Venezuelan women seek sterilizations as crisis sours child-rearing

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Venezuelan women get sterilization surgery amid crisis
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Venezuelan women get sterilization surgery amid crisis
Medical personnel move a woman after her sterilization surgery, as other women are waiting for the procedure, at a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
Women wait for sterilization surgery at a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
Women prepare for sterilization surgery at a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
Women wait for sterilization surgery a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
Medical personnel move a woman after her sterilization surgery in the operating room of a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
Medical personnel move a woman after her sterilization surgery in the operating room of a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
Medical personnel move a woman during her sterilization surgery in the operating room of a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
Surgeons carry out a sterilization on a patient in an operating room at a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
A patient lies on a bed during sterilization surgery in the operating room of a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
A patient lies in bed while recovers after sterilization surgery in a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
Yoon rings are seen on a metal tray in an operating room during sterilization surgery at a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
Alejandra Jordan (R), 30, and her sister Andreina Jordan, 34, recover after sterilization surgery at their home in San Francisco de Yare, Venezuela July 28, 2016. REUTERS/Carlos Garcia Rawlins 
Alejandra Jordan (C), 30, rests on a couch while she recovers after sterilization surgery at her home in San Francisco de Yare, Venezuela July 28, 2016. REUTERS/Carlos Garcia Rawlins 
Doris Arocha (C), 30, who was sterilized two months ago, watches television with her children while they eat dinner at their home in San Diego, Venezuela July 19, 2016. REUTERS/Carlos Garcia Rawlins 
Anayanci Castillo (C), 37, talks to her daughter Katerine, while they travel on a bus before Anayanci's sterilization surgery in Ocumare, Venezuela July 26, 2016. REUTERS/Carlos Garcia Rawlins 
Alejandra Jordan, 30, talks on the phone before her sterilization surgery at the door of her house in San Francisco de Yare, Venezuela July 11, 2016. REUTERS/Carlos Garcia Rawlins 
Medical personnel push Emileidy Ojeda, 26, in a wheelchair after a sterilization surgery in a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
Emileidy Ojeda, 26, breastfeeds her four-month-old son David, ahead of her sterilization surgery, at their house in San Francisco de Yare, Venezuela July 11, 2016. REUTERS/Carlos Garcia Rawlins 
Geraldine Rocca, 29, waits for the results of a pregnancy test before her sterilization surgery in Caracas, Venezuela July 26, 2016. REUTERS/Carlos Garcia Rawlins 
Women wait on a bus as they travel for sterilization surgery outside a hospital in Caracas, Venezuela July 27, 2016. REUTERS/Carlos Garcia Rawlins 
Alejandra Jordan, 30, dresses her son Josue, before her sterilization surgery, at her home in San Francisco de Yare, Venezuela July 11, 2016. REUTERS/Carlos Garcia Rawlins 
Janna, 7, plays with a puppy while her mother Geraldine Rocca cooks the lunch at her grandmother's house in Caracas, Venezuela July 20, 2016. REUTERS/Carlos Garcia Rawlins 
Alejandra Jordan, 30, shows the food she has at home, while she recovers after a sterilization surgery, in San Francisco de Yare, Venezuela July 28, 2016. REUTERS/Carlos Garcia Rawlins 
Geraldine Rocca, 29, takes a pregnancy test before her sterilization surgery in Caracas, Venezuela July 26, 2016. REUTERS/Carlos Garcia Rawlins 
Geraldine Rocca, 29, carries her son Jeremy in a stroller as she travels to take a pregnancy test before her sterilization surgery in Caracas, Venezuela July 26, 2016. REUTERS/Carlos Garcia Rawlins 
Alejandra Jordan, 30, combs her daughter Valeria's hair at their home in San Francisco de Yare, Venezuela July 11, 2016. REUTERS/Carlos Garcia Rawlins
Alejandra Jordan (2nd R), 30, poses for a picture with her children (L-R) Valentina, 13, Valeria, 6, and Josue, 4, ahead of her sterilization surgery, at their home in San Francisco de Yare, Venezuela July 11, 2016. REUTERS/Carlos Garcia Rawlins 
Geraldine Rocca, 29, (2nd R) poses for a picture with her children (L-R) Jeremy, Nicole and Janna, ahead of her sterilization surgery in Caracas, Venezuela July 20, 2016. REUTERS/Carlos Garcia Rawlins S
Lisibeht Martinez (R), 30, who was sterilized one year ago, plays with her children in a bathtub in the backyard of their house in Los Teques, Venezuela July 19, 2016. REUTERS/Carlos Garcia Rawlins 
Lisibeht Martinez (L), 30, who was sterilized one year ago, sits next to her children while they play in a bathtub in the backyard of their house in Los Teques, Venezuela July 19, 2016. REUTERS/Carlos Garcia Rawlins 
Luis Espinoza, 3, takes a bath next to a water tank, at his home in Charallave, Venezuela July 7, 2016. Luis's mother Oleydy Canizalez plans to have a sterilization surgery. REUTERS/Carlos Garcia Rawlins 
Oleydy Canizalez, 29, poses for a picture with her husband Julio Espinoza, 28, and her son Luis, 3, before her sterilization surgery, at their home in Charallave, Venezuela July 7, 2016. REUTERS/Carlos Garcia Rawlins 
Geraldine Rocca, 29, carries her son Jeremy, ahead of her sterilization surgery in Caracas, Venezuela July 20, 2016. REUTERS/Carlos Garcia Rawlins 
Oleydy Canizalez (R), 29, looks at her son Luis, 3, while he eats lunch, before her sterilization surgery, at their home in Charallave, Venezuela July 7, 2016. REUTERS/Carlos Garcia Rawlins
Yelis Toussaint looks to her son Jhonanyel, while he sleeps on a bed, before her sterilization surgery at their home in Charallave, Venezuela July 7, 2016. REUTERS/Carlos Garcia Rawlins 
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Venezuela's food shortages, inflation and crumbling medical sector have become such a source of anguish that a growing number of young women are reluctantly opting for sterilizations rather than face the hardship of pregnancy and child-rearing.

