Every day they come. Whether they are brought in by friends, come alone, or even by ambulance, the stream is steady and their arrival is expected. By their very presence, the women who turn up at casualty departments or the emergency services of maternity hospitals tell their own story about the reality of abortion in Portugal.
For this is a country where the practice is almost completely outlawed. Less than 300 abortions are performed legally each year, as it is allowed only in the case of rape, danger to the woman's life, or a serious problem with the foetus. Yet more than 7,000 women are treated in hospital each year for complications after backstreet abortions. They are the tip of the iceberg, a sign of how widespread is the practice of clandestine abortion.
Poorer women in particular have been in the hands of medically unqualified people, and some of them never recover. Each year, a few of them die. In the same way that Ireland has found a way of dealing with the abortion problem without legalising it - by making use of British clinics - Portuguese society has tacitly accepted illegal abortion for decades. There were only four prosecutions in 1996, leading to one conviction, despite the fact that the places where they are carried out are not hard to find.
Now the country is facing a referendum on whether to make legal abortion more widely available. A proposal to allow it on request in the first 10 weeks of pregnancy goes before the people next Sunday. The arguments for and against are familiar: to some, abortion is the deliberate killing of a unique and helpless human being, while others say that it is a personal decision which can only be taken by the woman herself.
But this debate differs from other countries' experiences in some respects. Firstly, the women who have had abortions are being heard, and are more central to the discussion. Secondly, it is not about whether abortion will take place in Portugal; the choice on offer is to continue the practice underground, with all the attendant consequences, or else to decriminalise it so that abortions are carried out in hospitals.
Unlike Ireland, only a minority of those women seeking an abortion go abroad, mainly because this is more expensive. A few go to Britain, while there is a steady stream of women going to Spain. A clinic located just across the Spanish border advertises in Portuguese newspapers, coyly offering "voluntary treatment of pregnancy". There are also the illegal clinics in Portugal which are staffed by doctors and nurses, with an anaesthetic available. Either of these options costs about £800 (200,000 Escudos) plus travel, or four times the monthly minimum wage. For about £320, an abortion would at least be carried out by a nurse or midwife. Women who can't find this amount pay about £160 for a non-medic to end their pregnancy, without an anaesthetic.
The Portuguese Family Planning Association has been campaigning for an end to these double standards for years. Its executive director, Duarte Vilar, describes Portuguese society's attitude as hypocritical. He estimates that there are 16,000 to 20,000 illegal abortions each year, although recent data suggests that it could be two or three times this level.
The fact that there is only about one prosecution for every 5,000 or 10,000 illegal abortions means that it is officially tolerated: "It has always been a part of life here. Everyone knows where to have an abortion in Portugal, including judges, the police and all the authorities. It has been very consistent, both before and after the revolution in 1974: the state always wanted to say publicly that they were against abortion and that they had banned it, but there has always been a culture of tolerance towards abortion."
Another long-term activist in the throes of the referendum campaign is Manuela Tavares, from the women's organisation Umar. Its work includes community development projects in the disadvantaged suburbs of Lisbon.
On the wall of the office in the city centre, there's a photograph of a 1982 protest inside the parliament chamber, calling for legalisation of abortion. You can make out her face among the demonstrators. She talks with energy and hope about the campaign, although she is not convinced by the polls which show that about 60 per cent of the population will vote for liberalising the law. A national movement has been set up for the campaign, drawing in women's groups and the left, among others. They are wary of the power that individual priests may have when voters are making up their minds, especially in rural areas of this predominantly Catholic country.
The question being put to voters is very specific. It asks if they are in favour of decriminalising abortion on request in the first 10 weeks of pregnancy. This is one of the main proposals contained in legislation presented to parliament by the Socialist Party. But the referendum itself came as a surprise to those pushing for the new law.
