Mexico City ? In Mexico, where most abortions are illegal, hardly a week goes by that Dr. Armando Valle Gay doesn’t see a woman who’s had one.

They arrive at his public hospital in downtown Mexico City, often hemorrhaging, sometimes beset with serious infections. Most of the time they are treated and sent home, their pregnancy ended and their health restored. Occasionally, they leave his care no longer able to have children. One left in a hearse.

There are more than a half-million abortions each year in this overwhelmingly Roman Catholic nation, all but a handful of them illegal, according to a 1994 study by the Alan Guttmacher Institute.

Now the Supreme Court has jumped into the issue for the first time, signaling the judiciary’s new relevance at a time when Mexico is in the experimental stages of multiparty democracy.

A sharply divided court late last month affirmed a Mexico City law that removed criminal penalties for abortion in cases of rape and in proven instances of severe fetal deformity. It also reduced the maximum sentence a woman can face for an illegal abortion from five years in prison to three years. For someone who performs an abortion, the penalty ranges up to 10 years in prison.

Pro-legalization forces call the ruling a major victory, saying it establishes a constitutional right to abortion, however limited.

They also applaud the court’s newfound independence, made possible when conservative Vicente Fox, a member of the anti-abortion National Action Party, won the presidency and ended seven decades of one-party rule, allowing the court to exert autonomy.

Opponents speak out

“Very grave” is how Mexico’s leading spokesman for abortion opponents, Jorge Serrano Limon, described the ruling, even though sexual assault for years had been a theoretically justifiable cause for abortion.

“It leaves without judicial protection all of these persons in the womb who are handicapped or who have been conceived in cases of rape,” he said. “It’s going to promote illegal abortions, because now the abortionists will not face punishment.”

Even now, punishment of those who have or perform illegal abortions is rare in Mexico despite the fact that abortion is banned in all but a few circumstances in the country’s 31 states and the federal district of Mexico City.

The most common exceptions are rape and when the pregnancy endangers the woman’s life. In one state, Yucatan, economic hardship is an exception. Still, legal abortions are rare and make up a small fraction of the total, experts say.

Women buy the best service they can afford, which might be $10 worth of unreliable herbs at a Mexican market or a $1,000 trip to a safe, legal clinic in San Diego.

“There are illegal abortions for 1,000 pesos ($110), in which a nurse inserts a probe into you. There are illegal abortions for 3,000 pesos in clinics without anesthesia where they scrape you with a knife,” said Marta Lamas, director of the Information Group for Reproductive Choice, which supports legalizing abortion.

Complications

Those who can afford safe abortions in the United States or in private Mexican clinics typically experience few health problems. But poor women can experience severe complications, even death. According to official government estimates, abortion is the fourth highest cause of maternal mortality in Mexico.

In urban areas, women have grown savvy and tend to use legal and illegal drugs to induce abortions, said Valle Gay, the Mexico City gynecologist. The most common is misoprostol, also known as Cytotec, an otherwise legal ulcer drug that has abortion-producing properties, he said.

As a result, the worst complications Valle Gay saw even seven years ago from botched abortions are now rare in Mexico City, an advance he said has not yet reached rural areas.

Although physical conditions have improved for women who obtain abortions, the weight of a devoutly religious culture leaves many of them feeling guilty and isolated, said Adriana Ortiz Ortega, a Mexican feminist and author of several books on the subject.

In conducting research for her latest book, “If Men Could Get Pregnant, Would Abortion Be Legal?” Ortiz interviewed one woman who likened the termination of her pregnancy to a religious experience.

The woman told Ortiz that after she awoke, still groggy from the anesthesia, a white-coated doctor appeared before her as a vision. He told her, “Everything is fine, child. Nothing is going to happen to you.”

“She thought she had actually died and she was in heaven and this was God talking to her,” Ortiz said. “She had this sense of guilt or religious belief that was so much embedded in her,” but she felt absolved by the dream.