Imposing Misery: The Impact of Manila's Contraception Ban on Women and Families
August 2007
Likhaan, ReproCen, and the Center for Reproductive Rights have released a report documenting the devastating impact of Manila’s contraception ban on women and their families. In 2000, the mayor of Manila, Jose "Lito" Atienza, issued an Executive Order (EO) "upholding natural family planning" and "discouraging the use of artificial methods of contraception like condoms, pills, intrauterine devices, surgical sterilization, and other [methods]." This sweeping EO, in effect, bans city health centers and hospitals from providing contraception to women in need of this essential reproductive health care service. Poor women are suffering the most under this ban.
The report, Imposing Misery: The Impact of Manila’s Contraception Ban on Women and Families, is based on a series of compelling interviews with women affected by the EO, government and health officials, and nongovernmental organizations. Its conclusions are clear: the EO harms the lives and health of women, as well as their families, by depriving them of the basic human right to make decisions about their own bodies and whether and when to have children. Further, the report establishes that the EO violates national and international law.
This report alerts the Manila City and national government to the violations resulting from the EO and issues recommendations to nullify the policy. Likhaan, ReproCen, and the Center for Reproductive Rights are working to ensure that Manila residents have easy and affordable access to a full range of family planning options, in accordance with the Philippines’ obligations under constitutional, national, and international law. In addition, these three organizations have called on the new mayor, Alfredo S. Lim, who took office this July, to revoke the ban.
UN Body Urges Action on Maternal Mortality in Nepal
June 2007
The U.N. body monitoring compliance with the International Covenant on Economic, Social and Cultural Rights (ICESCR) has urged the Nepalese government to take action to address its high rates of maternal mortality. In Nepal, a woman dies every 90 minutes in childbirth, making the country one of the most dangerous places in the world to give birth. To reduce the alarming maternal mortality rate, the Committee on Economic, Social and Cultural Rights (CESCR) advised the government to prioritize reproductive health care and contraceptives, especially in rural areas. The Committee also urged the government to adopt measures to enable women to give birth in the care of a trained health professional, a notable recommendation in a country where 80 percent of deliveries take place in the home and are most often attended by family members or neighbors.
The Center brought these violations of women's reproductive rights to the attention of Committee members through a shadow letter submitted prior to CESCR's review of the Nepalese government's periodic report. Our letter emphasized the catastrophic nature of maternal mortality; the impact of Nepal’s decade-long conflict on maternal health; the limited availability of effective and safe contraceptive methods; and the inequitable access to health services experienced by rural and poor women. The letter also drew the Committee's attention to the devastating impact of unsafe abortion, a leading cause of death and morbidity among pregnant women in Nepal. Abortion was legalized in 2002, yet women are still dying from unsafe abortion for many reasons, including the government's failure to crack down on illegal providers. We are disappointed that the Committee did not recognize the government's failure to ensure access to safe abortion services as a violation of the state’s obligation to protect the right to health under the ICESCR.
The Center applauds the Committee's attention to matters of grave importance to women’s health and lives. We will continue to push the Nepalese government to implement policies to improve the reproductive health of women and girls and better ensure their rights.
Center Cites Rights Violations in Death of HIV-Positive Woman Following Childbirth
June 2007
Gita Bai, a 30 year-old woman, died on April 2, 2007 when, because she was HIV-positive, doctors at a public hospital in India refused to assist her during childbirth. In response to the violations of Ms. Bai's human rights, the Center submitted a letter to the Human Rights Commission of the state of Madhya Pradesh in support of a petition filed by our partners, the MP Network of People Living with HIV/AIDS (MPNP+) and the Human Rights Law Network, MP Unit, Indore (HRLN, MP). The Center has requested that the Commission respond immediately to this case.
Ms. Bai was evicted from the M.Y. Hospital while in labor after the doctors learned of her HIV status. She subsequently gave birth in a vehicle on her way out of the hospital. When she attempted to re-enter the hospital after delivering her baby, the guards were ordered to block the doorway, thereby preventing her from receiving life-saving treatment. When she was finally admitted, two days later, she was denied crucial follow-up care, including nevirapine, a drug used to prevent maternal-infant HIV transmission. After three days of trauma and humiliation, Gita Bai succumbed to the most common causes of maternal death: sepsis and excessive bleeding.
