Process
Violations of due process occur when, in the context of criminal proceedings related to abortion, the minimum guarantees that protect the accused are ignored or infringed—such as the right to an effective defense, to receive clear information, and to be treated with dignity. In other words, criminalization is not limited to the violence inherent in legal intervention; it can intensify throughout the process through practices that violate human rights and add further layers of institutional violence.
In practice, these violations occur, for example, when statements are taken without the accused person’s consent, searches are conducted without explanation, or photographs are taken without authorization. They also take place when information about a person’s rights is not provided in an accessible manner—including the right to remain silent—or when conditions necessary for an adequate defense are not ensured, such as access to legal counsel or representation. When these practices take place within a health care setting, a space intended for care is transformed into one of coercion and vulnerability.
In the case of young people, these practices can have particularly serious consequences. Their heightened vulnerability requires reinforced protection safeguards, which are frequently not observed. This includes ensuring accompaniment and legal defense through the presence of a trusted person or legal representative, as well as providing information appropriate to their age and circumstances so that they can clearly understand the decisions affecting them.
Violations of due process compound the harms of criminal prosecution. Beyond the risk of legal sanctions, the accused experiences defenselessness, fear, and exposure before institutions meant to guarantee rights and care. In this sense, stigma and institutional criminalization can converge to deepen harm.
Criminalization Protocol
When stigma permeates medical practice, what GIRE refers to as a criminalization protocol emerges: a set of actions and decisions that, rather than contributing to care in accordance with appropriate clinical guidelines, appear to prioritize surveillance and the interpretation of certain behaviors as potentially criminal. In this context, the suspicion that an induced abortion has taken place can trigger a chain of adverse consequences affecting both the quality of care and the dignity and rights of the service user. It is described as a protocol because, although these practices are not formalized in manuals, they are systematically repeated in the cases analyzed and form a recognizable pattern.
How Does a Protocol Begin?
People seek medical services in response to excessive bleeding, pain, contractions, fever, or vomiting. Some have undergone an induced abortion (for example, through the use of misoprostol) while others are experiencing a miscarriage. During the clinical assessment, the presumption that an abortion may have been induced can become the starting point of the criminalization protocol. When this happens, medical care is mediated by assumptions of culpability.
Once this suspicion takes hold, the service user begins to be treated as though they were involved in a criminal act. What might be described as a “medical truth” is constructed and imposed over the person’s own account of the circumstances that led them to seek hospital care. This, in turn, triggers a series of practices such as:
- imposing a version of the facts;
- engaging in medical negligence;
- keeping the service user and their support network in a state of uncertainty that generates confusion, distress, and fear;
- altering or distorting clinical information (for example, recording an increased gestational age in the medical file).
In more extreme cases, accusations of other crimes such as infanticide are made, even when no formal criminal investigation has been opened. This entire process forms part of what GIRE refers to as the construction of culpability, insofar as the collection of indicators and the interpretation of medical facts cease to be oriented toward meeting the service user’s health needs and instead become directed toward constructing a criminal narrative. The stigma associated with abortion shapes the way in which the service user’s account is no longer received as a need for medical care, but rather as potential evidence of culpability. Under this logic, the idea that a crime has been committed is reinforced, and the person is treated as responsible before the criminal justice system, regardless of factual reality.
In response to constant surveillance and accusations, service users develop self-protection strategies such as remaining silent, withholding their account, seeking legal advice, or framing their responses defensively. This phenomenon—what GIRE calls the construction of defensive responses—results in individuals becoming trapped within the dynamics of the criminalization protocol, where perceptions of culpability and mechanisms of surveillance persist. This process also shifts attention away from the service users’ health needs. Forced to focus on how their behavior may be interpreted, they stop communicating what they require for their well-being and instead prioritize protecting themselves from potential legal proceedings.
In this type of situation, certain practices take place that violate due process and the human rights of service users. These include asking service users to sign documents while they are experiencing a medical emergency or conditioning the provision of adequate care upon giving a statement. Such actions have significant consequences even when no criminal proceedings are ultimately initiated, as they expose service users to mistreatment, humiliation, and institutional violence. For this reason, criminalization can be understood as producing effects that extend beyond formal judicial action.
Spheres of Criminalization
Criminalization protocols operate across three interrelated levels:
- Legal. Through the threat of initiating criminal proceedings and activating criminal justice mechanisms.
- Medical. Through the imposition of negligent or coercive practices that affect how care is provided and violate professional ethics.
- Social. Through the broader impact of criminalization on family members and accompanying persons, who also experience fear, uncertainty, and restrictions in their daily lives.
It is important to emphasize that criminalization does not affect only service users. Family members and those providing accompaniment likewise experience adverse effects, primarily through misinformation and fear of potential legal repercussions. This situation disrupts their daily lives, leading them to fear leaving their homes, receiving summonses, or facing legal proceedings—even when no crime has been committed.
Health Care Settings
The criminalization of abortion can be better understood by contrasting two types of health care settings:
- Stigma-free healthcare: characterized by timely care, clear and accurate information, adherence to clinical protocols, and the absence of legal or moral interference.
- Stigmatizing healthcare: marked by obstacles and practices that generate intimidation and misinformation, violate rights, and, in many cases, prevent the provision of effective care.
Pointing out the existence of a criminalization protocol helps to make visible how, when stigma permeates health services, it becomes a key factor guiding medical practice, transforming care into surveillance and creating a cycle of punishment, culpability, and defense that affects both service users and those who accompany them.
The following diagram compares standard health care protocol with criminalization protocol. The former reflects the care that all service users should receive when seeking healthcare for an obstetric need. The latter diverts that process by prolonging resolution times and, in some cases, ultimately denying the necessary care. The diagram also illustrates the processes of construction of culpability and of construction of defensive responses, which unfold alongside the criminalization protocol.
