María Antonieta Alcalde: “Nicaragua is one of the few countries in the world that completely criminalizes abortion”

The director of IPAS Latin America and the Caribbean shares with DIVERGENTES the challenges surrounding sexual and reproductive rights in Central America, a region marked by fierce legislative debates and shifts between conservative and progressive groups in recent years


In recent years, Latin America and the United States have become battlegrounds for sexual and reproductive rights, with clashing conservative and progressive groups. The region has swayed between major advancements and severe restrictions in abortion access.

Just in the past five years, Argentina saw one administration legalize abortion while the following government seeks to ban it again; in Mexico, abortion was decriminalized in 15 states, granting women the right to choose; and the U.S. Supreme Court overturned the historic Roe v. Wade decision, ending 49 years of federal abortion rights protections.

Meanwhile, in Central America, Guatemala’s Congress passed a law increasing prison sentences for abortion, although it was ultimately shelved by the executive branch. El Salvador faced two international trials for its strict reproductive rights laws, and Honduras’ Supreme Court approved a constitutional challenge against an article penalizing abortion, awaiting a new legislative initiative.

Nicaragua has strictly and totally banned abortion for the past 17 years, with little sign of change under the Ortega-Murillo regime, who outlawed the practice upon coming to power in 2007.

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A fierce fight has emerged to end the criminalization of voluntary pregnancy termination, but also to uphold and intensify restrictions. Women and girls—forgotten in these debates—are the ones ultimately forced to bear the consequences.

During this same period, the organization IPAS Latin America and the Caribbean (IPAS LAC), led by María Antonieta Alcalde Castro, a master’s degree holder in Gender, Society, and Policy, has engaged in these discussions, ensuring abortion rights for women across all territories.

Castro, a longtime advocate for sexual and reproductive rights, discusses with DIVERGENTES the challenges her organization has faced over the past five years, her hopes for opportunities and concerns about risks in this field, and the current state of abortion access for women in Central America and Latin America.

María Antonieta Alcalde: “Nicaragua is one of the few countries in the world that completely criminalizes abortion”
San José, Costa Rica. Feminist groups outside of the Inter-American Court of Human Rights the day before Beatriz’s trial against the State of El Salvador for violating her sexual and reproductive rights | DIVERGENTES

How do the support networks throughout the region operate?

Legal frameworks for abortion access vary by country, with Central America facing the most restrictive conditions. Despite the illegality, abortion can be safely managed.

At IPAS, we work with organizations and support networks, as a crucial part of our model is recognizing and empowering the vibrant Latin American movement. In Central America, we closely collaborate with 23 networks of companions.

Many of these are groups of friends or women who have undergone abortions, discovering that self-managed abortion at home is highly safe. The World Health Organization (WHO) supports this in its abortion guidelines.

These networks provide companionship to women facing unwanted pregnancies, offering information and, in many cases, delivering the medications for safe, home-managed abortions.

At IPAS, we support organizations, enhance their capabilities, and ensure they have medical referrals. If complications arise, they know where to go, which depends on the specific context.

Some places, like Argentina and Mexico, allow companion work openly with government support. However, in El Salvador, Nicaragua, Honduras, and the Dominican Republic, companions operate clandestinely due to risks to safety and freedom.

For these reasons, we also support their security efforts. Their bravery saves lives every day. We work with over 60 civil society organizations providing companion support.

Regarding Nicaragua’s situation, how do you perceive the abortion landscape?

It’s truly sad that human rights defenders in Nicaragua face constant persecution, especially those supporting abortion rights.

Nicaragua is one of the few countries globally that completely criminalizes abortion. We know this doesn’t decrease the demand for abortion; it only makes it more unsafe for women, people with the capacity to gestate, and those who assist them. The situation is tragic.

Still, the solidarity and compassion of the groups in Nicaragua provide hope. Despite complex circumstances, companions bravely support women, girls, and teenagers in need.

Central America has alarming indicators of teenage pregnancies, sexual violence, and child pregnancies, showing the demand for abortion services that, unfortunately, don’t exist. Thankfully, some organizations provide these services.

We also work extensively in providing access to contraceptives and comprehensive sexual education. Nicaragua’s total prohibition of abortion and sexual education is concerning. To prevent abortions, we must prevent unwanted pregnancies, and this begins with sex education, which also addresses high levels of sexual violence. We don’t see this in Nicaragua, and it’s troubling.

