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 case of an abortion, which rises to between 30 and 50 years for a crime of aggravated homicide if it is an out-of-hospital birth occurred when the pregnancy exceeds 20 weeks and even if it is accidental.
This regulation prevented Beatriz, 2013, from interrupting her pregnancy in 22, despite the risk of 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 their daughter also had no life expectancy, 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 with her pregnancy until at 26 weeks she had an emergency cesarean section to deliver 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 in 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 access to a legal, early and timely interruption of her pregnancy, which put his life at risk and affected his integrity, health and other rights." Beatriz already had a precedent of a risky pregnancy in 2012 that also ended in cesarean section to avoid a hypertensive disorder known as preeclampsia. On that occasion, it was a premature birth at 32 weeks of a child who, after 38 hospitalizations, managed to move forward.
The ruling, which will be known in a few months, could set a historic precedent in Latin America, where abortion is banned in all cases in five countries: El Salvador, Honduras, Nicaragua, Haiti and the Dominican Republic.
Doctors advised abortion
In the hearing on Wednesday, the Commissioner and Rapporteur for the Rights of Women 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" for the diseases she suffered, while it was diagnosed that the fetus was "incompatible with life outside the womb." Therefore, they warned that, if pregnancy progressed, "there was a probability of maternal death" so they recommended its "interruption".
For this reason, Mantilla recalled that Beatriz requested to terminate her pregnancy, although the doctors refused considering that the Penal 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 the Inter-American Commission on Human Rights granted her precautionary measures in April 2013 in favor of her, which resulted in the cesarean section to which she was subjected almost in extremis.
Beatriz's mother intervened on the first day of the hearing and called the 81 days her daughter spent hospitalized "torture." "The doctors had their hands tied, despite the suffering she had," he said, stressing that they had told his daughter that "she could not continue with her pregnancy because their lives were in danger." In this sense, he indicated that, at 12 weeks of pregnancy, they did explain 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," he said.
For his part, who was head of the high-risk unit of the National Maternity Hospital of El Salvador, Guillermo Antonio Ortiz, explained that he attended to Beatriz in her two pregnancies. "The first thing she told me in the second pregnancy is that if her daughter is not going to live, she did not want to risk, nor did she want to die, so she asked me for help to interrupt it," she revealed. Therefore, a Medical Committee met, made up of 15 specialists, who determined by "unanimity" that there was a "high risk" of complications if the pregnancy continued, so at 14 weeks of gestation it was the best time to make the interruption ".
Beatrice was taken "to the extreme"
Despite this, the abortion could not be performed because the hospital's lawyer reminded them that El Salvadoran law did not allow it, nor was there any protocol for the interruption of pregnancy to deal with this type of case. "The cesarean section, which involved a risk of blood loss, could have been avoided," said the doctor, who regretted that, given the impossibility of performing an abortion, a woman was taken to the "extreme" because at that time there was "a high probability of dying if the intervention was not done."
Throughout his more than 20 years at the hospital, Ortiz said he saw "many women die because they did not have the opportunity to have a safe abortion, despite having requested it, being the boss, and that is 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 order to interrupt 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 giving the reason to 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 again failed her a 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 is restored and that what happened to her does not happen to any other woman again."
This Court already condemned in December 2021 the State of El Salvador for the "arbitrary criminalization" of Manuela, who was deprived of 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 miscarriage. There she was arrested 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 under detention of cancer leaving her two children orphaned.
Salvadoran President Nayib Bukele already made it clear in 2021 that he will not 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 will come from the resolution of the Inter-American Court based in Costa Rica.
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