Mexico City(CNN) Susana Dueñas Rocha was just 21 years old when she was sentenced to 30 years in prison. A court found her guilty of obtaining an abortion, a criminal offense in Mexico.
Rocha's throat dried and her eyes welled as she listened to the ruling in 2004 in Guanajuato, a state just north of Mexico City. Her mind kept racing: Why would no one believe her? She told everyone who would listen that she didn't have an abortion but a miscarriage.
Just months earlier, she had collapsed in a classroom at her university and was rushed to a hospital. She thought she was ill and didn't know she was pregnant, she said.
The doctor was suspicious -- and strongly opposed to abortion. He told her he felt that it was his moral duty to report her. Using a hospital form, he wrote a "confession" on behalf on Rocha that said she'd willingly "killed her unborn baby." The letter led to her imprisonment.
But after a tireless fight led by the legal charity Las Libres, Rocha was released in 2010, with the court citing a lack of sufficient evidence. She served seven years of her 30-year sentence. Today, she's 35 years old and a cleaner in a school in Guanajuato. Every day, she thinks about the other women she knows who remain behind bars for allegedly obtaining abortions.
"I know how hard it is for them," she said, perched on a seat in the Las Libres office in Guanajuato, dangling a keyring of Christ in her fingers. "I lived that hell. It's too much for me to even think about."
At the time of Rocha's imprisonment, the Catholic Church and anti-abortion activists held strong political and social influence in Mexico, just as they do today. Abortion remains illegal nationwide in all circumstances except rape, though in Mexico City, abortions were decriminalized a decade ago.
The numbers of women imprisoned for abortion vary, depending on which experts you speak to. GIRE, a Mexican human-rights based organization, says 4,000 women are in jail for abortion across Mexico. Others, including Las Libres, say their data shows that the numbers reach 10,000. The numbers are skewed in part because no official government data is collected.
But while the Catholic Church and anti-abortion groups certainly hold power, they have not been the lone driving force behind the country's anti-abortion laws.
From 2000 to 2014, Human Life International, a US-based anti-abortion organization, allocated $7.9 million in funds to support grassroots anti-abortion efforts in countries with some of the world's harshest abortion laws, including Mexico and El Salvador. The organization supports "pro-life activities," according to its own tax records.
"As long as one baby is aborted in the world or one person euthanized, we will continue to stand up for the dignity of the human person, made in the image and likeness of God," said Deborah Piroch, director of public relations for Human Life International.
The organization conducts mission trips in 100 countries, according to Piroch.
"The [trips] may comprise anything from national family planning to planning in an African parish community to chastity training at a Catholic school to training pro-life priests at a seminary in Latin America to hosting a pro-life conference in Asia," Piroch said. "Our work is diversified but focuses on pro-life training and tailored for the needs of the region."
Mexico is a major focus for anti-abortion campaigners, including Human Life International. With the group's financial support, at least 160 anti-abortion centers have been opened across the country and across Latin America.
Some of the activities the group supports in Mexico include lobbying politicians, hosting conferences, organizing protests and staging social media activism. It closely follows the efforts of foreign anti-abortion groups, occasionally going so far as to send US representatives to work alongside them.
Mary Alice Carter, executive director of Equity Forward, a US-based reproductive health care watchdog, said there is hypocrisy in how Human Life International operates.
"Anti-abortion organizations like HLI claim they don't want to see women punished for their reproductive decision but have spent decades funding groups and campaigns overseas that lead to the prosecution and imprisonment of women," she said. "It's nothing short of unconscionable that HLI continues to fund these efforts."
In a home at the edge of Guanajuato, Martha Patricia Mendez Manuel, 23, perches on the edge of her seat. In November 2017, Manuel had a miscarriage. The medical staff at the hospital at the time was suspicious. They asked her where she had gotten the abortion pills. How many did she take? Who helped her? "They called me a murderer while I was crying out for help," she said.
Later, the nurse brought Manuel the fetus, wrapped in a bloodied cloth. She told her to ask it for forgiveness and to kiss it. She then took Manuel to a room where new mothers and babies are held and told her to wait there until she was to be taken to the office of the Ministry of Health to be charged with homicide.
Manuel narrowly escaped prison due to a lack of evidence. But the experience left her with deep psychological scars, and she developed depression. She was also subjected to intense abuse and harassment in her town and was forced to leave her home and family behind to start fresh. "They called me 'the girl who killed her baby.' "
Manuel's experience reflects a common scenario for women in Mexico. A lack of reproductive care across the country has taken its toll on women, both physically and psychologically, with high rates of health complications, and even death, from unsafe abortions.
Human Life International is not the only US anti-abortion organization operating abroad to finance activism on the ground. US groups helped finance the lobby movement in Ireland as it battled abortion laws, for example. 40 Days for Life, a religious anti-abortion campaign that focuses on community outreach with anti-abortion campaigners, is in Kenya and Brazil, among other countries.
But as one of largest anti-abortion organizations in the United States, Human Life International has expanded its efforts over recent years, including in the Philippines, where abortion is strictly illegal.
Protests led by affiliated organizations in Mexico are common. Campaigners park vans outside hospital clinics and sometimes mislead women by claiming to be part of the hospital procedure, offering fake ultrasound scans as a tactic to get them to "rethink" an abortion. In July, anti-abortion protests got so out of hand that they led to the prevention of the opening of an abortion clinic in Mexico City.
Some pro-choice groups, such as GIRE and Fondo Maria, say Human Life International has also made multiple attempts to smear their work since 2008, publishing false reports aimed at discrediting their findings and research related to abortion access.
Additionally, pro-choice advocates in Mexico and El Salvador spoke of intimidation tactics by the opposition, including harassment and death threats. Increasingly, anti-abortion groups, such as Pro-Vida, identify women who they believe to have obtained an abortion and publish their names and addresses on the Internet.
Teresa Herrera, communications director for the global women's reproductive health charity Marie Stopes in Mexico City, recounted a 2015 incident when her colleague was kidnapped outside one of the group's health clinics.
She was driven around for an hour by a person who identified themselves as an anti-abortion activist. The person verbally abused her in an attempt to intimidate her for her work, but she was not physically harmed. Staff are now advised to not wear their uniforms outside clinics to avoid being identified.
Legally restricting abortion in Mexico does not prevent women from seeking the procedure. As of 2009, the rate of abortion in the country had increased by more than half since 1990, when it was 25 per 1,000 women. But to obtain an abortion remains a challenge.
If a woman in Mexico wants to obtain an abortion, she can either do so through illegal means or travel to Mexico City to undergo the procedure through efforts by organizations like Fondo Maria, which funds and supports women traveling to the capital for an abortion.
Women must take buses across the country overnight to do this. They are also forced to take time off work and miss out on money because they need to spend several days in Mexico City for the procedure and waiting time.
In Mexico City, there are at least two dozen public hospitals that perform free abortions in a city of 8.8 million. A 2018 Guttmacher Institute study found that women who sought abortions in Mexico City between 2013 and 2015 were from Mexico City (66%) or its surrounding metropolitan area (22%), while the remainder came from bordering states (7%) or the rest of Mexico (5%).
Whether a woman chooses to obtain an abortion or has a miscarriage or complication, the consequences under Mexican law can be grave.
In January, Dafne McPherson, a Mexican woman accused of murdering her newborn and found guilty in July 2016, was released after her conviction was overturned. An appeals court says the evidence was flimsy. McPherson told reporters after leaving jail, "the only thing I can say to other women who are in my situation is, never lose hope."