Morena Herrera and Sara García personify transgenerational feminism in El Salvador. Herrera, a former guerrilla fighter in the 80s, founded the organization Las Dignas (“women with dignity”) two years before the signing of the 1992 Peace Accords and led the post-war feminist movement. García, 26 years her younger, cut her political teeth in Las Dignas’ debate school and is now a figurehead of the Citizens’ Association for the Decriminalization of Abortion. In one of the countries with the strictest legislation in the world, the two women work together to promote reforms and fund the legal defense of dozens of women condemned to up to 30 years in prison for obstetric emergencies.
They are spokespersons for the family of Beatriz, a young woman who in 2013 was forced to give birth to an anencephalic fetus, born without a brain. Doctors from the Salvadoran public health system recommended that she terminate the pregnancy because her life was at risk due to her lupus diagnosis and the Inter-American System backed her request, but authorities denied her the abortion. Ten years later, Salvadoran medical personnel still have their hands tied in similar cases.
Beatriz died in 2017, but her family has pressed forward with its suit against El Salvador for putting her life in jeopardy. The Inter-American Court of Human Rights will hear the case on March 22 and 23. The Inter-American Commission on Human Rights already established a year ago that the treatment of Beatriz was “cruel, inhumane, and degrading.”
Earlier this month, Herrera and García visited Washington for a gathering of the “Green Wave of the Americas,” an abortion rights movement that for the first time included U.S. organizations. Their green handkerchiefs, which in 2018 spread from Argentina to all of Latin America, began to appear in the United States a year ago, upon the leak of the Supreme Court ruling reversing Roe v Wade.
In this interview, they insist on the regional significance of the Beatriz case, warn that Salvadoran women continue to die following the refusal of abortion, and denounce that President Nayib Bukele, who as a candidate supported abortion to protect the mother’s life, has now allied himself with ultraconservative international groups opposed to the procedure in any form.
Those same groups have activated a campaign calling the Inter-American Court’s ruling a new Roe for the Americas. That is perhaps the only point of agreement with the feminist movements, who hope that the resolution will force revisions to legislation in El Salvador and across the region.
You turned Beatriz into a symbol.
Morena Herrera: She is one. Beatriz’s doctor once told me: “Morena, right now I have a room of 49 women in similar or worse condition, but Beatriz is different: First, in that she decided to speak out and has maintained her request to terminate the pregnancy; and second, in that you have supported her, and it has given her strength.” She was threatened and pressured to back down. One day she put a call on speakerphone for me to hear, from an executive of the organization Sí a la vida (“yes to life”), who told her: “If you let go of your request we offer to take you to a hospital that is like a hotel, for you to have your child; we offer you a house; and we offer you employment for your husband.” These were basic needs: housing and employment for her partner, who was an agricultural day laborer and didn’t even work his own land. But she said, “I want to live; I will not back down.”
Why do you think the family has pressed forward with her case, even years after her death?
MH: When we asked her what she wanted from the process, she told us: “I want healthcare for me and my son,” but also: “I want no other women to suffer as I have.” Her mom heard her say it. She is certain that Beatriz wanted to continue.
Sara García: Our first contact with Beatriz was in the community where she lived. We asked her and her mother if they agreed with the doctors’ recommendation. Both said yes. It was Beatriz’s second pregnancy, and the first time around she almost died, so I think that their fears were stoked. The mom held a press conference to ask that her daughter be allowed to end the pregnancy.
What are they requesting from the Inter-American Court?
MH: Acknowledgement that her rights were violated. We have also worked with the family to request economic reparations for the days they missed work to support her, and for physical and emotional harm. The mother wants her daughter’s request that this not happen to other women to be heard.
If the court rules in their favor, do you expect they will order legislative changes?
