Gladys, an indigenous woman from rural Ecuador, went to hospital after injecting poison into her stomach to end her pregnancy. Doctors went straight to the police, and she was sentenced to two months in jail for having an abortion with consent. Elsewhere in the South American country, a 20-year-old Afro-Ecuadorian woman went to hospital after a fall, and found out she was pregnant and miscarrying. She was swiftly arrested and spent four months awaiting trial, where she was cleared. They are among the many women criminalised because of strict abortion laws in Ecuador that put the lives and health of women and girls – particularly those from poorer backgrounds – at risk, a comprehensive report by Human Rights Watch (HRW) has found. Abortion is illegal in the staunchly Catholic country except in cases where the life and health of the woman are in danger or the pregnancy is the result of a rape. In April the high court decriminalised the procedure in all cases of rape, loosening restrictions that had allowed abortion only in cases of rape if the woman had a mental disability. Illegal abortions carry a sentence of up to two years in prison, and doctors who perform abortions can face up to three years behind bars. The report, published on Wednesday, found that the country’s laws disproportionally affect indigenous and Afro-descendent women and girls living in poverty. HRW reviewed 148 abortion cases between 2009 and 2019. It found 120 women and girls were prosecuted – the majority of indigenous or Afro-Ecuadorian descent – including 33 who served time in prison. About 12% were girls – and they almost always lived in poverty. Women and girls charged with abortion often have their right to medical confidentiality violated, said HRW, and they face “significant obstacles” to accessing decent legal representation. “The criminalisation of abortion not only undermines the ability of women and girls to access essential reproductive health services, but it also exacerbates inequalities and discrimination,” said Ximena Casas, women’s rights researcher at HRW. “Ecuador should remove all criminal penalties for consensual abortion. At a minimum, it should guarantee effective access to abortion on all legal grounds and stop prosecuting women and girls seeking essential medical care.” In 2017, the country’s health ministry reported that 15.6% of maternal deaths were due to clandestine abortions, with a growing number of women and girls using the drug Misoprostol, which is used to treat stomach ulcers and causes abortion by inducing labour. Analysts say that poor education, especially in impoverished communities, is partly to blame. “Of the cases I’ve seen, all of them have been women living in impoverished conditions,” said Ana Cristina Vera, director of Surkuna, a feminist organisation based in Quito, the capital, that provides legal support for women charged with abortion. “This only widens inequality between women.” Latin America has some of the strictest anti-abortion laws in the world, with the region’s most liberal laws found in Argentina, Uruguay, Cuba, Guayana, and some parts of Mexico. Argentina legalised abortion on demand during the first 14 weeks of gestation in December. “The movement for women’s rights is a global one, and after Argentina took that giant step, we took a small one in Ecuador with the court ruling in April on rape,” said Vera. “Nothing has ever been given to us, we women have had to fight for our rights.”