In a dystopian novel about a world in which women have no rights, a character could be arrested for having a miscarriage. She might not even have known she was pregnant. She would be handcuffed to her hospital bed, accused of either deliberately inducing an abortion or not doing enough to save the fetus she was unaware she was carrying. The police would put her in a dirty, overcrowded jail cell filled with women, some of them there for reasons similar to hers. She would be sentenced to 40 years in prison for aggravated homicide, prohibited from seeing her family, and publicly labeled a “baby killer.”
But this story doesn’t come from the pages of fiction. It’s a reality in El Salvador. It happened to Maria Teresa Rivera, who spent three years in jail, separated from her young son, after a miscarriage that caused so much blood loss, she passed out. And variations on the theme have happened to more than 129 women in El Salvador, one of five countries – along with Nicaragua, Chile, Honduras and the Dominican Republic – with a total ban on abortion, including when a pregnancy endangers the health of the mother or results from rape.
As a consequence, many women who experience complications during pregnancy or have miscarriages do not seek help out of fear of being arrested. And those with unwanted pregnancies often find themselves trapped and desperate. The law is killing women. In a 2013 BBC report, El Salvador’s Health Ministry acknowledged that in 2011, suicide was the most common cause of death among 10- to 19-year-old girls, half of whom were pregnant.
On June 17, the U.N.’s Working Group on the issue of discrimination against women in law and in practice will present a report to the Human Rights Council in Geneva stating that restrictive abortion laws are discriminatory and dangerous. “Criminalization of termination of pregnancy is one of the most damaging ways of instrumentalizing and politicizing women’s bodies and lives,” the report says. The restrictive laws apply to 40 percent of the world’s women, according to the Working Group, “subjecting them to risks to their lives or health in order to preserve their function as reproductive agents and depriving them of autonomy in decision-making about their own bodies.”
El Salvador used to allow abortion in certain circumstances, but the law was tightened in 1998, according to Charles Abbott, legal adviser for Latin America and the Caribbean for the Center for Reproductive Rights. Now, because some women are being charged not with the crime of abortion but of aggravated homicide, they are getting the maximum sentence possible under Salvadoran criminal law: 40 years. “That’s the same sentence that state officials responsible for the massacre in El Mozote got,” Abbott says, referring to the single worst massacre of the country’s civil war when, in 1981, the army killed more than 800 civilians.
Condemnation of restrictive abortion laws doesn’t just come from human-rights institutions – the international medical community is also clear on the issue. Access to safe abortion allows women and girls to end pregnancies while maintaining their health, say experts.
According to a study by the Guttmacher Institute and the World Health Organization (WHO) recently published in the Lancet, outlawing safe abortions or making them difficult to obtain does not decrease the incidence of induced abortions. Instead, it leads to clandestine or unsafe abortions that endanger women’s lives and health.
The WHO reports that each year, 21.6 million women worldwide go through unsafe abortions, and an overwhelming majority of these happen in developing countries. Unsafe abortion is responsible for 13 percent of all maternal deaths, meaning 47,000 women die from complications of unsafe abortions, while millions are left temporarily or permanently disabled.
At the same time that strict abortion laws discriminate against women, they also add another layer of inequity, based on class. In El Salvador, wealthy women can afford to fly to Miami for abortions or to go to private clinics. “One doctor who testified in the case of one of the women accused of obstetric emergency summed it up,” says Abbott. “‘If this woman came to my private clinic,’ the doctor said, ‘I would never have called the police. But she came to the public hospital where I also work, so I called the police.’ Discrimination based on economic status creates intersectional problems for women who are poor, especially women living in rural areas.”
If the aim is to decrease the rate of abortion, the answer isn’t in deterring women from ending their pregnancies, say experts – it’s in helping them avoid unwanted pregnancies in the first place. While abortion rates declined significantly across most developed regions between 1990 and 2014, they remained largely unchanged in developing regions, where people face barriers in accessing family planning.
“High abortion rates are directly correlated to high levels of unmet contraceptive need,” Gilda Sedgh, lead author of the Guttmacher Institute and WHO study, says in a statement. “Our findings indicate that in many developing regions, women lack the contraceptive services they need and are unable to prevent pregnancies they do not want to have.”
Still, researchers acknowledge that even with universal access to quality family planning services, unintended pregnancies and abortions would still occur due to factors such as sexual violence, failure of contraceptive methods and the possible changing circumstances of pregnant women. Knowing that, they argue, women and girls should have the right to see abortion as a real and safe option, not as something to fear. “The discriminatory use of criminal law, punitive sanctions and legal restrictions to regulate women’s control over their own bodies is a severe and unjustified form of state control,” says the Working Group in its report released in April. “Ultimately, criminalization does grave harm to women’s health and human rights by stigmatizing a safe and needed medical procedure.”