Health
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In El Salvador, a pregnancy complication followed by a prison sentence

Rights groups seek repeal of tough abortion ban as young, poor women convicted of homicide for stillbirths, miscarriages

SAN SALVADOR, El Salvador — “I couldn’t believe I was in ​prison,” Mirna Isabel Ramírez, a mother from the poor San Salvador neighborhood of Mariona, said of the ordeal that began almost 13 years ago. “That first night I slept on the floor. On the way ​there, the police told me, ‘They’ll kill you in there for what you’ve done.’” ​​​

Not long before then, Ramírez, 34 and pregnant at the time, felt ill one morning and rushed to the bathroom. ​​“I had no idea she was coming,” she said. “I didn’t understand. I gave birth to my baby in the toilet.” She said that she and her husband were in shock, so he called neighbors to go to their home. But when they arrived and saw the scene, they immediately alerted the police. “To this day, I don’t know why,” she said. “They called me a murderer and had no sympathy for me.”

Miraculously, her daughter, Briseyda, survived. Her grandmother took her to the hospital while Ramírez was interrogated by police, who believed she tried to kill her baby. She was arrested and never returned home before her trial. A few months later, at a hearing in which the public defender she first met only minutes before told her she wasn’t permitted to speak, she was found guilty of attempted aggravated homicide. Her sentence: 12 and a half years in prison​.

Mirna Isabel Ramírez served over 12 years in prison after being found guilty of attempted aggravated homicide. Her pardon was eventually supported by the Supreme Court, with only weeks left in her sentence.
Matt Chandler

​Her case is one of many in El Salvador highlighted by local and international human rights groups and by the United Nations. All the women involved are young and poor and were convicted for killing babies who were stillborn or died through miscarriages or for reasons unknown.

Since 1997, abortion has been prohibited in El Salvador, without exception — including in the cases of rape or danger to the mother’s health. Amnesty International says the law has created a culture of suspicion toward women, particularly pregnant women.

“El Salvador is moving to becoming a strong democracy. The battle over abortion is an extreme reflection of discrimination against women,” said Erika Guevara-Rosas of Amnesty International. “We know of 129 cases of women charged with abortion-related crimes and put in prison between 2003 and 2013. But there is no statistical information, and the number could be higher. And we know of 17 cases of women jailed for aggravated homicide.”

​In El Salvador’s only women's prison, Ilopango, five of “Las 17,” as they’re known, took turns to tell their stories. Sad and resigned to their situation, all are serving sentences of 30 to 40 years for allegedly killing their babies at birth. They sleep in dormitories of as many as 230 women and get up at 6 a.m. to a breakfast of rice and beans. Some work in the prison for a few dollars, and some study before they find themselves locked up again by 5 p.m.

In Teodora del Carmen Vásquez’s case, she lost consciousness the moment she gave birth unexpectedly in the bathroom of her workplace. “I don’t know if my baby was alive when it was born,” she said. She said she was excited to be a mother. Police, who had been called to help with the birth, questioned her at the hospital.  

Vásquez’s prosecutor sought a jail sentence of 75 years, the maximum at the time. Sentenced to 30 years, she has served almost eight. When she arrived in prison, she barely left her cell, out of fear she would be beaten. Now she won’t answer other inmates’ questions. “I don’t talk about it,” she said. “If people ask, I just say I’m in here for murder, and the conversation stops.”

Dennis Muñoz, the women​’s lawyer, said, “It’s better to go to jail for kidnapping, extortion or ​any ​murder than for killing a ​baby.​ It’s seen as the worst. It carries so much emotional weight.”

He said in the last year ​three more women have been arrested on charges of aggravated homicide after their babies died​.​ For him, it is as much as an issue of class discrimination as one of injustice or human rights. The women in these cases, he said, are presumed guilty by police, public defenders, judges and doctors and must prove their innocence.

He also blames El Salvador’s male-dominated machismo culture.

“The view here is that the only option for a woman is to be a mother,” Muñoz said. “A woman who is not a mother is not a woman. They are idealized, and whatever their state of health, they must save their child.”

‘If people [in prison] ask, I just say I’m in here for murder, and the conversation stops.’

Teodora del Carmen Vásquez

sentenced to 30 years for her newborn’s death

In 2013 the Ministry of Health reported that almost a third of pregnancies in El Salvador are among adolescents, the highest rate of teenage pregnancy in Latin​ ​America. Many women and girls have limited access to health services or medical advice. Some resort to illegal abortions, citing fear of shame and rejection in their community. Of pregnant girls and women ages 10 to 19 who die, over half commit suicide

In many instances, it is when women seek help at public hospitals that they are reported to police by doctors concerned they will be prosecuted for failing to report a crime. One doctor who performs abortions​ ​in the private sector and asked to remain anonymous told Al Jazeera his colleagues lack “knowledge both of the law and of doctor-patient confidentiality, plus they are scared of losing their job.” But there’s a double standard, he said. “The same doctor who reports a patient in the public sector will receive them with open arms in their private clinic and not report them because he’s getting paid.”

