Santiago

Chile / Santiago

OVERVIEW

Historically, Chilean society has been considered a conservative society. For example, divorce was only legalized in 2004 and, until 2017, abortion was illegal with no exceptions. This cultural conservatism is due to many factors, including decades of military dictatorship and the influence of the Catholic Church. The majority of the populace live in urban centers (88%), and they identify as Roman Catholic (67%), or as Evangelical or Protestant (16%). However, Chile is a country in transition, and progressive social mores are becoming more mainstream. For this reason, Chilean sexual and reproductive health is in a state of transition.

In Chile, you will find a range of health care options. You can purchase birth control without a prescription. Emergency contraception (the morning after pill) has been a hotly debated political issue, but it is available for purchase (and, as of 2015, no prescription is required). There are no travel or residency restrictions related to HIV status, and you can get STI tests at public or private facilities. There is currently no known PrEP program in Chile but there is an HPV vaccination program. You can find pads, tampons and menstrual cups in Santiago (there is a specific menstrual cup seller that we list in the "Menstruation" section). For decades, Chile had one of the strictest abortion laws in the world, but abortion is now permitted in certain circumstances (see "Abortion" section below for details). Homosexuality is legal, and gay civil unions are recognized by the government.

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 Chile, you can purchase birth control without a prescription. It is estimated that about 65% of Chilean women use some form of contraception and that about 62% use a modern method. The most popular methods are birth control pills (24.8%), IUD (23.1%), the male condom (6.9%) and female sterilization (6.1%).

What to Get & Where to Get It

• In Chile, you can find a huge selection of birth control pills("píldoras anticonceptivas” in Spanish) available, and they can be purchased at pharmacies. The International Planned Parenthood Foundation (IPPF) lists 75 birth control pills registered in Chile, including combined pills, phasic pills and progestin-only pills. Some brands you can expect to see are Microlut, Microval, Microgynon CD, Nordiol, Nordiol 21, Anovulatorios Microdosis, Anulette, Anulette CD, Innova CD, Lo-Femenal, Microfemin, Microgynon, Microsoft CD, Nordette, Norvetal, Rigevidon, Anulette 20 and Loette. For a full list of pill options, click here.
• If you want Nuvaring, you can find it Chile.
• If you want the contraceptive injection ("anticonceptivo inyectable” in Spanish), you can find Cyclofem, Cyclofemina, Depo-Prodasone, Mesigyna and Novafem. In many Latin American countries, you can get the injection directly at the pharmacy, but we're not sure if this is also possible in Chile.
• If you want the contraceptive implant ("implante anticonceptivo” in Spanish), you can find Implanon, Jadelle and Norplant in Chile.
• If you want an IUD ("DIU” in Spanish), you can find Mirena in Chile.

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 Chile, emergency contraception (the morning after pill) is legal. As of 2015, no prescription is required to purchase EC. However, it is a hotly debated and political issue. In 2006, President Michelle Bachelet liberalized contraception policy and made emergency contraception available for free in state-run hospitals, which were available to women ages 14 and up (with no parental consent required). This change inflamed conservative critics. In 2008, the Constitutional Court of Chile banned free distribution of emergency contraception. Furthermore, the court ruled that the hormone levonorgestrel, which is found in EC pills, is “abortive”, and therefore against the right to life. In 2010, a new law allowed teenagers to purchase EC without parental consent.

What to Get & Where to Get It

• You can purchase dedicated emergency contraception in Chile at pharmacies or clinics. They are also offered for free at clinics. One brand you may find is Escapel-1 (take 1 pill within 120 hours after unprotected sex). You may also see Escapel-2, Poslov and Pregnon (take 2 pills within 120 hours after unprotected sex).
• You can have an IUD inserted to prevent pregnancy. Please refer to the "Contraception" section for details.
• If you can't access dedicated emergency contraception, you can use regular oral contraceptives (birth control pills) as emergency contraception. For progestin-only pills, you can take Microlut or Microval (take 50 pills within 120 hours after unprotected sex). For combined pills (progestin-estrogen), you'll need to remember that, in 28-day packs, only the first 21 pills can be used. You can take Microgynon CD (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). You can take Nordiol or Nordiol 21 (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can take Anovulatorios Microdosis, Anulette, Anulette CD, Innova CD Lo-Femenal, Microfemin, Microgynon, Microsoft CD, Nordette, Norvetal or Rigevidon (for all of these, take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). Finally, you can also take Anulette 20 or Loette (take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later).

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 not travel or residency restrictions tied to HIV status in Chile. This means that, if you're a foreigner and you plan to travel to Chile, you will not be asked about your HIV status upon entry in the country. You can also legally carry antiretroviral medication for your personal use.