María Antonieta Alcalde: “Nicaragua is one of the few countries in the world that completely criminalizes abortion”
Abortion is not punishable in Costa Rica only when the life and health of women is at risk, according to Article 121 of the Penal Code.

What access do Nicaraguan migrant women have to abortion in Costa Rica, given that Costa Rican law only allows abortion for health reasons under strict restrictions?

The situation is severe, and many migrate across the region, with Costa Rica being a major destination. Costa Rica’s abortion law is highly restrictive, allowing it only for health reasons with significant limitations.

Our work in Costa Rica includes expanding abortion access, interpreting health broadly—as WHO defines it, including mental and social well-being. Migrant populations, often undocumented and excluded from Costa Rica’s social security, face additional barriers.

Working with migrant populations is a priority for IPAS LAC. In Mexico, we’ve developed an app for migrant populations to access support on their journey.

Migrants, regardless of legal status, are entitled to basic health services, including legal abortion, and governments must provide free health assistance.

The app, Te Acompaño, was developed with migrant input and helps us expand our work in northern Central America and Mexico, particularly with Nicaraguan migrants in Costa Rica.

Has there been any shift in El Salvador regarding abortion rights under President Nayib Bukele, following the Manuela vs El Salvador ruling and the pending Beatriz vs El Salvador decision?

Along with Nicaragua, Honduras, the Dominican Republic, and Haiti, El Salvador has one of the strictest reproductive rights frameworks. Cases like Beatriz’s, forced to continue a dangerous and non-viable pregnancy, reveal severe cruelty.

In El Salvador, we sadly see increased persecution against women’s rights defenders.

We hold high expectations for the Manuela and Beatriz cases to open dialogues with the current government, yet we continue to face challenges. The UN’s Committee Against Torture has deemed forced pregnancy in cases of fetal inviability as inhumane, cruel, and degrading treatment, comparable to torture.

In the report, it’s mentioned that in the past five years, conservative governments have risen in the region—not only in Latin America, like Javier Milei in Argentina, but also with Donald Trump, who is seeking re-election in the United States. How does this situation look for Central America?

Without a doubt, it’s a very complex situation. Across the region, we’re seeing a high level of polarization, which is extremely concerning, combined with highly conservative but also very populist governments, such as Milei in Argentina and, in an inverse way, Trump in the U.S.

In Central America, it’s concerning because we have very authoritarian governments, but also progressive ones, like (Bernardo) Arévalo in Guatemala and (Xiomara) Castro in Honduras, who are our hope that we can say, “Yes, it’s possible.”

There is a stigma suggesting that Central America is more conservative than the rest of the region, or that it’s more Catholic. I expect some of these conservative governments to lose ground and for us to see more openness.

If Trump wins the upcoming election, it will be a setback. For better or worse, the U.S. presidency is very influential in Central America, and in Mexico as well. It will lead to a very challenging period for the region in terms of sexual and reproductive rights, women’s rights, and LGBTQ+ rights.

It will also be a time to reflect on how we organize better. Despite the complex challenges, the Latin American movement is very strong, having faced barriers and pushed the agenda forward. I see an opportunity in the coming years for Central America to rethink collective spaces, to find ways to strengthen both the communities and the governments, so they can be role models for the rest of the region, not the conservative governments.

Honduras
The Emergency Contraceptive Pill was “released” by an Executive Agreement approved in 2023. The pill had been banned during the coup against the government of Manuel Zelaya – husband of President Xiomara Castro – in 2009 (Jorge Cabrera and Fernando Destephen).

In Honduras, last year President Xiomara Castro approved an agreement to allow the free use and sale of the Emergency Contraceptive Pill (ECP), but women’s organizations have pointed out that it’s still not available in pharmacies and hasn’t been provided in health centers, even in protocols requiring it for survivors of sexual violence. What is your understanding of the availability of the ECP in this country?

I wouldn’t think that in the 21st century there would still be a country that prohibits emergency contraception. Numerous scientific studies show its effectiveness and safe use. It’s confirmed not to be an abortifacient, as it prevents pregnancy in the first place.

The approval was a step forward for the region, but without a doubt, the health system in Honduras needs to adapt and overcome the fears generated by the prior ban. Moreover, this ban was enforced with persecution. To get the ECP, women had to resort to drug trafficking networks.

The Health Ministry is making efforts to promote its use. Part of our work is to support organizations in tracking and ensuring its availability, at a minimum, for survivors of sexual violence. We’re also collaborating with the Health Ministry to ensure its availability.

