Women’s rights activists fear that a suspected rise in miscarriages linked to the Zika epidemic could lead to a surge in criminal prosecutions of women for deliberate abortion or homicide under El Salvador’s draconian abortion law.
El Salvador is one of six countries with a total ban on abortion, and the aggressive persecution of women suspected of terminating a pregnancy has led to serious miscarriages of justice.
More than 250 women were reported to the police between 2000 and 2014, of whom 147 were prosecuted and 49 convicted – 26 for murder and 23 for abortion, according to research by the Salvadorian Citizens’ Group for the Decriminalisation of Abortion. The vast majority were young, poor and single, and said that they had lost their baby after a medical complication.
The Zika virus is spreading fast in El Salvador as overwhelmed health authorities struggle to contain the outbreak.
The health ministry has advised women to delay pregnancy for two years amid growing fears that in Brazil thousands of cases of microcephaly – a congenital abnormality which causes the infant to develop an abnormally small head and brain – are linked to the Zika epidemic.
But authorities have remained silent on growing concerns that Zika may also increase the risk of a miscarriage or still birth.
“If Zika increases the likelihood of miscarriage there’s a definite risk that more women with a certain profile – those who are poor, young and use public health services – are at the very least going to be investigated by police and may end up being prosecuted for an intentional abortion or homicide,” said Sara García, from the Citizens’ Group.
Dr Nelson Menjivar, a gynaecologist with a small private practice in San Salvador, said that last month he had attended to 11 women who had suffered a miscarriage two or three weeks after contracting Zika. The women were healthy, aged 16 to 32, with no other risk factors, and were attending for a routine ultrasound.
“These women were all in their first trimester who came to me without any symptoms simply to find out exactly how many weeks pregnant they were, but each had suffered a miscarriage. I saw three women in one afternoon, one after another, it was shocking,” he said.
“The only thing in common was they had suffered a fever, rash and conjunctivitis – class Zika symptoms – two or three weeks earlier.”
According to Dr Menjivar, several of his colleagues working in private practice have seen numerous similar cases this year.
But those most in danger of falling foul of the law are the country’s poorest women who rely on public health services. There are no known cases of women using private healthcare services having been investigated by police after a miscarriage or a clandestine abortion.
The unfolding Zika crisis has left scientists scrambling to understand the risks posed by Zika which until recently was regarded as a relatively benign mosquito-borne virus.
In El Salvador, like many countries, private clinics are not required to submit patient information to the ministry of health, which means important epidemiological data is simply being lost.
The UN has called on Latin American countries hit by the Zika epidemic to allow women access to abortion, but authorities in El Salvador so far seem unmoved. Health clinics first started seeing patients with Zika in September 2015; no babies with microcephaly linked to the virus have so far been born.
