Nicaragua is one of only three countries in the world to maintain a blanket ban on abortion, even in cases of rape, incest, or life- or health-threatening pregnancies.1Such blanket abortion bans are incompatible with international human rights obligations, including obligations on the rights to life, health, and non-discrimination. Their imposition can, and most often does, have serious effects on the lives and health of women and girls.

Nicaragua’s blanket ban on abortion was initially enacted in November 2006 and reaffirmed in September 2007, and includes a ban on previously-legal therapeutic abortions.2It allows for prison sentences for doctors who carry out abortions under any circumstances—even to save a pregnant woman’s life—and on women who seek abortions, again, regardless of the reason. Although it appears that actual prosecutions are rare, the ban has very real consequences that fall into three main categories:

  1. Denial of access to life- or health-saving abortion services;
  2. Denial or delay in access to other obstetric emergency care; and
  3. A pronounced fear of seeking treatment for obstetric emergencies.

The net result has been avoidable deaths.

The potentially most wide-ranging effect of the ban on therapeutic abortion—albeit the hardest to measure—is the surge in fear of seeking treatment for pregnancy-related complications, in particular hemorrhaging, because woman and girls are afraid they will be accused of having induced an abortion. While the Nicaraguan government has developed medical guidelines to mitigate some of the effects of the ban, it does not monitor the implementation of the guidelines and does not appear to properly investigate and sanction all medical personnel who cause unnecessary delay of or deny women access to legal care. Nicaragua’s government has not made an effort to counter public misperceptions regarding abortion, the blanket ban, and available legal care options. This lack of due diligence may have resulted in additional fatalities not directly related to the ban on therapeutic abortion.

In the interests of protecting women’s human rights including the rights to life, physical integrity, health, and non-discrimination, Human Rights Watch calls on Nicaragua’s government to repeal penal code provisions that criminalize abortion, and instead guarantee in law that women have access to voluntary and safe abortions. And regardless of the legality of abortion, Nicaragua must immediately guarantee women and girls access to emergency obstetric care.

1 The other countries are Chile and El Salvador. See Center for Reproductive Rights, “The World’s Abortion Laws,” (accessed September 19, 2007).

2 Therapeutic abortion was not defined in Nicaraguan law, but was set out in an official norm issued by the Health Ministry: “The termination of pregnancy before 20 weeks gestation… due to maternal pathologies that are made worse by the pregnancy or for maternal pathologies that have a negative effect on the development and growth of the fetus.” Health Ministry of Nicaragua, Medical Treatment Department/Department of Comprehensive Treatment for Women, “Norm for treatment of abortion” (Ministerio de Salud de Nicaragua, Dirección de Atención Médica/Dirección de Atención Integral a la Mujer, “Norma de atención al aborto”) August 1989.