Contraceptive Coverage In Bolivia: What's The Situation?

In Bolivia, oral contraceptives are available without a prescription at pharmacies. It is estimated that about 62% of Bolivian women (who are married or in unions between the ages of 15 and 49) use some form of contraception, and that 40% use a modern contraceptive method. The most popular methods of contraception are the rhythm method (17.1%), injectables (13.6%), IUDs (10.1%), female sterilisation (7.8%) and male condoms (4.8%). Emergency contraceptive pills (or the morning-after pill) technically require a prescription, but this is not widely enforced and locals report being able to buy them over the counter.

Contraceptive pills are available over the counter

In Bolivia, contraceptive pills are available over the counter at pharmacies, clinics, or social marketing programs. There is no requirement for a prescription to purchase birth control pills.

There are at least 12 brands of birth control pills available in Bolivia, including Diane-35, Microgynon, Microgynon-30, Minigynon, Nordette, Norvetal, Yasmin, and Yaz. These can be purchased from pharmacies, clinics, or social marketing programs.

While emergency contraceptive pills (morning-after pills) technically require a prescription, this does not seem to be widely enforced, and locals report being able to purchase them over the counter at pharmacies.

It is estimated that about 62% of Bolivian women who are married or in unions between the ages of 15 and 49 use some form of contraception, with 40% using a modern contraceptive method. However, it is also estimated that 18% of women in this age group have unmet family planning needs.

The most popular methods of contraception in Bolivia include the rhythm method (17.1%), injectables (13.6%), IUDs (10.1%), female sterilization (7.8%), and male condoms (4.8%). The pill and withdrawal methods are used by only 4% of women on average.

Emergency contraceptive pills are available over the counter

In Bolivia, emergency contraceptive pills are available over the counter in pharmacies, although a prescription is technically required. This requirement, however, does not seem to be widely enforced, and locals report being able to purchase the morning-after pill without a prescription.

There are no age restrictions on purchasing emergency contraception in Bolivia, but healthcare providers and pharmacists can refuse to sell it for moral or religious reasons. If this happens, it is recommended that you try another provider, as there are others that will sell it without issue.

There are many dedicated emergency contraceptive brands available in Bolivia, including:

• UPRIS (take 1 pill within 120 hours after unprotected sex)
• Glanique 1, Impreviat and Postinor 1 (take 1 pill within 120 hours after unprotected sex)
• Glanique, Imediat N, Pilem, Postinor-2, Pregnon and Tace (take 2 pills within 120 hours after unprotected sex)

If you cannot access dedicated emergency contraception, you can also use regular oral contraceptives as emergency contraception. For combined pills (progestin-estrogen), you will need to use the first 21 pills in 28-day packs. You can take brands such as Microgynon CD (4 pills within 120 hours after unprotected sex and another 4 pills 12 hours later), or Microgynon, Microgynon-30, Minigynon, Nordette or Norvetal (4 pills within 120 hours after unprotected sex and another 4 pills 12 hours later).

IUDs, injectables, and implants require a prescription

In Bolivia, IUDs, injectables, and implants require a prescription. However, this requirement is not strictly enforced, and these contraceptives can often be obtained without a prescription from pharmacies and clinics.

IUDs, or intrauterine devices, are a form of long-acting reversible contraception (LARC) that is inserted into the uterus by a healthcare provider. They are highly effective, with a 99% success rate in preventing pregnancy, and can last for several years before needing to be replaced. In Bolivia, IUDs can be obtained from organisations such as Marie Stopes, which offers both hormonal and copper IUDs.

Injectables, or contraceptive shots, are another form of reversible contraception that can be administered by a healthcare provider. In Bolivia, injectables are available from various sources, including Marie Stopes, which offers monthly or quarterly injections.

Contraceptive implants are small, rod-like devices that are inserted under the skin of the arm and can provide protection against pregnancy for an extended period. In Bolivia, implants are available from organisations such as Marie Stopes, which offers the FEMPLANT implant, and CIES, which offered implants at a price of 200Bs. in June 2015.

While IUDs, injectables, and implants are technically prescription-only in Bolivia, it is possible to obtain them without a prescription from certain sources. This informal availability may be due to a lack of strict enforcement of the prescription requirement or other factors. However, it is important to consult a healthcare professional before obtaining or using any of these contraceptive methods to ensure safety and effectiveness.

HPV vaccination is available

The HPV vaccine is recommended for girls aged 9-14 who have not yet become sexually active. This is because the vaccine is most effective when administered before sexual debut and can prevent cervical cancer, which is the leading type of cancer among women in Bolivia.

The HPV vaccination program in Bolivia has faced some challenges, including supply limitations and cultural barriers. However, efforts are being made to increase vaccine coverage and protect girls from cervical cancer.

Abortion is only permitted under specific circumstances

Abortion is illegal in Bolivia, except in specific circumstances. The procedure is only permitted in cases of rape, incest, or to protect the woman's health. This policy is part of the Penal Code established in 1973 and has been in force since then. However, even when the abortion falls under these exceptions, it is challenging to obtain as judicial permission is required, which can be a lengthy process. As a result, many pregnant women resort to unsafe, clandestine abortions.

The difficulty in accessing legal abortions has led to high rates of clandestine abortions in Bolivia. According to the Bolivian Ministry of Health, almost all of the 67,000 abortions performed in the country in 2011 were clandestine, and approximately half of the women who underwent these procedures required hospital care afterward. The prevalence of unsafe abortions has been linked to the high maternal mortality rates in the country.

While there have been efforts to change the law, such as a bill introduced by legislators from the Movement for Socialism in 2005, they have been quickly rejected. In recent years, there have been legal challenges to the anti-abortion legislation, but the laws remain largely unchanged.

Although abortion is illegal in most cases, it is not widely stigmatized in indigenous communities. Women in these communities sometimes turn to traditional healers for abortifacient herbs or teas. Additionally, the abortion pill, misoprostol, has made abortions more accessible, safer, and more private.

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