News Abortion

Salvadoran Government Ordered to Provide Beatriz Access to Life-Saving Care

Kathy Bougher

The Inter-American Court of Human Rights, the highest human rights court in the Americas, handed down Thursday a decision ordering the government of El Salvador to provide Beatriz access to health care that could save her life.

The Inter-American Court of Human Rights in San Jose, Costa Rica, the highest human rights court in the Americas, handed down Thursday a decision ordering the government of El Salvador to provide Beatriz with life-saving care. It ordered the state to provide the measures necessary to protect her life, health, and well-being, as well as refrain from interfering with the actions the doctors consider appropriate.

Beatriz, a 22-year-old woman who suffers from several life-threatening health problems, is 25 weeks pregnant with an anencephalic fetus, meaning it is missing part of its brain and will likely die at birth or shortly thereafter.  Her doctors recommended she receive an abortion, and she requested one on April 11. However, abortion is illegal under all circumstances in El Salvador.

The spokesperson for the Inter-American Court, Paola Ugaz, explained that the case is not going through formal channels; rather, the Inter-American Commission on Human Rights asked the judges to issues an immediate order to the Salvadoran government to avoid irreparable harm to Beatriz. This is the first case on abortion that the court has considered. The government has until June 7 to present a first report to the court on its compliance with the measures ordered.

The Salvadoran Supreme Court’s Constitutional Chamber handed down a ruling on May 29 which prohibited the therapeutic abortion that Beatriz requested in April. In spite of that decision, the Inter-American Court ruled that the Salvadoran government is obligated to guarantee that “the medical team providing treatment receives the appropriate protection needed in order to fully exercise their function in accordance with the decisions that the medical team adopts based on medical science.”

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Morena Herrera, president of the Citizen Group for the Decriminalization of Abortion, which has supported Beatriz, said, “We hope that the Salvadoran government complies immediately with this resolution from the Inter-American Court to proceed with the termination of Beatriz’s pregnancy in a manner that allows her to continue her life fully and safely.”

According to the Center for Justice and International Law (CEJIL), the court’s decisions carry a mandatory requirement for governmental compliance since El Salvador is a member state of the Organization of American States and signed the American Convention on Human Rights, which includes acceptance of the court’s competency.

News Abortion

Human Rights Bodies Call on El Salvador to Provide Life-Saving Abortion

Jodi Jacobson

International human rights bodies are urging the government of El Salvador to act to save Beatriz. Please add your voice.

See all our coverage of Beatriz here.

Petition the El Salvadoran President and Supreme Court for Beatriz’s life here.

This week two international human rights bodies called on the government of El Salvador to act expeditiously in providing an abortion to Beatriz, a 22-year old woman with uncontrolled lupus whose pregnancy is threatening her life. El Salvador has a total abortion ban; there are no exceptions for the health or the life of a pregnant woman, or in cases of rape or incest.

Pregnant with an anencephalic fetus, Beatriz (a pseudonym) is desperately ill and facing renal failure. She and her husband are parents of a toddler. Her family is desperately poor, and with each day that passes, the likelihood of serious and life-long medical complications requiring treatment, such as dialysis, increases dramatically. These complications will incur further costs her family cannot possibly afford and compromise their future economic security.

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Both the Office of the United Nations High Commissioner for Human Rights and the Inter-American Commission on Human Rights are urging the government of El Salvador to act swiftly to save Beatriz. The Office of the High Commissioner called the situation “cruel, inhuman, and degrading.”

We urge the Government of El Salvador to take all necessary measures to ensure the protection and full enjoyment of the right to life, and to the highest attainable standard of health for Beatriz, in accordance with international human rights law,” said the UN experts on right to health, torture, and violence and discrimination against women, Anand Grover, Juan E. Méndez, Rashida Manjoo and Kamala Chandrakirana.

This diagnosis of Beatriz’s condition was issued by the authorities of the Specialized National Maternity Hospital in San Salvador in March, and reiterated by the National Bioethics Commission of El Salvador (CNBES) through a statement last Tuesday. Furthermore, it has been confirmed that her foetus is anencephalic and with no extra-uterine viability.

“This situation of uncertainty has increased the suffering of Beatriz as she is aware of the health conditions of the foetus and the risk of death she faces, and is forced to go through a cruel, inhumane and degrading situation,” the independent experts stressed.