A few days after the first stage of the legislation was passed last February, the Socialist prime minister - who is personally opposed to abortion - announced a deal with the opposition for referenda on this and two other topics. The unusual situation of a party at odds with its leader means that the two largest parties, the Socialists and the Social Democrats, are not taking an official position, although individual members are pressing their case.
One Socialist member of parliament who nearly succeeded in getting a similar measure through last year is the youthful Sergio Sousa Pinto. He points out that if the current proposal is passed, Portugal will be in line with France, and have the most liberal abortion laws among the Catholic countries of southern Europe. He says he is confident about people's pragmatism, since everyone has a friend or relative who has had an abortion.
"The strongest reason for backing the measure is the terrible public health problem associated with illegal abortion carried out under improper conditions, which is an offence to human dignity. Women die or are injured for life." He is scathing about the state's attitude to abortion: "This is total hypocrisy. People know where abortions are carried out, yet the police and the courts do not act. If they did, it would lead to tens of thousands of people going to jail."
One of his opponents is Maria Jose Nogueira Pinto, from the centre-right Popular Party. She was trained as a lawyer, and before becoming a member of parliament was the director of the main maternity hospital in Lisbon. She says that one cannot ignore the fact that another human life is involved when people talk about women controlling their bodies, and that one must have a very strong reason for extinguishing this life. She mentions the baby which was left aside in her hospital because doctors thought it was too premature to survive; despite this the child lived, and is now a 14-year-old boy. She wants better sex education and availability of contraception in order to reduce unwanted pregnancies, which was how the Netherlands cut its abortion rate.
Also opposing the liberalisation is Father Nuno Serras Pereira, a Franciscan priest who works from the small office of the Movement for Life. He says that clandestine abortion does not disappear after legalisation, and it can even increase.
"Women die following legal abortions too, as figures from the US show. It's a great concern for us when mothers have abortions illegally, and we seek to give them alternatives."
His group is showing people photographs of babies in the womb as part of the campaign. But Father Pereira has serious reservations about using images of aborted foetuses, a tactic which has been so controversial in Ireland. He is worried that this could be too upsetting, especially for women who are pregnant or have had abortions.
One factor which is changing the way that people see the issue is the willingness of women - some of them public figures - to come forward and say they have had an abortion. Maria Jose Paixo, a sociologist who has been active in campaigning for family planning and who has grown-up children of her own, has more than one personal experience of abortion to draw on. The first was carried out by a midwife, and there were no complications. But when she decided to pay a lot more for a subsequent abortion at a private clinic, she was dealt with by a doctor who she describes as "a sadist". The procedure involved being treated at the clinic and then going home to miscarry on her own.
She knows too about the risks: a woman from the Cape Verde islands who worked for her mother died from internal bleeding after an illegal abortion. The denial and secrecy were a factor in her death.
The atmosphere of fear and guilt which results from the clandestine nature of abortion is something which concerns the writer and journalist Maria Teresa Horta. She too has a grown-up family, as well as having had a number of abortions. She rails against the denial of sexuality and the hypocrisy, in a country where "abortion is forbidden and yet it is not forbidden".
"No woman is happy to have an abortion. It is really the last thing people choose to do, but sometimes it must be done, even if the reason is simply that the women does not want to have the child. "Every day many women have abortions in inhuman conditions; there are even women who carry this out themselves when they don't have the money. There are deaths, and we do not know the numbers of women who are injured for the rest of their lives. But society prefers this than to say yes to abortion."
The referendum debate is touching on the big issues such as the definition of life, conflicting rights, and people's vision of society. But one option which does not seem to be on offer is, in reality, stopping the practice of abortion. The referendum is an opportunity to state how society feels about it, and to decide how it should be carried out.
Statistics and reality
Illegal abortions (estimate): 16,000 to 20,000
Women treated in hospital for post-abortion complications: 7,302
Prosecutions: 4
Convictions: 1
Maternal deaths - in childbirth: 4; after illegal abortion: 2
* All figures for 1996