Six months pregnant with her first child, teenager Estefanie Esmeralda is well aware of the dangers the mosquito-borne Zika virus may pose to her unborn baby.
Virus looms but El Salvador stands firm on abortion ban
"Babies aren't to blame for Zika and the mistakes people make. Babies are a blessing from God."
Yet she like many people in El Salvador can not have a legal abortion, which is banned in the socially conservative nation.
"I've been told about Zika, the problems it can bring and the precautions I need to take to not get the virus. It's a risk that you run," said the 16-year-old as she waited for a free pre-natal check-up at the country's main hospital for women.
"I don't think the abortion law should be changed," she told the Thomson Reuters Foundation. "Babies aren't to blame for Zika and the mistakes people make. Babies are a blessing from God."
El Salvador's health ministry has advised women to postpone pregnancy until 2017 after a rise of babies born in Brazil with microcephaly, a condition marked by an abnormally small head and underdeveloped brain linked to Zika.
But a legal abortion is not an option. Due to El Salvador's stringent law, among the world's most restrictive, women ending unwanted pregnancies risk illegal, unsafe back alley procedures and the possibility of prison.
El Salvador, with 6.4 million residents, is one of three Latin American countries that outlaw abortion without exception, even in cases of rape, incest, a severely deformed fetus or when a woman's life is in danger.
The Zika outbreak in El Salvador has done little to ignite debate about easing the ban.
Most Salvadorans are members of the Roman Catholic Church or numerous Christian Evangelical churches that consider abortion a sin and believe the rights of unborn children, enshrined in El Salvador's constitution, should be protected from conception.
Earlier this year, the top United Nations human rights official, Zeid Ra'ad Al Hussein, urged Zika-affected countries to ease abortion laws.
In El Salvador, health ministry figures show the number of suspected Zika cases has fallen sharply from a peak of more than 1,000 cases a week in January to fewer than 50 a week in April.
But cases could spike with the upcoming rainy season.
Since the outbreak began, health authorities say 259 pregnant women reported symptoms of Zika, which include fever and joint pain. Of that number, some have given birth and others are being monitored. There have been no confirmed cases of microcephaly linked to Zika in El Salvador.
The U.S. Centers for Disease Control and Prevention has concluded that infection with the Zika virus in pregnant women is a cause of microcephaly and other severe brain abnormalities.
For chief neonatologist Dr. Ana Lorena Parada, who works with newborns at the women's hospital, Zika has not shifted her position on abortion.
"Personally, I'm not in favor of abortion," Parada said. "An abortion isn't a solution. It can have consequences.
"A 12-year-old can't decide for herself if she is ready to have an abortion," she said.
But El Salvador's vice-minister of health, Dr. Eduardo Espinoza, questions the nation's abortion law.
"It seems to me that this is a little archaic, and that it is not fair," Espinoza said in an interview.
He said women's rights groups must lead a pro-choice debate and pressure lawmakers to ease the ban.
"It doesn't depend on us. I'm obliged to comply with the law and the law states we can't interrupt a pregnancy," he said.
PRISON FOR MISCARRIAGE
The Citizen Group for the Decriminalisation of Therapeutic, Ethical, and Eugenic Abortion (CFDA), a local rights group, says the abortion ban causes maternal deaths by forcing women to undergo dangerous back street abortions.
Angelica Rivas, a lawyer at CFDA, says the ban particularly affects poor women, as wealthier women can travel abroad to private clinics.
An estimated 35,000 clandestine abortions take place in El Salvador every year.
"The abortion ban kills and harms women, and in this country it can also put women in jail," Rivas said.
Under Salvadoran law, doctors must report cases of women who they suspect of having induced an abortion.
The rights group says scores of women have been wrongly convicted of murder and imprisoned when they in fact suffered miscarriages, stillbirths or pregnancy complications.
Of the 147 women prosecuted for abortion-related crimes between 2000 and 2014, 25 remain in jail, with some serving sentences as long as 40 years, the CFDA said.
Resistance to changes to the ban comes from not only the Catholic church and evangelical groups but conservative lawmakers and the left-wing ruling FMLN party that fear alienating voters.
Elsewhere in Latin America, however, reproductive rights campaigners say Chile may ease its outright abortion ban.
In March, Chile's chamber of deputies approved a bill to decriminalize abortion in some circumstances.
The bill needs to be approved by the Senate to become law.
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