For the past two weeks, women’s rights advocates in Nicaragua have been watching with sorrow and frustration as the news about Savita Halappanavar has been unfolding. Savita, an Indian national living in Ireland, died of septicemia following a miscarriage—a miscarriage that was undeniable and unpreventable, and yet doctors denied her appropriate medical treatment rather than end a doomed pregnancy.
Here in Central America, women are denied life-saving treatment every day.
In Nicaragua and El Salvador, abortion is outlawed under any and all conditions—two of only four countries in the world to do so. And while the laws of other countries in the region may allow for abortion under certain, very narrow conditions, in practice very few women can receive an abortion under such “exceptions.” Women who have suffered from pregnancy complications are accused of trying to “murder” their unborn children. Women with life-threatening illnesses are denied treatment because to do so might harm their pregnancy—just the same explanation that Savita’s husband received from their doctors in Galway.
At Ipas, we saw this firsthand with a young woman called Amalia. Amalia was 27, and eight-weeks pregnant with her second child when she was diagnosed with cancer—an aggressive recurrence of a cancer treated 10 years earlier. Because she was pregnant, the public health service denied her treatment because it might harm the fetus. Ipas and other human rights groups brought the case to the Inter-American Commission on Human Rights, to seek a precautionary measure that would compel the state to provide treatment—a request that was quickly granted. Under public and international scrutiny, the state then provided Amalia with the gold standard of care—treatment received by few others in Nicaragua. Under this treatment, the government maintained, the fetus would survive and thrive.
Sadly, the government was proven incorrect. Amalia delivered a severely malformed baby at seven months. She lived another 17 months. Throughout the case, the government maintained that an abortion was not necessary. The result of Amalia’s case speaks for itself; women undergoing cancer treatment still need the option of therapeutic abortion.
In El Salvador we met Karina, a woman with three children who was arrested after she was found hemorrhaging as a result of an unsafe abortion. She had become pregnant after receiving a tubal ligation (a procedure that is almost, but not entirely, 100 percent effective). Her mother had told her she would not be allowed home if she became pregnant again, and she was so ashamed that she told no one. Police determined that she’d induced an abortion, and she was prosecuted and sentenced to 30 years in prison without ever being allowed to speak to a lawyer, or testify on her own behalf.
After we learned about her, Ipas, the Center for Reproductive Rights and a number of other NGOs worked with Karina to bring a review of her case. With the legal representation and fact finding that she had been denied eight years earlier, we were able to win her freedom. But other women continue to face scrutiny and harassment over their pregnancy complications: Approximately 600 women in El Salvador are under investigation or being prosecuted for suspected abortion.
Women and doctors alike live in a culture of fear in countries that outlaw abortion. Doctors are afraid to provide any medical treatment that might harm or end a pregnancy. And women who have pregnancy complications are afraid to seek treatment for fear that they will be accused of inducing an abortion. The result? Women, like Savita, who are unnecessarily injured or die.
What is more frustrating is that numerous human rights bodies have ruled that to deny abortions to women whose lives and health are endangered by their pregnancies is a violation of their human rights. Ireland was told directly by the European Court of Human Rights that they must provide mechanisms to provide abortions under the law (abortion is legal in Ireland if a woman’s life is in danger). Nicaragua has been questioned repeatedly by international human rights bodies about its total ban on abortion, which runs contrary to multiple international agreements.
How many Amalias, Karinas or Savitas must there be before nations take women’s human rights seriously?