Yesterday, the Inter-American Court for Human Rights also called on the government to provide a life-saving abortion for Beatriz.

These actions come after concerted efforts by health and rights advocacy groups inside the country to save Beatriz’s life, alongside those by Amnesty International and Rewire, among others. As reported by Voices From El Salvador, doctors and medical authorities within the country have been urging action for some time. Two weeks ago, doctors at the National Maternity Hospital filed an appeal with the Salvadoran Supreme Court, asking it to give the OK on terminating the pregnancy to save Beatriz’s life. The court asked the National Bioethics Commission of El Salvador (CNBES, in Spanish) for its opinion, which it provided this week. The CNBES advised the court that Beatriz’s doctors should be allowed to immediately proceed with the potentially life-saving procedure.

Citizens Association for the Decriminalization of Abortion, a group that advocates for legalization of abortion in El Salvador, also supports Beatriz’s case. The group is using the case to demonstrate why it believes abortion should be safe and legal. On Thursday, April 25, the group asked the Inter-American Court for Human Rights to intervene.

Voices reports:

Lic. Oscar Luna, the Ombudsman for the Defense of Human Rights in El Salvador, published a statement on April 16 also supporting Beatriz’s case as a human rights issue, stressing the mother’s right to life. He wrote in 2009, “the complete ban of abortion greatly increases the pain and suffering of women and girls, including those who seek medical attention for complications that require an abortion… because the penalty for abortion causes physical pain, fear, depression, and prison. In many occasions the suffering can lead to death or suicide.”

Luna says, “During my term [as Ombudsman], I have insisted that the human rights approach to health care ought to have an integral focus, taking into account the needs and requirements particular to women during all the different stages of life; and that in all forms, it is urgent to double up the efforts to decrease the causes of mortality and morbidity in El Salvador.” He concluded that the medical team should “use all means necessary to protect Beatriz’s right to life, health, and personal integrity.

However, powerful forces within the country oppose providing this urgently needed care for Beatriz. Voices reports that the “Catholic Church and Yes to Life oppose allowing Beatriz to terminate her pregnancy, even if it means that she loses her own life.”

“In one sense,” writes Voices, “Beatriz’s case is extreme – it is a potentially life or death situation for her. But in many ways her case is not that different from other Salvadoran women who are socially and economically marginalized, lack knowledge of or access to contraception, and have little control over when and with whom that have sexual intercourse.”

Efforts to save Beatriz now turn to the government of El Salvador. To help increase the pressure on the government to act quickly, please sign our petition. The more international press and visibility we can give to this case, the more quickly the government is likely to act.

Analysis Human Rights

In El Salvador, Yet Another Woman’s Life Subordinated to Non-Viable Fetus

Kathy Bougher

A 22-year-old Salvadoran woman with severe chronic medical conditions is pregnant with a fetus without a brain. But a 1998 law in El Salvador prohibits all abortions, without exception.

See all our coverage of Beatriz here.

Petition the El Salvadoran President and Supreme Court for Beatriz’s life here.

Beatriz wants to live. A 22-year-old Salvadoran from a poor, rural community, Beatriz (a pseudonym to protect privacy) suffers from chronic and severe medical conditions. She is the mother of an infant. And she is roughly 18 weeks pregnant with an anencephalic fetus, a fetus without a brain. Doctors at the Maternity Hospital determined that the pregnancy is life-threatening, and Beatriz requested that Salvadoran medical personnel perform an abortion, but a 1998 law in El Salvador prohibits all abortions, without exception.

The Salvadoran feminist organization Agrupación Ciudadana por la Despenalización del Aborto Terapéutico, Ético y Eugénesico (Citizen Group for the Decriminalization of Therapeutic, Ethical and Eugenic Abortion), which has been working to decriminalize abortion in the country since 2009, petitioned the Salvadoran Supreme Court on April 15 to intervene and to direct medical personnel to provide without fear of criminal prosecution the procedures Beatriz needs to save her life. Under current law, both Beatriz and any medical personnel involved in an abortion would face criminal charges and prison time. The court responded with a temporary directive that medical personnel provide the care necessary to guarantee her life and health while they make a decision regarding the petition for an abortion. Medical personnel were also directed to present to the court within five days a report on the condition of the mother and the fetus to inform their deliberations.

