Reproductive Justice
A Quiet Inquisition

A Quiet Inquisition

When Delma Rosa Gómez was 27 years old, she was diagnosed with advanced stages of metastatic cancer. When she told her physician she was pregnant, they replied that they couldn’t start chemotherapy. “They said any treatment could provoke an abortion. And they couldn’t give me an abortion because it was penalized by law. They said I could end up reporting them, and they could go to jail or something like that.” After three months and much public pressure, her doctors began chemotherapy treatments. Gómez gave birth to a stillborn child at eight months. She died within a year, leaving behind another child. The 2014 documentary A Quiet Inquisition chronicles the tragic stories of women like Gómez in Nicaragua, one of the only six countries in the world that bans abortion in all instances — even if the woman’s life is in danger. Along with its neighbor El Salvador, the Dominican Republic, and Chile, it is one of the four Latin American nations included in this category.

The documentary tackles this subject through the lens of a woman doctor in Nicaragua’s capital city of Managua. The film follows the daily life of Dr. Carla Cerrato, an OB/GYN at a public hospital, as she navigates the difficult territory between a restrictive law that endangers women’s lives and established medical norms that are now illegal. The documentary shows her daily routine, the demographic makeup of her patients, and the clinical procedures she performs with her team.

Some of the most difficult scenes to watch are those that involve teenage girls. Sexual assault permeates these young women’s lives, and their pregnancies — and at times self-induced attempts at abortion — demonstrate the desperation many young Nicaraguans face on a daily basis in relation to their reproductive health. Pregnant teenagers comprise the majority of Dr. Cerrato’s patient load. When the filmmakers ask her how many teenagers she sees a month, she tells them she has to subdivide the age group: those 13 and younger; those between 14 and 16; and those over 16. Some of these girls come in with wanted pregnancies but face complications because of their young age. Others become pregnant because of rape and try to self-induce abortions. The film lays bare teenage girls’ vulnerability in the face of sexual assault, tyrannical abortion laws, and grinding poverty.

A Gender Revolution

Nicaragua did not always have such draconian reproductive health laws. The current ban, which overturned a 130-year-old therapeutic abortion law, passed in 2007, a year after the former leftist guerrilla leader Daniel Ortega won the presidency by allying himself with the Catholic Church.

To understand the gendered implications of the current abortion ban, you have to look back on Nicaragua’s recent political history. In 1961, two years after the Cuban Revolution, the Marxist Frente Sandinista de Liberación Nacional (FSLN, or the Sandinistas) formed in Nicaragua. The guerrilla army worked to overthrow the brutal dictatorship of the ruling Somoza family and create a socialist state.

A woman walking past a wall with writing saying, “July 19, 1979 Free Nicaragua.” (Margaret Randall)

In the 1970s, the FSLN — led by Daniel Ortega and his brother Humberto — picked up their revolutionary activities. By 1979, the Sandinistas had overthrown the government and taken power. They expropriated land and businesses owned by the corrupt Somoza family, nationalized banks, and organized peasants and workers into Civil Defense Communities. They also enforced a clear separation of church and state.

By 1980, with both Cuba and the U.S. pressuring the Sandinistas to take a firm side in the Cold War, the FSLN signed an agreement with the Soviet Union. As the Reagan administration began to support the covert counterinsurgency actions of the Contras (through illegal arms deals with Iran), the Sandinistas switched from implementing pluralism to defending the Revolution.1

Women’s emancipation was central to the FSLN’s revolutionary program in the 1980s. Gender equality was seen as a central part of social equality for all. Sandinista doctrine posited that “the Sandinista people’s revolution will abolish the odious discrimination that women have been subjected to compared with men” and “will establish economic, political and cultural equality between women and men.”2 In fact, 30 percent of the FSLN’s combat forces were women, and they participated in every aspect of combatant and civilian life as equals to their male counterparts. In a crucial military operation in 1978, in which Sandinista forces stormed the National Palace in Managua, the second in command was a woman — Dora Maria Tellez.

