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Irish Law, “Conscience Clauses,” and Needless Death: Three Questions About Savita Halappanavar’s Death

1:36 pm in Uncategorized by RH Reality Check

Written by Editor-in-Chief Jodi Jacobson for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

See all our coverage of the tragic case of Savita Halappanavar here.

An Irish flag hangs against a blue sky

Could the tragic death of an Irish woman happen in the United States?

Last night, we reported on the unnecessary and tragic death of Savita Halappanavar, who entered an Irish hospital undergoing what turned out to be a miscarriage of a wanted pregnancy at 17 weeks, and was denied a life-saving abortion because, as she and her husband were told, Ireland is “a Catholic country.” Translation? Even a non-viable fetus, perhaps already dead but in any case absolutely certain not to survive, is more important than a woman’s life.

Numerous questions have arisen in the wake of this case.

One: Why did this happen? Doesn’t Ireland, a country with otherwise draconian abortion laws, allow abortion to save the life of the mother?

Two: Was there any doubt an abortion was necessary to save Savita’s life?

Three: Can this happen in the United States?

I’ll take these in turn.

The reason this happened is at once very simple and highly complex. It starts with Irish abortion law, and ends with the imposition of a misogynistic ideology on a woman literally begging for mercy from pain and for her own life as she pleaded with her doctors numerous times to perform an abortion on a fetus it was clear would not live.

Current Irish law on abortion is somewhat murky. The country’s laws, like those of most others, have shifted dramatically over the past two centuries, until in the mid-fifties abortion was made illegal in virtually all circumstances. The legal landscape changed again over 20 years ago when the Irish Supreme Court decided that women had a constitutional right to an abortion where there was “real and substantial risk” to the life of the mother. The Supreme Court decision came in response to the case of “X,” who, as a February 2012 article in the New York Times pointed out, was a 14-year-old girl prevented from leaving the country to have an abortion after she became pregnant from rape. After that decision, according to a Human Rights Watch (HRW) report:

 abortion [in Ireland remained] legally restricted in almost all circumstances, with potential penalties of penal servitude for life for both patients and service providers, except where the pregnant woman’s life is in danger.

In its 1992 decision, the Irish Supreme Court also required the government to clarify the conditions under which a legal abortion might take place.

Nonetheless, as we reported in December 2011, Human Rights Watch found that 20 years later:

Read the rest of this entry →

In Malawi, Banda’s Succession to Presidency Could Dramatically Improve Women’s Lives

12:48 pm in Uncategorized by RH Reality Check

Written by Jessica Mack for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

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Malawian President Bingu wa Mutharika died of a heart attack suddenly this month, enabling Vice President Joyce Banda to succeed the helm. This will almost certainly change – and perhaps save – the lives of millions of Malawian women.

Banda, the country’s first female Vice President and leader of the opposition party, had been embroiled in a political struggle for months as Bingu had tried to remove her. Bingu’s move to edge her out was part of his tightening grip overall, foreshadowing what could have been another stubborn and potentially bloody transfer of power after 2014 elections, and almost certainly not to Banda.

With all due respect to the late Bingu, his death opened a rare window for reform Malawi, and golden opportunity – especially for Malawi’s women. Joyce Banda is a widely-respected and heralded champion for women’s rights and health, and has never been shy to speak her mind about it.

Banda is Southern Africa’s first female head of state, and the continent’s second (after Liberia’s Ellen Johnson-Sirleaf). Isobel Coleman at the Center for Foreign Relations recently called her “a remarkable person who despite the odds, just might be able to put Malawi on a positive path,” as compared to her “disaster” of a predecessor. Banda left an abusive marriage as a young mother of three, and went on to found several small businesses and organizations for women before being elected to Parliament in 1999.

Read the rest of this entry →

Uganda: Pregnancy and Childbirth Mean Playing Russian Roulette With Women’s Lives

10:13 am in Uncategorized by RH Reality Check

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Written by Jessica Mack for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Sylvia Nalubowa’s surviving twin is two-and-a-half; Jennifer Anguko’s baby turned one this past winter. Both of their mothers died giving birth to them – they are orphans of maternal mortality, an epidemic that continues to plague Uganda as it does the rest of the developing world. But these babies are also children of history.

