Six countries ban abortion outright, even when a woman’s life is in danger. Nicaragua is one of these countries. As the second poorest country in the Western Hemisphere, Nicaragua struggles with a high maternal mortality rate and inadequate healthcare for many of its impoverished citizens. The total abortion ban only serves to exacerbate these issues.

For over 100 years, Nicaragua permitted therapeutic abortions, which are abortions typically performed to preserve a pregnant woman’s life or health. To obtain an abortion, three physicians had to confirm that the woman’s life or health is at risk. However, following the contentious presidential elections in 2006, Nicaragua’s government amended the Penal Code. In 2008, the Penal Code was modified to ban abortion in all cases. This ban makes no exception for rape, incest, or the survival of pregnant women. The code mandates prison sentences from one to three years for women and girls who receive abortions. The law also applies to the medical staff who assist these women in the procedures. Medical staff also receive a two to five year ban on working in medicine or the health sector. The code also includes “criminal sanctions for doctors and nurses who treat a pregnant woman or girl for illnesses such as cancer, malaria, HIV/Aids or cardiac emergencies if such treatment could cause injury to or lead to the death of the embryo or fetus.”

As a result of this ban, unsafe abortion is the leading cause of maternal death in Nicaragua. International Pregnancy Advisory Services, an abortion advocacy group, estimates that at least 100 women died between 2011 and 2016 because they were denied abortions. Women who are diagnosed with illnesses such as cancer during their pregnancies are denied chemotherapy and other treatment. A 26 year old single mother, who was diagnosed with thyroid cancer. She was also two months pregnant. The only option she had was to possibly go to the hospital and be put on a feeding tube so she could wait to die. Luckily, this woman was provided with medication to terminate her pregnancy so she could undergo chemotherapy.

Even women who naturally miscarry a wanted pregnancy avoid seeking medical care for fear of accusations of attempting to self-abort and facing imprisonment. When women with pregnancy-related conditions seek medical care, physicians are often unwilling to treat them, for fear of accidentally injuring the fetus. Even if a miscarriage is in process, physicians will not intervene if they can still detect a fetal heartbeat. This delay or refusal of care puts women and girls at risk for receiving inadequate medical treatment.

By preventing access to abortion and necessary medical care, the Nicaraguan government effectively violates the bodily autonomy of half of its population. Nicaragua’s constitution specifically promises to uphold human rights in accordance with the Universal Declaration of Human Rights, the American Declaration on the Rights and Duties of Man, the International Covenant on Economic, Social and Cultural Rights, the International Covenant on Civil and Political Rights, and in the American Convention on Human Rights.

Although the constitution references these various human rights conventions, Nicaragua’s actual law does not comply with them. The United Nations Universal Declaration of Human Rights and International Covenant on Civil and Political Rights prohibit inhumane or degrading treatment, as well as arbitrary interference of privacy. The Inter-American Commission on Human Rights American Declaration on the Rights and Duties of Man and the United Nations International Covenant on Economic, Social and Cultural Rights provide special protection and care to pregnant women, as well as the general right to preservation of health. The Organization of American States American Convention on Human Rights identify the rights to personal liberty, humane treatment, and privacy. With the complete ban on abortion, the Penal Code violates the terms set out in these conventions.

To lower its maternal mortality rate and provide women with equal access to lifesaving healthcare, Nicaragua must reverse its total abortion ban. Permitting abortion on request in any circumstances is preferable. If this is not possible, permitting abortion to protect the life and health of the pregnant woman, as well as in cases of rape or incest, would dramatically reduce maternal mortality rates and dangerous self-abortion attempts. Nicaragua’s women have made significant gains in political involvement and education. However, the lack of abortion access and reproductive freedom will prevent the majority of women from exercising control over their own bodies and futures.