What happens when abortion is banned?

September 25, 2014

ElSalvador2Sunday, September 28, Amnesty International is taking part in the International Day to Decriminalize Abortion. The importance of access to safe, legal abortion is clearly demonstrated in Amnesty’s new report, On the Brink of Death: Violence Against Women and the Abortion Ban in El Salvador. In contrast to a global trend in liberalization of abortion laws in the last 20 years, El Salvador completely outlawed the procedure in 1997, without exceptions for rape, or incest, or the life of health of the woman. This report therefore tells us what happens in a country where abortion is totally illegal.

  1. In contrast to the expressed aim of such laws, the World Health Organization has found that laws that totally ban abortion do not, in fact, decrease abortion rates. Rather, they drive women and girls to seek unsafe, clandestine abortions. According to (undoubtedly low) estimates by the Salvadoran Ministry of Health, there were 19,290 abortions between 2005 and 2008. Amnesty has identified multiple factors that continue to motivate Salvadorans to terminate their pregnancies. One critical factor is the high rate of teenage pregnancy—the highest in Latin America, with 23% of 15 to 19 year-old Salvadoran girls having had at least one pregnancy. This high rate, in turn, is the result of a lack of access to sexual education and contraception. Unwanted pregnancies are also caused by the state’s failure to protect women and girls from violence, including rape and other forms of coercion.
  2. The high rate of clandestine abortions has claimed the lives of at least 11% of the women and girls undergoing the illegal procedures, in stark contrast to the safety record of legal abortion.
  3. Not only does the ban on abortion drive women and girls to risk dangerous treatments, it discourages them from seeking emergency medical treatment when complications do arise for fear of prosecution. Unfortunately, the fear that doctors will not maintain confidentiality is well-founded. 57% of the 129 cases of criminal complaints of abortion documented by the Citizens Group for the Decriminalization of Abortion were found to have originated from healthcare professionals.
  4.  The bond of trust between women and their doctors is further eroded by the fact that El Salvador’s complete ban on abortion prevents doctors from giving their patients the full of range of medical options, including those that may be in patients’ best interest. As one doctor explained to Amnesty, medical professionals may know that an abortion is the “best option” because the patient’s life is at risk. “But we can’t tell a woman that,” the doctor said, “because if we do, she’ll say, ‘yes, I want the interruption,’ And we’ll say, ‘Yes, but we can’t, because it is illegal.’” In 2013, for example, Beatriz’s (not her real name) doctors did tell her that an abortion was necessary because of her lupus and other complications. Nonetheless, she was forced to wait until the state allowed her to have an emergency caesarian when the fetus theoretically became viable—even though it died hours later as the result of known congenital defects. This delay not only endangered Beatriz’s life, it also caused her unnecessary physical and emotional trauma. 
  5. Young girls and adolescents are especially at risk of dying from complications of childbirth and pregnancy—a particularly troubling fact given El Salvador’s combination of high rate of teen pregnancy and a complete ban on abortion.
  6. Women and girls who have had abortions are not the only ones who have to fear their own doctors. Medical professionals have also filed reports against those who have suffered miscarriages. Amnesty’s report draws special attention to the cases of 17 women who were convicted of either having an abortion or aggravated homicide despite their protests that they had in fact miscarried. Some face sentences of up to 50 years. According to a lawyer advocating for the release of these women, the complete ban on abortion has led to a “witch hunt” and a presumption of guilt. The investigation and prosecution of these women may have resulted in serious violations of their right to due process.
  7. Some girls facing unwanted pregnancies without access to abortion end up taking their own lives. According to the Salvadoran government’s own figures, 57% of the deaths of pregnant girls between the ages of 10 and 19 were the result of suicide. Amnesty suspects that these deaths are underreported because of the stigma surrounding both teen pregnancy and suicide. As one youth told Amnesty researchers, “You can easily end up deciding that it’s best not to [carry on living]. . . .when you’re crying, when you feel bad, when you feel like there is no way out, when you feel like you have no support, that option seems like the easier one.”

Take action and tell Salvadoran President Sánchez Cerén to:

  • Decriminalize Abortion.
  • Release women and girls imprisoned for having abortions or miscarriages
  • Ensure access to abortion, particularly in cases of rape or incest; when the woman’s health or life is in danger; and when the fetus is unlikely to survive.
  • Provide access to contraception and comprehensive sex education