"Faces" tells the stories of women's lives lost to Nicaragua's abortion ban

Photo by Sara Gomez

Carmen was a 16-year-old woman living with her family in small house made of scrap wood and tin. Diagnosed with leukemia, Carmen became pregnant twice within a year after a pharmacist denied her contraceptives, telling her that her body couldn’t accept any additional “poison.”

The first pregnancy ended in miscarriage; the second time, she was admitted to the hospital when her leukemia relapsed 22 weeks into her pregnancy. She remained in the hospital for 10 days, during which little attention was given to her pregnancy. “They told her that she was just going to die,” Carmen’s sister said. “They didn’t pay much attention to her.”

Esperanza, a 24-year-old university student from a middle-class family in Nicaragua, was six-weeks pregnant when she began feeling violently ill. Instead of receiving treatment immediately, she was referred from hospital to hospital for an ultrasound because health-care providers are required by law to check for fetal viability before they can provide treatment and many health centers lacked the capability to do so.

Esperanza and Carmen (not their real names) were just two of the more than 80 Nicaraguan women who died from pregnancy-related causes since abortion was outlawed. Esperanza died from an ectopic pregnancy (a pregnancy that develops outside of the uterus) – the first woman in seven years to do so in Nicaragua. Carmen died as a result of her relapse, which was aggravated by her pregnancy.

Both of these women’s lives, as well as the lives and health of many other women, might have been saved if they had had access to reproductive health care, including, therapeutic abortion — abortion performed to preserve the life or health of a pregnant woman. Therapeutic abortion was legal in Nicaragua until October 2006, when the National Assembly voted to eliminate the only exception to their country’s law banning abortion.

The stories of Esperanza and Carmen, as well as the stories of their families and the health-care providers working under the new law in Nicaragua, are told in “The Faces Behind the Figures,” an Ipas booklet now available in English for the first time.  This booklet, also available in Spanish, details the ways that the law violates women’s basic human rights to life and health, rights that are enshrined in the Nicaraguan Constitution.

Nicaragua’s abortion laws have been shown to harm women who develop pregnancy-related complications and emergencies unrelated to abortion. Doctors who are wary of facing punishment may hesitate to provide obstetric services that may actually be legal. In some cases, this hesitation can result in delays that cause permanent damage to women’s reproductive systems; in others, it may result in women like Esperanza being transferred to other hospitals without receiving treatment.

Dr. Jorge Orochena, Director of Quality Control in the Nicaraguan Ministry of Health, explains: “There have been situations that should have been treated, but aren’t out of fear…In one hospital we had a patient with an ectopic pregnancy, it was ruptured, there was nothing to do [to save the fetus] but [the patient] was not treated…the doctors don’t want to put themselves on the line.”

Attempts to challenge or reverse the ban have not been successful so far. In January 2007, the Nicaraguan Center for Human Rights and other organizations brought the law to Nicaragua’s Supreme Court of Justice (CSJ), but the Court never ruled on appeal. In September, the Nicaraguan National Assembly, when revising the national penal code, again voted against legalizing therapeutic abortion, cementing the country’s complete ban.

Despite this setback, Ipas continues to work to make health care available to the women who need it and to make sure the stories of Esperanza, Carmen and countless others are heard. Nicaragua has agreed to international treaties that guarantee that all of its people, regardless of gender or economic background, have the rights to dignity and to receive health care. Bringing the ban on abortion to international organizations, such as the Inter-American Institute of Human Rights in Costa Rica, on the grounds that the ban violates these international treaties may be key to pressuring the Nicaraguan government to change the legislation.

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258