Their mothers have become the face of a landmark case in Uganda that seeks, for the first time, to assign blame to the government for the deaths of women in childbirth. Last March, Ugandan human rights groups joined families of the deceased to file Constitutional Petition 16, alleging that the Ugandan Government failed to protect the women’s constitutional rights to life and health by allowing them to die in ill-equipped and poorly managed public hospitals, or failing to provide them with basic maternal care.

“We are seeking a declaration that maternal deaths happening due to avoidable causes is a violation of the right to health,” said Primah Kwagala, a lawyer for the Centre for Health, Human Rights and Development (CEHURD), a lead petitioner of the case. “The government should own up and increase funding towards maternal Health, and fulfill the Abuja Declaration to give at least 15% of the annual budget to the Health Sector.”

One of the key complaints in the petition is the Government spends just one-quarter on maternal health of what it pledged to spend, per capita.

Each woman died of negligence, essentially, as do 1 in 35 Ugandan women during pregnancy or childbirth. From ill-equipped health workers untrained for obstetric emergencies to inaccessible clinics, birth control stock-outs, and unsafe abortions gone very wrong, women in Uganda are forced to play Russian Roulette with a failing health system.

The petition was filed in March and heard in October, garnering impressive and global attention from advocates and media around the world. It seemed a rare breakthrough in an endless news cycle that treats maternal deaths as sad, but inevitable.

“Maternal health has been overlooked, as people seem to look at it as the daily status quo. People do not know that they have a right to good health service provision; they think it is a privilege,” said Kwagala.

An objection was raised during the petitions hearing which derailed promising momentum, and which must first be ruled upon before the actual petition hearing can move forward. Since then, five months have elapsed and the global media has long since packed up. Read the rest of this entry →

United Nations Commission on the Status of Women Fails to Uphold Women’s Human Rights

12:31 pm in Uncategorized by RH Reality Check

Written by Alex Garita for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

The United Nations Commission on the Status of Women meets every year for two weeks to review progress on implementation of the Fourth World Conference on Women’s Beijing Platform for Action adopted in 1995. The theme of this year’s review was “The Empowerment of Rural Women and their role in poverty and hunger eradication, development and current challenges.” Other resolutions debated by the Commission included “Eliminating Maternal Mortality and Morbidity through the Empowerment of Women” and “Women and Girls and HIV/AIDS”.

This year marked the first time in history that the CSW did not produced “Agreed Conclusions” (the closest they ever came was in 2006 on Violence against Women but an agreement was reached the following week). The most contentious issues, not surprisingly, were related to  women’s access to comprehensive sexual and reproductive health care, including family planning, control over their sexuality and protection of their reproductive rights, comprehensive sexuality education, and eliminating harmful practices such as early and forced marriage, including child marriage.

At 1 am on Wednesday, March 14, negotiations among Member States of the United Nations broke down over the refusal by some countries to support actions that would urge governments to provide rural women with essential reproductive health care services and information. On one occasion, a representative even went so far as to state that “sexual and reproductive health has nothing to do with rural women” and that “what they need is economic opportunity and access to clean water.”

It’s truly shameful that this came from the government of a country where 65 percent of the population lives in rural areas, where women in those areas live on less than $1 a day, where complications during pregnancy and childbirth may likely leave them severely injured or even dead, and where women have one of the highest rates of HIV infection  in the world. Really, what they most need is sexual and reproductive health care. Maybe then we can start talking about what healthy women can actually do with their lives.

It is not uncommon that country diplomats based in the United Nations are completely disconnected from their countries’ realities, not to mention their health policies and programs which, at least on paper, are set to provide women with sexual and reproductive health services within primary health care. It is our responsibility- women’s and women’s organizations and all of our allies- to educate these diplomats as well as hold our governments accountable. A message to the world has been sent: the United Nations’ only political body which discusses women’s issues cannot agree on meeting their health needs and human rights. We must quickly act to make sure that this never happens again, and that the Member States of the United Nations are acting in accordance with its own principles: equality, non- discrimination, and human rights.

