Service Users Referred to Other Medical Units to Access VTP

The Supreme Court’s ruling in AU 54/2018 on conscientious objection is more specific and protective of rights than the provisions set forth in NOM-046. In its decision, the Court established that health institutions, both public and private, must at all times have willing, trained, and available personnel to perform the procedures requested by service users and must not refer them to another medical unit for care. Thus, GIRE requested information on the total number of service users who, between January 2016 and October 2022, were referred to a different medical unit due to a lack of personnel trained to perform VTP. The aim was to assess whether service users have timely access to termination of pregnancy services from the moment they request them.

The expected response from the federal entities and federal-level institutions was that no service users had been referred to another medical unit, since VTP constitutes a medical emergency procedure and, as such, health care personnel are required to provide these services, even if they are objectors.

Illustration of a woman making a paper wheel

Federal Entities
(January 2016 to October 2022)
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Entity Users Referred to Other Medical Units Period

Aguascalientes

4

2017-2019

Baja California

0

October 2022

Baja California Sur

4

2016-October 2022

Campeche

No records

–

Chiapas

Incorrect response

–

Chihuahua

0

October 2022

Mexico City

No information

–

Coahuila

No records

–

Colima

No records

–

Durango

Incorrect response

–

Guanajuato

No records

–

Guerrero

No information

–

Hidalgo

0

July 2021-October 2022

Jalisco

1

Not specified

State of Mexico

No records

–

Michoacán

1

Not specified

Morelos

0

2019-October 2022

Nayarit

0

Not specified

Nuevo León

0

Not specified

Oaxaca

No records

–

Puebla

No records

–

Querétaro

0

2016-October 2022

Quintana Roo

No records

–

San Luis Potosí

No records

–

Sinaloa

No records

–

Sonora

1

Not specified

Tabasco

0

Not specified

Tamaulipas

No response

–

Tlaxcala

No records

–

Veracruz

No information

–

Yucatán

3

2016-October 2022

Zacatecas

0

Not specified

Created by GIRE based on SAI data.

Findings

  • Six federal entities reported that at least one service user was referred to another medical
    unit due to a lack of willing, trained, and available personnel to perform VTP procedures.
  • Nine federal entities reported that no service users were referred to another medical unit
    due to a lack of willing, trained, and available personnel to perform VTP procedures.
  • Eleven federal entities do not maintain records of referred service users, while six others
    did not provide the requested information, did not respond to the request, or provided
    an incorrect response.

Overall, 18.7% of federal entities do not guarantee that service users receive care at the place and time they request VTP services, and in 43.7% of cases it is not possible to determine whether service users were referred to another medical unit. These figures constitute a violation of the state’s obligation to ensure the availability of trained and willing medical and nursing personnel to provide quality, non discriminatory care at all times, including induced abortion services.

Federation
(January 2016 to October 2022)
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Obligated Entity Users Referred to Other Medical Units

IMSS

0

ISSSTE

Hospital Regional de Alta Especialidad Bicentenario de la Independencia, State of Mexico

No cases have been reported

Hospital Regional Centenario de la Revolución Mexicana, Emiliano Zapata, Morelos

Incorrect response

Dirección Normativa de Salud, Mexico City

Non-existent

Hospital Regional General Ignacio Zaragoza, Mexico City

Termination of pregnancy is not performed under any circumstances

Hospital Regional Lic. Adolfo López Mateos, Mexico City

0

Hospital Regional León, Guanajuato

0

Hospital Regional Dr. Manuel Cárdenas de la Vega, Sinaloa

0

Hospital Regional Mérida

0

Hospital Regional Morelia

0

Hospital Regional Monterrey

0

Hospital Regional 1.º de Octubre, Mexico City

No information

Hospital Regional Presidente Benito Juárez, Oaxaca

0

Hospital Regional Puebla

Incorrect response

Hospital Regional B Veracruz

0

Hospital Regional Dr. Valentín Gómez Farías, Jalisco

0

PEMEX

No information

SEDENA

No information

SEMAR

No information

Secretariat of Health

Hospital de la Mujer

No VTP is performed

Hospital Nacional Homeopático

No obstetric services available

Hospital Juárez del Centro

No obstetric services available

Created by GIRE based on SAI data.

Findings

  • Three of the six obligated entities (PEMEX, SEDENA, and SEMAR) do not have
    information on the number of service users referred to other medical units due to a lack
    of willing, trained, and available personnel to perform VTP procedures.
  • In the case of IMSS, it was reported that no service users had been referred to another
    medical unit. However, it was also noted that no VTP requests or procedures were
    recorded during the period analyzed. It is therefore unsurprising that no users were
    referred to other medical units.
  • It is concerning that the Hospital de la Mujer, under the Secretariat of Health, responded
    that it does not perform VTP procedures, given that it is a secondary-level hospital
    focused on reproductive and gynecological care.
  • The fact that the Ignacio Zaragoza Regional General Hospital, part of ISSSTE, stated
    that it does not perform abortions under any circumstances is also alarming.

In conclusion, it is not possible to conduct an analysis of the number of service users referred to other medical units based on the responses provided by obligated entities. This situation was to be expected given the deficiencies in records of personnel who perform VTP procedures, as well as in recording of and follow-up on requests.