“Abortion in my country is a hidden health crisis,” he said, and one that disproportionately affects poor and rural women. In the city, he said, “a woman is more able to resolve the issue, and there’s a black market for medicine.” In contrast, he described how ​he asked a patient in a rural area why she’s having a fifth child and she said she couldn​’t afford the $5 contraceptive injection.

The Ilopango women’s prison in El Salvador, April 21, 2015.
Edgar Romero

Last year Amnesty International and a local group, the Citizen​s’ Group for the Decriminalization of Abortion, formally sought a pardon for “Las 17.” In January, Guadalupe Vásquez, who spent over seven years in prison after her baby — a product of rape — died​ ​moments after being born​​, was pardoned​.

“One vote in the Assembly made all the difference,” she told Al Jazeera. The country’s Supreme Court had already found in her favor, and a second vote in the Legislative Assembly followed its lead. Despite her example, seven of the women have already been informed they will not be pardoned, and the remaining women have been advised that the Supreme Court has found against them. The political vote​, which has yet to take place, ​is expected to be a formality.​

According to Muñoz, Vásquez’s pardon was unusual and was the only time from 1998 to 2015 that a woman in El Salvador has been pardoned​ for any crime. “There was an admission of an error in the judicial process — that the judge made a mistake because there was a lack of evidence and the cause of the baby’s death was undetermined,” he said.

Guevara-Rosas said Vásquez’s pardon provoked a backlash. “The conservative culture toward sexual issues prevails,” she said. “Most of the mainstream media is owned by conservative groups. The 17 are depicted as criminals, and the government is accused of not punishing women who kill their babies.”​ ​

Despite its more leftist position, the Farabundo Marti National Liberation Front has not amended the abortion ban​ ​since taking power in 2009. While Sánchez Cerén has recently indicated the issue should be studied, he has also said “respect for life” comes first.​ 

On Wednesday, Amnesty International delivered a petition of 300,000 signatures to his office and that of the President of the Legislative Assembly. It calls for a repeal of El Salvador’s abortion ban. Guadalupe and Mirna were among the local and international campaigners who met with Sigfrido Reyes, the FMLN assembly president. He told them it’s not “politically easy” to put the issue of “Las 17” on the agenda and referred to “the conservative fury” that exists among certain groups. He also said some on the right who supported a pardon for the women were prohibited by their parties from voting in their favor.

“The state has to continue looking at these cases, at these sentences, and find new options,” Reyes said.

El Salvador’s very influential Catholic and evangelical churches have consistently argued that any reform of the abortion law — including decriminalizing it in cases in which the mother’s life is at risk — would simply be a first step in a wider campaign for decriminalization.

“This is the doorway. As happened in other countries, they are searching for emblematic cases to push for legalization,” San Salvador’s Archbishop José Luis Escobar​ said in 2013. He was referring to the case of a woman identified at the time only as “Beatriz,” who had lupus and was carrying an anencephalic fetus and appealed to the Supreme Court to be allowed to terminate her pregnancy because her life was in danger and the baby was not expected to survive. She was not permitted to have an abortion, but in a compromise, she was allowed a cesarean section at 27 weeks, and the baby died hours later. 

The church points to the constitution’s protection of citizens’ rights, including, it says, unborn children’s. Politicians on the right, from GANA (Gran Alianza por la Unidad Nacional) and ARENA (Alianza Republicana Nacionalista) in particular, agree. Speaking last year, Congresswoman Ana Wilma De Cabrera of GANA said such cases were “sporadic” and the “law can’t change because of one case.”

In March the main conservative opposition party, ARENA, narrowly won the most seats in legislative elections, making the possibility of abortion reform more unlikely.

“Those politicians in favor of change won’t speak openly because they know they’ll pay a political cost. It will be a hard fight,” said Alberto Romero of the Citizen​s'​ Group for the Decriminalization of Abortion. Without a pardon for the 17, he said, they will ask the president to commute the women’s sentences. And without a change in the law, he said, “we want the Health Ministry to tell doctors they’re no longer obliged to report women and an exception to be made in the penal code if a mother’s life is at risk.”

At the prison, the women themselves are divided over the issue of abortion. ​None said they wanted an abortion, and they said that if they had, they would have it at the start of their pregnancies.

Ramírez left them when she completed her sentence just before Christmas. ​Her pardon was supported by the Supreme Court, but with only weeks left in her sentence, there was no vote in the Assembly. ​Now she’s trying to spend as much time as she can with her daughter. Briseyda, who turns 13 in May, still doesn’t know the truth.

“She knows I was arrested but not why. I don’t want her to know. How can I tell her? She’ll just feel bad,” she said.

Her hope is that all El Salvador’s women will be treated differently from how she was. Her message for those with the power to take away freedom is simple. “Investigate, because you don’t know. I lost so much and I wasn’t allowed to defend myself,” she said. “I want those in jail to have the chance I didn’t.”

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