Guatemala

OVERVIEW

In Guatemala, you will find women's health care resources, but not without some challenges. Birth control is legal and available without a prescription. There are varying reports regarding the legality and availability of emergency contraception (the morning after pill), but most pharmacists tend to advise women to take birth control as replacement emergency contraceptive (due to lack of availability). While you can find pads and tampons in the city, there are no known sellers of menstrual cups. Note that, once you're outside of cities in Guatemala, it may be difficult to find many menstrual products. You can receive STD/STI testing at medical facilities, and there are no travel restrictions tied to anyone who tests positive for any STI. Abortion is generally illegal, unless the woman's life is in put in jeopardy by pregnancy.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Guatemala, no prescription is required to purchase birth control. In 2015, it was estimated that 57.2% of Guatemalan women (who are married or in unions, and of reproductive age) used a modern contraception method. It was also estimated that 17.3% of Guatemalan women, who are married or in unions, have unmet family planning needs. Contraceptive use in Guatemala seems to be less widely accepted due to traditional religious views. Much of the country is strongly Catholic, and families often view children as "what God gives you" or "out of your hands." Furthermore, it is often men in the families who make family planning decisions, and reportedly some men look down upon birth control, sometimes even viewing it as something for sex workers rather than wives. This has lead to a situation in which many women and their families are unaware of the birth control methods available to them, and they may even be intimidated away from pursuing them.

Guatemala has a particularly high teen pregnancy rate. By the age of twenty, 44% of Guatemalan women are mothers and about 50% are married. By the age of 30, a woman may have had seven or eight children in Guatemala. For women who are uneducated or live in rural areas, these numbers are higher. The majority of children who do not attend school in Guatemala are indigenous children, especially indigenous girls. According to report written by the Council of on Hemispheric Affairs, "even though contraception is available, it is often denied to teens. In Guatemala’s machismo culture, girls are frequently denied birth control at health centers unless accompanied by a man. In the chance that a girl is not denied, most are persuaded by the Catholic Church to not use an effective method of birth control." Furthermore, "The actions by Guatemala’s government in an attempt to decrease teen pregnancy and eradicate sexual violence should be commended; however, more work needs to be done for young girls to finally have an alternative to dropping out of school and becoming pregnant. "

What to Get & Where to Get It

• In public hospitals, you can get free sexual health consultations, condoms and birth control injections. The injections last for 3 months.
• If you want to purchase birth control pills, some brands you can expect to see are Denoval, Neogynon, Nordiol, Ovral, Lo-Femenal. Microgynon and Nordette. They can be purchased at pharmacies without a prescription.
• If you would like an IUD, you can get the insertion done by O.SA.R. (Observatorio de Salud Reproductiva. It's a public institution but the service is not free. You'll pay around 150-200 Guatemalan Quetzal (Q).
• If you would like to get an implant at APROFAM, it will cost around 450-600 Q.

Costs

Generally, birth control pills cost around 22-115 Q for a one month supply. While some public hospitals do birth control implants for free, others charge around 450-600 Q. For an IUD insertion, you can expect to pay around 150-200 Q.

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Guatemala, the morning after pill is available only at a clinic of Doctors Without Borders and used only in case of rape victims.

There are varying reports regarding the legality and accessibility of EC (morning after pill) in Guatemala. However, it can generally be stated that dedicated EC is either fully illegal or very hard to get. For this reason, if you do need some form of EC, it's recommended to use hormonal birth control as replacement EC. You'll find instructions below in the "What to Get & Where to Get It" section on how to do this. There are also many pharmacists in Guatemala (especially in more urban areas, like Guatemala City) who will be willing to help you understand how to take birth control as EC as well.

What to Get & Where to Get It

For dedicated Products / Progestin Only (the morning after pill) Take 1 pill within 120 hours after unprotected sex:

• Postinor 1

If you can't access the morning after pill, you can use Oral Contraceptives (Progestin-Estrogen Combined) used for EC Note: in 28-day packs, only the first 21 pills can be used Take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later:

• Denoval
• Neogynon
• Nordiol
• Ovral

Take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later:

• Lo-Femenal
• Microgynon
• Nordette

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

There are no travel restrictions applied to anyone who is HIV+ or anyone who has any STI.

What to Get & Where to Get It

Testing Facilities

Check out the local city pages, like the Guatemala City page, for local recommendations.

Support

• Asociación Gente Positiva: "Offers medical assistance, psychological assistance, nutritional counseling, access to a medicine bank, legal assistance, job assistance, education and prevention, accompaniment and social work in Guatemala City. Website in Spanish and English."
• Association for prevention: Phone: +502 220 1332; 253 3453, E-mail: oasis@gua.gbm.net, Contact person: Ruben Mayorga
• APAES Solidaridad for prevention: 2 avenida 11 40 zona 1, Guatemala / Guatemala, Phone: +502 232 7649; 220 7225, Contact person: Mario Andrade
• OASIS: 6a. Ave. 11-40 zona 1, Guatemala / Guatemala, Phone: 220 1332; 253 3453, Fax: 232 1021, E-mail: oasisgua@infovia.com.gt
• ASI (Carlitos): 1a Ave.11-19 zona 1, 20. Nivel, Guatemala / Guatemala, Phone: 220 8506; 220 8509; 220 8511, Fax: 251 6531, E-mail: asiagpc@guate.net

Medications & Vaccines

What to Get & Where to Get It

There is currently no common source of PrEP in Guatemala.

