In Panchimalco, the annual Palms Festival includes a procession of the Virgin Mary through the town’s narrow streets, attracting people from all over the country who come to idolise her. Pregnant women in El Salvador face numerous challenges; the threat of the mosquito-borne illness, Zika, which has been linked to microcephaly in newborns; the constant threat of gang violence with one of the highest murder rates in the world; and increasing occurrences of rape.

Sanitation workers from the community health clinic in Santa Tecla fumigate houses, streets, sewers and schools against mosquitos as part of a government programme to fight mosquito-borne diseases such as Zika, dengue and chikungunya. The most serious threat to women’s reproductive rights, however, is the state’s ban on abortion. El Salvador is one of just six countries in the world – including Nicaragua, Chile, The Vatican, Malta and the Dominican Republic – where abortion is banned under any circumstances, and the only one which pursues and prosecutes women who have a termination.

‘Dios existe,’ (God exists) cries Maria Teresa Rivera as the supreme court annuls her conviction for the aggravated homicide of her prematurely-born infant. Rivera served four years of a 40-year sentence before a judge decided that a review of medical evidence did not show she intentionally killed her child. While in prison, Rivera was unable to see her other son, Oliver, whose photo she holds. Women face two to eight years in prison for miscarrying, but some face charges of aggravated murder, which has a 40-year minimum sentence.

A pro-life mural in a side street of the main highway from Chalatenango to San Salvador. Overtime, the majority of society has embraced the abortion ban but there is a proposed legal change on the horizon, which would allow abortion in the cases of rape, if the mother’s life or health is at risk, or if the foetus is unviable. The legislative assembly is expected to decide whether to push through the controversial bill to congress in the coming weeks.

Idalia Alverado Sanchez and her husband Alex await the arrival of their first child at the maternal waiting house in Planes de Renderos. The house helps women who come from areas without access to a nearby hospital to wait out the end of the pregnancies, so they can be close to a hospital and avoid complications.

Pregnant women line up to receive mosquito repellent at the maternal waiting house. A misunderstanding occurred and the women were told they would receive repellent and mosquito nets, although after receiving the repellent, the nets were loaded onto a truck and sent to local hospitals and maternal waiting houses. The repellent was provided by the World Food Programme with the support of the Canadian government, and the mosquito nets by the NGO Operación Benidicíon El Salvador.

Abigail Sanches waits to be examined. Doctors and nurses working in the public hospitals are trained to look out for signs of abortion and report any suspicious alterations to a woman’s uterus to the authorities. This provokes criminal charges that can lead to between six months to seven years in prison. Poorer women suffer the most as doctors in private hospitals are not required to make such reports.

Doctor María Isabel Rodríguez, director of Hospital Nacional de la Mujer in San Salvador, congratulates Brenda Molina, 34, on her newborn twins. The hospital held a press conference for the first babies born on Mother’s Day.

Families gather at the general cemetery to pay tribute to their mothers on Mother’s Day.

Norma Guttierez, 25, changes her two-month-old baby, also named Norma, who has microcephaly. Doctors believe this is due to Norma contracting Zika in her first trimester. She and her husband have already paid $120 (£92) for tests and medicine, even though they have two other young daughters and are quite poor. Norma was using a mosquito net while sleeping at night at their home in Santa Elena but cannot afford insect repellent. They are worried about baby Norma’s future.