Traditional contraceptives like condoms or birth control pills have virtually vanished from store shelves, pushing women towards the hard-to-reverse surgery.

"Having a child now means making him suffer," said Milagros Martinez, waiting on a park bench on a recent morning ahead of her sterilization at a nearby Caracas municipal health center.

The 28-year-old butcher from the poor outskirts of Caracas decided on the operation after having an unplanned second child because she could not find birth control pills.

SEE ALSO: Venezuela food shortages leave zoo animals hungry

Her daily life revolves around finding food: she gets up in the middle of the night to stand in long lines outside supermarkets, sometimes with no choice but to bring along her baby son, who has been sunburnt during hours-long waits.

"I'm a little scared about being sterilized but I prefer that to having more children," said Martinez, who with dozens of other women took a bus from the slums at 4 a.m. to attend a special "sterilization day" in this wealthy area of Caracas.

While no recent national statistics on sterilizations are available, doctors and health workers say demand for the procedure is growing.

The local health program for women in Miranda state, which includes parts of Caracas, offers 40 spots during these "sterilization days" but as recently as last year did not usually fill them.

Now all the slots are scooped up and some 500 women are on the waiting list, according to program director Deliana Torres.

"Before, the conditions for this program were that the women be low-income and have at least four kids. Now we have women with one or two kids who want to be tied up," she said.

SEE ALSO: Venezuelan schoolchildren express hunger in drawings

Health workers at a national family planning organization and at three government hospitals in the states of Falcon, Tachira and Merida echoed her view that demand for sterilizations had grown in recent months.

The trend highlights how the oil-rich nation's brutal recession is forcing people to make difficult choices.

Venezuela is a largely Roman Catholic country where Church doctrine rejects all forms of contraception and abortion is banned unless a woman's life is at risk. The Archbishop of Merida, Baltazar Porras, told Reuters an increase in sterilizations would be a "barbarity."