Healthcare settings
Creation of guilt
The construction of culpability is an institutional mechanism activated when stigma introduces a logic
of hypervigilance into medical practice. Under this dynamic, care becomes oriented toward building a potential criminal case: gestures, words, and clinical history are interpreted as possible indications that a service user has committed a crime. The consultation ceases to be a space for care and support and instead becomes an environment in which clinical information is treated as criminal evidence, reinforcing a perception of culpability.
This phenomenon is particularly evident when interactions with medical or social work staff take on a tone of pressure or persistent questioning directed at service users and their families—for example, when they are asked to “admit” that an induced abortion took place, even in the absence of supporting evidence and while the person is experiencing a medical emergency. In these cases, information is not sought in order to clarify the clinical situation, but rather to confirm a preexisting narrative in which the service user is suspected of having committed a moral or legal transgression.
The construction of culpability is the cumulative result of multiple practices that undermine care, including the imposition of facts, medical negligence, misinformation, and the alteration of clinical data. Taken together, these elements shape a narrative that positions the service user as a presumed wrongdoer. Although this is not a formal or legal process, it can operate as though it were one: care adopts an investigative logic rather than a logic centered on care, and the service user’s experience becomes subordinated to interpretations shaped by stigma and suspicion.
In this context, the service user’s dignity is overshadowed by moral and criminal frameworks that should have no role in clinical practice. Culpability emerges not from the facts themselves, but from their interpretation through the lens of stigma—even in the absence of any crime.
Creation of defense
The construction of defensive responses is the mirror image of the construction of culpability. When service users perceive that health care personnel are attempting to build a narrative that casts them as responsible for a crime, their responses shift toward self-protection. This defense is emotional, discursive, and strategic, arising in response to being interrogated, monitored, or judged in a setting meant to be oriented toward care.
In this context, service users and their family members begin to behave as though they were already involved in a criminal proceeding: they carefully measure what they say, avoid providing details, and modify their accounts out of fear; some even resort to strategies commonly associated with legal defense, such as invoking the right to remain silent when they lack legal advice or representation. These reactions are not evidence of culpability, but rather reflect the—often accurate—perception that a case is being built against them.
Paradoxically, these defensive strategies often reinforce the suspicions of health care personnel. From a position of distrust, silence, requests for time, or reluctance to provide statements are interpreted as confirmation of the stigmatizing narrative that the person is “hiding something.” This dynamic generates a vicious cycle in which the hypervigilance of the medical staff produces defensive behavior, which in turn further fuels surveillance and criminalization.
The construction of defensive responses illustrates the extent to which stigma transforms the dynamics of medical care. The clinical encounter, which should be grounded in trust and care, becomes a tense exchange shaped by fear of accusation and the urgency of self-protection. This phenomenon reveals that, in contexts where abortion remains codified in criminal law, emergency medical care may be experienced as a situation of risk that demands defense rather than a moment of relief in which service users should feel cared for and protected.
Concluding Remarks
The information presented in this section demonstrates that the criminalization of abortion, even when partial—that is, limited to a specific number of weeks or to certain legal grounds—, constitutes a structural barrier to the exercise of the right to health and reproductive health of girls, adolescents, women, and other people with the capacity to gestate. Including abortion in criminal codes does not prevent it from occurring; rather, it creates an environment of stigma, fear, and surveillance that directly undermines access to timely, safe, and high-quality health services.
GIRE has found that fear of legal consequences or institutional abuse inhibits women and people with the capacity to gestate from seeking—or even contemplate seeking—abortion services in public institutions. Moreover, analysis of cases accompanied by GIRE shows that abortion criminalization operates beyond the criminal justice system. Within health care services, it manifests through practices such as the imposition of facts, medical negligence, keeping service users in a state of uncertainty, distortion of clinical information, the initiation of criminal proceedings, and violations of due process. These practices reflect recurring institutional dynamics—identified by GIRE as a criminalization protocol—that relegate the state’s obligation to guarantee comprehensive, confidential, and non-discriminatory care to the background.
The findings further demonstrate that criminalization extends into the family, community, and broader social spheres, where abortion-related stigma reinforces mechanisms of control, culpability, and self-censorship. These forms of social criminalization deepen structural inequalities and disproportionately affect those who already face greater barriers to accessing healthcare. When reproductive autonomy is restricted, not only are fundamental rights violated, but pregnant people are also exposed to serious risks to their physical and mental health, as they are forced to navigate abortion processes under conditions of insecurity, uncertainty, and fear.
In this context, it is essential for the Mexican state to abandon the use of criminal law as a tool for regulating abortion and to move toward its total decriminalization. This measure is necessary to fulfill constitutional and international obligations to respect, protect, guarantee, and promote the right to health, as well as to eradicate institutional practices that reproduce violence and discrimination within health care services.
At the same time, the implementation of public policies aimed at transforming health systems is urgently needed. This implies mandatory and ongoing training for medical and administrative personnel in human rights, a gender perspective, and non-stigmatizing care, as well as the establishment of effective oversight and accountability mechanisms. It is also essential to guarantee that no person is reported, investigated, or interrogated in connection with the termination of their pregnancy when seeking medical care.
This study underscores the need to strengthen a culture of the right to decide as a central pillar of public policy on reproductive health. Shining light on the concrete consequences of abortion criminalization helps dismantle social stigma, prevent human rights violations, and move toward a health care model that recognizes reproductive autonomy as an indispensable component of social justice and substantive equality.
Fecha de elaboración: septiembre de 2026.