Gita Bai's case is a stark example of the discrimination faced by people living with HIV/AIDS, and reveals the heightened vulnerability of women–especially pregnant women–to abuse and discrimination.
INDIA MUST PROTECT WOMEN'S HEALTH, UN BODY SAYS
March 2007
In an advanced version of its Concluding Observations released this month, the Committee monitoring compliance with the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) voiced concern about high maternal mortality rates, unsafe abortion, and inadequate obstetric and family planning services in India. Maternal mortality accounts for 15% of all deaths of women of reproductive age in that country. The Center called attention to these issues in a shadow letter submitted to Committee members, which highlighted violations of Indian women's sexual and reproductive rights.
Specifically, our letter pointed to the serious risk faced by adolescents and adult women of dying of pregnancy-related causes. It also emphasized lack of access to modern contraceptives, lack of awareness and education about HIV/AIDS, and the prevalence of harmful practices such as child marriage. Furthermore, our letter outlined disturbing evidence of coercion in family planning services as a result of state-level laws and policies that punish couples for having more than two children. A recent Supreme Court case that upheld one such coercive law—denying individuals with more than two children the right to hold or run for public office at the panchayat level—is a tragic example of the state's failure to comprehend the impact of widespread disregard for reproductive health and rights in India.
The Committee urged the Indian government to prioritize decreasing maternal mortality rates by establishing adequate obstetric delivery services and ensuring women access to health services, including safe abortion and comprehensive contraceptive services. The Committee also recommended that the Indian government provide detailed information about the impact of its programs to decrease maternal mortality and improve access to health care. The Center commends the CEDAW Committee for demonstrating its commitment to women's health and rights by raising these important issues and hopes the Indian government will take immediate steps to implement the Committee's recommendations.
CENTER FILES CASE AGAINST GOVERNMENT OF NEPAL
February 2007
On February 22, the Center for Reproductive Rights and our partner, The Forum for Women, Law, and Development in Katmandhu, filed a case in Nepal's Supreme Court to force Nepal’s government to protect women's lives. Five years ago Nepal legalized abortion. Yet, five years later, the right to abortion remains a right on paper only. According to the World Disasters Report, neo-natal and maternal mortality claim twenty-five times more lives each year than the lives claimed yearly in Nepal's decade-long conflict. Complications from unsafe abortion are estimated to account for 20 percent of maternal deaths in health facilities alone—not counting the women who never make it to a hospital. An abortion in a government hospital can cost more than the average monthly salary, and 80 percent of rural women are not even aware that abortion is legal. Women are still dying from unsafe abortion. Rural and poor women are the ones who suffer most.
Melissa Upreti, Legal Adviser for Asia at the Center for Reproductive Rights and a Nepali citizen, joined the fight for abortion rights in Nepal over a decade ago, and is a petitioner on the case. "By failing to ensure that this essential health service is affordable and available, the government is discriminating against women, because only women need abortion. We are asking the government to prove its commitment to women by making safe abortion available and affordable to all women," Upreti said.
A NEW REPORT NOW AVAILABLE FROM THE CENTER!
January 2007
Litigating Reproductive Rights: Using Public Interest Litigation and International Law to Promote Gender Justice in India > >
NEPAL DRAFT CONSTITUTION RECOGNIZING REPRODUCTIVE RIGHTS IS ADOPTED
December 2006
On December 16, 2006, Nepal's interim constitution was agreed upon by national political leaders. The interim constitution recognizes the right to reproductive health and other rights relating to reproduction as fundamental rights. This recognition constitutes a major political victory for women. It also marks the first time that a government in the region has explicitly recognized women's reproductive rights as fundamental rights in a national constitution. The Center is pleased that the constitution has been adopted. "If the government's own official estimates are correct, more women have died due to pregnancy in the last decade than men and women due to the armed conflict. Most of these deaths could have been prevented," said Melissa Upreti, Legal Adviser for Asia at the Center. "The recognition of women's reproductive rights as fundamental rights is a bold and timely step in the right direction."