“Gun, Cross, Pen, Nail File,” a photo from the Nicaraguan Revolution.
(Margaret Randall)

Active participation in the revolution ensured that women were represented in the new government. And after coming to power, the FSLN made significant progress towards gender equality. During the 1980s, the Sandinistas prohibited the use of women as sex objects in advertising, required employers to give nursing women breaks to breastfeed their children, eliminated the distinction between legitimate and illegitimate children, and banned the family wage.3

In the film, Dr. Cerrato speaks about the Sandinistas, recalling how her identity was formed during the 1980s. The Sandinistas allowed her to go to medical school and taught her the importance of gender equality. As she tells the filmmakers, “All of who I am is from the 1980s.” Thus Daniel Ortega’s political resurrection, and his alliance with the Catholic Church, is an act of betrayal to Dr. Cerrato. “We spoke of gender equality, the power of women and now they say your life isn’t worth much.”

The legacy of the FSLN and the Sandinistas permeate the film — from graffiti on walls to election flags to billboards. The opening scenes show a smiling Daniel Ortega on a bright pink billboard next to the words “Cristiana, socialista, solidaria!” (Christian, socialist, comrade). It’s no coincidence that “Christian” comes first.

Religion and Women’s Health

While Daniel Ortega puts religious dogma before women’s lives, the women in the film demonstrate that they have no problem reconciling their religious beliefs with the need for a therapeutic abortion. In one scene, an expectant grandmother discusses her daughter’s pregnancy with Dr. Cerrato. With the possibility that the amniotic sac had ruptured, the woman asks if they could perform a therapeutic abortion if necessary. When Dr. Cerrato informs her that it is illegal in all circumstances, the woman recalls the period before the total ban, “At that time they provided therapeutic abortions.” To her, there is no question that she would save her daughter: “I’m still a Christian but that does not divide me. In my opinion if it is to save my daughter, if there is no hope for this baby, that’s like a fish out of water, then she’ll get infected and lose her uterus.”

The film also shows public backlash against the abortion ban. Feminist groups and medical professionals have vociferously condemned the total ban. While they still push for gender equality, the overall conservative and misogynistic religious and governmental culture remains entrenched.

The political role of the Catholic Church is crucial in understanding the current abortion law. But evangelicalism is also on the rise across Latin America, and Nicaragua is no exception. One scene in the film even shows an evangelical woman on the streets of Managua and the opening scenes scroll past the walls of evangelical churches. I wonder what role evangelicalism has played in the politics surrounding the abortion ban. Has Ortega also curried favor with evangelical leaders, hoping to win their votes as well?

In 2016, Daniel Ortega changed the constitution in order to run for a third term as president and won. And despite vocal opposition to the abortion ban, his government doesn’t seem poised to make changes anytime soon. Dr. Cerrato’s description of Ortega’s “pact with the Church” in order to gain political support and votes perfectly crystallizes the stakes of putting politics before health: “It’s more serious than votes. It’s women’s health.” The film is at its strongest when it puts this message front and center. Restrictive abortion policies are a question of life and death. And women are dying because of them.


  1. On the FSLN and the Revolution see Jeffrey L. Gould, To Lead as Equals: Rural Protest and Political Consciousness in Chinandega, Nicaragua, 1912-1979 (Chapel Hill: University of North Carolina Press, 1990); Sergio Ramirez, Adiós Muchachos: A Memoir of the Sandinista Revolution, trans., Stacey Alba D. Skar (Durham: Duke University Press, 2011); Matilde Zimmermann, Sandinista: Carlos Fonseca and the Nicaraguan Revolution (Durham: Duke University Press, 2001); Return to text.
  2. Quoted in Maxine Molyneux, “Mobilization Without Emancipation? Women’s Interests, the State, and Revolution in Nicaragua,” Feminist Studies 11, no. 2 (1985): 227-254. Return to text.
  3. On gender and the FSLN see Molyneux, “Mobilization Without Emancipation?”; Margaret Randall, Sandino’s Daughters: Testimonies of Nicaraguan Women in Struggle (New Brunswick, NJ: Rutgers University Press, 1981); Idem, Sandino’s Daughters Revisited: Feminism in Nicaragua (New Brunswick, NJ: Rutgers University Press, 1994). Return to text.

Cassia received her PhD in Latin American History with a Concentration in Gender Studies from the University of California, Los Angeles. Her book manuscript, titled A Miscarriage of Justice: Reproduction, Medicine, and the Law in Rio de Janeiro, Brazil (1890-1940), examines reproductive health in relation to legal and medical policy in turn-of-the-century Rio de Janeiro. Cassia’s research has been supported by the Woodrow Wilson Foundation, the Coordinating Council for Women in History, the Fulbright IIE, and the National Science Foundation.