Abortion is not legal in El Salvador under any circumstance. The country bans the procedure even when a pregnancy results from rape, when the fetus has abnormalities incompatible with life, and when continuing the pregnancy threatens the pregnant person’s life. Penalties start at two years in prison and, in practice, can reach 50 years when prosecutors reclassify the case as aggravated homicide.
No Exceptions, and the Ban Is in the Constitution
Until 1998, Salvadoran law allowed abortion in three narrow situations: rape, fatal fetal abnormality, and risk to the pregnant person’s life. A new penal code eliminated all three. The following year, lawmakers amended Article 1 of the Constitution to recognize “every human being since the moment of conception” as a person.1ConstitutionNet. Constitution of the Republic of El Salvador Because fetal personhood is written into the Constitution, restoring even a medical exception would require a constitutional amendment, not an ordinary statute.
El Salvador is one of roughly two dozen countries worldwide that maintain an absolute prohibition. Its enforcement is among the harshest anywhere.
Prison Sentences Under the Penal Code
Articles 133 through 137 of the Penal Code set different penalties depending on who acted and how:
- A person who ends their own pregnancy, or anyone who performs the procedure with the pregnant person’s consent, faces two to eight years (Article 133).
- Performing an abortion without the pregnant person’s consent, or obtaining consent through threats or violence, carries four to ten years (Article 134).
- A doctor, pharmacist, or medical assistant who performs the procedure faces six to twelve years, plus professional disqualification for the same period (Article 135).
- Persuading a pregnant person to seek an abortion, or providing financial or other support, carries up to five years. If the same person also performs the abortion, the sentence increases by one-third (Article 136).
- Causing an abortion through negligence carries six months to two years. A pregnant person who negligently causes their own pregnancy loss is exempt from this provision (Article 137).
How a Pregnancy Loss Becomes a 30- to 50-Year Sentence
The sentences in the abortion articles are only part of the picture. Prosecutors frequently bypass them altogether and charge women under Article 129, which covers aggravated homicide and carries 30 to 50 years in prison. This reclassification typically happens when a pregnancy ends late in gestation, whether or not there is evidence the woman did anything to end it.
The practical consequence is that a woman who arrives at a hospital after a stillbirth can be charged with the same offense as someone convicted of premeditated murder. Court records reviewed by researchers show that a significant number of these convictions involved naturally occurring late-pregnancy stillbirths rather than induced abortions. Prosecutors have built the cases by framing the fetal death as homicide and relying on the constitutional provision that personhood begins at conception. Sentences have run from 30 to 40 years, with some women receiving the full 50.
Miscarriages and Obstetric Emergencies That Became Criminal Cases
Over the past two decades, at least 181 women have been prosecuted after obstetric emergencies, according to data compiled by advocacy organizations before the government’s recent crackdown on civil society. Many did not seek or attempt an abortion. They had miscarriages, stillbirths, or other medical crises, went to a hospital, and were reported to police by the staff treating them.
A coalition of cases known as “Las 17” drew international attention to women sentenced between 1999 and 2011, most charged with aggravated homicide after reported miscarriages. At least 65 imprisoned women have been released over the years through legal challenges and pardons, but the prosecutorial pattern has not stopped.
Poverty is a consistent factor. Most of the women charged are young and low-income, and either gave birth outside a hospital or arrived at an emergency room already in crisis. Women with the resources to access private healthcare rarely face investigation.
Hospitals Are Required to Report Suspected Abortions
Enforcement depends on the healthcare system functioning as an arm of law enforcement. Doctors, nurses, and other hospital staff are legally required to report any patient they suspect of having induced an abortion, and this obligation overrides patient confidentiality. Medical records, test results, and statements a patient makes during treatment can all become evidence in a criminal case.
Many prosecutions originate from reports filed while a patient is still receiving emergency care. A woman arrives bleeding at a public hospital, and before she is stabilized, staff may contact police. Under the state of exception declared by President Nayib Bukele in 2022, advocates report that surveillance inside hospitals has intensified, including cameras installed in operating rooms, emergency consultation areas, and pharmacies. Administrative detention before an initial hearing, once capped at 72 hours, can now run up to 15 days under emergency powers.
The predictable effect is that pregnant people who fear prosecution delay seeking care or avoid it entirely. Treatable emergencies can become fatal ones.
International Rulings the Government Has Not Followed
Two cases before the Inter-American Court of Human Rights have directly challenged how El Salvador enforces the ban.
Manuela v. El Salvador
Manuela was sentenced to 30 years for aggravated homicide after an obstetric emergency that ended her pregnancy. She died in prison two years later from cancer, after receiving inadequate medical treatment while incarcerated.2Center for Reproductive Rights. Manuela v. El Salvador In 2021, the Court found that El Salvador violated her rights to life, personal integrity, privacy, equal protection, and freedom from arbitrary detention under the American Convention on Human Rights, and held that the state’s treatment of her constituted gender-based violence under the Convention of Belém do Pará.3Inter-American Court of Human Rights. Case of Manuela et al. v. El Salvador
Beatriz v. El Salvador
Beatriz had lupus and kidney disease, and her pregnancy involved an anencephalic fetus with no chance of survival outside the womb. El Salvador refused to allow a termination. The Inter-American Commission brought the case to the Court, which held the state responsible for violating her rights and ordered it to issue regulations giving medical personnel clear legal guidance for pregnancies that endanger a patient’s health or life.4Inter-American Commission on Human Rights. IACHR Takes Case Involving El Salvador’s Absolute Ban on Abortion to the Inter-American Court of Human Rights
Both rulings are legally binding on El Salvador as a party to the American Convention. The government has not implemented the ordered reforms. No regulations have been issued to protect medical workers who intervene in life-threatening pregnancies, and prosecutorial practice has not shifted.
Fewer Organizations Can Defend Accused Women
The groups that historically defended women charged under the ban are themselves under pressure. In 2025, El Salvador’s legislature passed a Foreign Agents Law that taxes foreign donations to NGOs at 30 percent, requires organizations receiving international funds to register as “foreign agents,” and lets the executive cancel legal status and impose fines up to $250,000. The law prohibits vaguely defined “political activities” and activities that “disturb public order.”
The Agrupación Ciudadana por la Despenalización del Aborto, which had provided legal aid to prosecuted women and helped secure the release of dozens, announced its legal dissolution in February 2026 in response to the law. It said it would continue as a regional activist movement rather than a registered Salvadoran NGO. Women facing prosecution now have fewer organizations able to represent them, investigate their cases, or bring international attention to what happens to them.