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Story Publication logo October 1, 2013

Fear, Loss and Secrets: Abortion Laws in El Salvador and Nicaragua

Image by Eleanor Klibanoff. Nicaragua, 2013.

In Nicaragua and El Salvador, a complete abortion ban has led to unsafe abortions and turned doctors...


"I didn't want to have an abortion. I didn't want to be pregnant. I didn't want to be raped. I was 16 years old, and I didn't want to be alive." Ana Luisa, now 18, speaks in barely a whisper, her voice betraying the fear that has followed her since her secret abortion almost exactly two years ago.

Ana Luisa has a right to be scared. She lives in El Salvador, one of seven countries in the world that completely bans abortions, including in cases of rape. Both women and doctors are currently serving jail time for their involvement with illegal terminations.

This controversial law made headlines in July 2013 when the highest courts denied a life-saving abortion to "Beatriz," a woman with lupus and kidney failure. The fetus she was carrying suffered from anencephaly, a partially developed brain cavity that virtually guarantees the baby will not survive outside the womb.

After weeks of waiting, doctors sidestepped the legal minefield by delivering via emergency cesarean section. Beatriz survived; the baby did not.

This extreme case demonstrates the limitations of El Salvador's complete abortion ban. There was a public outcry throughout the country and across the world.

A month later, though, it appears that even Salvadorans have lost interest in the issue.

"Yes, that was very bad, and made El Salvador look very bad," says Carla Moran, 46. Without slowing her street-side tortilla production, Moran waves the issue away as easily as she brushes aside the swarming flies. "But she survived, thank God. The case is over, because she survived. Why are you still asking about it?"


Despite the summer heat, Ana Luisa looks flawless, from her patent leather pumps all the way up to her slick ponytail. She walks through the food court of an upscale San Salvador mall with haughty confidence that could discourage even the most persistent suitor. Her throaty voice and easy laugh likely have the opposite effect.

But Ana Luisa's swagger quickly slips away as she leans forward and begins to describe "the worst time of my life."

After being raped by a friend of her older brother, Ana Luisa discovered that she was pregnant. At age 16, she knew nothing about the laws that the UN recently called a "clear contravention of El Salvador's human rights obligations."

"I had never considered abortion, either as a good thing or a bad thing," she said. "My sister told me that doctors wouldn't give me an abortion, but she knew a friend who had done it illegally."

Ana Luisa faced a choice that haunts Salvadoran women who have been raped. If she had the baby, she would have to drop out of school and put her adolescence on hold in order to raise a child. She would likely never go to college as planned. If she decided to put the baby up for adoption, the child would serve as a constant reminder of the rape that took her virginity and childhood. She feared the social stigma of teen pregnancy, rape or no.

"But I knew that if I had this abortion, I could never report the rape, because I broke the law too." Ana Luisa twists a plastic cup in her hands until it breaks. "I could have justice, but then I'd have a baby, too."

Ana Luisa understood that she could never report the rape to the police, but she soon discovered a more difficult truth: she could never, ever tell anyone about her experience.

The words of her sister still ring in her ears, two years later. "You need to pretend like this never happened. You were never raped. You were never pregnant. You didn't have an abortion, you were just never pregnant." She sighs. "That's what I told myself, again and again."

The decision to have an abortion was difficult for Ana Luisa. She didn't want to break the law, a law she didn't even know existed. She didn't want to lie to her parents and her doctors. She didn't want to have to terminate a pregnancy. She stayed in bed for a week, trying to decide what to do.

"There was only losing. I could break the law, maybe get in trouble, and live with fear. Or I could ruin my life and have a baby that I couldn't take care of, a baby without a father. I was trapped."

Her brown eyes fill with tears for the first time as her voice cracks, still trying after all this time to make sense of her options. "I thought about suicide. I thought if I killed myself, the decision would be made. And I knew then that if I was willing to die, I could have an abortion. If I, a living teenager, was going to die over this, I could have an abortion. Nothing made sense, but that made sense to me."


At the intersection of a few main thoroughfares in the center of San Salvador, there is a small park dominated by a statue of Jesus—"El Salvador Del Mundo." Tourists can buy t-shirts and buttons from a kiosk nearby, advertising the fact that they visited the Savior of the World and El Salvador's namesake. Here, religious iconography is as commonplace as the fast food restaurants that Salvadorans love; in the park, Jesus holds out his arms, beckoning towards a beautiful new McDonalds. It is this religious fervor that allows the abortion ban to remain in place, and even spread. Neighboring Nicaragua adopted a similar policy in 2006, in a re-election deal between now-President Daniel Ortega and the Catholic Church.

"In order to win back power, the Sandinistas had to get support from every pulpit in every church. Sexual rights fell by the wayside," says Wendy Flores, director of the Strategic Group for the Decriminalization of Therapeutic Abortion, a collective of feminist and pro-choice groups in Nicaragua that is working to legalize abortion in cases of rape or where the mother's life is in danger. "These political conditions make it almost impossible for anything to change."

While Nicaragua is still feeling their way with these relatively new laws, El Salvador is aggressive in their pursuit. Doctors are required to report anything suspicious that comes their way and women are serving up to 30 years in prison for illegal abortions, according to the Center for Reproductive Rights in New York.

"Even women with intended pregnancies are seen as suspicious if they come in with obstetric complications," says Lilian Sepulveda, the director of the Global Legal Program for the Center for Reproductive Rights in New York City. "There are women being denied medical treatment because doctors are scared to intervene. These same women could go to prison for having an abortion."


Even if Ana Luisa had followed the letter of the law and carried her unintended pregnancy to term, she would have had very little support from the Salvadoran government. In Nicaragua, the only help new mothers receive is a small stipend for milk, according to Diana Aguilar, a psychologist working with adolescent mothers at Casa Allianza, a non-profit in Managua.

"There is no government support," says Aguilar. "In Managua, there is a public hospital but, besides that, there is no support for young mothers."

Since the ban went into place in 2006, the rate of girls under the age of 14 giving birth has escalated by 48 percent. Government assistance for rape victims and teenage mothers has not risen accordingly.

"For a woman who gets pregnant, especially a poor woman, or a woman in the countryside, there are no options," says Magaly Quintana, chapter director of Nicaragua's Catholics for the Right to Choose, an international pro-choice organization. "She cannot have an abortion. But if she is a child herself, or if her health is in danger, she cannot raise the child to be healthy and happy and whole. This is damaging to the women and to Nicaragua as a country."

In these two Central American countries, doctors walk on eggshells for fear of violating imprecise but very real laws, while women and girls are forced to risk their health and well-being.

"I had an abortion." We sit in the crowded food court, Ana Luisa's eyes never leaving mine as she tests out the words, words she's been swallowing for two years. "I had an abortion and now, I have to live with the fear and the secrets. But I'm alive, I don't have a baby and I'm not in jail. Maybe, in El Salvador, I'm lucky."


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