The Abortion War Isn’t The Only Battleground for Women’s Lives

Last month in El Salvador, 26-year-old Beatriz Garcia, a survivor of the abortion war, succumbed to the larger war that is the daily struggle for survival among poor women. I want to tell you her story because it shows just how much, and how little, the war over abortion matters.

Beatriz grew up in an impoverished village in rural El Salvador. Her school met for two hours a day but by age 14, like 50 percent of Salvadoran children, she dropped out. By 18, she was married and pregnant—and diagnosed with lupus, a chronic auto-immune disorder that causes her body to attack its own organs.

In pregnancy, lupus can trigger kidney failure and stroke, both of which are life-threatening. In fact, seven months into her pregnancy, Beatriz’s lungs filled with fluid and her kidneys stopped working. Doctors performed an emergency cesarean section, and both Beatriz and her newborn son spent weeks in intensive care. With permanent damage from the ordeal, Beatriz’s doctors advised her to get sterilized.

But Beatriz did not get sterilized. Instead, she returned home to the tiny house she and her husband shared with his parents. Every few weeks, she moved back to her mother’s home, though, because her husband beat her. After particularly bad beatings, she would leave him, taking the baby with her. Then they would make up. She would move back. He would beat her again.

Beatriz didn’t bother reporting him to the police. Domestic violence is commonplace in El Salvador; more than half of all Salvadoran women experience it. Yet, due to underreporting, ineffective law enforcement and resignation, it goes unpunished.

It wasn’t ignorance or poverty that kept Beatriz from getting sterilized. It was her choice. At first it wasn’t clear her son would survive. She didn’t get sterilized because she worried he would die. Later, when it became clear her son wasn’t developing normally, Beatriz feared if she got sterilized, she would lose her husband.

Two years later, swollen and covered with painful sores, Beatriz sought medical care. An ultrasound revealed she was 14 weeks pregnant. But it showed something else: the fetus lacked a brain. There was no chance for survival. And given her precarious health, this pregnancy might well kill her.

Anywhere else in the world, she would have been given an abortion. But El Salvador bans abortion without exception.

Word of Beatriz’s predicament reached the country’s abortion-rights advocates, who petitioned the government seeking a life-saving abortion. For 81 days in 2013, the world’s cameras were trained on Beatriz as the Salvadoran government debated her fate. There were protests in the streets of San Salvador, declarations from the United Nations and Amnesty International and urgent outcry from international abortion activists on both sides. From her bed in a squalid public hospital, Beatriz filmed a video pleading for her life.

In the end, the Salvadoran government forced Beatriz to wait until her death was imminent. Finally, blood pressure soaring, lungs filled with fluid and kidneys failing, the laws of self-defense kicked in and her doctors performed a cesarean section. A justified homicide, rather than a legal abortion. Thus, the abortion ban survived, and so did Beatriz. As expected, her daughter died. Beatriz buried her—and returned to her son, her mother, her husband, her life.

At her mother’s two-room cinderblock house, Beatriz and her son slept on a thin foam mattress over a sagging metal frame. No money for diapers, she awakened night after night in a puddle of urine. At five, he doesn’t speak. It is clear that without special education, he will never realize his potential. He gets no support services, though. No one in her family has a job. There are none to be had.

Last week, three and a half years after the cameras left, Beatriz died. She contracted pneumonia while hospitalized after a motorcycle accident. The doctors released her, forgetting that pneumonia can kill lupus patients. She died at home, gasping for breath.

The battle over Beatriz’s abortion was fought at a fever pitch: her case pushed “life” and “choice” to their limits. Millions were spent fighting over whether she should have been made to carry her doomed fetus.

Consider how little difference the abortion would have made to Beatriz, though. Of course, she wouldn’t have spent months in the hospital worrying about her son, her mother, her husband, and dying. But an early abortion offered no lasting relief from the things that made her life hard.

Beatriz’s case meant more to the war over abortion than the abortion meant to Beatriz.

Our 40-year battle over abortion can and has distracted us, in cases like these, from the powerful opportunities we could have to change and save women’s lives. I don’t think we’ll ever resolve the abortion war—but I believe we can and must find common cause in confronting the forces of class, education, power, illness and gender that circumscribe the life options of the most vulnerable women and children.

The reproductive justice movement has begun to push back on these forces, setting their agenda around the belief that “all people deserve the social, financial, political and legal conditions required to make genuine choices about reproduction–choices that must be respected, supported and treated with dignity.” Last year, RJ advocates persuaded pro-life and pro-choice Californian lawmakers to abandon the “family cap,” which had punished women who have a child within a year of beginning welfare by refusing to increase the family’s monthly stipend.

The RJ movement should not have to labor alone on the left. It is time for a new movement—one comprised of pro-life and pro-choice advocates who’ve grown weary of the battle over abortion law not because they don’t care about abortion, but because they care deeply about women and children.

It will take a bipartisan movement to push back against government policies that circumscribe poor women’s choices. But if we start by understanding what poor women need, we have a shot at escaping the absurd standoff—in which we hurl rhetoric about choice and life while so many women have far too little of either.


Michelle Oberman is the Katharine and George Alexander Professor of Law at Santa Clara University School of Law and an internationally recognized scholar on the legal and ethical issues surrounding adolescence, pregnancy and motherhood. She works at the intersection of public health and criminal law, focusing on domestic and international issues affecting women’s reproductive health. Her book When Mothers Kill (2008) won the Outstanding Book Award from the Academy of Criminal Justice Sciences.