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|City=Asunción | |City=Asunción | ||
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[[File:Juan Augusto Sosa Ocampos - Título Brillante Asunción.jpg|400px | thumb|right|]] | |||
'''OVERVIEW''' | '''OVERVIEW''' | ||
In Paraguay, you can purchase many forms of contraception, including condoms, pills, injectables and IUDs. You can also obtain emergency contraception (the morning after pill) without a prescription. While you may technically need a prescription, locals have confirmed that pharmacists sell EC without a prescription. You can receive STI tests at various clinics, and there are specialized testing resources provided by the AIDS Healthcare Foundation (AHF) and SOMOSGAY for the LGBT community. You can find pads and tampons sold in pharmacies and supermarkets. If you are interested in menstrual cups, there is a local seller, which we have included in the "Menstruation" section. Regarding pregnancy and recommended ob/gyns, we have included some information below. Note that women receive 12 weeks of maternity leave but only 9 weeks include wage coverage. Finally, abortion is completely illegal except for cases when the woman's life is endangered by the pregnancy. This law is strictly enforced. While there is an underground abortion network in Paraguay, there are many unsafe and untrained providers, so it's recommended that you exercise extreme caution if you are considering this route. | |||
==Contraception (Birth Control)== | ==Contraception (Birth Control)== | ||
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===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
In Paraguay, you can obtain | In Paraguay, you can obtain condoms and birth control pills without a prescription.<ref>[http://ocsotc.org/wp-content/uploads/worldmap/worldmap.html Global Oral Contraceptive Availability World Map]</ref> According to a 2015 report, 77.4% of Paraguayan women (who are of reproductive age and married/in unions) use some form of contraception, including traditional methods. The most common contraceptive methods were birth control pills (17.4%), injectables (16%), male condoms (12.8%) and female sterilization (9.6%).<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use 2015]</ref> Furthermore, according to WHO data, Paraguay ranks in the list of top 10 countries in terms of the prevalence of condom use.<ref>[https://www.google.com/maps/d/viewer?mid=1CHn6J3MIZbMD2fHhX-gt3n9wOA4&hl=en_US&ll=-23.402764999999988%2C-58.88671899999997&z=8 Most Prevalent Condom Use Around the World]</ref> Some Paraguayan women do not have adequate access to family planning resources (it was estimated that 6.4% had unmet family planning needs), yet the rate of unmet needs is lower than many neighboring countries. | ||
Historically, Paraguay has faced challenges in offering family planning services. In 1966, Centro Paraguayo de Estudios de Población (CEPEP), the national family planning association, was founded, which provides subsidized family planning services, gynecological exams, pregnancy care and contraception. However, family planning services were discouraged or even illegal in Paraguay for decades. This began to change in the 1980s, as family planning services expanded in the country. Finally, the 1992 Constitution of Paraguay guaranteed the right to family planning. During this period, Paraguayan usage of modern contraception grew from 35% in 1990 to 49% in 1998.<ref>[http://www.un.org/esa/population/publications/abortion/profiles.htm Paraguay Abortion Policy]</ref> The total fertility rate in Paraguay dropped from an estimated 4.2 children per woman in 1995-2000 to 1.91 children born per woman in 2016.<ref>[https://www.cia.gov/library/publications/the-world-factbook/fields/2127.html Total Fertility Rate]</ref> | Historically, Paraguay has faced challenges in offering family planning services. In 1966, Centro Paraguayo de Estudios de Población (CEPEP), the national family planning association, was founded, which provides subsidized family planning services, gynecological exams, pregnancy care and contraception. However, family planning services were discouraged or even illegal in Paraguay for decades. This began to change in the 1980s, as family planning services expanded in the country. Finally, the 1992 Constitution of Paraguay guaranteed the right to family planning. During this period, Paraguayan usage of modern contraception grew from 35% in 1990 to 49% in 1998.<ref>[http://www.un.org/esa/population/publications/abortion/profiles.htm Paraguay Abortion Policy]</ref> The total fertility rate in Paraguay dropped from an estimated 4.2 children per woman in 1995-2000 to 1.91 children born per woman in 2016.<ref>[https://www.cia.gov/library/publications/the-world-factbook/fields/2127.html Total Fertility Rate]</ref> | ||
