USULUTAN, El Salvador—Imelda Cortez, a 20-year-old Salvadoran woman, was at home one evening in April 2017 when, seemingly out of nowhere, she began experiencing sharp abdominal pain. Suspecting a flare-up of her colitis, she went into the bathroom, where, to her astonishment, she gave birth to a baby girl. She would later say that she hadn’t even known she was pregnant.

Her mother called for help, and Cortez was rushed to the hospital. Doctors found no signs of induced labor or any other indications that Cortez intended to harm her child. Nevertheless, one of the doctors accused her of trying to have an abortion and reported the case to the police. Abortion is illegal in El Salvador, and Cortez was arrested and eventually charged with attempted murder. The charge carries a possible sentence of 20 years in prison.

Though prosecutors gathered witness testimony and medical and psychological reports to make their case, Cortez’s lawyers insisted they had no compelling evidence. “The accusation is based on speculation,” Bertha de Leon, one of the lawyers, told me in November when she went to a courthouse in Usulutan, a small city in southeastern El Salvador, for a hearing that was ultimately postponed. “Nobody cares about defending her legal process.”

What the records do show, de Leon and the other lawyers said, is a history of sexual abuse inflicted by Cortez’s 70-year-old stepfather, Pablo Henriquez. DNA testing determined that he is the father of Cortez’s baby. Yet even after Cortez opened up about the abuse, which she says began when she was just 12, the authorities took a year to arrest Henriquez. Moreover, in a cruel demonstration of the repressive nature of El Salvador’s abortion laws, Cortez and Henriquez faced the same maximum prison sentence of 20 years.

Cortez is one of more than two dozen women who have recently been imprisoned for suspected or attempted abortions in El Salvador. Between 2000 and 2014, 147 women faced trial for abortion-related crimes in the country, and about one-third were eventually convicted, according to a report by the Organization of Salvadoran Women for Peace, a local NGO.

These Salvadorans make up just a fraction of the countless women affected by Latin America’s notoriously harsh abortion laws, which are a testament to the clout historically wielded by Catholics and evangelicals in the region. According to the Guttmacher Institute, a U.S.-based group that studies reproductive health around the world, 97 percent of women of reproductive age in Latin America and the Caribbean live in countries with restrictive abortion laws, meaning abortion is only allowed in certain cases or is prohibited altogether.

On top of legal trouble, the laws create significant health risks. An estimated 760,000 Latin American women are treated for complications from unsafe abortions each year, and about 10 percent of maternal deaths in the region are the result of unsafe abortions, according to a 2018 Guttmacher Institute report. Others have died after being denied abortions outright. Though it is difficult to determine the exact number, such cases have been recorded in El Salvador, the Dominican Republic, Paraguay and Argentina.

The region’s abortion laws are particularly harmful to young women and girls. Latin American countries have some of the highest teen pregnancy rates in the world, and pregnancies in girls under 15 are increasing, according to a 2014 report by Planned Parenthood. Up to 90 percent of pregnancies for girls under the age of 14 are the result of rape, and the risk of maternal mortality doubles for pregnant girls under 15. Nevertheless, most Latin American countries deny minors the chance to have an abortion that could save their lives.

Since 2017, activists who object to restrictive abortion laws have had some success drawing regional and global attention to their cause. This was most vividly on display last August in Argentina, when an estimated 1 million people filled the streets of Buenos Aires to demand unrestricted legalization of abortion during the first 14 weeks of pregnancy. The decriminalization bill was ultimately rejected by the Senate, but its supporters are confident something like it will pass one day soon.

Approving the law would make Argentina the latest Latin American country to legalize abortion. Cuba led the way, approving abortion without restrictions back in 1965, and more recently it has been joined by two other countries, Uruguay and Guyana, as well as Mexico City.

In other countries, including Brazil, the Dominican Republic and El Salvador, activists and politicians have worked together to propose liberalizing the country’s strict abortion laws.

Yet these efforts have run into an equally fierce right-wing counter-mobilization, fueled by religious fundamentalist leaders and conservative political parties that have gained ground since 2015.

The abortion debate in Latin America is, naturally, bound up with broader discussions about women’s rights. “Until our bodies are not being monitored and controlled by governments, we will never be able to achieve real equality,” says Paula Avila-Guillen, director of Latin America initiatives at the Women’s Equality Center, a U.S.-based organization that promotes reproductive rights. She notes that countries with restrictive laws on reproductive rights also tend to have high levels of gender-based violence and gender inequality. In addition to having some of the strictest abortion laws in the world, Latin America also has the world’s highest rates of femicide—the killing of women deliberately because of their gender. A 2007 study showed that restrictive abortion laws were influenced by perceptions of women as second-class citizens incapable of making their own decisions without government supervision.

