In 1971, Rothman, a teacher and mother of four, founded with Carol Downer the Los Angeles Feminist Women's Health Center, which taught women how to perform their own cervical self-examinations and pregnancy tests.

They also popularized a procedure called menstrual extraction, which could be used as a method of early abortion.

parts she found in supermarkets, hardware stores, aquarium shops and her husband's biology lab,

María de Jesús González was a practical woman. A very poor single mother, the 28-year-old's home was a shack on a mountain near the town of Ocotal in Nicaragua. She made the best of it. The shack was spotless, the children scrubbed. She earned money by washing clothes in the river and making and selling tortillas.

That nowast quite enough to feed her four young children and her elderly mother, so every few months González caught a bus to Managua, the capital, and slaved for a week washing and ironing clothes. The pay was three times better, about £2.60 a day, and by staying with two aunts she cut her costs. She would return to her hamlet with a little nest-egg in her purse. She bought herself one treat - a pair of red shoes - but she would leave them with her family in Managua, as they were no good on the mountain trails she had to go up to get home.

During a visit to Managua in February she felt unwell and visited a hospital. The news was devastating. She was pregnant - and it was ectopic, meaning the foetus was growing outside the womb and not viable. The longer González remained pregnant, the greater the risk of rupture, haemorrhaging and death.

What González did next was - when you understand what life in Nicaragua is like these days - utterly rational. She walked out of the hospital, past the obstetrics and gynaecological ward, past the clinics and pharmacies lining the avenues, packed her bag, kissed her aunts goodbye, and caught a bus back to her village. She summoned two neighbouring women - traditional healers - and requested that they terminate the pregnancy in her shack. Without anaesthetic or proper instruments it was more akin to mutilation than surgery, but González insisted. The haemhorraging was intense, and the agony can only be imagined. It was in vain. Maria died. "We heard there was a lot of blood, a lot of pain," says Esperanza Zeledon, 52, one of the Managua aunts.
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Her children have been taken into care and her mother now lives alone. The only mementos of González's visits to her aunts in Managua are some clothes and the red shoes.

No one knows how many other women have died, or are going to die, as a result of the law. The Pope seemed to acknowledge an increased risk to women's health but Nicaragua's government has made no formal study of the law's impact. Women's rights organisations say their 82 documented deaths are the tip of the iceberg. The Pan-American Health Organisation estimates one woman per day suffers from an ectopic pregnancy, and that every two days a woman suffers a miscarriage from a molar pregnancy. That adds up to hundreds of obstetric emergencies per year.

Human Rights Watch, in a recent report titled Over Their Dead Bodies, cited one woman who urgently needed medical help, but was left untreated at a public hospital for two days because the foetus was still alive and so a therapeutic abortion would be illegal. Eventually she expelled the foetus on her own. "By then she was already in septic shock and died five days later," said the doctor.

Another woman, named Mariana, said she obtained a clandestine abortion because her pregnancy aggravated a permanent health condition. "I was very afraid. It was very traumatic not to be able to talk about it, because it is a crime. The abortion saved both me and the two children I already have." The report said the potentially most harmful impact was that girls and women were afraid of seeking treatment for pregnancy-related complications, especially haemorrhaging, in case they were accused of having induced an abortion.
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Inspector Martylee Ingram has the same, almost apologetic tone. She is discussing the harrowing case of an 11-year-old girl, Vera, who has been raped and is now 27 weeks pregnant. Asked if Vera should have the baby, she hesitates. The law says yes and her job is to enforce the law. The inspector shakes her head. "But me, as a woman and policewoman, I'd say no. I feel like she shouldn't have it. It's a baby having a baby. She might not survive."

Last month an assembly vote on whether to uphold the law was an emotional and boisterous affair with dozens of girls and women in the public gallery chanting in protest. Separated by just a sheet of glass, the two sides were a study in contrasts. One comprised mostly elderly men in suits, some of whom opened their speeches by saying "I am a Catholic". The other comprised mostly young women in jeans and T-shirts. "Shame, shame, shame on you all," shouted one teenager. "Daniel Ortega is a rapist," shouted another, a reference to allegations the politican raped his stepdaughter. (He was acquitted of all charges.)

Among the police officers keeping an eye on the protesters was a twentysomething woman with a slight bump beneath her blue uniform. She was four months pregnant and anxious, it turned out, because she had been diagnosed with toxic plasmosis, a bacterium that enters the bloodstream during pregnancy and can gravely damage the foetus. She watched the votes stack up in favour of the blanket ban and shook her head, but said nothing.

most . . . ideas about how to ban abortion in this country consist of something very similar to the Nicaraguan law which makes the physicians into criminals.

there is no such thing as an abortion to save the life of the mother,