Reporting
Expecting In El Salvador
Expecting
The pregnant teen, the villager giving birth far from home, the woman imprisoned for miscarrying: pregnancy in El Salvador, where women can’t choose where, or whether, to give birth
Midwives who work in the poor, rural stretches of El Salvador rarely travel alone. They often visit gang-controlled areas to tend to their patients, women who have little access to medical care and even less say over their reproductive lives.
As of 1997, it is illegal to have an abortion in El Salvador. Women who miscarry or have stillbirths can be charged with homicide, which comes with a sentence of up to 50 years. About a third of all pregnancies are of teenagers between the ages of 15 and 19, some of whom have been raped. A common concern among survivors is how they’ll support their child.
So women and girls have their babies, whether they want to or not, whether they’re ready to or not. An alarming number feel they have too few options and resort to taking their own lives. Suicide is now the primary cause of death among pregnant teens, with girls swallowing sulfur pills, traditionally used to wash beans.
It is in this climate that midwives spend their days hiking through cornfields, fending off dogs with sticks, carrying syringes loaded with contraception, advising girls on how to avoid pregnancy, and coaching others after they’ve conceived.

Midwife Lolita Hernández de Rivera (left) examines 24-year-old María Laura Linares, who is 18 weeks pregnant.

Patty Hernández Hernández with her 3-month-old granddaughter. Patty tended to her daughter-in-law’s pregnancy before she delivered. Midwives are not allowed to assist with hospital births.

Salvadora Dias Rivas (not pictured) was given a 30-year sentence on homicide charges. Salvadora admitted to the crime, although she says her boyfriend, who is in a gang, forced her to kill her baby. Her two children, Yessina Carolina (right) and Elias Edwardo (left), now live with their grandparents.

Teodora del Carmen Vásquez de Saldaña in the women’s prison in Ilopango. Teodora had a miscarriage in 2007 and was charged with homicide. She spent nine years in prison while her family helped raise her now-15-year-old son, Ángel.

María Cristina, 17 and 38 weeks pregnant, rests at the waiting house. She comes from a remote community called Pepestenango, on the outskirts of Suchitoto.

Flor Arely Sánchez Paz (left) faced homicide charges and 40 years in prison after having an obstetric emergency in which she almost bled to death. Before she was acquitted, she spent nine months in a holding cell while her mother took care of her five children.