But Venezuela's crisis has triggered almost daily riots for food and slammed a shrinking middle class as well as the poor who were once a bastion of support for late leftist leader Hugo Chavez's self-styled "beautiful revolution."

Pregnant women are particularly affected as they struggle to find adequate food and supplements, give birth in crowded and under-equipped hospitals, and have to spend hours in lines for scarce diapers, baby food and medicines.

The government ministries for health, women and information did not respond to requests for comment.

'I WANTED FIVE KIDS'

Sterilizations are usually straightforward procedures that involve closing or blocking a woman's fallopian tubes, known as tubal ligation.

"I heard about these free sterilization days on the radio. Immediately I showered, dressed, and went out (to find out about them)," said Rosmary Teran, 32, who had her second child two months ago and also came to the health center from a poor neighborhood before dawn.

Some health workers fear the economic meltdown is putting pressure on women to make a choice they may come to regret if the crisis eases.

"Sometimes we hear: 'My husband told me to get sterilized because another child now wouldn't be practical'," said social worker Ania Rodriguez at family planning group PLAFAM in central Caracas.

Rodriguez says she meets with up to five women a day seeking sterilizations, up from one or two per week about a year ago. When women seem unsure or pressured into sterilizations, Rodriguez tries to steer them towards contraceptives like intra-uterine devices, which are somewhat more available and affordable than birth control pills or condoms.

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When they have them, pharmacies sell a pack of three condoms for around 600 bolivars, only 60 U.S. cents at the black market rate but a big expense for those who earn the minimum wage of some 33,000 bolivars per month. On the Caracas re-sale market, those same condoms fetch around 2,000 bolivars.

Venezuela's elite can afford those prices but the ailing middle class and poor are increasingly stuck.

"I couldn't find the (contraceptive) injections, the pill, nothing. It's very expensive on the black market, and now you can't even find stuff there anymore," said Yecsenis Ginez, 31, who has one son and decided to get sterilized.

"I thought I would have up to five kids, I had loads of names in mind. But it would be crazy to fall pregnant now."

Still, some women have had to wait for months to be sterilized because there are limited spots at state-led hospitals and private clinics can charge about 12 times the monthly minimum wage. And some health centers are unable to provide sterilizations at all due to a lack of equipment or specialists.

SEE ALSO: Kids, teachers ditch school as crisis engulfs Venezuela

DISARRAY

Amid what now feels like a distant oil boom, Chavez built thousands of Cuban-staffed health centers in poor neighborhoods and also launched popular maternity-health programs during his 1999-2013 rule.

But with Venezuela's state-led economic model decaying and oil prices depressed, hospitals have deteriorated sharply under his successor Nicolas Maduro.

Medicine shortages hover around 85 percent, according to a leading pharmaceutical association. Equipment ranging from surgical gloves to incubators is scarce, and many underpaid doctors have left the public sector or emigrated.

The government still says it has one of the world's best health systems and accuses detractors of waging a smear campaign. It has stopped releasing timely health data, though.

The World Health Organization says Venezuela's neo-natal mortality rate was 8.9 per 1,000 live births last year, above the Americas region's average of 7.7. It says Venezuela's maternal mortality rate was 95 per 100,000 live births in 2015, one of the worst rates in Latin America and up from 90 in 2000.

The nation of 30 million people has one of Latin America's highest rates of teenage pregnancies and large numbers of single-parent households, U.N. data shows.

As they waited to be called into the operating room for their sterilizations, women in blue scrubs and hairnets wistfully recalled happier times in once-booming Venezuela.

"Before, when you got pregnant, everyone was happy," said mother-of-two Yessy Ascanio, 38, as she sat on a bed in a side room. "Now when a woman says 'I'm pregnant', everyone scolds you. It makes me sad for young women."

As some of her peers nervously looked out at patients being wheeled out after their sterilization, Ascanio advised: "If you get scared, just remember those food lines."

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