The constitutional recognition of women's rights to reproductive health, freedom from violence and discrimination, equal property, and proportionate representation at all levels of government marks significant progress. The interim constitution will provide the starting point for a new constitution, which is expected to be completed by 2009. The Center and its partners will work to ensure that the current provisions are included in the new draft constitution and lobby for the recognition of pregnancy, marital status, gender, and age as prohibited grounds of discrimination. "This commitment must now be translated into reality through concrete policy measures," Upreti said. "The support of government officials, civil society and donors will be critical."
Upreti had submitted recommendations to the Interim Constitution Drafting Committee (ICDC) advocating for inclusion of reproductive rights in the text. Advocate Chhatra Gurung, a member of the ICDC and the Legal Aid and Consultancy Center, a long-time NGO partner, played an instrumental role in advancing the recommendations. Another long-time partner of the Center, the Forum for Women, Law and Development in Katmandu, gave strong support to the recognition of women's health rights in the drafting process.
Read Melissa Upreti's letter to the members of the Nepalese Interim Constitution Drafting Committee > >
BIG STEP FORWARD FOR NEPALESE WOMEN
December 2006
December 18, 2006, on the 27th anniversary of CEDAW, the Government of Nepal ratified CEDAW 's Optional Protocol. Now Nepali women have the power to bring claims of gender discrimination directly to the UN committee that monitors compliance with CEDAW. Women in Nepal experience many reproductive health problems due to discrimination, and the Center for Reproductive Rights would like to congratulate the Nepali government for empowering women to use the leading international women's rights mechanism to obtain justice when domestic remedies fail.
Discrimination impacts many aspects of women's reproductive lives in Nepal. The country has one of the highest maternal mortality rates in the world, with 740 women dying per 100,000 live births. Most women still do not use modern contraceptives. Child marriage is common, and HIV/AIDS is spreading fast.
The Nepali government's willingness to hold itself accountable to women and to international bodies such as CEDAW is admirable, and provides hope for the women of Nepal. Our partner, the Forum for Women Law and Development (FWLD), has played a major role in Nepal's ratification of the CEDAW Option Protocol by lobbying the government extensively. The Center is working closely with FWLD to develop strategic litigation on reproductive rights in Nepal.
CENTER SUPPORTS CASE ON BEHALF OF NEPALESE GIRLS
October 2006
The Center was recently invited to submit a memorandum in support of a case in Nepal that centers on a harmful traditional practice. The Nepalese practice of kumari pratha involves appointing a girl as young as two years old to assume the role of a "living goddess" until she attains puberty.
Separated from their parents, Kumaris adhere to strict religious rules and rituals that impose severe restrictions on their mobility, diet, access to health care and education. The practice also interferes with their rights to marry and establish families, as spouses of Kumaris are believed to suffer misfortune or die young. Our memorandum, which was submitted to Nepal's Supreme Court in October, argues that the practice represents an institutionalized form of discrimination against girls.
Many reproductive rights violations are rooted in harmful cultural practices and religious beliefs. The Center's memorandum to the Court demonstrates that under international human rights law, enjoyment of the right to cultural and religious freedom cannot be protected by governments at the expense of other basic human rights. On October 31, Nepal's Supreme Court heard the case and ordered the government to form a committee to investigate the harmful impact of the practice and offer recommendations for reform.
TRAINING LAWYERS IN INDIA AND NEPAL
September 2006
In August, the Center, in collaboration with our local partners, the Human Rights Law Network and the Forum for Women, Law and Development, conducted multi-day capacity building trainings for lawyers in India and Nepal. The trainings, the first of their kind in the region, provided information about international and comparative legal norms and jurisprudence. They are part of the Center’s long term strategy to build the capacities of regional legal organizations to do strategic reproductive rights litigation and engage with international mechanisms and national human rights bodies. Approximately forty lawyers traveled from various parts of India and Nepal to participate. By sharing information about successful legal approaches in different parts of the world, the Center works with local experts to develop creative legal strategies to address rights abuses. Based on positive feedback from participants, the Center will develop a more in-depth series of trainings in the region and support litigation initiatives.
