IN FEBRUARY 2008, Manuela—an eight-months-pregnant, 33-year-old mother of two—suffered a miscarriage in the outdoor toilet of her home in a rural area of El Salvador.
After losing, and then regaining, consciousness, Manuela (not her real name) managed to make it back to her house and ask her parents for help.
When she got to the hospital, she was handcuffed to the bed for a week. Authorities suspected that Manuela’s miscarriage was actually “an abortion to hide her infidelity”; her husband had left her seven years prior, and she did not have the financial means to divorce him.
During a trial that took place later that year, Manuela’s mother was accused of being an accomplice. Law-enforcement officials also took statements from Manuela’s illiterate father, who ended up signing documents that implicated his daughter.
Manuela was condemned to 30 years in prison.
Following her death behind bars two years later, in 2010, her family learned that her miscarriage had been the result of undiagnosed lymphatic cancer.
ABORTION HAS BEEN ILLEGAL IN EL SALVADOR SINCE 1998. This is the case in any and all circumstances, including when the pregnancy poses a risk to the life of the mother. The extremely conservative politics of the country are due in part to the Roman Catholic Church, which exerts an outsized influence on Salvadoran politics and spearheaded a campaign in the 1990s that led to some of the most draconian laws against reproductive rights in the world.
Even women suffering from spontaneous abortions or obstetric complications have been targeted for prosecution. Between 2000 and 2014, there were more than 250 complaints to authorities from medical personnel, which resulted in 147 prosecutions and 49 convictions—26 for murder, and 23 for abortion.
In November 2015, photographer Laia Abril began working on a project about 17 Salvadoran women who were accused of homicide after suffering miscarriages or obstetric complications, and subsequently sentenced to 30 to 40 years in prison. These women had come to international attention a year prior via a movement called Las 17 (the 17 women), which sought presidential pardons for them; in prison, they were the targets of physical and psychological abuse by other inmates, and their families were often subject to threats.
Twelve of the 17 women are serving their sentences in a women’s prison called Ilopango, where overcrowding is the norm and inmates suffer from intense heat and what observers describe as “strict rules that are as impractical as they are cruel.” (Three of the 17 have been pardoned; others have had their motions denied or are still waiting to find out their fates.)
The court records of the 17 women reside in the headquarters of Agrupación Ciudadana por la Despenalización del Aborto (Citizens’ Coalition for the Decriminalization of Abortion), an organization run by Morena Herrera, an activist who has been fighting for Salvadoran abortion rights for a decade.
Many pregnant women in El Salvador who have miscarriages or complications during pregnancy are afraid to seek medical help. There is good reason for this: often, medical-services personnel themselves will report the women who come in with obstetric emergencies to the police.
In 2011, suicide was the most common cause of death in 10-to-19-year-old women, half of them pregnant, according to El Salvador’s Ministry of Health. This percentage has increased in recent years. According to the World Health Organization, over 47,000 women across the globe die annually because of lack of access to abortion.
In desperation, women in El Salvador and elsewhere turn to things like rat poison and other toxic substances for help. Women throughout history who have wanted or needed to end their pregnancies have been known to vaginally insert cayenne pepper, turpentine, and gin; eat gunpowder and fungi; and drink laundry bluing, lye, bleach, and even—according to one 5,000-year-old document from China—hot mercury. Such substances may end a pregnancy, but they can also cause gangrene, psychosis, and death.
Some Salvadoran women are punished with community service after having abortions, including forced volunteer work in day-care centers, in hopes that they will recover their “maternal instinct.”