El Salvador could be forced to change its restrictive 1998 law that prohibits abortion in all cases, including rape or if there is a risk to the life or health of the mother or baby. This country establishes a prison sentence of six to eight years in the case of an abortion, which rises to between 30 and 50 years for a crime of aggravated homicide if it is an extra-hospital birth that occurred when the pregnancy exceeds 20 weeks and although be accidental.
In 2013, this regulation prevented Beatriz, 22, from terminating her pregnancy, despite the risk posed by having her daughter, given that the young woman suffered from systemic lupus erythematosus, lupus nephropathy (kidney damage) and rheumatoid arthritis. In addition, the hospital had diagnosed that her daughter had no hope of life either, because she was going to be born with anencephaly, a congenital malformation that prevents brain development. Despite all these circumstances, no one listened to her and she was forced to continue her pregnancy until at 26 weeks she underwent an emergency caesarean section to give birth to a premature baby who only survived five hours, while the mother remained in intensive care for four days.
Beatriz died in 2017 in a traffic accident, but her emblematic case is being examined at the Inter-American Court of Human Rights, after both her family and several organizations that defend the right to abortion denounced the State of El Salvador "for the lack of of access to a legal, early and timely termination of her pregnancy, which put her life at risk and affected her integrity, health and other rights". Beatriz already had a precedent for a risky pregnancy in 2012 that also ended in a cesarean section to avoid a hypertensive disorder known as preeclampsia. On that occasion, she was a premature birth at 32 weeks of a child who, after 38 hospitalized, managed to get ahead.
The sentence, which will be known in a few months, could set a historical precedent in Latin America, where abortion is prohibited in all cases in five countries: El Salvador, Honduras, Nicaragua, Haiti and the Dominican Republic.
At the hearing this Wednesday, the Commissioner and Rapporteur for Women's Rights of the Inter-American Commission on Human Rights, Yulisa Mantilla, recalled that when Beatriz was diagnosed with an eleven-week pregnancy, medical reports considered that she was "high risk " due to the diseases he suffered, at the time that the fetus was diagnosed as "incompatible with extrauterine life". For this reason, they warned that, if the pregnancy progressed, "there was a probability of maternal death" for which they recommended its "interruption".
For this reason, Mantilla recalled that Beatriz requested to terminate her pregnancy, although the doctors refused, taking into account that the Criminal Code of El Salvador establishes that abortion is a crime and they ran the risk of being prosecuted and imprisoned. This caused the young woman to file an amparo before the Constitutional Chamber of the Supreme Court of Justice of El Salvador to order that the pregnancy be interrupted and thus be able to safeguard her life. However, the amparo was rejected and in April 2013 the Inter-American Commission on Human Rights granted precautionary measures in her favor, which resulted in the caesarean section to which she was subjected almost in extremis.
Beatriz's mother intervened on the first day of the hearing and described as "torture" the 81 days that her daughter spent in hospital. "The doctors had their hands tied, despite the suffering she had," she said, while stressing that they had told her daughter that she "could not continue with her pregnancy because the life of her They were both in danger." In this sense, she indicated that, at 12 weeks of pregnancy, they did explain to her that there was a possibility that the mother could be saved through a "treatment" that they could not do, in reference to abortion. "She was determined to terminate the pregnancy because she wanted to live and there was no hope that the baby would survive," she stressed.
For his part, the former head of the high-risk unit of the National Maternity Hospital of El Salvador, Guillermo Antonio Ortiz, explained that he cared for Beatriz during her two pregnancies. "The first thing he told me in the second pregnancy is that if her daughter is not going to live, she did not want to risk it, nor did she want to die, so she asked me to help her interrupt it," he revealed. For this reason, a Medical Committee, made up of 15 specialists, met, who "unanimously" determined that there was a "high risk" of presenting complications if the pregnancy continued, so that at 14 weeks of gestation was the best time to do the interruption".
Despite this, the abortion could not be performed because the hospital lawyer reminded them that the law of El Salvador did not allow it, nor was there any protocol for termination of pregnancy to deal with this type of case. "The caesarean section, which implied a risk of blood loss, could have been avoided," remarked the doctor, who lamented that, given the impossibility of performing an abortion, a woman was taken to the "extreme" as there was at that time "a high probability of dying if the intervention was not performed".
Throughout his more than 20 years at the aforementioned hospital, Ortiz indicated that he saw "many women die because they did not have the opportunity to have a safe abortion, despite me having requested it, being the boss, and that is indeed a frustration". Faced with this situation, he revealed that some women, in cases similar to Beatriz's, escape from the hospital without medical authorization in search of terminating their pregnancy in clandestine places.
This context could change if the Inter-American Court of Human Rights dictates measures aimed at El Salvador allowing therapeutic abortion, agreeing with Beatriz, who will not be able to see the resolution of her case, after dying in 2017 from pneumonia after suffering a motorcycle accident. . "The State failed her the first time and failed her again for the second time by not giving her the treatment she needed in the hospital," said her mother through tears, who only hopes that "Beatriz's image will be restored and that this It happened to her, it won't happen to any other woman again."
This Court already condemned the State of El Salvador in December 2021 for the "arbitrary criminalization" of Manuela, who was deprived of her liberty, after trying to access reproductive health services in a public hospital when she faced an obstetric emergency. Specifically, Manuela went to a public hospital in 2008 after a spontaneous abortion. She was arrested there and transferred directly to prison after being denounced by the medical personnel who treated her. Subsequently, she was sentenced to 30 years in prison for the crime of homicide and in 2010 she died in detention for cancer, leaving her two children orphans.
The Salvadoran president, Nayib Bukele, already made it clear in 2021 that he is not going to propose any reform to any article of the Constitution that has to do with the right to life from the moment of conception. Perhaps the changes come from the resolution of the Inter-American Court based in Costa Rica.
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