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El Salvador's ban on abortion is driving hundreds of girls who become pregnant after being raped to commit suicide every year because they see no other option, a government official said.
Leading cause of suicide
Teenage pregnancy is one of the leading causes of suicide in the Central American country of 6 million people. Three out of eight maternal deaths in El Salvador are the result of suicide among pregnant girls under 19, latest government figures show.
Many of these girls have not only suffered sexual abuse at the hands of relatives, stepfathers or gang members, but they are also often silenced and prevented from seeking help by the stigma surrounding rape.
On top of that, they face the unwelcome prospect of giving birth to an unwanted baby due to El Salvador's total ban on abortion even in cases of rape, incest, a deformed foetus or when the women's life is in danger, campaigners say.
Read: Incest: SA kids at risk
"There is stigma and fear in reporting rape that occurs in families," said Mario Soriano, a doctor who heads the programme for youth and adolescent development at El Salvador's health ministry.
"Sometimes the person carrying out sexual violence is the family's sole breadwinner and so the possibility that their economic help will be taken away is used as a threat against the girl not to report the crime," Soriano told the Thomson Reuters Foundation in an interview at a military officers' club.
"There's a correlation between sexual violence and the high rate of suicides among adolescents – that's the reality. Pregnancy is a determining factor behind teenage suicides."
Rejection
El Salvador has one of the highest rates of teenage pregnancy in Latin America, with girls aged 10 to 19 accounting for nearly a third of all pregnancies in the country last year.
Under Salvadoran law, it is a crime to have sex with a child under the age of 15, but activists say the law is frequently flouted, citing official figures that show 1 540 girls under 15 became pregnant in El Salvador last year.
The offence carries a prison sentence of between 14 and 20 years, but few perpetrators are sent to jail.
Soriano said a 1998 total ban on abortion has led many pregnant girls to contemplate suicide or a backstreet termination rather than risk rejection from their families, friends and teachers.
Read: Alabama law that may restrict abortion challenged
"A pregnant girl is often discriminated against. She can find herself kicked out of the house and dumped by her boyfriend, so family is not seen as a source of help. She's also expelled from school because she's seen as setting a bad example to other pupils," Soriano said.
"El Salvador's abortion law is one of the most restrictive in the world. At the health ministry, we're aware of the need to modify the abortion law," he added.
El Salvador is one of about 28 countries globally that prohibits abortion in all circumstances, according to the Centre for Reproductive Rights.
Preventing teen pregnancy
Tackling El Salvador's high prevalence of teenage pregnancy and suicide as a result of rape are top priorities, Soriano said. Last year, the health ministry set up an alliance of 23 groups, including government bodies, doctors' associations, and international aid agencies, to address these problems.
Getting boys and men involved is part of the solution.
"This is a macho culture where the man decides what to do. We're inviting men to participate in preventing adolescent pregnancy and discuss what is means to be a man," Soriano said.
But other initiatives to stem teenage pregnancy, such as improving sex education in schools and access to contraception, have been publicly condemned by El Salvador's influential Catholic Church and some evangelical groups.
Read: SA teens urged to find out about contraception
In 2001, the Church blocked a manual for teachers, created by the education ministry, from being used as a guide to teach sexual health in schools.
"The sex education curriculum in schools is being revised. There's still a lot of pressure from the Church," Soriano said.
"Women and girls in El Salvador aren't empowered to be responsible for their body and know their rights. Our challenge is to ensure they know their rights and that their parents protect those rights," he said.
Read more:
More abortions in countries where it's illegal
Viewing ultrasound doesn't change abortion plans
Contraception saves millions of lives each year
Image: Death of an unborn child from Shutterstock
