Elena was twenty-one when she went to the emergency room with severe abdominal pain and was told she was pregnant. The news came as a shock. Living in one of the poorest neighborhoods in Tegucigalpa—the sprawling capital of Honduras—Elena (whose name has been changed here to protect her privacy) lacked access to proper nutrition and had received no prenatal care since she didn’t even know she was pregnant. At the public hospital that day in 2017, she learned she was suffering from an internal infection and severe anemia. Elena was told her fetus had died, and she spent three days in the emergency room.
But what came after the miscarriage was even more shocking.
“While she was still on the hospital gurney, a prosecutor came over to her to ask her questions. One of the medical personnel had reported her,” Elena’s pro bono attorney, Claudia Herrmannsdörfer Acosta, explains. “Far from being treated for an obstetrical emergency, she left the hospital without knowing what was going on, handcuffed and facing criminal charges.”
What followed was a five-year legal battle against the accusation that Elena had intentionally ended her pregnancy—in a country with one of the most stringent anti-abortion laws in the Americas.
“Cases of desperation”
Abortion is illegal under the Honduran constitution, and since 1985, there have been no exceptions. Individuals and abortion providers can face up to six years in prison for terminating a pregnancy, and an amendment passed in 2021 further entrenched the ban by requiring approval from three quarters of Congress to overturn it.
Of course, just because abortion is illegal does not mean Hondurans don’t choose to end their pregnancies; they just don’t have a safe way to do so. Instead, some use combinations of herbs or other medications in risky ways. “There are cases of desperation,” Herrmannsdörfer Acosta says. Over the course of her twenty-five years as an attorney and women’s rights advocate, she has seen first-hand the impact these laws have on women.
“Sometimes, I’ve heard such desperation that women say they’re capable of doing anything,” she explains, remembering one young woman who told Herrmannsdörfer Acosta she was so desperate to end her pregnancy, at the height of the COVID-19 pandemic, that she contemplated putting a knife inside of herself.
The swearing-in of the country’s first female president, Xiomara Castro, in January 2022 led many Honduran feminists to hope for incremental change, such as allowing abortion in cases that are referred to as “los tres causales”—rape, when the life of the pregnant person is in danger, or when the fetus won’t survive outside the womb. But in a deeply conservative, patriarchal, and religious country where women have been historically and systematically excluded from political power and hold only 27 percent of congressional seats, it’s an uphill battle.
Yet it’s a cause some women are willing to take on. Somos Muchas por la Libertad y la Vida de las Mujeres (We Are Many for the Liberty and Life of Women) is a coalition of grassroots organizations and activists committed to chipping away at—and eventually overturning—the ban. Composed of lawyers and human rights defenders from across the country, they’re known simply as Somos Muchas. At the forefront of the effort is Herrmannsdörfer Acosta, the founder of a law firm dedicated to social justice cases that is fighting to overturn the law, with the support of Lawyers Without Borders Canada and twenty other human rights organizations and defenders.
At the heart of their work is the argument that the ban violates the fundamental rights to life, personal dignity, health, equality, and non-discrimination that are guaranteed under Honduras’s constitution as well as international human rights treaties and conventions the government has ratified. While their first legal effort failed in early February, Honduras has since sworn in a completely new Supreme Court, and Herrmannsdörfer Acosta and her team have filed a reversal appeal they hope the new slate of fifteen magistrates will consider favourably.
“We need a plan B”
Abortion isn’t the only aspect of reproductive health care that is difficult to access here. More than one in five Honduran women lack access to modern contraceptive methods, such as condoms, IUDs, or pills, with 38 percent of adolescent women reporting a lack of access.
Regina Fonseca is a long-time women’s rights advocate who co-founded the Centro de Derechos de Mujeres (the Centre for Women’s Rights) to help empower women and push for political change. She has seen the impact unintended pregnancies have on women’s lives, and she views changing Honduras’s laws as critical in the fight to advance sexual and reproductive rights.
Which is why she and other feminists were hoping that one of the things Castro would use her presidency to reverse would be a 2009 ban on emergency contraception known by the acronym PAE, which stands for its name in Spanish. That ban took effect after a right-wing coup d’état deposed Castro’s husband, then president Manuel Zelaya, ushering in twelve years of conservative party rule. During that era, the Catholic and evangelical churches exerted significant political power, Fonseca explains.
“Those who did the coup were conservative groups,” she says. “And over these last twelve years, we’ve seen all of the neoconservatives speaking out very strongly against women’s rights and the LGBTQ community, and especially against sexual and reproductive rights.”
With Castro, a self-described feminist from the leftist Liberty and Refoundation—or LIBRE—party, in power, it seemed like a good opportunity for activists to launch the Hablemos Lo Que Es PAE (Let’s Talk About What PAE Is) campaign. Its goals were twofold: educating the public about what the pill actually does and getting Castro’s government to legalize it.
Instrumental in the effort was Sandy Cabrera Arteaga, a young feminist activist and philosophy student who leads Acción Joven (Young Action), a nonprofit that is part of Somos Muchas and works to promote young people’s sexual, reproductive, and mental health and human rights.