Abortion is illegal under all circumstances in six Latin American countries: El Salvador, Honduras, Nicaragua, the Dominican Republic, Haiti and Suriname. El Salvador is one of the harshest enforcers of the ban, regularly throwing women in jail for suspected abortion. There are also known cases of women incarcerated for abortion in Mexico and Honduras.

“Their lives are being destroyed,” Avila-Guillen says, referring to Cortez and other Salvadoran women who have been jailed. “As long as these laws are on the books, any prosecutor can decide to criminalize women. Women will always be vulnerable.”

Argentina’s Green Wave

In Argentina, which is seen as a leader on human rights in the region and enjoys a reputation for path-breaking feminist activism, the movement to decriminalize abortion has been active for decades.

In recent years, though, a number of high-profile cases have been especially galvanizing. In 2007, Ana Maria Acevedo, a 19-year-old mother of three from the northeastern province of Santa Fe, was diagnosed with cancer of the jaw while pregnant with her fourth child. Doctors denied her chemotherapy because she was pregnant, and they also denied her an abortion.

Under Argentina’s current law, abortions are supposed to be allowed in two cases—when the mother has been raped or when her life is at risk. But doctors still often seek a judge’s approval to carry out the procedure. The bureaucratic back-and-forth that typically ensues can be deadly when the survival of a woman like Acevedo is at stake.

Acevedo’s baby was eventually delivered by cesarean section when she was just six months pregnant. The baby did not survive, and Acevedo died two weeks later. Her mother, Norma Cuevas, blames officials for creating needless delays that cost Acevedo her life. “I begged the hospital to save my daughter’s life with an abortion. The hospital sent me to get an order from a judge, but the judge sent me back to convince the doctors. They kept playing a game of back-and-forth with me,” Cuevas told The Guardian in August 2018. “I don’t want any more women to die my daughter’s pointless death.”

While women like Acevedo are denied abortions outright, others undergo unsanctioned procedures, with varying degrees of risk. An estimated 3,000 Argentine women have died from unsafe abortions in the past 25 years, according to Amnesty International. The problem disproportionately affects low-income women, who are more likely to have procedures performed by untrained practitioners or to attempt an unsafe at-home remedy, such as using parsley to induce an abortion, which can lead to a life-threatening infection. Middle- and upper-class women, by contrast, know where to get safe abortions, and they have the money to pay for it, says Maria Alicia Gutierrez, an activist in Buenos Aires.

Early last year, frustrated with the current state of affairs, a coalition of feminist organizations known as the National Campaign for the Right to Legal, Safe and Free Abortion renewed its efforts to press lawmakers to consider reforms. It marked the seventh time the coalition had tried to bring the bill allowing abortions without restrictions during the first 14 weeks of pregnancy in front of the legislature, but it was the first time lawmakers agreed to actually debate and vote on the law.

Activists say that breakthrough can be attributed to the work they’ve done to “socially de-penalize” abortion through education programs and grassroots actions. Over the years, they have tried to change public opinion by working with schools to develop programs to talk about reproductive rights, organizing marches, and holding an annual conference that now draws thousands of people from across the country. “It’s not something that happened from nowhere,” says Gutierrez.

In June, the lower house of Argentina’s Congress narrowly passed the bill, with 129 votes in favor and 125 against. Advocates of the bill reported a sense of elation when they heard the news, particularly given how long and hard they had fought.

That set up the showdown over the Senate vote in August. In the lead-up to the vote, pro-abortion demonstrators in the center of Buenos Aires donned green handkerchiefs with the slogan: “Sexual education to decide. Contraceptives to not have abortions. Legal abortion so as not to die.” When displayed together, the handkerchiefs created a mass of green known as “the green wave.” The massive street demonstrations represented one of the largest mobilizations in favor of women’s rights the country had ever seen, and the activists garnered support from throughout the region.

“The movement gained enormous visibility,” says Gutierrez, a board member of the National Campaign. “Abortion came out of the closet. It was brought out in the open all over.”

The Senate vote represented the final hurdle for the measure. President Mauricio Macri had said that, while he personally opposed abortion, he would sign any version of the bill presented to him by lawmakers.

On the day of the vote, Aug. 8, the “green wave” gathered outside the Senate to demand that politicians approve the bill. Ultimately, however, the senators rejected it by a vote of 38 to 31.

Lawmakers’ comments after the vote underscored how divided they were. “Abortions happen and the debate here is if abortion is legal or illegal,” said Sen. Norma Durango, who voted in favor of the bill. “Abortion will not be less tragic because it is done in an operating room,” said Sen. Esteban Bullrich, who voted against it.

Early the next morning, Gutierrez and other activists from the National Campaign climbed to the top of the stage that had been set up in the large plaza outside Argentina’s Congress, a monumental, neoclassical building where they had waited more than 15 hours for the decision. Standing in front of a big screen on which the Senate vote was projected, Gutierrez told demonstrators that their work would continue despite the bill’s defeat.

