I’ve written before about abortion in Latin America. I’ve written about how abortion rates in Latin America are higher than rates in the U.S. in spite of the fact that abortion is illegal in most of Latin America. I’ve written about the approximately 5,000 Latinas who die every year from botched illegal abortion.

In this Sunday’s New York Times magazine, Jack Hitt focuses on one Latin American nation, El Salvador, which eight years ago criminalized all abortions. All of them, for any reason. Women can get a maximum sentence of 50 years in prison for getting an abortion. [Update: See correction to the Hitt article here.]

Physicians are under pressure to report any women who might have aborted to the proper authorities, on pain of prosecution —

“Many doctors are afraid not to report,” says Mira, the obstetrician I spoke to. This fear is heightened for doctors, she explains, by the fact that nurses also have a legal duty to report abortion crimes but are often confused about their obligation of confidentiality. So doctors are afraid that the nurses will report them for not reporting. “The entire system is run on fear,” Mira said.

The criteria for deciding whether a woman aborted sound like something out of The Crucible.

If the woman is “confused in her narrative,” Vargas said, that could well indicate that she’d had an abortion.

Vargas offered me an example. “Last year, in March, we received a 15-year-old who came referred from a hospital in an outer area,” she said. “She had a confused patient history. She had already been operated on and had a hysterectomy and had her ovaries taken out. She was in a delicate state, on respiratory assistance in intensive care. The doctors there said they had seen a perforation in the space beneath the cervix.

“This was around Eastertime last year, and the prosecutor’s offices were closed,” Vargas said. She had not seen any of the evidence herself, she said, but saw that the other doctors “had tried to call the prosecutor’s office, but it was closed. I came in, and on the chart what was pending was to call the police. So I called them.”

Courts can order vaginal inspections of women under suspicion. If a woman needs a hysterectomy after a suspected back-alley abortion, the uterus is sent to the Forensic Institute for examination. If the case goes to trial, the organ may be used as evidence against the woman.

El Salvadore’s laws are so insane physicians cannot even terminate an ectopic pregnancy before it becomes critical —

Consider an ectopic pregnancy, a condition that occurs when a microscopic fertilized egg moves down the fallopian tube — which is no bigger around than a pencil — and gets stuck there (or sometimes in the abdomen). Unattended, the stuck fetus grows until the organ containing it ruptures. A simple operation can remove the fetus before the organ bursts. After a rupture, though, the situation can turn into a medical emergency.

According to Sara Valdés, the director of the Hospital de Maternidad, women coming to her hospital with ectopic pregnancies cannot be operated on until fetal death or a rupture of the fallopian tube. “That is our policy,” Valdés told me. She was plainly in torment about the subject. “That is the law,” she said. “The D.A.’s office told us that this was the law.” Valdés estimated that her hospital treated more than a hundred ectopic pregnancies each year. She described the hospital’s practice. “Once we determine that they have an ectopic pregnancy, we make sure they stay in the hospital,” she said. The women are sent to the dispensary, where they receive a daily ultrasound to check the fetus. “If it’s dead, we can operate,” she said. “Before that, we can’t.” If there is a persistent fetal heartbeat, then they have to wait for the fallopian tube to rupture. If they are able to persuade the patient to stay, though, doctors can operate the minute any signs of early rupturing are detected. Even a few drops of blood seeping from a fallopian tube will “irritate the abdominal wall and cause pain,” Valdés explained. By operating at the earliest signs of a potential rupture, she said, her doctors are able to minimize the risk to the woman.

Hitt interviewed one woman serving a 30-year sentence whose three children are growing up without her. He describes young women chained to hospital beds and guarded by police. Clandestine networks, something like the Underground Railroad, help poor girls travel to abortion providers in other countries.

The Rev. Thomas J. Euteneuer, the head of Human Life International, says “El Salvador is an inspiration,” an important victory for the “pro-life” movement.

Every now and then I run into a so-called “libertarian” who wants to criminalize abortion. You can talk to these lamebrains until you are purple, and they will not understand why criminalizing abortion limits the liberty and dignity of women.

Well, assholes, this is why.

Update: See also Scott Lemieux.