On the day of love...

By Alfonso Rosale

Tuesday, February 14, 2023

She had three diseases that indicated that the pregnancy should be terminated (systemic lupus erythematosus, lupus nephropathy and rheumatoid arthritis) and if we add to this that her pregnancy product had no brain, there was zero chance of life outside the uterus, it was not necessary to have a great knowledge in medicine to understand that the best thing for her was to terminate it".

This was the case of Beatriz, a young Salvadorian woman, pregnant with a child without brain, and with an incurable chronic disease. Safeguarding the life of a pregnant woman, especially if the product of her pregnancy has no chance of survival (ananephalous, i.e. no brain, no possibility of life), in any health system in the world, is an easy decision. But not in El Salvador.

El Salvador prohibits abortion since 1998, under any circumstances. According to the provisions of Article 133 of the Penal Code, women who perform abortions or persons who support them in the procedure can be punished with 2 to 8 years in prison. There are a total of five countries in the world (out of 196 countries), 4 of them in the Mesoamerican region (El Salvador, Honduras, Nicaragua and Dominican Republic) with laws where the pregnant woman is totally unprotected (abortion is not allowed under any circumstances). A legacy of the governments of Arena, a political party of the ultra-right and at the moment very discredited by the high rates of corruption among its leaders. But the legacy has continued with leftist parties, such as the FMLN, also discredited by corrupt acts and with two exiled ex-presidents, currently fugitives from Salvadoran justice. And although we are in times of new ideas, the legacy persists. Many laws have been modified during this government, but not the laws that protect the health of pregnant women.

Therapeutic abortion, legally authorized in 191 countries, is defined as the voluntary termination of a pregnancy before fetal viability (22 weeks or less than 500 g), for maternal health reasons. There are five basic medical reasons that justify therapeutic abortion: serious risk to the life of the mother, to safeguard the physical or mental health of the mother, risk of congenital or genetic disease, reduction of embryos or fetuses in multiple pregnancies, and serious risk to the life of the fetus.

In Beatriz's case, two of the five medical indications for termination of pregnancy were met. But the Salvadoran State denied Beatriz's basic right to life. The guild of the Medical College of El Salvador stated in 2018 "there is no situation, in current medical practice, where human life, should be intentionally destroyed through abortion for the purpose of saving the life of the mother." Demanding the permanence of the criminalization of abortion in our country.

I wonder what arguments crossed the brains of the three women doctors who were part of the 11-person board of the Medical College. With such a statement, they undermined the most fundamental human right of all Salvadoran women. Were they aware of their betrayal, not only to the rest of women but to the Hippocratic oath? Or were they subjugated by the vast majority of alpha males and fellow directors? I get it from religious fanatics, but from fellow physicians? But yes, even if I don't understand it, the recent pandemic has made it clear to me, that very despite all those hours of study, political and religious agendas prevail over science, in some colleagues. I wonder what those 11 doctors would have done if Beatriz had been their daughter: take her out of El Salvador to have her pregnancy terminated in another country?

For the cases of women imprisoned for the crime of abortion or aggravated homicide, they are all poor women: 9 out of 10 are under 30 years of age, 7 out of 10 are single and self-employed, and with less than 9 years of education. The miserable history of our country repeats itself: the viper crawls among the vulnerable and has a predilection for biting the barefoot. On the day of love, I feel like reflecting on the systematic cruelty imposed by our laws on the women of our country.

Original text published in Diario el Mundo.

Resumed March 1, 2023 

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