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Within the past few days Amnesty International has initiated a petition asking for life-saving medical care, including an abortion; the United Nations has spoken; and the Salvadoran Minister of Health, Dr. Maria Isabel Rodriguez, has requested that the Supreme Court approve the request. Dr. Rodriguez emphasized that Beatriz’s kidney function continues to deteriorate as the pregnancy advances, and that the public health system is ready to perform an abortion. The Salvadoran Attorney General for Human Rights also supports the request.

At a press conference the Agrupación convened in San Salvador on April 18, Esther Major, an Amnesty International representative in El Salvador, characterized the way Beatriz is being treated as “nothing less than cruel and inhuman.”

“While we are talking, while the Court is thinking and the government is delaying, Beatriz is suffering. … The Salvadoran government has clear obligations, international as well as domestic, to protect Beatriz’s life, and to assure that Beatriz can access vital treatment as soon as possible.”

Legal reforms in 1998 in El Salvador, promulgated by conservative religious forces, outlawed  abortion without exception. Previously it was permitted if the pregnancy resulted from rape or incest, the mother’s life was in danger, or the fetus was not viable. In addition, a constitutional amendment was added declaring that life begins at conception, which means that prosecutors can charge women who seek abortions with aggravated homicide, punishable by 30 to 50 years in prison, rather than the lesser crime of abortion, which carries a term of two to eight years.

Threats of prosecution and prison terms are not to be taken lightly under the 1998 law. The Agrupación has mounted legal and educational campaigns to secure the release of six women from prison. Since no comprehensive data exist in the country, the Agrupación is conducting its own research, which reveals that currently at least 24 women are serving prison terms of up to 40 years for abortion or aggravated homicide related to abortion charges.

The Sí a la Vida (Yes to Life) Foundation, an anti-abortion religious organization, expressed its belief that feminist groups are exploiting and manipulating Beatriz in order to legalize abortion in the country. An opinion column in the Salvadoran press on April 17 pleaded with Beatriz, “Don’t kill it!” while obscuring the fact that the fetus is anencephalic and cannot sustain life outside the uterus, using language such as “you are expecting a baby that might be born sick.”

Beatriz waits as the Agrupación works through the restricted avenues available to save her life and perhaps create fissures in the wall of political and religious opposition to the decriminalization of abortion even under limited circumstances for women in the country. For Beatriz, the eyes and voices of the world constitute her hope for life.

Beatriz is not the only woman for whom death looms as a highly possible outcome of pregnancy. Since all abortions are illegal in the country, they all take place in clandestine conditions. The Agrupación’s as-yet-unpublished research from 2010 and 2011 finds that perhaps 35,000 unsafe abortions (as defined by the World Health Organization) take place every year in El Salvador.

As in the death of Savita Halappanavar in Ireland in 2012, Beatriz’s life could also be subordinated to that of a non-viable fetus. Although El Salvador refers to itself as a secular nation, the Catholic Church, conservative evangelical churches, and groups such as Sí a la Vida wield overwhelming political power and influence.

Beatriz’s situation becomes the most recent and most urgent of the many the Agrupcación has addressed. The long-term goals of the group focus on substantial reforms to the country’s draconian abortion law. In addition, since 2009 the Agrupación has organized legal and public education campaigns to gain the release of six women who were serving prison terms of up to 30 years for the “crimes” of abortion or aggravated homicide related to abortion. The group continues to work on the release of at least 24 more women still in prison, according to the research they have done. As the Agrupación gathers data on women who have been formally charged with abortion or aggravated homicide, a clear pattern emerges of the selective prosecution of young, poor, rural women. In addition, court documents in numerous cases reflect obvious medical, prosecutorial, and judicial errors or negligence. In several of the cases where women regained their freedom from prison, appeal processes revealed that no evidence that an abortion occurred or was provoked by the woman was ever presented in court, and in some cases evidence demonstrated that the fetal death resulted from natural causes and was not caused by the woman. Money speaks, and if Beatriz had the financial resources, she might have been able to secure appropriate health care in a private facility where she would have a greater  probability of receiving life-saving treatment without fear of imprisonment.

Beatriz’s life is threatened by her health conditions and a high-risk pregnancy. However, the deeper threats come from an intractable and misogynistic political and religious system which criminalizes women for being young, poor, rural women.  Right now the eyes and voices of  the world constitute Beatriz’ hope for life. She wants to live.

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