A Pro-Life Death Sentence

In the Nicaraguan city of Leon, a 27-year-old, known only as Amalia, is being denied treatment for cancer because she's 10 weeks pregnant and chemotherapy would harm her fetus. Since 2006, abortion has been illegal in Nicaragua under all circumstances, even when a woman's life is at stake, so while Amalia is in the hospital, nothing is being done for her. Amalia's sister has gone public, desperately seeking to pressure the government to help keep Amalia, who has a 10-year-old daughter, alive. La Prensa, Nicaragua's main newspaper, quoted her sister making a public statement interrupted by sobs. "We are asking that my sister be given treatment, we are asking that you don't forget that my sister is a human being, we are asking that this treatment be immediate," she said, before being unable to continue. But so far, the Nicaraguan Medical Association, a government group, insists that doctors must "luchar por las dos vidas por igual," or fight for both lives equally.

Amalia's life is being discarded because Daniel Ortega, determined to return to power, made a profoundly cynical deal with the Catholic Church. As head of the Sandinistas, he once led a movement with at least an ostensible commitment to feminist values; by some estimates, as many as a third of Sandinista militants were women. Yet 16 years after he was voted out of office, Ortega got religion in a bid to regain Nicaragua's presidency. He started attending mass regularly and peppering his speeches with references to God. He married his longtime companera, Rosario Murillo, in a wedding presided over by his onetime archenemy, Catholic Cardinal Miguel Obando y Bravo. He also threw his support behind the country's increasingly vocal anti-abortion movement.

Before 2006, abortion was already severely restricted in Nicaragua, but both the Catholic Church and a rapidly growing movement of evangelicos wanted the last loopholes shut. They'd been infuriated and galvanized by another high-profile abortion case, that of a girl known in the Nicaraguan press as Rosa or Rosita. Rosita was only 9 years old when she became pregnant. She claimed she'd been raped by a neighbor, though it would later emerge that she had really been impregnated by her stepfather. While Nicaragua's government and the Catholic Church fought to prevent her from having an abortion, her case became an international cause c&eacutel&egravebre. Eventually, Nicaraguan feminists -- working with Rosita's mother and stepfather, an alliance that would come back to haunt them -- smuggled the girl out of a hospital and took her to a private home, where an abortion was performed by three of the country's top gynecologists. (Not long after the abortion ban passed, when the truth about Rosita?s stepfather was revealed, Ortega?s government had some of the feminists involved investigated for their supposed complicity in his crimes.)

When I was in Nicaragua in 2006 researching my book about the global battle over reproductive rights, The Means of Reproduction, I interviewed Rafael Cabrera, a prominent gynecologist and the president of Nicaragua's leading anti-abortion group . Cabrera claimed that a network of foreign feminist organizations were subverting Nicaragua's values and that the abortion ban was partly an attempt to beat them back. "Since 1984, NGOs have started to organize here, backed by foreign agencies -- IPPF, Ipas, Pathfinder, Marie Stopes, and others," he said. "They've started programs for women that include contraception, and many of them practice abortion. ? All these abuses came to a peak in the case of the girl Rosa."

There's something disingenuous in Cabrera's complaints of foreigners meddling in Nicaraguan politics, since he is himself the local representative of Human Life International, a global anti-abortion group based in Virginia. Nicaragua's abortion ban is partly rooted in local politics, but it's also part of a much broader fight pitting international groups of religious conservatives against equally international groups of feminists and human-rights activists. And that's why Amalia's case is not just an atrocity -- it's also a warning of what hardline "pro-life" laws can lead to.

Several other countries in Latin America and around the world either have or are contemplating Nicaragua-style blanket bans. Chile has had such a ban since 1989, courtesy of Augusto Pinochet, while El Salvador has had one since 1998. Last spring, the Dominican Republic approved an amendment to its constitution outlawing all abortion, without exception. Kenya, where abortion is already illegal except when a woman's life is at stake, appears to be on the verge of adopting a new constitution with even harsher restrictions. (Meanwhile, unsafe abortion in Kenya is rampant; in East Africa as a whole, botched abortions are responsible for nearly a fifth of maternal deaths.)

In Kenya, as in Nicaragua, conservatives champion the ban on nationalist grounds, claiming that it's necessary to stave off the depredations of promiscuity-promoting foreigners. And there, as in Nicaragua, foreign anti-abortion groups are playing an active role. Earlier this month, Scott Fischbach, the head of global outreach at Minnesota Citizens Concerned For Life, told the anti-abortion Web site LifeNews.com, that his group "helped those involved in drafting the language" in the proposed new Kenya constitution. Rep. Jeff Fortenberry of Nebraska issued a statement throwing his support behind the ban: "I implore the Committee of Experts to uphold this language and be magnanimous enough and loving enough to say yes to life, boldly welcoming the precious children that may hold the future of our world in their hands."

There is no evidence that such bans are very effective in preventing abortion. Abortion is broadly restricted throughout Latin America and Africa, but the two regions have far higher abortion rates than North America or Western Europe, where abortion is legal and widely accessible. The way to bring down abortion rates is with access to contraception, sex education, and policies that increase women's autonomy.

But abortion bans do have consequences -- profound ones. Indeed, Amalia's case may not even be unique. "The criminalization of all forms of abortion has the effect of delaying and even denying women and girls a range of treatments which could, unintentionally, result in the termination of the pregnancy," Amnesty International concluded in a 2009 report about Nicaragua. Doctors, the group found, "are delaying treatment of women and girls for fear that they may be prosecuted for causing an abortion or damage to the fetus. ? Fear of prosecution means that women and girls are now delaying seeking treatment or even deciding not to seek hospital treatment for haemorrhaging, sepsis or other serious complications following unsafe abortions or miscarriages. The decision to delay treatment can have serious health consequences and even lead to their death."

So while the ordeal Amalia and her family are being subjected to is shocking, it was also predictable. This is what happens when a society decides that a fetus is worth more than the woman who carries it.