What would happen if Arizona embraced a total ban on abortion?
Arizona House Representative Raquel Terán, along with four other lawmakers, traveled to El Salvador to find out.
The Democratic legislator said it was an opportunity to examine the impact of total abortion bans through the lens of a country that has outlawed the practice for over a decade. Though Arizona may be far from a total ban, reproductive health experts suggest the state is closer to outlawing abortion than some might expect.
“We often talk about how the worst consequence of abortion bans is the criminalization of women,” Terán said. “Witnessing firsthand what can happen because of abortion restrictions was emotional, because I saw that it was the most vulnerable women who were most affected.”
Last week, Terán, along with State Representatives Merika Coleman of Alabama, Stephanie Howse of Ohio, Cindy Polo of Florida, and State Senator Nikema Williams of Georgia, spent four days in El Salvador, from November 12 to 15, meeting with health care providers, human rights lawyers, and abortion activists in the country.
Notably, the delegation traveled to Izalco Prison in Sonsonate, to meet with 13 women who they said were prosecuted as a result of the abortion ban, some after seeking medical attention for pregnancy emergencies. All of them were low-income women, Terán said.
“The people who we saw in jail were the poor women – it wasn’t the middle class, it wasn’t the rich,” Terán said.
Since 1998, abortion under any circumstances has been illegal in El Salvador, including in cases where the life or health of the mother is at risk. Women can be charged with aggravated homicide if they’re suspected of having had an abortion.
But Terán said some of these women were incarcerated even though they may not have had the procedure – a woman named Sarita, who had been in Izalco Prison for six years, allegedly was arrested after suffering a miscarriage the night her brother committed suicide. She had fainted, and was taken to a local hospital. The staff suspected an attempted abortion, and contacted authorities. She was 18.
“At first, she thought she was being charged for her brother’s death – she couldn’t understand why she was being detained. Later, she finds out she’s being charged for her child’s death,” Terán said, noting the young woman was eventually sentenced to 30 years in prison. “It all depends on the judgment of the health care providers who are tending to them. If they have suspicions, they have to report it to authorities.” Doctors or nurses with less training, time, or resources may be more prone to error, she said.
The trip included visits to the primary maternal hospital in the country, meetings with lawyers handling the cases of incarcerated women, and attending a sex education program for adolescents, who account for a third of all births in the country. It was funded by State Innovation Exchange, an organization that helps state legislators promote progressive policy initiatives. All five of the legislators are current members of the nonprofit's Reproductive Freedom Leadership Council.
Terán claimed the trip was not about lobbying, but about understanding the possible future of states that are actively seeking to eliminate access to abortions.
“If Roe v. Wade leaves, Arizona can become El Salvador,” Terán said.
Not everyone's convinced by the argument.
"The group of abortion activist lawmakers had to go all the way to El Salvador to find women persecuted for having an abortion because we don’t do that in the United States, and no one is proposing it," said Cathi Herrod, president of Center for Arizona Policy, a powerful conservative group that pushes anti-abortion legislation.
"None of the pro-life laws passed in states throughout the country would punish women for having an abortion. None – much less put them in jail. This is a ridiculous attempt to make a correlation where there isn’t one. This comparison shows just how reasonable the pro-life laws are in states throughout the U.S. Here, we care about both the pre-born and the mother."
Still, if Roe v. Wade is repealed by the Supreme Court, which now has a conservative majority, abortion would automatically become a criminal offense in Arizona. An existing state law, which was reaffirmed in the 1970s, bans any attempt to “procure the miscarriage” of a woman unless the procedure is necessary to save the mother's life. Under that law, people who seek out abortions in the state, as well as providers or individuals who dispense information about abortion care services, could serve up to five years in prison.
“The threat of losing access to abortion in Arizona is real, and we see that in the way the court is being stacked,” said Tayler Tucker, media relations manager of Planned Parenthood Arizona. “El Salvador is a helpful study because it shows what we already know from the United States pre-Roe – that people will continue to get this care if they need it, even if we criminalize people for making their own reproductive decisions.”
In Arizona, current restrictions still make accessing abortion care difficult, particularly for low-income residents, according to Tucker.
An initial barrier comes from a national law: The federal Hyde Amendment prohibits the use of any public funds for abortions, meaning individuals who receive their health care from Arizona’s state Medicaid must pay out of pocket or raise their own funds to get an abortion.
Arizona law now prohibits anyone other than a physician from performing abortions, and under the state’s 2012 “informed consent” law, a physician, rather than a nurse trained in facilitating abortions, must give women seeking abortions a variety of information about alternatives and health risks related to the procedure. These requirements worked to shut down many abortion providers in more rural areas, Tucker said.
Since 2010, the state has additionally mandated a 24-hour “reflection period” for women seeking an abortion, meaning they must make two visits to an abortion provider before they can get the service. For women who must travel hundreds of miles to get to one of these centers, this may mean needing to secure overnight housing, or childcare – 60 percent of people seeking abortions in the state already have one or more child at home, according to Tucker – both of which prove costly.
“It’s this kind of slow erosion by all these small things that can easily pass in legislation that compound together to make it an extremely difficult form of health care to get access to," Tucker said. “I think a lot of people in the United States think that just because Roe v. Wade is there, when you need or want an abortion you can just wake up and go."
The Consulate of El Salvador in Tucson and Embassy of El Salvador in Washington, D.C., have not yet responded to requests for comment.