In a stunning decision made worse by the length of time it took to be handed down, the Supreme Court of El Salvador gave a young woman a death sentence on Wednesday by denying "permission" for an abortion needed to save her life.



Beatriz (a pseudonym) is now 24 weeks into an extremely high-risk pregnancy, complicated by a severe form of lupus, an autoimmune disease, hypertension, and renal (kidney) failure. Moreover, her pregnancy is not viable. The fetus she is carrying is anencephalic -- it does not and will never have a fully formed brain -- and can not survive more than a few hours after childbirth, if it survives at all. More than ten weeks ago, in the first trimester of pregnancy, Beatriz's doctors determined she herself could not survive this pregnancy and strongly recommended to authorities that she be allowed to have an abortion to save her life. The minister of health concurred. According to the New York Times:



In a letter addressed to the Supreme Court last month, Health Minister María Isabel Rodríguez described Beatriz's situation as "grave maternal illness with a high probability of deterioration or maternal death." Given the fatal prognosis of the fetus, "it is necessary to undertake a medical-legal approach urgently," Ms. Rodríguez wrote.

This was no routine medical recommendation: Abortion is banned in El Salvador without exception, and both physicians providing and women receiving abortions can be imprisoned for many years. It is thus not often that physicians, much less the minister of health, are willing to put themselves at risk even when a woman's life is in danger. And in part as a result of these realities, maternal mortality in El Salvador remains very high.



Beatriz could have had an abortion before the end of her first trimester, and we likely would never have heard of her. But the country's attorney general asserted he would indeed prosecute the case if the doctors performed an abortion, and so a cruel and confusing international circus began.



First, advocates both domestically and internationally put pressure on President Mauricio Funes who failed to act out of fear of retribution from the Catholic Church and the far right in El Salvador. Many of the advocates working on Beatriz's case postulated that Funes would simply wait things out until she died as a result of kidney failure or the stress on her body of labor and delivery. Then both the government and the Church could simply claim she had died of "natural causes."



Next, advocates took the case to international bodies, which quickly called on the government of El Salvador to provide Beatriz with the health care she needs. Both the Office of the United Nations High Commissioner for Human Rights and the Inter-American Commission on Human Rights (IACHR) weighed in; the Office of the High Commissioner called the situation "cruel, inhuman, and degrading." The IACHR gave the government 72 hours to comply with its findings. But the President again did nothing. Meanwhile, Catholic bishops in the country joined by members of the political right started to ratchet up the opposition to providing Beatriz with life-saving health care, further underscoring how little her life means to them.



Finally, the case went to the Supreme Court where Beatriz herself pleaded for her own life, telling the court she wanted to live and raise her son. In a response that was as shocking then as today's final decision is now, the Court told her they'd get back to her within 15 days, completely dismissing the agony of pain and uncertainty each day of waiting means for this woman. Meanwhile, every day that has passed has taken an increasing toll on her body and health, multiplied the costs of her medical care, increased the risk of death from a c-section or labor, and made less and less likely the prospect that she will survive. Speaking by phone to RH Reality Check last week, Beatriz's lawyer Victor Hugo Mata asserted that "if anything happens to Beatriz, the judges of the Supreme Court will in some way be responsible."



Today, as reported by the New York Times, the court ruled 4-to-1 against saving Beatriz's life, citing the country's legal "absolute impediment to authorize the practice of abortion." The court ruled that "the rights of the mother cannot be privileged over those" of the fetus.

"The refusal of the Salvadoran Supreme Court to allow Beatriz to obtain a medical procedure that could save her life is an appalling and disgraceful violation of her fundamental human rights," said Lilian Sepúlveda, director of the global legal program at the Center for Reproductive Rights.



El Salvador's ban has not only resulted in the denial of medically-necessary abortions for women like Beatriz who desperately need them, but also in the imprisonment of far too many women who have suffered miscarriages or obstetric complications. Salvadoran women have been paying an unacceptably high price for El Salvador's abortion ban. Women should never lose their fundamental rights, or be subject to such cruel and inhuman treatment, simply because they have become pregnant.

Anti-choice groups praised the decision with misogynistic glee. In a statement as grotesque as it is chilling, Julia Regina de Cardenal, director of the foundation Yes to Life, stated: "Once again Salvadorans have given an example to the entire world that we defend the right to life of all human beings however small, poor, vulnerable or defenseless."

In other words, a woman has no rights. She is not counted among those "human beings" noted by de Cardenal. Even when "the fetus" has no chance to live.