As Argentina becomes the first major Latin American country to fully legalize abortion, activists in the Dominican Republic fear their own government is banishing its women to the dark ages by upholding a total ban first implemented in 1884. The Dominican Republic is one of four countries in Latin America – along with Honduras, Nicaragua and El Salvador – where abortion is illegal in all circumstances. Scores of Dominican women die each year from botched attempts to end unwanted pregnancies. Incomplete abortions and miscarriages are estimated to result in 8% of the country’s maternal deaths every year. “The decision to legalize abortion in Argentina is a triumph for all women,” said Ysabel Paulino, a Dominican feminist and educator at the Autonomous University of Santo Domingo. “It is a fight we in the Dominican Republic have been waging – to defend the destiny of our bodies, what we do with our bodies and our right to life.” Despite the current ban, Dominican women go to extreme lengths to self-induce, often in secrecy and without clear medical guidance. These women risk up to two years in jail, while medical professionals face up to 20 years in prison and the loss of their license for aiding in a termination. In August, the president of the chamber of deputies, Alfredo Pacheco, created national uproar when he submitted a revised version of the country’s penal code which retained the abortion ban. Amid broad criticism, Pacheco soon after announced a new law permitting abortion in three cases: when a person’s life is in danger, when the pregnancy is the result of rape or incest, and when the fetus is incompatible with life. Feminist organizations condemned the ruling as insufficient, claiming the law would prove worthless against a penal code criminalizing abortion. It remains unclear when the new law will take effect. Meanwhile, the chamber of deputies is expected to pass the penal code sometime this year. It will then needs to be approved by the senate before President Luis Abinader will ultimately decide if it becomes law. Despite the ban, the Dominican health ministry already allows some exceptions under their supervision, according to Dr José De Lancer Despradel, the former general director of maternal, child and adolescent health. In 2012, he authorized the health ministry to make an exception in the high-profile case of Rosaura Almonte Hernández, or “Esperancita”, a 16-year-old leukemia patient, who doctors refused to treat with chemotherapy because she was nine weeks pregnant. De Lancer offered to move Rosaura from a private hospital to a public one to terminate her pregnancy, but the girl’s mother, Rosa Hernández, declined the offer, he said, because she didn’t want to transport her daughter. Rosaura later died after a miscarriage that sent her into cardiac arrest. Selene Soto, Hernández’s lawyer, said Hernández was not properly made aware of the options she had at the time. Furthermore, moving Rosaura would have been too costly for Hernández, she said, who was solely paying her daughter’s medical expenses. The story illustrates the many obstacles women face in a country where even the discussion of abortion is considered taboo and reproductive care is severely limited. When asked if the ministry continues to make exceptions, De Lancer said, “All of us who are doctors, gynecologists, and who work in the environment, we know that these things are done constantly. But they are handled with discretion,” he said. “They do not come to light because it is prohibited,” he said of the back channel procedures. “It is illegal.” Meanwhile, the death toll climbs. Damaris Mejía, a 31-year-old Dominican-Haitian woman, was 16 weeks pregnant when she started experiencing severe uterine pain in 2012. Doctors at a local hospital told her she had suffered a miscarriage and would need a curettage – a forbidden procedure that would clear her uterine lining of the fetus, but cautioned that they would be unlikely to find a doctor willing to terminate her pregnancy because of the ban. Doctors around the world perform curettages to treat uterine conditions, including abnormal bleeding and use them to detect cancer. The family drove from clinic to clinic, hospital to hospital, with no luck. Clandestine clinics exist throughout the country, but charge up to $500 – way beyond the reach of poor rural women in a country with a minimum wage of $250 a month. Researchers consider Dominican women of Haitian descent to be a group most vulnerable to the prohibition. Within days, Damaris’s pain was excruciating. At the final hospital the family visited, a doctor told her she should go home and rest. She died the following afternoon. An autopsy showed that her death had been caused by an infection from the dead foetus. Eight years later, the anguish of her death has not diminished for Damaris’s family, said her sister Juliana. “I don’t want to see any family live what we are living, what we have lived, what we have suffered,” she said.