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* | * In Paraguay, you will find that the pharmaceutical products available come from many countries, including Paraguay, Chile, Argentina, Brazil, USA, UK and Germany. | ||
* In Paraguay, you can find '''condoms''' in many stores. If you're a low-income Paraguayan, especially if you're an adolescent or young adult, you can get Pantera condoms from | * In Paraguay, you can find '''condoms''' ("condón” in Spanish) in many stores. If you're a low-income Paraguayan, especially if you're an adolescent or young adult, you can get Pantera condoms from [http://www.psi.org/country/paraguay/#solutions Population Service International (PSI) Paraguay]. They have been providing these condoms since 1998. | ||
* In Paraguay, you can purchase '''birth control pills''' without a prescription. If you go to a pharmacy, you can find many brands, produced both inside and outside of Paraguay, including Anulette 20, Anulette CD, Anuit, Cilest, Dal, Diane-35, Exluton, Femiane, Gynovin, Harmonet, Lerogin, Lerogin 20, Linosun, Marvelon, Microgen, Microgynon, Minulet, Neolette, Nordette, Norgeal, Norvetal, Norvetal 20, Qlaira, Selene, Triciclomex, Triquilar, Yasmin and Yaz. | * In Paraguay, you can purchase '''birth control pills''' ("píldoras anticonceptivas” in Spanish) without a prescription. If you go to a pharmacy, you can find many brands, produced both inside and outside of Paraguay, including Anulette 20, Anulette CD, Anuit, Cilest, Dal, Diane-35, Exluton, Femiane, Gynovin, Harmonet, Lerogin, Lerogin 20, Linosun, Marvelon, Microgen, Microgynon, Minulet, Neolette, Nordette, Norgeal, Norvetal, Norvetal 20, Qlaira, Selene, Triciclomex, Triquilar, Yasmin and Yaz. | ||
** Note: If you're a low-income Paraguayan, especially if you're an adolescent or young adult, you may want to contact [http://www.psi.org/country/paraguay/#solutions Population Service International (PSI) Paraguay]. They have been offering low-cost birth control, called Segura, in Paraguay since 2001. | ** Note: If you're a low-income Paraguayan, especially if you're an adolescent or young adult, you may want to contact [http://www.psi.org/country/paraguay/#solutions Population Service International (PSI) Paraguay]. They have been offering low-cost birth control, called Segura, in Paraguay since 2001. | ||
* If you would like a '''contraceptive shot/injection''', you can find Acefil, Ciclomes, Clinomin, Cycloven, Ginestest, Gynogen, Mesigyna, Neogestar, Neolutin N, Oterol, Ovoginal, Perlutal, Perlutin-Unifarma, Permisil, Segura, Unigalen, Vagital and Yectuna in Paraguay. | * If you would like a '''contraceptive shot/injection''' ("anticonceptivo inyectable” in Spanish), you can find Acefil, Ciclomes, Clinomin, Cycloven, Ginestest, Gynogen, Mesigyna, Neogestar, Neolutin N, Oterol, Ovoginal, Perlutal, Perlutin-Unifarma, Permisil, Segura, Unigalen, Vagital and Yectuna in Paraguay. | ||
* If you would like a '''contraceptive implant''', we're not sure which options are available in Paraguay (being researched). | * If you would like a '''contraceptive implant''' ("implante anticonceptivo” in Spanish), we're not sure which options are available in Paraguay (being researched). | ||
* If you would like an '''IUD''', you can find Mirena in Paraguay. | * If you would like an '''IUD''' ("DIU” in Spanish), you can find Mirena in Paraguay. | ||
===Costs=== | ===Costs=== | ||
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* In Paraguay, you should be able to purchase emergency contraception (the morning after pill) at public sector clinics, pharmacies, IPPF-affiliated systems and social marketing programs (e.g. PSI, DKT, MSI and PSIA). For progestin-only pills, you can find Imediat N, Postinor-2, Pregnon and Pronta (for these, take 2 pills within 120 hours after unprotected sex). | * In Paraguay, you should be able to purchase emergency contraception (the morning after pill) at public sector clinics, pharmacies, IPPF-affiliated systems and social marketing programs (e.g. PSI, DKT, MSI and PSIA). For progestin-only pills, you can find Imediat N, Postinor-2, Pregnon and Pronta (for these, take 2 pills within 120 hours after unprotected sex).<ref>[http://ec.princeton.edu/worldwide/ Princeton EC Website]</ref> | ||
