El Salvador's Harsh Anti-Abortion Law Unravels Progress Under State of Emergency
In El Salvador, women inmates stand at the doors to their cells at the Ilopango Women's Prison, a stark symbol of the country's severe reproductive laws. For years, campaigning led to the release of 81 women imprisoned under these strict regulations, but now, the suspension of civil rights by President Nayib Bukele is fueling a new wave of criminalisation.
A Personal Ordeal Highlights Systemic Injustice
Her ordeal began with stomach cramps; at 19 years old and training to be a nurse, she knew something was wrong. After waiting hours in the emergency department, she suffered an obstetric emergency. Under El Salvador's legal framework, such emergencies, including miscarriages and stillbirths, place women under criminal suspicion. She lost the baby, doctors alerted the police, and she was arrested and handcuffed.
"She couldn't understand what happened," says a lawyer in El Salvador, speaking anonymously for fear of political reprisals. "She went to hospital with a stomach ache, not knowing she was pregnant, and had an emergency. Then she was taken to prison, and faced a prosecution asking for a 50-year sentence. She was in complete shock."
Restrictive Laws and Fragile Progress
El Salvador has some of the most restrictive reproductive laws globally. Since 1998, abortion has been banned under all circumstances, including rape, incest, and risk to the mother's life. A 1999 constitutional amendment enshrined protection of life from conception. In practice, women accused of terminating pregnancies face charges of aggravated homicide, with sentences up to 50 years. Women with obstetric emergencies are often reported by hospital staff and imprisoned for negligent homicide.
In recent years, fragile signs of change emerged. While the law remained, sustained advocacy by women's rights groups and international pressure shifted its application. Between 2009 and 2023, campaigners secured the release of dozens of women imprisoned for abortion-related charges, miscarriages, stillbirths, and obstetric emergencies.
Morena Herrera, a reproductive rights advocate, helped lead this fightback. "By 2023 we had managed to get them all out of prison," Herrera says. In total, 81 women were freed from 2009, many from decades-long sentences for aggravated homicide.
State of Emergency Reverses Gains
Now, under a state of emergency, progress is unravelling. In March 2022, President Nayib Bukele, a populist who described himself as the "world's coolest dictator," assumed emergency powers and suspended civil rights in a move known as the "state of exception." Framed as a temporary response to gang violence, it has had far-reaching consequences for human rights and justice.
Due process has been suspended, and about one in 50 adults is imprisoned. Advocates say these powers have expanded into hospitals, ensnaring women with miscarriages, stillbirths, and obstetric emergencies. "We are experiencing a new spiral of criminalisation against women," says Herrera, former president of Citizens' Group for the Decriminalisation of Abortion.
In a further restrictive sign, this group, the only one campaigning for decriminalisation, announced its legal dissolution, citing an "incompatible" political climate.
New Cases and Legal Erosion
According to lawyers in El Salvador, at least 29 women have faced investigations since 2022, with several currently behind bars. "Women go to hospitals seeking medical help, are identified as suspected of having induced an abortion and prosecuted. They are accused of aggravated homicide and face sentences of 30, 40 and 50 years in prison," Herrera says.
She describes cases like a woman prosecuted after her baby died during a breech delivery, and another charged with attempted aggravated homicide after giving birth alone in a toilet, even though the baby survived.
Behind this regression is Bukele's state of exception. Constitutional protections, such as access to a lawyer and presumption of innocence, have been suspended or undermined. Administrative detention, once limited to 72 hours, now extends to 15 days before an initial hearing, with detainees having no contact with legal counsel or family.
Juanita Goebertus, Americas director at Human Rights Watch, notes that after initial hearings, most women are placed in pre-trial detention, spending months or years without effective legal access or family contact.
Impact on Legal and Medical Systems
The Salvadorian lawyer says Bukele's emergency powers have fundamentally altered the legal landscape. In the case of the 19-year-old trainee nurse, her testimony was ignored, despite defence requests. Prosecutors sought a 50-year sentence, but the court gave three years for negligent homicide, later converted to 144 days of community service, with an appeal pending.
"There was some form of progress with the women being released in the campaign," the lawyer says. "But now, again, we see ourselves in this wave of criminalisation."
Paula Ávila-Guillén, director of the Washington-based Women's Equality Center, explains that before the state of emergency, informal legal networks helped protect women from immediate arrest. "We created a system with lawyers on the ground. Hospitals, instead of immediately calling the police, would call up the legal defenders, to allow us to defend the women properly." This system kept women out of prison and ensured they were presumed innocent.
Now, "it is detention first, investigation later, often without meaningful access to legal defence," Ávila-Guillén says. "These women are not accused of gang activity or organised crime, yet they are prosecuted under emergency rules designed for security threats."
Climate of Fear and Broader Context
The resultant climate of fear deters medical professionals and lawyers from intervening. "Because of the fear these rules have created, there is a fear from both doctors, nurses and even from legal defenders to take these cases," she adds. Hospital staff are compelled to report patients, and healthcare professionals suspected of performing abortions face up to 12 years in prison.
A Salvadoran healthcare professional claims authorities installed cameras in hospitals, including operating rooms and emergency consultation rooms, creating constant surveillance. Herrera says women are too frightened to speak up, making defence harder.
Ávila-Guillén cautions that while the impact on women may be an "unintended consequence" of the state of emergency, it is not unforeseen. Authoritarian governments treat such outcomes as incidental damage. "Strongman leaders believe this is the cost of doing business," she says. "If you want a 'safe' country, then some people will pay the price."
Regional Erosion of Women's Rights
The re-criminalisation in El Salvador occurs amid broader erosion of women's rights across Latin America. In Argentina, President Javier Milei has curtailed access to abortion and contraceptives through funding cuts. In Chile, president-elect José Antonio Kast appointed an evangelical far-right opponent of abortion as minister for gender equality. In Ecuador, courts have moved to ban the morning-after pill.
Bukele is a close ally of Donald Trump in Latin America, and advocates say there is little international political will to address these abuses. "This government is aligning itself with the most conservative positions of other governments internationally," says Herrera.
"I worry that El Salvador is being held up as an example, as a model for other countries to follow," she adds. "And I worry that this will become the future for women across the continent."
