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Nicaragua's Total Ban On Abortion Spurs Critics
Advocates for greater access to abortion argued that even that law was too restrictive, prompting an estimated 32,500 women to get illegal and potentially unsafe abortions in Nicaragua every year and accounting for 16 percent of the more than 100 maternal deaths here annually, according to a 2002 ministry study. By contrast, the Health Ministry recorded only six legal abortions in Nicaragua last year.
But church leaders and other anti-abortion activists in Nicaragua contended that the number of legal abortions in Nicaragua was far higher, reaching about 1,000 a year.
"This idea of 'therapeutic abortion' was being abused," said Brenes, the archbishop. "People were easily getting doctors to say that the abortion was being done to save the mother's life, when in reality it was a person who just said, 'I don't want this child.' "
Nicaragua's tight presidential election this month offered Nicaragua's anti-abortion movement the opening it had been waiting for: With Ortega's conservative opposition evenly divided between two challengers, none of the top three candidates could afford to alienate the church.
On Oct. 6, Obando, Brenes and various evangelical pastors led tens of thousands of citizens in a march to the National Assembly to demand a repeal of the exception for therapeutic abortions. Legislators obliged, fast-tracking consideration of the ban under procedures normally reserved for national emergencies.
Every major medical society in Nicaragua opposed the proposed ban. Their concerns were echoed by Nicaragua's health minister and a long list of foreign embassies and international organizations such as the U.N. Development Program.
"But the legislators wouldn't even meet with us," said Carmen Solórzano, a leading member of Nicaragua's Society of Obstetrics and Gynecology. "I'm indignant that in a state that is supposedly secular, the church has so much influence while the government won't even listen to doctors."
The Rev. Rolando Álvarez, spokesman for the Managua archdiocese, said that although church leaders oppose abortions in the case of rape or a malformed fetus, they intend to urge lawmakers to clarify that the elimination of therapeutic abortion should not prevent doctors from saving a woman's life when her pregnancy puts her in mortal danger.
Women's rights groups and medical associations, meanwhile, are preparing to petition Nicaragua's highest court to declare the ban unconstitutional. That approach met with success last May in Colombia, which, like El Salvador, had a blanket prohibition on abortions.
Failing that, activists who oppose the ban say they will take their case to an international body such the U.N. Human Rights Committee or the Inter-American Commission on Human Rights -- with Bojorge's relatives the likely plaintiffs.
According to Flores, the hospital director, although Bojorge showed signs of vaginal bleeding and uterine contractions on her arrival at the hospital, doctors decided to give her medication to stave off the contractions because an ultrasound indicated that her fetus was alive. The next day, another test indicated that the fetus had died, and Bojorge was taken off the medication to allow her body to expel the dead fetus naturally. Instead, she went into shock, possibly because the placenta had detached, causing massive blood loss.
Flores contends that the doctors' decision to prevent Bojorge from delivering while the fetus was still alive was routine. Jiménez, of the Women's Autonomous Movement, argues that it was an extremely risky undertaking for a hospital that lacked ready access to ultrasound equipment. (The hospital's equipment is broken, forcing doctors to transport patients to a separate facility for scans.)
"In this sort of situation, the safe thing to do is to just abort the fetus," Jiménez said. "It's obvious that the doctors were paralyzed by the new law."
Bojorge's relatives, meanwhile, are not sure what to think. "No one at the hospital ever told us what was going on," her mother, Rosa Rodriguez, 44, said sadly during an interview in front of the tidy tin shack where Bojorge lived with her husband and 4-year-old son.
Rodriguez and Bojorge's husband, Marvin Savala, a 24-year-old construction worker, had not even heard of the charge that the new abortion legislation may have played a role in Bojorge's death.
But as he contemplated that possibility, Savala's eyes darkened.
"If that's the case, then the doctors were very wrong," he said. "They should have done whatever it took to save my wife. Now I've lost not just our baby, but my whole family."