Inter-American Court finds El Salvador liable for obstetric violence in high-risk pregnancy case – JURIST
The Inter-American Court of Human Rights announced on Friday its judgment finding El Salvador violated human rights law by denying a woman seeking a pregnancy termination timely access to medical care in 2013. The decision in Beatriz y otros v. El Salvador was adopted on November 22.
The court focused its ruling on the absence of clear medical protocols for high-risk pregnancies, which led to what it termed the “bureaucratization and judicialization” of essential medical care. The court found that extended waiting periods and hospitalizations while seeking legal approvals constituted dehumanizing treatment amounting to obstetric violence. This failure to provide adequate and timely healthcare violated Beatriz’s rights to personal integrity, health, and private life under both the American Convention on Human Rights and the Convention of Belém do Pará.
The court ordered El Salvador to establish clear medical and judicial guidelines for handling high-risk pregnancies within one year and implement training programs for healthcare workers and judicial personnel. The judgment included monetary reparations for Beatriz’s family and legal costs for women’s rights organizations.
The case involved a 22-year-old woman, identified by the pseudonym Beatriz, who faced prolonged delays in medical care despite carrying a non-viable fetus and experiencing severe health complications. During her second pregnancy, Beatriz, who suffered from systemic lupus erythematosus, lupus nephropathy, and rheumatoid arthritis, learned she was carrying a fetus with anencephaly – a condition incompatible with life outside the womb. Despite medical recommendations to terminate the pregnancy before 20 weeks due to serious risks to her health, doctors were unable to proceed due to fears of criminal prosecution. After multiple requests from her family and human rights organizations for access to therapeutic abortion were denied, Beatriz ultimately underwent a cesarean section at 26 weeks, and the baby died five hours after birth.
Notably, the court declined to address El Salvador’s absolute criminalization of abortion, a decision that drew criticism. In a partially dissenting opinion, Judge Humberto Sierra Porto argued the court “failed to analyze the most relevant human rights violations” by not examining the broader implications of criminalizing abortion in cases of maternal health risks or fetal non-viability. Sierra Porto warned that the court’s limited approach could “set a negative precedent weakening the protection of sexual and reproductive rights of women in the region.”
The court’s narrow focus starkly contrasts the Inter-American Commission on Human Rights’ March 2020 merits report on the case. The commission found that El Salvador’s absolute ban on abortion severely affected Beatriz’s right to life, health, personal integrity, and privacy, emphasizing that protection of life from conception cannot absolutely prevail when a woman’s life and health are at risk. Additionally, the commission determined that El Salvador’s current restrictive framework violated the principle of legality and represented a regression in rights, as the country’s previous criminal code had permitted therapeutic, eugenic, and ethical abortion.
El Salvador maintains what Human Rights Watch described as one of the world’s strictest abortion bans, with women facing up to 50-year prison sentences on related charges, even in cases of miscarriage or obstetric emergencies. According to Amnesty International, while Latin America has seen progress in countries like Colombia, Argentina, and Mexico regarding abortion access, strict restrictions persist in many States, with marginalized women facing the greatest barriers to care. Thus, the organization reported that health professionals providing reproductive services often face “stigmatization, physical and verbal attacks, intimidation and threats, and criminalization through prosecutions, investigations and unjust imprisonment.”