CENTER SHADOW LETTERS SEE RESULTS AT UN
August 2006
The Center for Reproductive Rights submitted shadow letters to the 35th and 36th sessions of the Committee on the Elimination of Discrimination Against Women (CEDAW) highlighting violations of reproductive and sexual rights of women in Malaysia, China, and the Philippines. Delegations from these countries reported to the Committee on their efforts to fulfill treaty obligations under the Convention on the Elimination of Discrimination Against Women, a key UN treaty established to further women's right to nondiscrimination and gender equality. The Committee has since released its Concluding Observations, calling attention to several concerns the Center raised in its shadow letters.
- Philippines: The Center, in collaboration with NGO partners EnGendeRights, Reproductive Rights Resource Group-Philippines (3RG-Phils), and Health Development Initiatives Institute, prepared a shadow letter detailing numerous violations of the Convention resulting from arbitrary restrictions on modern methods of contraception including emergency contraceptive pills; criminal abortion laws; and abuses in post-abortion care facilities. One of the direst consequences of the government's failure to respect reproductive rights is the country's high rate of maternal mortality. In its Concluding Observations, the Committee urged the State party to take concrete measures to improve women's access to sexual and reproductive health services, in accordance with the Convention. Specifically, the Committee called on the Philippines government to make contraceptives more available and affordable and to provide comprehensive sex education to adolescents. The Committee recommended that the government consider removing provisions in abortion laws that punish women and instead provide access to quality services to reduce maternal mortality rates.
- China: Our shadow letter underlined many areas of concern, including: harmful effects of the one-child policy such as forced abortion, coerced sterilization, and increased trafficking and abduction of women; limited access to infertility treatment; maternal mortality; sex-selective abortions; and deficiencies in sex education. The Committee, through its Concluding Observations, expressed concern over rights violations ensuing from these practices. It advised the Chinese government to investigate and prosecute instances of forced sterilization and abortion and to strengthen and enforce existing laws outlawing sex-selective abortion and female infanticide.
- Malaysia: The Center's shadow letter commended Malaysian authorities for taking measurable steps to improve women's reproductive rights but stressed the areas in which the government does not fulfill its obligations under the Convention. Specifically, it pointed to the lack of equal access to basic reproductive health services and information, especially for vulnerable groups including adolescent girls and migrant and domestic workers. The letter also outlined the effects of Malaysia's restrictive abortion law, which forces women to undergo clandestine and unsafe abortions. Disappointingly, CEDAW's Concluding Observations failed to address core issues relating to reproductive rights and recommend government action in these areas.
UNITED NATIONS COMMITTEE ON THE ELIMINATION OF DISCRIMINATION AGAINST WOMEN (CEDAW) ADDRESSES SEXUAL AND REPRODUCTIVE RIGHTS IN THAILAND
On January 19, the Center submitted a shadow letter to the Committee on the Elimination of Discrimination against Women (CEDAW), highlighting issues affecting the reproductive health and lives of women in the Kingdom of Thailand. On February 3rd, the Committee issued concluding observations, highlighting the State’s responsibility to focus on and uphold women’s reproductive and sexual rights.
The Center's letter highlighted several concerns, including limited access to family planning; high incidence of unsafe abortion; vulnerability, especially of adolescent girls, to HIV/AIDS and other STIs; specific challenges facing rural and hill tribe women who experience relatively higher maternal mortality rates; and the government's failure to take legislative measures to address sexual violence, specifically marital rape.
In its Concluding Observations, the Committee pointed to many of the issues outlined in our letter. To address these problems, the Committee recommended that the Thai government make access to effective contraception available to all women in order to reduce the number of illegal abortions. The Committee advised that the government take steps to provide reproductive health education for women, men, and adolescents and to raise awareness about contraceptive protection, HIV/AIDS, responsible sexual behavior and male responsibility. The Committee also recommended that the Thai government amend the Penal code to address marital rape as a criminal offense. The Center hopes that the Thai Government, in response to the Committee’s recommendations, will take measures to improve the reproductive health of women and girls and better ensure their rights.