Changing the law is a necessary step, but it’s not enough to ensure access. Access has several components: health services must have the supplies, healthcare professionals must be trained and offer these services, but the population must also demand it.

President Xiomara Castro also promised to decriminalize therapeutic abortion under certain conditions, but there hasn’t even been a draft bill. You mentioned working with the Health Ministry; have you had conversations about this project?

It remains a commitment, and our expectations are still there. We would like Honduras to at least move forward on basic grounds, like when the pregnancy results from rape, when it endangers the life of the pregnant woman, and in cases of fetal inviability. If we can’t achieve all that, at least securing a health exception to save women’s lives.

Unfortunately, we see that Xiomara Castro doesn’t currently have the strength she needs in Congress, but we see progress little by little.

We haven’t had specific conversations with the Health Ministry about a draft bill, but we have spoken with organizations to keep pushing. Governments come and go, but civil society organizations continue fighting for the agenda.

Argentina sparked many of the conversations about abortion decriminalization and made history with full decriminalization in 2020. Now that’s under threat. Have your support networks faced challenges under the new government?

IPAS LAC has worked in Argentina for decades. We supported the campaign to decriminalize abortion, then worked closely with the federal Health Ministry to establish services, and have been active in many provinces.

Since the Milei administration came to power, all this is now at risk. Not only were ministries shut down, like the Ministry of Equality, but also the Sexual and Reproductive Health Program, which coordinated efforts at the federal level. This is now completely frozen. Milei even mentioned plans to dismantle the Health Ministry.

We’re in a situation where social security issues are minimized, with a marked idea that the market controls everything. It’s a model that existed in the past and caused a lot of harm in the region.

Regarding abortion, what we’re seeing is an almost total freeze at the federal level of the work that was being done. Federally, the Ministry provided supplies to the provinces, conducted training, and issued guidelines, all of which is now frozen.

Fortunately, Argentina being a federated country, the provinces still coordinate their own health services. We continue working closely with Buenos Aires and other provinces. We see local leadership and support networks actively assisting public services, ensuring people know these services remain available.

In the more conservative northern provinces, there’s a freeze and a lot of fear. For those provinces that weren’t fully committed, it was like, “Let’s stop this, or we’ll face repercussions.” There were also provinces that stopped working because they no longer received federal support.

In Argentina, while people have the right to terminate a pregnancy up to 14 weeks without justification, and later for specific reasons, access to public services depends on where they live, and access to private services depends on their financial means. Here, support networks have done tremendous work covering the government’s responsibilities.

There was already a bill proposed to overturn abortion decriminalization, but fortunately, it didn’t pass. We’re remaining vigilant.

Since when has this freeze been in place?

Virtually since Milei took office. We saw some provinces that were just starting to implement services decide to halt. In those cases, it happened even before he was sworn in, but the topic was already being discussed. There was a fear that abortion clearly went against the president’s and his government’s wishes, and they preferred “not to get involved.”

One of IPAS LAC’s most interesting projects is the Safe and Legal Abortion Minisites, which operate in Mexico. How do they work? Could they be expanded to the rest of Latin America?

I love this project. We started it in Mexico after different states began decriminalizing abortion, creating a need for specific information. We have websites in states like Guerrero, Colima, and Baja California, so anyone searching online can find the nearest service and the state’s legislation.

These are sites developed by IPAS, but we donate them to state governments so they can have a space to inform. In our experience, when abortion was decriminalized in Mexico 17 years ago, these websites became a central information source. We hope this encourages more women to use public services and feel safe seeking information.

We have other tech platforms that offer abortion information. We have a chatbot called Sofía that provides information for the entire region. Sofía is available 24/7 with highly specific responses. We created it based on questions from women across the region who needed support.

We have an interactive abortion map at abortoenmipais.ipaslac.org, showing each country’s legislation and the organizations offering support. We also have Safe Abortion at Home, a website with digital tools guiding self-managed medical abortion.

We have a safe abortion video with misoprostol, which is available across the region. There’s also a chatbot for migrants, Te Acompaño. These are our tech tools available throughout the region.


The information we publish in DIVERGENTES comes from contrasted sources. Due to the situation in the region, many times, we are forced to protect them under pseudonymity or anonymity. Unfortunately, some governments in the region, including the Nicaraguan regime, do not provide information or censor independent media. For this reason, despite requesting it, we cannot rely on official, authorized versions. We resort to data analysis, anonymous internal sources, or limited information from the official media. These are the conditions under which we exercise a profession that, in many cases, costs us our safety and our lives. We will continue to report.