Historic moment in the Americas: Hope for a woman’s right to bodily autonomy 

The reproductive rights landscape has shifted throughout the Americas in the last few years, with progress to decriminalize and ensure sexual and reproductive health. However, there are still too many countries where total abortion bans are fatal for pregnant women.

This could soon change as the Inter-American Court of Human Rights — the highest judicial body for human rights in the Americas — recently heard the case of Beatríz, a Salvadoran woman who was denied an emergency reproductive procedure despite the fact that her pregnancy was unviable and at very high risk. This is the first reproductive rights case that the Inter-American Court of Human Rights has taken up, and it will set a precedent concerning sexual and reproductive health and autonomy. Beatríz’s story is one that many women in the Americas face, especially in countries and states that restrict reproductive rights. This is the first time the court will hear and consider a case similar to Roe v. Wade in Latin America, and the decision could signify progress or a setback in the protection of reproductive rights, not only in El Salvador but throughout the region.

In 2013, Beatríz, a mother raising her 13-month-old, was dealing with severe health complications related to her lupus and kidney disease when she learned she was pregnant. Doctors informed Beatríz that she was carrying an anencephalic fetus (without a brain) and deemed her pregnancy non-viable, posing a real threat to her life. She needed a life-saving procedure but instead endured a 14-week wait as doctors refused to provide the care she needed for fear of criminal prosecution due to the country’s total abortion ban. Only under intense pressure from the Inter-American Court of Human Rights did Salvadoran officials find a legal loophole enabling Beatríz’s doctors to perform an emergency cesarean, after which the fetus died.

Beatríz’s story rocked the country of El Salvador and reverberated worldwide. Her plight is all too common under El Salvador’s harsh ban targeting reproductive rights, which does not allow women to end pregnancies even in cases of rape, incest, and fatal fetal abnormalities, or when their health or lives are at risk. Women who arrive at hospitals hemorrhaging are often accused of attempting to end the pregnancy themselves, and the judicial system is quick to sentence them to up to 30 years in prison for crimes they have not committed.

The reality is countries with restrictive reproductive laws, such as El Salvador, the Dominican Republic, Honduras and Nicaragua, are the countries with the worst indicators of maternal mortality and adolescent pregnancy. The total criminalization of reproductive choice has a profoundly negative impact on the life, health and dignity of women and girls. Now the Inter-American Court decision in Beatríz’s case could have a ripple effect in the region, potentially guaranteeing a legal threshold for the protection of a fundamental human right.

A positive ruling from the Inter-American Court could mean a favorable outcome in the next case the court will hear regarding Rosaura Almonte, a teen from the Dominican Republic referred to in the media as “Esperancita.” In July 2012, Esperancita arrived at a public hospital with a high fever, extreme weakness and bruises. She was diagnosed with acute lymphoblastic leukemia, a type of cancer common among children that tends to progress quickly. If untreated, it can kill patients in just a few months. Around the same time, doctors also discovered Esperancita was about a month pregnant. She should have received an emergency procedure followed by chemotherapy but instead suffered for 20 days as medical staff debated whether they should prioritize her life over a fetus that medical experts concluded would be non-viable under any circumstance. In the end, Esperancita died on Aug. 17, 2012, from hypovolemic shock, an emergency condition in which severe blood loss makes the heart unable to pump enough blood to the body.

These two cases detailing the plight of Beatríz and Esperancita are emblematic of how total reproductive health care bans affect how women live and how women die. These bans force doctors to stand by and let pregnant people suffer, even die, before they can provide essential medical care. 

The Dominican Republic is currently debating the modification of its Penal Code, which dates back to 1884. Polls show major support for reproductive choice and especially when the woman’s life or health is at risk, when the pregnancy is unviable, and when it is the result of rape or incest. However, the Dominican Senate decided to approve a Penal Code that maintains the total criminalization of reproductive choice, which is a violation of fundamental human rights. 

Activists in the Dominican Republic and throughout Latin America have been fighting for decades for reproductive freedom and human rights. The Green Wave — a collective fight for legal abortion, beginning in Argentina with people wearing green bandanas, pañuelos, symbolizing the rally cry for choice reform that spread to Colombia and Mexico — is still raging in the region and arrived in the United States as last year’s Supreme Court ruling that overturned Roe.  

Anti-choice legislators are emboldened more than ever to introduce and pass laws to control the bodies and lives of women and girls — we only have to look at what’s happening currently in Florida and Texas. The United States should take note of what has occurred in Latin America for decades under reproductive health care bans: People are prosecuted, health complications skyrocket and women die. We are inching closer to this grim reality in the U.S. 

In the Inter-American Court of Human Rights, the law is a vector for change. But change isn’t done in isolation — and it takes people and a movement to come together to fight for what’s right. It takes people and a movement who are willing to challenge the systems that seek to control and oppress women. 

As an elected official, I have a duty to make decisions that advance lifesaving policies and protect the lives of women and girls, and this moment is long overdue for El Salvador, the Dominican Republic, the U.S. and nations around the world to end total bans and allow reproductive rights and choice for all.

Adriano Espaillat is the first Dominican American elected to Congress and represents New York’s 13th District.