Read the letter > >
Women of the World – East and South East Asia
This report, a joint venture between the Center for Reproductive Rights, the Asian-Pacific Resource & Research Centre for Women (ARROW), and four NGO partners in East and Southeast Asia, provides an extensive compilation of laws and policies that influence women's reproductive health in five countries of the region – China, Malaysia, the Philippines, Thailand and Vietnam. It offers advocates and policymakers a broad view of women’s reproductive rights in these countries, and draws attention to specific issues that require legal and policy reform. It serves as a resource for those interested in advancing and protecting women's reproductive health and rights through legal advocacy, and ensuring that states comply with their obligations to respect, protect and fulfill women's reproductive rights under international law.
The report was published in December 2005. To order a copy, email publications@reprorights.org. You can also download the document in PDF format.
Also Available . . .
Women of the World: Laws and Policies Affecting their Reproductive Lives - South Asia
Our acclaimed Women of the World reports are a global series detailing local laws, policies and quality of life statistics as they relate to women's reproductive health and rights.
To order, please visit our online bookstore.
Asian women and girls face significant barriers to the enjoyment of their reproductive rights due to a range of historical, social, political, economic, cultural and modern legal factors.
Several Asian countries have maternal mortality rates that are amongst the highest in the world. There is a huge gap in the fulfillment of contraceptive need leading to alarmingly high rates of unwanted pregnancies. Some governments have responded to high fertility rates by enforcing stringent population policies, extensively limiting women’s control over their fertility. Social norms and practices such as son preference and early marriage have further compounded these problems, resulting in devastating consequences for women’s lives and health.
Find out more about our
Regional Partner Organizations in Asia.
Center Helps Facilitate Training Workshop in the Phillipines, December 2005
While in the Philippines, Center for Reproductive Rights President Nancy Northup and Pardiss Kebriaei, Center attorney, helped facilitate the "National Workshop on Sexual and Reproductive Health and Rights for Legal Advocates," a training for lawyers and advocates, cosponsored with local groups EnGendeRights and the Reproductive Rights Resource Group-Philippines. The training, took place in Quezon City, and brought together over 20 judges, lawyers, advocates, and public officials. It included sessions on rights-based approaches to reproductive health and rights; advocating with the CEDAW Committee, presented by the Chairperson of the Committee herself; various reproductive rights issues of concern in the Philippines; and legal advocacy strategies. Nancy Northup gave an overview of U.S. Supreme Court jurisprudence relating to sexual and reproductive health and rights, and Pardiss Kebriaei led a session on comparative jurisprudence relevant for the Philippines context.
Fourteen Nepalese Women Freed for Abortion-related Offenses; Others Continue to Languish in Prison
Nepalese and international reproductive rights advocates, including the Center for Reproductive Rights, are applauding King Gyanendra’s pardon of 12 women imprisoned for abortion-related offenses.
Statement from Nancy Northup, President, Center for Reproductive Rights, Responding to India Supreme Court Decision on Country's Sterilization Practices
The Center for Reproductive Rights is extremely pleased that the Indian Supreme Court is taking action against the illegal and coercive sterilization practices in its country, after concerned Indian nongovernmental organizations filed a petition against the government two years ago. The Court made a step in the right direction this week, by ordering state governments to regulate health-care providers who perform sterilization procedures and to compensate the relatives of victims who may die from botched operations. The Center now eagerly awaits the full decision of the Court scheduled to be issued in the next two to three months. This is an opportunity for the Court to formally acknowledge women’s reproductive rights as basic rights under the constitution and to retroactively punish negligent providers and compensate surviving victims.
China Turns One-Child Policy into Law
China's so-called "one-child" policy has been officially adopted as law. The shift marks an important change in China's approach to population control, as it brings the greater legal force of legislation into an arena that has been fraught with abuse and inconsistently applied features.
Regional Partner Organizations