Catalina Martinez Coral, regional director for Latin America and the Caribbean for the Center for Reproductive Rights, says these are not empty words. The vote really did seem to mark a turning point.

“Although it’s true that it lost legislatively, a lot was won on a social level,” she insists. “Argentine women were able to fully mobilize civil society. Not just the feminist groups took to the streets. Other human rights groups, common citizens, and boys and girls also filled the streets. They were able to retake public opinion, and that was an important gain.”

There is some data to back up that view. A 2018 poll showed that nearly 58 percent of Argentines favor legalizing abortion.

Yet all this talk of the progress abortion rights activists have made risks overshadowing the fact that their movement ran into fierce opposition from Argentines still deeply opposed to abortion. They staged huge demonstrations of their own, with the country’s blue-and-white flag waving alongside the yellow flag of the Vatican, a revered institution in a country where 71 percent of the population is Catholic. Pope Francis, originally from Argentina, signaled his disapproval of the bill on the day of the vote when he kissed a group of Argentines who visited Rome with Argentine flags bearing the anti-abortion slogan “Let’s save both lives.”

“What was new in Argentina… was the level of animosity that the anti-rights groups came out with,” Gutierrez acknowledges. “Now we have to always be responding and reacting to the advancement of the anti-rights groups, which are very active with street protests and talking to the media.”

Activists like Gutierrez are acutely aware that the failure to legalize abortion in Argentina continues to cost women their lives. One week after the bill was voted down in the Senate, an Argentine newspaper reported that a woman died after attempting an at-home remedy involving parsley. It caused an infection that sent the woman, a 24-year-old mother of two, into septic shock.

“A Fight for Our Daughters and Granddaughters”

More than 3,700 miles north of Argentina, a feminist coalition in the Dominican Republic has been waging its own campaign to revise restrictive abortion laws. While Argentina allows abortion in certain cases, the Dominican Republic has yet to grant even one exception to its ban. This despite the fact that public opinion in the Caribbean nation largely supports decriminalization. According to one poll, 67 percent of Dominicans support abortion in cases of rape or incest, 76 percent when the pregnancy is unviable, and 79 percent when the mother’s life or health is at risk.

In 2014, Dominican President Danilo Medina took the landmark step of reforming the country’s penal code to carve out exceptions for those three scenarios. The change would have gone into effect in December 2015, but opposition groups challenged it in the country’s Supreme Court, arguing that legalizing abortion goes against the Dominican Constitution, which declares that life begins at conception. In December 2015, the Supreme Court ruled that Medina’s reforms were unconstitutional.

Dominican women who attempt abortions can be sentenced to up to three years in prison. Health professionals who carry out abortions face even longer sentences, from four to eight years. The country rarely enacts these punishments, but the ban can still have grave consequences.

In 2012, a 16-year-old Dominican woman was nine weeks pregnant when she was diagnosed with leukemia. Chemotherapy would have killed the fetus, so she was denied treatment because of the country’s abortion laws. After an intense national debate that lasted 20 days, she was given treatment, but it was too late. She miscarried at 13 weeks and died shortly thereafter.

In 2015, some 200 women died while giving birth in the Dominican Republic, according to the latest statistics from the World Health Organization. The country’s Health Ministry estimates that 8 percent of maternal deaths are from abortion complications, while the Dominican Republic Medical Association and the Society of Gynecology and Obstetrics believes the real figure is higher—at 20 percent.

The Coalition for the Rights and Life of Women, an alliance of feminist organizations in the Dominican Republic, has been working since 2017 to pressure politicians to approve a new bill that would enact the reforms championed by Medina.

On Nov. 25, the International Day for the Elimination of Violence Against Women, thousands turned out for a march in Santo Domingo, the capital, to demand equal rights for women. Part of their platform involved pressuring legislators to vote in accordance with the desires of the Dominican people when it comes to abortion. “We walk with the unity of our force, because the women of the Dominican Republic deserve to live without being attacked, mocked, raped or assassinated because of machista hate,” one group that participated in the march said in a statement published on its blog.

Prior to the march, Susi Pola, an activist in the Dominican Republic, told me she was confident that the abortion law revisions would ultimately be implemented. “We’re in the process of bringing about a change in thinking,” she said. “Maybe I won’t live to see it, but the change will come.”

She acknowledges that significant hurdles remain, notably the anti-abortion campaigning conducted by Catholic and evangelical religious leaders and the corrupt nature of lawmakers who Pola says vote in their interests and not those of the people they are representing.

But Pola said the movement in Argentina had given her new hope. “The fight continues. I’m 72 and the fight still goes on. It can never stop,” she said. “It’s a fight that’s not for us anymore, but for our daughters and granddaughters.”