In recent years, Chile has seen growth in its HIV infection rate, particularly among young people. The HIV infection rate increased by 35% and the AIDS-related death rate increased by 34% between 2010-2016. Health experts point to many reasons why, including a generally conservative culture, lack of proper education or attention paid to HIV, and a lack of public policies to target early detection. It is estimated that about 0.6% of the adult population is living with HIV, and that 70% of people living with HIV know their status. Furthermore, it is believed that about 59% of children and adults who are HIV-positive are receiving ART.

Regarding HPV, Chile has a national vaccination program. As the HPV Information Centre reports, "Current estimates indicate that every year 1441 women are diagnosed with cervical cancer and 734 die from the disease. Cervical cancer ranks as the 4th most frequent cancer among women in Chile and the 2nd most frequent cancer among women between 15 and 44 years of age. About 2.5% of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time, and 85.7% of invasive cervical cancers are attributed to HPVs 16 or 18."

Testing Facilities

If you have Chilean health insurance, the most affordable option is your local CESFAM, which are public clinics. They can give you STI tests, and they can also offer check-ups and consultations. Midwives and reproductive health professionals also work at CESFAM facilities. If you're covered by Chilean health insurance, the services should be free. If you're not covered by Chilean health insurance, you will need to pay for the services. For example, here are some CESFAM locations:

• CESFAM Padre Orellana: Address: Padre Orellana 1708, Santiago, Región Metropolitana, Chile, Phone:+56 2 2386 7743
• CESFAM Benjamín Vuel: Address: Calle San Ignacio de Loyola 1217, Santiago, Región Metropolitana, Chile
• CESFAM Ignacio Domeyko: Address: Cueto 543, Santiago, Región Metropolitana, Chile
• CESFAM Garín: Address: Calle Janequeo 5662, Quinta Normal, Santiago, Región Metropolitana, Chile

If you don't have Chilean health insurance or if you would like a faster alternatives, then you go to a private clinic. These are more expensive than CESFAM, but they're usually not too expensive. Here are some recommended private clinics for STI tests:

• Clinica Alema de Santiago
• Clinica Santa Maria
• Clinica Las Condes

Support

• The government provides free antiretroviral therapy for Chilean citizens.
• Asamblea de Organizaciones Sociales y ONG's con trabajo en VIH/SIDA - ASOSIDA: Address: San Ignacio N° 165, Santiago, Telephone: +5626720000, Fax: +5626720000. Email: asambleavih@gmail.com
• Corporación Caleta Sur: Address: Buenaventura 03906, Lo Espejo, Santiago. Telephone: +56 2 5640388. Email: caletasur@caletasur.cl
• Corporación Chilena de Prevención del SIDA - ACCIONGAY: Address: San Ignacio N° 165, Santiago, Telephone: +5626720000, Fax: +5626720000, Email: comunicaciones@acciongay.cl.
• Programa Nacional de Prevención y Control del VIH/SIDA e ITS - Centro de Documentación: Address: Mac-Iver 541, oficina 68, Santiago, Telephone: +5625740673, Fax: +5626395040.

Medications & Vaccines

What to Get & Where to Get It

• If you have a yeast infection ("infección por levaduras" in Spanish), you can ask the pharmacist for Fluconazole, which is antifungal medication. They'll be able to give you Fluconazole or something similar.
• If you have a urinary tract infection ("Infecciones de las vías urinarias" in Spanish), you can contact a doctor/pharmacist to find out next steps.
• Chile has a national HPV vaccination program, which was launched in 2014. It targets to vaccinate girls at age 9.
• There are no known providers of PrEP in Chile.

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 Chile, you will be able to find pads and tampons. Pads are definitely the most easy to find and the most popular. You'll be able to find some tampons, which are becoming more popular too. As for menstrual cups, you can buy LadyCup on the LadyCup Chile website. You can buy MoonCup online and have it delivered from the UK to Chile -- click here for details. There are no known sellers of DivaCup or Lunette in Chile, so those products may need be purchased online or bought through alternative channels.

Gynecological Exams

What to Get & Where to Get It

• Ricardo F. Estay Villalón: He's at Clinica Vespucio. Recommended by a Santiago local. Pap 9700 +- and consult about 15000. Address: av. serafín zamora # 190, La Florida, Chile.
• Dr. Guillermo Galan: Languages: English, Spanish. Over 40 years of private practice. "I am a volunteer for the International Planned Parenthood Federation (IPPF) since 1987, an organization that provides sexual and reproductive health information, education and services in over 170 countries." Address: Guardia Vieja 181, Providencia, Santiago de Chile, Chile
• Dr. Carolina Ortega: Languages: English, French, Spanish. Over 10 years of private practice.
• Dr. Juan Enrique Schwarze: Languages: English, German, Spanish. Over 20 years of private practice. Address: Camino Farellones 18.780 km 4, Lo Barnechea, Santiago de Chile, Chile

Costs

We still need to gather more information on costs -- but one expat has told us that she paid $5-20/visit (on average) after her insurance coverage (she was covered by Banmedical).