* If you can't access dedicated emergency contraception, you can use regular birth control pills as replacement EC. To do this, you can take Control NF (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Anulit (take 8 pills within 120 hours after unprotected sex). You can take Norgeal (take 40 pills within 120 hours after unprotected sex). You can also take combined progestin-estrogen pills as replacement EC but you should remember that, in 28-day packs, only the first 21 pills can be used. To do this, you can take Control or Neogynon (for these brands, take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can take Microgynon (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). You can also take Norvetal 20 (take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later). | * If you can't access dedicated emergency contraception, you can use regular birth control pills as replacement EC. To do this, you can take Control NF (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Anulit (take 8 pills within 120 hours after unprotected sex). You can take Norgeal (take 40 pills within 120 hours after unprotected sex). You can also take combined progestin-estrogen pills as replacement EC but you should remember that, in 28-day packs, only the first 21 pills can be used. To do this, you can take Control or Neogynon (for these brands, take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can take Microgynon (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). You can also take Norvetal 20 (take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later).<ref>[http://ec.princeton.edu/worldwide/ Princeton EC Website]</ref> | ||
* This information was provided by the [http://ec.princeton.edu/ Princeton EC website], so refer to that website for more details. | * This information was provided by the [http://ec.princeton.edu/ Princeton EC website], so refer to that website for more details. | ||
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* [https://www.aidshealth.org/#/archives/countries/py Kumbaé Clinic - AIDS Healthcare Foundation (AHF) Paraguay]: Focuses on the LGBT community. "AHF Paraguay offers rapid HIV testing and care, Hepatitis B vaccines, sexually transmitted disease testing and treatment, and educational and prevention services free of charge." Address: Independencia Nacional 1032, c/ Manduvirá. CP 1250. Asunción, Paraguay. | * [https://www.aidshealth.org/#/archives/countries/py Kumbaé Clinic - AIDS Healthcare Foundation (AHF) Paraguay]: Focuses on the LGBT community. "AHF Paraguay offers rapid HIV testing and care, Hepatitis B vaccines, sexually transmitted disease testing and treatment, and educational and prevention services free of charge." Address: Independencia Nacional 1032, c/ Manduvirá. CP 1250. Asunción, Paraguay. | ||
* Wellness Center Asuncion-Somos Gay: This clinic is included in the AIDS Healthcare Foundation Global Directory, so they should either provide HIV tests or be able to direct you to a clinic that does. Address: Independencia Nacional, 1031, c/ Manduvira, C.P. 1250, Asunción, Paraguay. Phone: (+595) 21495802; (+595) 981410729 | |||
===Support=== | ===Support=== | ||
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* If you have a yeast infection, you can ask the pharmacist for Fluconazole. | * 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. | |||
* In Paraguay, you can get an HPV vaccine. There is also a nationwide vaccination program, which was established in 2013 and targets 10 year old girls.<ref>[http://www.hpvcentre.net/statistics/reports/PRY_FS.pdf Paraguay: Human Papillomavirus and Related Cancers, Fact Sheet 2016]</ref> | * In Paraguay, you can get an HPV vaccine. There is also a nationwide vaccination program, which was established in 2013 and targets 10 year old girls.<ref>[http://www.hpvcentre.net/statistics/reports/PRY_FS.pdf Paraguay: Human Papillomavirus and Related Cancers, Fact Sheet 2016]</ref> | ||
