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El Salvador violated rights of woman who died in prison while serving 30-year abortion sentence, international court finds

A woman with “Yes to legal abortion” written on her back takes part in a protest in San Salvador in 2012. (Ulises Rodriguez/Reuters)
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The Inter-American Court of Human Rights ruled Tuesday that El Salvador violated the rights of a woman who died in prison while serving a 30-year sentence on an abortion conviction. The court mandated that El Salvador pay damages to the woman’s family and establish protocols to guarantee health care in obstetric emergencies like the one that led to her imprisonment.

El Salvador is one of the few countries in Latin America that penalizes abortion under any circumstance. This week’s ruling is the first time an international court has weighed in on the impact of the country’s restrictions.

The woman, identified only by the pseudonym Manuela, lived in a rural area with her family, including two children. In 2008, she was admitted to a hospital in the town of San Francisco Gotera, where doctors diagnosed her with “serious postpartum preeclampsia,” a potentially fatal pregnancy complication involving high blood pressure. Her doctor alerted authorities, who assumed that she had sought an abortion to conceal an affair.

Police searched her house and found the body of a newborn. Manuela was detained on Feb. 28, 2008, and later sentenced to 30 years in prison for aggravated homicide.

Advocates for Manuela argued that she suffered a natural loss of pregnancy after a series of obstetric emergencies linked to undiagnosed lymphatic cancer and a fall while drawing water from a river. “All of the above prompted her to lose her pregnancy,” read a statement released by the Center for Reproductive Rights and the organization Colectiva Feminista. According to the statement, Manuela wasn’t aware she was going into labor — she fainted and lost her baby.

Manuela died in prison in 2010 at age 33 of lymphatic cancer. The Inter-American Court of Human Rights found that she received medical care “late” and “irregularly” while in prison.

It also ruled in her criminal case that Manuela had suffered a medical emergency and that, after being arrested, was not properly represented by her lawyer. “In the present case, there is no doubt that Manuela suffered an obstetric emergency caused by preeclampsia,” the ruling read. “The Court emphasizes that obstetric emergencies, because they are a medical condition, cannot automatically give rise to a criminal sanction.”

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The court, formed under a treaty by members of the Organization of American States, ordered El Salvador to regulate the obligation to maintain medical confidentiality and to guarantee proper care in cases of obstetric emergencies. The court’s rulings are legally binding.

The Salvadoran government did not respond immediately to a request for comment.

“El Salvador must assume its responsibility for Manuela’s death, pay damages to her mother, father and children, and implement various structural measures so that no other woman repeats her case,” said in a statement Catalina Martínez Coral, regional director of the Center for Reproductive Rights, one of the organizations that presented the case to the court. “The court’s decision also recognizes rights that must be applied in Latin America and the Caribbean.”

El Salvador is one of a few countries in Latin America — along with Nicaragua, Suriname, the Dominican Republic and Honduras — where abortion is not legal under any circumstance.

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