MH: They have the power to do so. We hope that their ruling will be as far-reaching and specific as possible, because the Salvadoran state evades responsibility in this type of case. For example, in its November 2021 Manuela ruling, the court ordered the state to implement a holistic sexual education program. The government has said that it opened a process of “introspection” in 2022 to review the curriculum. But in practice, under pressure from groups who do not support women’s rights, they have eliminated everything relating to sex education. They have even removed from the learning indicators that girls and boys be able to identify the different parts of their body. On that point, El Salvador has regressed.
In cases like that of Beatriz, the state argues that its priority is to save both lives. Do you think they will argue this again?
MH: We have insisted that efforts to save both lives should be undertaken when the woman wants it, but that, when she says that she wants to protect her own health, she be heeded. The state argues that El Salvador has not totally criminalized abortion, because article 27 of the Penal Code grants the right to defense, but they know perfectly well that this does not apply in abortion cases because intervention requires prior authorization. They also say that Beatriz was not at immediate risk of death. And there is an even greater manipulation: They say that the state was sued for letting her child be born.
SG: The state distorts the facts. They try to present anencephaly as a disability, in suggesting that Beatriz requested the abortion because the fetus had a disability. But the Inter-American Court itself had already recognized that her rights were violated in the precautionary and provisional measures ordered in 2013. It is an acknowledgement that Beatriz endured violence and that non-repetition measures must be established — regardless of the state’s assertion that it offered adequate medical care to Beatriz for the 81 days that she was hospitalized.
Did they not?
MH: The account of events has been manipulated. The state says that it even gave her permission to leave the hospital and see her partner and son on some weekends, but that was not a government initiative. She had said, “I’ll get out of here, one way or another,” and the doctors demanded that she sign a waiver of their responsibility, so we met with María Isabel Rodríguez, then-minister of health. When she asked why the doctors wouldn’t let her leave, we explained that El Salvador does not issue temporary permits for patients in good enough condition to receive them. She said, “I will see to it this afternoon that they allow it, on the condition that she goes to the nearest hospital should she feel bad.” The state now presents this as an example of the emotional care that they gave her.
It appears that the Salvadoran government, including the one headed by the FMLN at the time, has had multiple personalities on abortion.
SG: That’s right. The state, through its own doctors, was the first to recommend the termination of Beatriz’s second pregnancy. Fifteen specialists from the public health system supported it.
Has the Salvadoran state’s position evolved in the past decade?
MH: It depends on how you interpret the state. Most doctors agree with Beatriz because every day they face legal limitations on providing adequate care. But now they are more scared to say so. Even so, when a woman arrives at the hospital with an obstetric emergency and is reported to the authorities, many doctors warn us and our lawyer colleagues sprint to defend the women. On the other hand are the heads of the Ministry of Health. I think Doctor Rodríguez even felt a commitment to changing the law. But in 2014, upon the swearing-in of Doctor Violeta Menjívar, who voted as a legislator for the 1998 constitutional ban, that changed. But we still had frank conversations with her.
SG: We studied the mothers’ health exception with Menjívar, and it was during her tenure that civil society organizations made various proposals to decriminalize abortion under four or two exceptions.
MH: And they gave us access to information. For example, we demonstrated with official data that suicide was the chief cause of maternal death among adolescents. With the current minister of health we don’t even have access to information.
Has the current Ministry of Health denied you statistical information?
MH: Right, just like there is no more access to other public information. Nor have we been able to meet with the Ministry, except regarding the order for reparations and medical care for Manuela’s family.
SG: In the Legislative Assembly, when the proposed “Beatriz” legal reforms, named in her memory, were presented, two legislators —Anabel Belloso, of the FMLN, and Johnny Wright, of Nuestro Tiempo— co-signed the bill, but it didn’t even last two weeks in the Legislation Commission before it was archived on the sole argument that article one of the Constitution establishes the protection of life from the moment of conception. No dialogue, no listening, despite the fact that the reforms addressed only the minimal exceptions: for health reasons, risk to life, sexual violence…
In recent years dozens of women accused of terminating pregnancy have been released from prison or amnestied. Is this a sign of a political opening or another contradiction in the state?
