Teodora Vásquez was nine months pregnant when she lost her baby. The poor rural woman from El Salvador had run to the emergency health services for help but instead found herself accused of murdering her unborn child and then sentenced to 30 years in prison.
"The whole family is depressed," Cecilia Vásquez told VICE News of her sister's eight-year incarceration in a jail three days journey from the family home. "It's been especially hard on her boy. He asks for her all the time. He gets to see her about once a year."
This week Amnesty International released a report that highlights the impact that El Salvador's pursuit of women suspected of having abortions is having on their families — particularly their children.
"Each time the authorities in El Salvador unfairly lock up a woman for having a miscarriage or suffering pregnancy related complications they are also condemning her children to a life of poverty and trauma," said Astrid Valencia, the author of the report.
El Salvador is one of five Latin American countries with a total ban on abortion, but it is the only one where the authorities regularly imprison women accused of terminating their pregnancies and where courts hand down massive sentences.
Ever since the ban was introduced in 1998, reproductive rights campaigners have sought to bring international attention to the way it has devastated the lives of the women prosecuted, often on the flimsiest of evidence. The activists say those accused tend to be poor single mothers who are particularly vulnerable to the violation of basic rights, with cases often stemming from health professionals reporting suspected abortions to the police when the women were really seeking medical help after a spontaneous miscarriage.
The Amnesty report seeks to widen the spotlight to include how families are left struggling to cope. Along with Vásquez's case, the report highlights the story of two other women.
One is María Teresa Rivera who is currently serving a 40-year sentence for aggravated homicide even though, Amnesty says, it stems from a miscarriage she had before she even knew she was pregnant. According to Amnesty, Rivera has only seen her son four times since she was jailed in 2011 when he was six years old. The boy lives with his grandmother who can only occasionally afford to make the trip of several hours to the jail. She told the rights group her reluctance also stems from seeing how upset he gets at every visit.
The most comprehensive study of abortion cases in El Salvador — carried out by the locally-based Citizens Group for the Decriminalization of Abortion — found that 147 women were prosecuted between 2011 and 2014. The group says that there are currently 21 women in prison.
El Salvador's particularly tough stance on abortion has its roots in a campaign led by conservative members of the Catholic Church and prominent elite pro-life activists that began shortly after the end of the country's civil war in 1992. Harvard sociologist Jocelyn Viterna says the political left — former guerrillas transformed into a political party — was reluctant to oppose the campaign at the time because it feared alienating catholic voters as it set about building the electoral base that would eventually put it in government from 2009.
"After the war the left initially defended reproductive rights," Viterna told VICE News. "Then it made a strategic decision to drop that [position] in order to get more power."
The anti-abortion legislation in El Salvador was also part of a region wide wave of total bans that began in Chile in 1989. Honduras introduced its ban in 1996 two years before the one in El Salvador. Nicaragua joined the group in 2006 and the Dominican Republic in 2009. A number of Mexican states introduced similar legislation around the same time, though women in Mexico have the option to travel to the capital that legalized abortion on demand during the first 12 weeks of pregnancy in 2007.
According to Viterna, the lack of any opposition in El Salvador allowed the anti-abortion lobby to take a step further than in the other countries and effectively pressure the police and courts to begin prosecutions and hand down guilty verdicts. When pursuing doctors who carried out clandestine abortions proved difficult, Viterna says they turned to easier targets — vulnerable women who arrived at hospitals with pregnancy-related emergencies.
But now, after years of what looked like a losing battle, a small but dedicated group of women's rights campaigners in El Salvador say they are finally cautiously optimistic of a future softening of the ban, even if it is just the introduction of an exemption in cases where a pregnancy puts the woman's life is in danger.
"Before you couldn't even say anything, but that is beginning to change" said Katia Recinos, a lawyer from the Citizen's Group.
Recinos says the shift started thanks to the international attention given to the particular case of a woman with lupus who was denied an abortion in 2013, even though doctors said she could die because of the pregnancy and the fetus was not viable. Since then activists have taken several cases to the Inter-American Commission of Human Rights. This year El Salvador's human rights ombudsman also released a report that detailed violations of the rights of women prosecuted.
"We are hopeful," Recinos said. "It's been difficult but things are beginning to move."
In the mean time 21 women remain in jail with their families facing new challenges as time passes.
Teodora Vásquez's relatives are now wondering when and how to tell her 12-year-old son the real reason behind his mother's incarceration.
"We never told him why," Cecilia Vásquez said of her nephew who was four years old when his mother was put behind bars. "We didn't want to hurt his little heart any more [than it already had been]."
Follow Jo Tuckman on Twitter: @jotuckman