Several days later, I was back at the doctor. They did some tests and called an ambulance. At the hospital they asked me what I had. I didn't want to say. I said I felt bad. They did tests on my urine, blood and lungs and found I had a severe respiratory infection. They did an ultrasound and found my kidneys, lung and liver were infected. And the ultrasound showed something else. They asked me: "Why do you have a perforated uterus? What have you done?" Then they did a vaginal exam, and it was the most painful thing for me in the world. They put something in me, and I cried out. They had two doctors holding me down. They said they knew I had had an abortion because my uterus was perforated and big and they would have to operate immediately. All I remember was going to the operating room, and then I don't remember anything because for the next six days I was in a coma.

"When we get a call from a hospital reporting an abortion," said Flor Evelyn Tópez, "the first thing we do is make sure the girl gets into custody. So if there is not a police officer there, we call the police and begin to collect evidence." Tópez is a prosecutor in the district of Apopa in San Salvador, a part of town noted for its poverty, crime and gang violence. She is a compact and tense woman. She wears a beautiful silver cross around her neck with smaller matching crosses for earrings. Her hair is pulled into a tight narrow bun across her head, held in place by small plastic flowers. Her gaze beams from steady eyes, each haloed in cobalt mascara.

Nationwide, after the ban came into effect in 1998, the number of legal cases initiated nearly doubled, according to a study published in 2001 by the Center for Reproductive Rights. Today the number of abortion cases investigated each year averages close to 100, according to Luz McNaughton and Ellen Mitchell, policy consultants with Ipas, an abortion rights advocacy group in Chapel Hill, N.C., who gathered the statistics for a study to be published later this year by the American Journal of Public Health. In 2004, the most recent year for which any statistics are available, there were 93 investigations of people associated with a clandestine abortion. In 2003, there were 111 investigations; in 2002, there were 85. (El Salvador's population is 6.5 million, roughly that of Massachusetts.) The vast majority of charges are brought against the woman or the provider. In a few cases, the boyfriend or mother or someone else who has helped out is also charged. Typically, the woman can avoid prosecution altogether if, after she is arrested, she names the provider.

When the woman is first detained, the form of custody can vary. Wandee Mira, an obstetrician at a hospital in San Salvador, told me that she had seen "a young girl handcuffed to her hospital bed with a police officer standing outside the door." In El Salvador, a person accused of a major crime is typically held in jail in "preventative detention" until the trial begins. Tópez, who said she had prosecuted perhaps 10 or 15 abortion cases in the last eight years, said that she took the severity of the case into account and sometimes argued for "substitutive measures instead of jail," like house arrest, while the accused was awaiting trial. My impression was that Tópez was emphasizing such relative leniencies as house arrest instead of detention, as well as suspended sentences for women who report the abortionist, because, like most people, she was uncomfortable with the inevitable logic that insists upon making a woman who has had an abortion into a criminal. Even Regina de Cardenal, whose group was instrumental in passing the ban, could not quite square the circle.

"I believe the woman is a victim," de Cardenal told me. "The criminals are the people who perform the abortions." When pressed about the fact that the law she helped pass does treat the woman as a criminal, she said: "Yes, it's part of the law of our country. Because the woman has murdered her baby -- and that's why she is sent to jail. But I believe that the woman who is sent to jail remains a victim of the abortion doctor, the abortionist, who knows exactly what he is doing."

In the United States, this conundrum is only beginning to emerge, as it did on "Meet the Press" in October 2004, when Tim Russert, the host, asked Jim DeMint, a South Carolina Republican representative then in the middle of what turned out to be a successful campaign for the U.S. Senate, to explain his position in favor of a total ban on all abortion procedures. DeMint was reluctant to answer Russert's repeated question: Would you prosecute a woman who had an abortion? DeMint said he thought Congress should outlaw all abortions first and worry about the fallout later. "We've got to make laws first that protect life," he said. "How those laws are shaped are going to be a long debate."

Russert refused to leave the congressman alone. "Who would you prosecute?" he persisted.

Finally DeMint blurted, "You know, I can't come up with all the laws as we're sitting right here, but the question is, Are we going to protect human life with our laws?"