“It’s Us Women Who End Up Dying”

If the changes in Argentina and the Dominican Republic are eventually approved, both countries would join others in Latin America that have reformed their abortion laws in recent years. In August 2017, Chile voted to allow abortion when a mother’s life is at risk. Lawmakers in Chile want to further liberalize the country’s abortion laws to allow the procedure without restrictions for up to 14 weeks.

In December 2017, Bolivian President Evo Morales reformed the country’s penal code to decriminalize abortion in eight cases, including those involving students, minors and women living in poverty, but the move was struck down two months later by the country’s legislature.

The experience of these countries suggests that legalizing abortion does not increase the rate of abortion, but rather just makes the practice safer. Abortion rates are similar in countries that allow abortions and countries that prohibit or restrict them, according to the Guttmacher Institute. In Uruguay, which decriminalized abortion in all cases for up to 12 weeks in 2012, statistics show a significant decrease in the number of procedures. Somewhere between 16,000 and 33,000 women had clandestine abortions each year before abortion was legalized, according to Uruguay’s Health Ministry. The first year after abortion was legalized, about 7,000 women had abortions and the number of abortions has remained under 10,000 each year since then.

Lilian Abracinskas, a feminist organizer and director of the Uruguayan organization Women and Health, believes this decrease could reflect problems with access to abortion despite legalization. She also points out that official statistics do not necessarily reflect the number of abortions in Uruguay because clandestine abortions are difficult to track.

Even in Latin American countries with less restrictive abortion laws, women still struggle to access abortions because of social stigma and the limited availability of doctors and providers. “What we’ve learned is that having a law is not the end of the road,” says Abracinskas. “Often just the legal change is not sufficient if all the other questions are not addressed. For me, achieving a cultural change is the most important.”

In Uruguay, gynecologists who are conscientious objectors to abortion are legally required to refer women to another provider. But in some small towns, the referrals don’t necessarily guarantee that women have access to abortion, The Guardian reported last year.

As Latin America’s leftist wave fades and conservative and even far-right politicians amass power throughout the region, the opportunities to increase access to safe abortion may dwindle, and gains that have been realized already could be jeopardized. Argentina, Brazil and Colombia all recently elected conservative presidents, and political analysts predict that more right-wing politicians will continue to gain ground in the region. The most conservative among them is Brazil’s recently elected president, Jair Bolsonaro, a far-right populist who has pledged to veto any law that would increase access to abortion. He also wants to prevent any government money from going to institutions that support legalizing abortion. Colombian President Ivan Duque has also declared himself against abortion.

A similar political trend is on display in El Salvador, where Imelda Cortez was charged with attempting an abortion despite the lack of evidence against her. In midterm elections held in March 2018, El Salvador’s right-wing ARENA party and its allies retook control of the legislature after 18 years out of power.

Shortly after the elections and before the new legislators took office, lawmakers considered two bills to decriminalize abortion—one presented by a legislator from the left-wing FMLN party to legalize four exceptions, and another presented by an ARENA legislator to legalize two exceptions. It was the first time lawmakers had considered any such proposals since the country fully criminalized abortion in 1998.

Activists did what they could to push the bills to a vote before the new lawmakers were sworn in. But they did not secure the support they needed in time; control of the legislature passed without a decision on the bills.

The bills remain under consideration, but bringing them to a vote is a low priority for the new legislature, and the chances of passing them now are slim anyway. Nevertheless, feminist organizers are trying to remain optimistic, stressing that public perceptions about abortion have started to shift. “The most important thing is that Salvadoran society has more information and a new way of thinking about the issue,” says Morena Herrera, a Salvadoran activist.

Indeed, polls show that as of March 2018, more than 50 percent of Salvadorans were in favor of decriminalizing abortions in cases where a pregnancy posed a threat to the life or health of the mother.

As the country waits for possible legal reforms, women like Cortez, most of them from poor rural areas, continue to face criminalization for obstetric emergencies. “So many of these cases have happened in silence, alone,” Herrera says.

At least in Cortez’s case, however, there is some cause for optimism. Last month, a court ruled that, contrary to prosecutors’ original claims, Cortez did not know she was pregnant and had not tried to get an abortion or harm her child. More than 18 months after she was first taken into custody, she was released on Dec. 17 into the arms of cheering relatives. “We believe that this case gives us hope to keep fighting for all the other women,” said Bertha de Leon.

But such isolated breakthroughs are no substitute for the sweeping changes in public opinion and legal reforms that would make the difference between life and death, or between freedom and imprisonment, for thousands of Latin American women.

“It’s us women who end up dying,” says Catalina Martinez Coral of the Center for Reproductive Rights. “We are the ones who have health complications and who end up being criminalized.”

Anna-Catherine Brigida is a freelance journalist covering immigration, human rights and security in Central America. Her work has been published by The Washington Post, The Guardian, Al Jazeera and other outlets.

Fuente: World Politics Review.