“The essence of the fight for PAE in Honduras is to be able to decide the number of children we want to have, when and where, and that it’s an autonomous decision,” Cabrera Arteaga, who also serves as the PAE campaign spokesperson, says. “People are always going to make mistakes or find themselves in emergency situations, and that’s why we need a plan B.”
Through catchy TikTok videos, educational Instagram posts, and a nationwide campaign, Cabrera Arteaga and her fellow activists busted myths, such as the idea that PAE causes cancer, and succeeded in getting more than 700,000 Hondurans to sign their petition demanding the government take action.
Activists turned the petition in to Castro in March 2022 and succeeded in inspiring one change to the law. A year later, the pills are now approved for use by victims of sexual violence. But there have been delays in importing them and distributing them to health centres, Cabrera Arteaga says. The number of PAE kits hospitals and health centres will receive depends on the number of sexual violence cases they report treating each year. But with sexual violence often underreported, this is problematic, she explains.
“Now that this protocol exists, maybe more women will go and seek out these services at a clinic if they know they’re available, so it’s absurd to have only that quantity,” Cabrera Arteaga says. “So we’ve made a small advancement—I won’t deny that having this protocol is a victory—but we’re still fighting to have PAE available for all.”
It’s an issue Castro is working on, says Heidy Alachán, a legal adviser in the president’s administration. The goal is to first pass Castro’s ambitious Comprehensive Law to Combat Violence Against Women, Alachán says, which her administration plans to present to Congress in the coming weeks. Then, eventually, they’d like to get PAE approved for use by anyone who needs it and to push to decriminalize abortion in those three extreme instances, Alachán explains.
“What we as Honduran women deserve and need”
But the battle to make emergency contraception available even in a very limited way shows just how hard fought change is in a country still recovering from the institutional shock of the coup. The campaigns to legalize PAE and abortion are both part of feminists’ broader efforts to give Hondurans access to the full spectrum of reproductive health care, from sexual education and contraception to abortion. It’s about empowering women by ensuring they have the right to make their own decisions about their bodies and their futures—an idea that fundamentally challenges the patriarchal status quo.
“Honduras is a highly conservative society, and the reaction of the anti-rights groups is very strong against everything that furthers an agenda of reproductive and sexual rights for women,” Alachán says. “So at this moment, in the case of PAE, this is a first step. It’s the base that lets us jump off toward fulfilling what President Castro established in her government and what we as Honduran women deserve and need.”
But it will take time and public education, Alachán says. Changing how Hondurans think about reproductive rights and sexual education—and how lawmakers vote on it—are significant challenges.
“We have to work to build alliances and at the same time work on preparing society so they understand this issue, but I completely believe this can happen,” Alachán says.
“It isn’t over yet”
Activists like Cabrera Arteaga, Herrmannsdörfer Acosta, and Fonseca continue to remind the government of the urgency—and the people behind the statistics.
Elena was absolved in October last year and is awaiting the official letter that confirms her absolution. She has been working informal jobs until she receives it, as more formal jobs require a clean criminal record, she explains, “and so I continue with this weight on top of me, like it isn’t over yet.”
She’s also now considering filing a lawsuit against the prosecutor’s office and the hospital for how she was treated, Herrmannsdörfer Acosta says. But the number of people who need the help of lawyers like her never seems to ebb.
One of the cases Herrmannsdörfer Acosta’s colleagues are working on now involves a mother of six in the northern part of the country who was convicted of murder for terminating her pregnancy and sentenced to twenty-five years in prison. Her legal team is planning to appeal her sentence at the Supreme Court in an effort to reduce it.
Meanwhile, Herrmannsdörfer Acosta and her colleagues wait to see how the Supreme Court’s new justices will proceed in the legal battle against the abortion ban. In the meantime, they’re committed to elevating the issue every way they can.
“Of course, the ideal thing is to get a favourable ruling,” Herrmannsdörfer Acosta says. “But we also see that the debate is important, the discussion is important, so that the subject of abortion isn’t hidden anymore.”
Update: Just after this story was first published, President Xiomara Castro signed an executive order ending Honduras’s long-time ban on emergency contraceptive pills, one of the very things the Hablemos Lo Que Es PAE (Let’s Talk About What PAE Is) campaign was fighting for. Sandy Cabrera Arteaga says of the news, “We, the feminist movement, have won the restoration of our right to reproductive health, and it’s a joy to know that we have been listened to at last.”
In this series, produced in partnership with Bigger Than Our Borders, a collaborative of Canadian nonprofit organizations, we’re spotlighting stories that demonstrate the impact of Canada’s feminist foreign policy. “Investing in human rights can seem abstract, but when judges rule in favour of human rights or when parliaments change discriminatory laws because civil society and lawyers took on the fight against injustice and corruption, that means thousands of people can live free and safe from persecution,” says Pascal Paradis, executive director of Lawyers Without Borders Canada. “Canada’s aid policy allows us to do just that.” Learn more about initiatives supporting women, girls, and gender-diverse individuals around the world at biggerthanourborders.ca.