* There is no official PrEP program in Paraguay.<ref>[http://www.prepwatch.org/ PrEPWatch World Map]</ref> | * There is no official PrEP program in Paraguay.<ref>[http://www.prepwatch.org/ PrEPWatch World Map]</ref> | ||
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In Paraguay, abortion is generally prohibited, according to the The Paraguayan Penal Code (1997). The only exception to this rule is when the woman's life is endangered by the pregnancy. In all other cases, including when when the woman's physical health (but not life is endangered by the pregnancy, when the woman's mental health is endangered by the pregnancy, when the pregnancy is the result of rape or incest, when there is risk of fetal impairment, or when the woman has economic or social reasons for requesting an abortion, the law prohibits abortion. If anyone illegally performs an abortion in Paraguay, they can face up to 15-30 months in prison. If the woman does not consent to the abortion, the prison sentence can have an additional 2-5 years added. If the woman dies during the abortion procedure, the prison sentence can have an additional 4-6 years in prison (if the woman consented to the abortion) or an additional 5-10 years in prison (if the woman did not consent to the abortion).<ref>[https://en.wikipedia.org/wiki/Abortion_in_Paraguay Abortion in Paraguay]</ref> | In Paraguay, abortion is generally prohibited, according to the The Paraguayan Penal Code (1997). The only exception to this rule is when the woman's life is endangered by the pregnancy. In all other cases, including when when the woman's physical health (but not life is endangered by the pregnancy, when the woman's mental health is endangered by the pregnancy, when the pregnancy is the result of rape or incest, when there is risk of fetal impairment, or when the woman has economic or social reasons for requesting an abortion, the law prohibits abortion. If anyone illegally performs an abortion in Paraguay, they can face up to 15-30 months in prison. If the woman does not consent to the abortion, the prison sentence can have an additional 2-5 years added. If the woman dies during the abortion procedure, the prison sentence can have an additional 4-6 years in prison (if the woman consented to the abortion) or an additional 5-10 years in prison (if the woman did not consent to the abortion).<ref>[https://en.wikipedia.org/wiki/Abortion_in_Paraguay Abortion in Paraguay]</ref> | ||
Paraguay dealt with a particularly controversial abortion case in 2015. The case focused on an 11-year old girl, who had been raped and impregnated by her stepfather when she was 10 years old. Her mother believed she was entitled to an abortion and hired a lawyer to take on the case. However, the Paraguayan government denied the petition, stating that she was healthy (and could, therefore, deliver the baby). The girl later delivered by the baby by cesarean section. While this case was denied, it opened up a wider conversation about abortion in Paraguay.<ref>[https://news.vice.com/article/11-year-old-in-paraguay-gives-birth-to-girl-after-being-denied-an-abortion 11-Year-Old in Paraguay Gives Birth to Girl After Being Denied An Abortion]</ref> | |||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* You can potentially get the "abortion pill" by mail. Check out [https://www.womenonweb.org/en/i-need-an-abortion this link] for details | |||
* If you are looking to obtain an abortion, there is an underground network of pro-choice doctors and feminists who may help you. Ask around. | |||
* 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=== | ===Costs=== | ||
There are underground abortion providers. We don't know the costs. | |||
If you are pregnant and considering getting an abortion outside Paraguay, 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== | ==Advocacy & Counseling== | ||
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==List of Additional Resources== | ==List of Additional Resources== | ||
* The women's organization, Kuña Aty Foundation, closed in 2015 due to lack of funds. | |||
* [http://somosgay.org/ SOMOSGAY]: "Hello! We are SOMOSGAY, and we are building a solidary association; we are committed with the innovation effective strategies against homophobia, improving HIV and AIDS prevention; defending the rights of those affected by this virus and the advancement of human rights in Paraguay." | |||
==References== | ==References== | ||