A year ago, Franci Machado started feeling really sick with nausea and vomiting. She went to the hospital and then again when her symptoms worsened a month later. Doctors told her she had thyroid cancer. And that she was two months pregnant.
Machado, a 26-year-old single mother, needed chemotherapy to save her life, but that could kill the fetus. Under Nicaraguan law, that’s considered an abortion. So doctors refused to treat Machado.
Abortion is illegal in Nicaragua, even if a woman’s life is at risk and in cases of child rape. Women’s rights activists have been fighting to change these laws since they were enacted a decade ago.
Machado has a sidewalk beauty shop in the Nicaraguan capital, Managua. It's nothing more than a tarp, a small mirror and an old swivel chair. She also has two small children.
“I pleaded for an abortion,” Machado says. “I told the doctors, ‘I can’t die — I have two children to take care of! I need to live for them!’”
But doctors refused. They could go to jail if they terminated her pregnancy. So she went to the hospital that diagnosed her, was put on a feeding tube and waited to die.
Then one night, more than a month later, two female doctors Machado didn’t recognize entered her hospital room and gave her some medication. A few hours later she had a stillbirth.
“The baby came with his two hands wrapped around his neck — the same place where I have my sickness,” Machado says. “In my mind, I heard his voice say to me, ‘I gave up my life for you.’”
Machado says she cried for her dead son, and started chemotherapy that same week.
Magaly Quintana is co-director of Católicas por el Derecho a Decidir Nicaragua (Catholics for the Right to Decide Nicaragua). She says Machado's mother asked her for help, so she wrote a letter to the director of the hospital.
“If this young woman didn’t know about the work we do, she would be dead,” says Quintana. “In this same hospital. She would have died. No medicine, no chemotherapy.”
Quintana says Nicaraguan President Daniel Ortega doesn’t want anyone to die on his watch, even though he championed the adoption of the strict abortion laws in 2006.
She says Catholics for the Right to Decide Nicaragua’s own conversations with doctors throughout Managua suggest Ortega’s administration quietly allows some hospitals to provide therapeutic abortions. But nobody knows what happens to women in other hospitals around the country.
IPAS, a local advocacy group, estimates at least 100 Nicaraguan women died over the past five years because they were denied abortions.
Catholics for the Right to Decide Nicaragua believes women infected with the Zika virus are permitted to have abortions. There have been at least 661 reported cases of Zika in Nicaragua to date, and 221 of those cases were in pregnant women. But so far, there are no records of children born with microcephaly, the birth defect associated with Zika infection.
Quintana says she thinks Ortega wants to avoid bad press: He’s running for his fourth term as president this November. He wants to keep the problem in the shadows, she says.
We reached out to representatives of the Ortega administration for a response to allegations the government is tacitly permitting abortions in some cases when a woman's life is at risk, and in cases of Zika pregnancies. We haven't received a response.
Activist Leslie Briseño refuses to let Nicaragua’s strict abortion laws slip from the public eye. Briseño is a single mother of a 15-year-old son, Alejandro. When he was 9, Briseño had a dangerous, ectopic pregnancy.
But she says doctors wouldn’t treat her. They told her to pray the pregnancy ended before it killed her.
“I can’t understand how one law can be so cruel to women,” says Briseño. “And so cruel to their families.”
Briseño says a female doctor sympathized with her plight and secretly gave her medication that ended the pregnancy. Soon after, Briseño started a citizens' coalition called Las Queremos Vivas (We Want Them Alive), which proposed legislation in early 2016 that would allow for abortions when a woman’s life is in jeopardy, or in cases of rape.
Briseño's team collected more than 6,000 signatures from all over the country, and well as 15,000 signatures online. The National Assembly accepted the legislation for consideration in March 2016, though there hasn't been a vote.
Ortega’s administration hasn’t commented on the proposal. The coalition is demanding a vote before the year ends.
“A Nicaraguan family is primarily sustained by women,” says Briseño. “Both emotionally and economically. So it’s necessary to realize that strict abortion laws aren’t something that only affects a woman, it affects the entire family in this country.”
Briseño says no woman should die when her life can be saved by a therapeutic abortion.
She says if Nicaragua’s national assembly rejects the new abortion legislation, her coalition will just keep fighting. And they won’t stop until their government gives women the right to live.
An earlier version of this story misstated the name of Quintana's organization.