Pregnancy

Laws & Social Stigmas

In Chile, women are entitled to 6 weeks of maternity leave before childbirth and 12 weeks after childbirth. The mother may also choose to take an additional 12 weeks off or 18 weeks of half-day work following the expiration of the initial 12 weeks.

The maternal mortality rate is 22 deaths per 100,000 live births. This rate is roughly comparable to Moldova and Brunei.

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 Chile, abortion is legally permitted in certain circumstances, under Law 21.030. These circumstances are: when the pregnancy endangers the life of the pregnant person, when the fetus will not survive the pregnancy, and during the first 12 weeks for adults or 14 weeks for people under 14 years old in cases of rape. For all other cases, abortion is illegal. This means that abortion is not available upon request.

However, abortion access is difficult for many Chilean women. According to a 2018 report by FIDH and Citizens' Observatory, the scope of Law 21.030 is narrow, which exposes it to many loopholes. For example, a law was passed in 2018 that allowed physicians and medical instutions to deny abortion services on the grounds of conscientious objection, if they oppose abortion for moral or religious reasons.

Furthermore, there is a "counseling service" requirement to the abortion law. As explained to one of our contacts in Chile: "Within the law, it is established that a woman whose pregnancy falls within the protected circumstances should be offered a 'counseling service' (known as 'acompañamiento'), whereby she can be accompanied in the decision on whether to interrupt or continue the pregnancy by a multidisciplinary team, if she so wishes. Together with being voluntary, the services should be free and readily available in all hospitals/ clinics that can provide abortion -- but, in reality, it has been asked of women to pay for it and it is not available in most places." (April 2019)

Before 2017, abortion was completely illegal without exceptions. However, in August 2017, Chilean lawmakers voted to allow abortions in certain cases. This reversed decades of the highly strict Chilean abortion laws, which were among the strictest in the world. These strict abortion laws can be attributed to the military dictatorship of Augusto Pinochet (1973-1990). According to these laws, a woman could not seek an abortion, even if the pregnancy endangered her life, if the pregnancy was the result of rape or incest, or if the fetus would not survive the pregnancy. If a woman obtained an abortion in Chile, she could face up to five years in prison.

Chilean laws were not always this strict. From 1931-1989, therapeutic abortion (i.e. abortion when doctors considered it medically necessary) was permitted in Chile. In fact, if a women received approval from two doctors, the abortion would be legal. Yet, "On 15 September 1989, however, the Government of Chile amended section 119 of the Health Code to provide that 'No action may be executed that has as its goal the inducement of abortion' (Law No. 18,826). The justification provided for the new restrictions was that, given the advances in modern medicine, an abortion was no longer needed to save the life of a pregnant woman. Owing to this amendment, it is generally, although not unanimously, believed that no abortions can now be legally performed in Chile." After the fall of Pinochet's military dictatorship, it was the Catholic Church authority that has most strongly advocated to keep existing abortion laws.

In January 2015, President Michelle Bachelet announced that she would send a draft bill to Congress. This bill would decriminalize abortion during the first 12 weeks of pregnancy (18 weeks, if the woman is under 14 years old) in the following cases: when the mother's life is endangered by the pregnancy, when the pregnancy is the result of rape, and when the fetus will not survive the pregnancy. In March 2016, the bill passed in the Chamber of Deputies with a surprising vote from a member of the Christian Democrats (the party that has opposed the bill). It now needs Senate approval to become an official law.

Due to the incredibly strict abortion laws, many women resorted to unsafe clandestine abortions for decades. The new abortion laws permit some women to receive abortion services, but they still do not permit abortion upon request. For this reason, it is important to understand that many Chilean women may seek abortions from clandestine providers or abroad. In fact, Chile has one of the highest abortion rates in Latin America, and 33,000 women are admitted to Chilean hospitals each year to abortion-related causes. There is an underground network of pro-choice doctors and feminist in Chile who help women procure Misoprostol (also known as "the abortion pill") on the black market. However, poor women often attempt to induce the abortions themselves, which often has dangerous consequences.