MH: It’s the result of our exploration of each and every option to free the women. We have sought sentence commutations, pardons, prison benefits, accreditation of work days while incarcerated… Some have argued that our seeking of pardons and commutations does not acknowledge that the women committed no crime, but the women themselves tell us that their freedom is paramount.
Some time ago, former E.U. ambassador Andreu Bassols told us, “El Salvador is known abroad for two things: gangs and the jailing of women.” The difference between the two, he told us, is that the problem of gangs is difficult to solve, whereas securing the women’s freedom depends solely on political will. I am certain that he addressed this with the president. We even know that other diplomats spoke with Bukele and he told them, “I’m not going to change the law, but I will free the criminalized women.”
We have perceived that political will in conversations, after pressuring for meetings, with the director of legal affairs of the Ministry of Justice and Security. We began to analyze each case with him in private meetings, and we saw some movement. But at the same time the Ministry of Health has not transmitted an order to cease the hospital arrests of women with complications in their pregnancies.
As for the judicial system, some judges are showing a degree of openness and rulings have cited the Manuela verdict and the right to doctor-patient confidentiality [in cases where hospital staff alert the authorities upon detecting signs of abortion in patients]. But the Attorney General’s Office is the most draconian institution of them all: When a judge says, “I don’t have sufficient grounds to send this woman to prison,” they appeal. It’s a game of contradictions. Without a clear stance from all three branches of government, we cannot guarantee that no more women will be condemned.
If the government made some effort to free the women, that means that it partly acknowledges an injustice. Why, then, do you think the president insists that he will not change the law?
MH: Because of his alliances with ecclesiastical, Evangelical, and Catholic sectors, or because of poor electoral calculus. He thinks that reforming the law will lose votes.
SG: Regression on sexual education coincided with the week that Catholic leaders offered support for presidential reelection. There is a clear connection there, despite the fact that Nayib, as a candidate, defended the exception to protect the mother’s life. He has since taken a more restrictive line.
What happened to the Bukele who, in the campaign and first weeks in power, presented himself as a feminist and boasted of gender parity in his government?
MH: In his platform, the Cuscatlán Plan, Bukele borrowed almost word-for-word from the platform “Nothing for Women without Women,” which we and many organizations drafted. It was the first time that a presidential candidate with real odds of winning incorporated the demands of women. But it was a media mechanism, without real commitment.
Then came the external factors. Bukele has established ties with international groups even more conservative than the Salvadoran right wing. When the Beatriz case was filed, Bukele tweeted that those who denied her the operation were “fanatics.” And when the Constitutional Chamber denied Beatriz’s appeal, Nayib wrote that the only dissident voice, Magistrate Florentín Meléndez, was the “voice of reason.” He has obviously moved on the issue, in political terms.
SG: Those groups are campaigning to undermine the Inter-American Court, the highest tribunal in the Americas. They question its financing, accuse it of ideological colonization, and attack the entire Inter-American System by saying that the Commission has an agenda to change abortion legislation.
Isn’t that one of the possible effects of a favorable ruling in the Beatriz case?
MH: The resolutions of the Court can be applied in other countries by jurisprudence and guide the legislation of other countries by convention. That’s how the inter-American human rights system works, and it’s why anti-rights groups have launched a campaign called “No Next Roe,” equating Roe v Wade to the Beatriz case and placing it on a level transcending El Salvador. The Court faces an enormous responsibility to justly rule for women across the continent.
SG: The campaign is promoted by a group calling itself the “Global Center for Human Rights,” which says that abortion is not healthcare and considers it ideological colonization. One of its leaders even joined a Salvadoran government delegation to the most recent OAS General Assembly. These organizations and the state speak of a fetus as a human life but scarcely mention what happened to Beatriz. They omit that it was her second pregnancy and skirt around the irregularities in her case reported in 2013 by advocates, doctors, the international community, and the Inter-American System itself. Nor do they mention that this is still occurring. Right now we are working on the case of a woman with an ectopic pregnancy who was denied adequate care and died. In El Salvador women continue to die because of this injustice.
