Beatriz, the 22-year-old Salvadoran woman who has been close to death as she has been forced to carry a fetus without a brain, received an emergency Caesarean section on Monday. Beatriz’s 27-week-old fetus, which has a fatal birth defect that has left it without a brain and parts of its skull, will likely not survive outside the womb for very long.
Over the past several months, Beatriz’s doctors warned that she would die if she was not allowed to end her pregnancy — but she was unable to get a legal abortion in her deeply conservative country, where terminating a pregnancy can lead to up to 30 years in prison. Her doctors took her case all the way to the Supreme Court, hoping to receive an exception to the country’s total abortion ban. The case stretched on for three months, and Beatriz’s health got worse every day.
Last week, the Supreme Court finally handed down its ruling, choosing to deny Beatriz the critical abortion care she needed to stay alive. Even though a team of Beatriz’s doctors repeatedly warned that the young woman — who suffers from multiple health conditions that worsen when she’s pregnant — would likely not survive if she was forced to carry the nonviable pregnancy to full term, the court decided that her health “was not yet in absolute danger.”
After weeks and weeks of waiting for a conclusion to the legal proceedings, Beatriz was already at the end of her second trimester when she was officially denied the right to a life-saving abortion. Since she was so far along in her pregnancy, El Salvador’s health minister determined that her case no longer fell under the country’s abortion laws. The country’s health department could therefore decide the best course of action to safeguard Beatriz’s life, including ending the pregnancy early by inducing birth.
“At this point, the interruption of the pregnancy is no longer an abortion. It is an induced birth,” the health minister, María Isabel Rodríguez, explained on Thursday. She said it could be either “an abdominal or vaginal birth.”
Late on Monday, the Associated Press reported that Beatriz received a C-section. She is currently recovering from surgery, and her pre-term baby is not expected to survive very long. “No one can say how long she will live,” one source told the AP in reference to Beatriz’s baby girl. “It was painful to see the little creature. That’s what the grandmother told us, and the doctors confirmed it.”
Essentially, Beatriz was forced to carry a nonviable fetus for months — all while her health deteriorated, and she remained in a hospital room separated from her husband and young son — until she could end her pregnancy with a type of reproductive care that makes El Salvador comfortable. The outcome will end up being exactly the same, since her baby will not be able to survive long without a brain. But, because El Salvador’s government claims that this type of C-section is not considered to be an abortion, it’s an “intervention of the pregnancy” that is allowed.
In fact, as RH Reality Check points out, the type of procedure that Beatriz received is actually more accurately described as a “form of abortion carried out through c-section.” It is so risky that it’s never performed in the United States. RH Reality Check’s editor, Jodi Jacobson, writes that El Salvador is “engaging in linguistic gymnastics” to make it appear as though Beatriz did not receive a medical service that could be considered abortion care.
Permitting some types of reproductive health care but not others, even if the outcome will ultimately be the same, is clearly not based in any type of medical logic. If Beatriz had received a less invasive abortion when she was in her first trimester of pregnancy, when her doctors first began asking for one, her health may not have devolved further — and she perhaps would already be back at home with her one-year-old son. But anti-choice advocates have successfully segregated abortion care from the rest of women’s health care without considering cases like Beatriz’s, in which a woman’s life hinges on the semantics of what’s considered to be an “abortion.”
That dynamic isn’t unique to conservative, Catholic-dominated countries like El Salvador. Here in the United States, a pervasive stigma surrounding this aspect of reproductive care has ensured that abortion services — as well as the women who have abortions — remain largely in the shadows. By obscuring the medical realities of abortion care, U.S. politicians have created an atmosphere in which Americans assume that birth is always the best choice for women and abortion is always the wrong choice. But, just as in Beatriz’s case, giving birth can actually be more dangerous for some women than having an abortion. Until lawmakers trust women and their doctors to make the best decisions about their own reproductive health, women will continue to face arbitrary barriers that don’t have anything to do with the medical care that’s best for them.