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

In Guatemala, you should be able to find pads and, in larger cities, you'll be able to find tampons. For a better selection, it's recommended to visit supermarkets, like La Torre of Paiz. There appears to be no sellers of menstrual cups in Guatemala (i.e. no DivaCup, MoonCup, LadyCup, Lunette, etc.), so menstrual cups should be purchased online. Note that, once you're in rural areas in Guatemala, you may not find any feminine hygiene products at all, aside from occasionally seeing Kotex pads.

Gynecological Exams

What to Get & Where to Get It

• Gynecare Women's Health Clinic: 2278-9212, 2278-9213, Open 9:00AM - 6:00PM.
• APROFAM: "APROFAM is a non-profit and private institution legally founded in 1964. Its objective is to provide quality, gender-equity, and comprehensive health services prioritizing on sexual & reproductive health. It offers diversified services that enable cost recovery and cross-subsidy for family planning, serving the poor across the country." Adress: 5ª Av. 13-18 Zona 1 01001 Ciudad de Guatemala, PBX: (502) 2321.0101, Email: info@aprofam.org.gt. You may also contact our Customer Care Center at http://www.aprofam.org.gt/en/health-centers/

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Guatemala, abortion is illegal in almost all cases, except for when the woman's life is endangered. As stated in Penal Code, Decree Number 17-73 (1973), Guatemalan law believes that "Abortion is the death of the product of conception at any time of pregnancy." Furthermore, "A woman who causes her abortion or consents to another person causing it, shall be punished with imprisonment of one to three years. If driven for reasons linked intimately to her state that produce undoubted psychic disturbance, the penalty shall be imprisonment of six months to two years."

According to a Guttmacher Institute report, "Although Guatemalan law permits induced abortion only to save a woman's life, many women obtain abortions, often under unsafe conditions and in response to an unintended pregnancy. Recent studies indicate that unsafe abortion is a key factor contributing to maternal morbidity and mortality in the country, but no national data on the incidence of abortion exist." Furthermore, "Nearly 65,000 induced abortions are performed annually in Guatemala, and about 21,600 women are hospitalized for treatment of complications. Abortions occur at a rate of 24 per 1,000 women aged 15–49, and there is one abortion for every six births."

As written in a UN report on Guatemala's abortion policy, "Since the amendment to the Penal Code in 1973, the Government has expressed concern about the high rate of occurrence of induced abortion. This concern reflects the Government’s firm opposition to the procedure, as also illustrated in the country’s Constitution. Although article 47 of the Constitution emphasizes the right of persons to decide freely on the number and spacing of their children, article 3 protects human life from conception. Also, despite this legal framework, public reproductive health services are insufficient to cover the needs of the population, and strong attacks on family planning services occur periodically."

What to Get & Where to Get It

• APROFAM: "APROFAM is a non-profit and private institution legally founded in 1964. Its objective is to provide quality, gender-equity, and comprehensive health services prioritizing on sexual & reproductive health. It offers diversified services that enable cost recovery and cross-subsidy for family planning, serving the poor across the country." Adress: 5ª Av. 13-18 Zona 1 01001 Ciudad de Guatemala, PBX: (502) 2321.0101, Email: info@aprofam.org.gt. You may also contact our Customer Care Center at http://www.aprofam.org.gt/en/health-centers/
• Planned Parenthood Guatemala: This website provides some information that may be useful (in Spanish).

Advocacy & Counseling

What to Get & Where to Get It

• El Refugio Shelter: "El Refugio (The Refuge) is a shelter for women and their children escaping abuse, trafficking and violence. In addition to shelter, women coming to El Refugio are provided with legal assistance, medical and dental care, education and job skills training, counseling, and discipleship. Women coming to El Refugio stay up to 12 months, as they go through our program and develop a plan for a healthy living situation." Hope Bible Mission, 8a Calle 12-43 Sector A-10 San Cristobal de Mixco Z-8, Guatemalla, 011 (502) 2479-5984.

List of Additional Resources

• Wings: "WINGS is a US and Guatemala registered nonprofit which for 15 years has provided family planning education and reproductive health services to marginalized communities in Guatemala. We believe that reproductive health is the first step in the fight against poverty, chronic malnutrition, maternal and infant deaths and gender inequality." Address: 9a Calle Poniente #17, Residenciales El Rosario #3, La Antigua Guatemala, (+502) 7832-5130
• UPAVIM: "The mission of our organization, UPAVIM, is to empower the women of our community, giving them an opportunity to improve the quality of life, for themselves and for their families. We pursue this mission by giving them access to education, employment opportunities, daycare services for their children, health care services, and programs for personal and professional development. We are a group of 75 women who live in the marginalized communities of Búcaro, La Esperanza, El Mezquital and Villa Lobos I and II, in Zone 12 of Guatemala City. We are all mothers and homemakers. Some of us are widows, some of us have been abandoned by our husbands or we confront alcoholism and/or domestic violence in our families. Many of us are the sole providers of economic support for our families."