What to Get & Where to Get It

• Abortion is legally permitted in certain circumstances (see above section), but it is not available upon request.
• You can potentially get the "abortion pill" by mail. Check out this link for details.
• There are currently three organizations that offer counseling services for abortions in Chile, as of April 2019. It is important to note that these counseling services are required prior to an abortion procedure. These organizations are Corporación Miles, Chile Unido, and APROFA. However, Corporación Miles may be the only service that offers this service for free, so it may be your best option.
• Línea Aborto Chile (Abortion Line Chile): Lesbianas Feministas por el Derecho a la Información (Lesbian Feminists for the Right to Information): Call - 8 8 9 1 8 5 9 0. "Lesbians and Feminists for the right to information supports Linea Aborto Chile to provide information on how to use misotrol to safely terminate a pregnancy until week 12, all according to official information from the World Health Organization." You can also visit their Facebook page. Email: femilesinfo@gmail.com
• If you are considering leaving the country to obtain a legal abortion, you can legal abortions on request in Uruguay, Guyana, French Guiana, Mexico City and the United States. You can get abortions when the woman's life endangered or to preserve the woman's physical/mental health in Argentina and Peru.

Costs

There are underground abortion providers for "rich people" that are known to be trustworthy yet expensive. We don't know the costs.

If you are pregnant and considering getting an abortion outside Chile, you will need to consider the following costs: transportation to the country where you will be obtaining an abortion, hotel or accommodation costs in that country, cost of the abortion in the country and the total amount of days you may need to be in the country both before and after the abortion.

Advocacy & Counseling

What to Get & Where to Get It

• Red Chilena Contra la Violencia Domestica y Sexual: "The Chilean Network against Violence against Women - the Chilean Network against Domestic and Sexual Violence - is an articulation of collectives, social organizations, non-governmental organizations and women. Since 1990, it has worked to eradicate violence against women. women and girls It carries out actions of denunciation, campaigns, studies and other public interventions coordinated throughout the country; organizes film cycles and talks; implements training schools and develops since 2007 the campaign "Beware! Machismo Mata "nationally." Email: redcontraviolencia@gmail.com
• Health Counseling from Corporación Miles: "We offer a counselling service (consejería) in sexual and reproductive health, in areas such as self-care practices and sexual wellbeing, perinatal loss, pregnancy and maternity, contraception, sexual and reproductive health of LGBTI people, prevention of STIs and HIV/AIDS, sexual violence and legal orientation. The counselling team is comprised of a clinical psychologist, a lawyer, a midwife and a gynecologist and the session(s) can be presencial or through the phone (for people living outside of Santiago)(http://mileschile.cl/proyectos/consejeria-en-salud-sexual-y-reproductiva/). Unfortunately, we are not yet able to provide transportation from people leaving in the territory or for our professionals to travel frequently or set an office in another region." Address: Ernesto Pinto Lagarrigue 183, Recoleta, Santiago. Phone: +56 2 2735 7539. Contact us at: comunicaciones@mileschile.cl
• Legal Counseling fro Corporación Miles: "Depending on the nature of the situation of the person seeking legal counsel (eg. if they can afford to pay for legal representation in another place or not) and of our means at the moment, we can offer free legal representation to any person whose sexual and reproductive rights have been violated in national (eg. criminal, civil and family tribunals, court of appeal, supreme court) and international settings (eg. Inter-american Court of Human Rights)." Address: Ernesto Pinto Lagarrigue 183, Recoleta, Santiago. Phone: +56 2 2735 7539. Contact us at: comunicaciones@mileschile.cl

List of Additional Resources

• APROFA: "APROFA works to ensure access to sexual and reproductive health care as a fundamental human right. Founded in 1965, APROFA is a pioneer of family planning in Chile and was the first organization in the country to focus on underserved and impoverished areas. The majority of its clients receive free care, including contraception, gynecological exams, and sexual health counseling." Central Office Address: Ramón Ángel Jara 450. Santiago Centro - Chile. Phone: +56 2 22645600. Email: aprofa@aprofa.cl
• Corporación Miles: They focus on sexual and reproductive health care and rights in Chile. The group does advocacy work with policy-makers and the media They also provide services to the community, including: education/workshops, health-related counseling, and sometimes legal counseling. Address: Ernesto Pinto Lagarrigue 183, Recoleta, Santiago. Phone: +56 2 2735 7539. Contact us at: comunicaciones@mileschile.cl
• Red Chilena de Profesionales por el Derecho a Decidir: They advocate for sexual and reproductive rights, including abortion access, in Chile. The group was established by Corporación Miles, which states that the network aims to create " ...nation-wide communication between professionals in favour of performing legal abortions and willing to campaigning for the broadening the current law so as to better the attention offered to women across the territory. This network allows us to connect women seeking good sexual and reproductive health to professionals in their region without fearing judgement or experiencing revictimization." Email: redchp.derechoadecidir@gmail.com.
• MOVIH Chile – Movimiento de Integración y Liberación Homosexual: This is a human rights and advocacy group in Chile that focuses on LGBTQ issues. It was founded in 1991. Address: Coquimbo 1410, Santiago Centro, Chile. Postal Code 833-0967. Phone: +56226714855. Email: movilh@gmail.com.