¡No Pasarán!

Using Special Powers, Brazil’s President Passes Law Requiring Compulsory Registration of All Pregnant Women

8:17 am in Uncategorized by RH Reality Check

Written by Beatriz Galli for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

In the dead of night on December 27, Brazilian President Dilma Rousseff enacted legislation that will require all pregnancies to be registered with the government. Provisionary Measure 557 (PM 557) created the National System of Registration, Vigilance and Monitoring Women’s Care during Pregnancy and Post Childbirth for the Prevention of Maternal Mortality (National Registration System).

She used a provisionary measure—intended only for urgent matters—that allows the president to pass a law without congressional approval. Congress only gets to debate and approve the law once it has been enacted. Rousseff claims that PM 557 will address Brazil’s high rates of maternal mortality by ensuring better access, coverage and quality of maternal health care, notably for high-risk pregnancies. Both public and private health providers must report all pregnancies—providing women’s names—with the National Registration System so the state can then track these pregnancies, from prenatal to postpartum care, presumably to evaluate and monitor health care provided.

How does simply monitoring pregnancies reduce maternal mortality? There is no guarantee that care will be available to all pregnant women and no investment in improving health services included in the legislation.

And what’s the benefit to women? PM 557 does authorize the federal government to provide financial support up to R$50.00 (roughly US$27) for registered pregnant women for their transportation to health facilities for pre-natal and delivery care. However, to receive the stipend women must comply with specific conditions set by the state related to pre-natal care. Let’s face it, that paltry sum may not even cover the roundtrip for one appointment depending on where a woman lives.

In fact, PM 557 does not guarantee access to health exams, timely diagnosis, providers trained in obstetric emergency care, or immediate transfers to better facilities. So while the legislation guarantees R$50.00 for transportation, it will not even ensure a pregnant woman will find a vacant bed when she is ready to give birth. And worse yet, it won’t minimize her risk of death during the process.

The biggest problem with maternal mortality in Brazil is not access to health-care services but rather the quality of health care in public health facilities. The majority of preventable maternal deaths actually take place in public hospitals, disproportionately affecting poor women, women who live in rural areas, youth and minorities.
Last but certainly not least, MP 557 violates all women’s right to privacy by creating compulsory registration to control and monitor her reproductive life. In fact, it places the rights of the fetus over the woman, effectively denying her reproductive autonomy. A woman will now be legally “obligated” to have all the children she conceives and she will be monitored by the State for this purpose.

It’s unclear why Rousseff sought to enact this legislation so quickly and with so little opportunity for debate or public opinion. What is clear though is that women’s real interests and health needs are not the focus here—just their uteruses.

Hormonal Contraception and HIV: Weighing the Evidence and Balancing the Risks

7:51 am in Uncategorized by RH Reality Check

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Written by Editor-in-Chief Jodi Jacobson for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

An article in yesterday’s New York Times by Pam Belluck suggesting that injectable contraceptive use might double the risk of HIV transmission among women and their partners sent a wave of anxiety through the global public health community. The story is based on a study conducted in Africa by Renee Heffron and her colleagues and published online this week in The Lancet. Heffron’s study suggests that HIV-negative women using injectable contraception might face a two-fold risk of acquiring HIV from their infected partners, and that HIV-positive women using injectable contraceptives may be twice as likely to pass the virus on to their uninfected partners.

The Heffron study also found that pregnancy doubled women’s risk of HIV infection, underscoring the complex interplay of sexual and reproductive health.

If the findings on injectable contraceptives are confirmed through further research, the implications are profound. Women make up 60 percent of those infected with HIV in sub-Saharan and are highly vulnerable to HIV infection for a range of economic, social, and biological reasons.  Women are simultaneously at high risk of death and disability from complications of pregnancy and unsafe of abortion.  Ending the spread of HIV, filling the unmet need for contraception, and preventing the large number of unintended pregnancies in Africa are critical and highly-intertwined global health goals which, if reached, would save millions of lives and dramatically improve prospects for women and children.

Remove injectable contraceptives from this mix and the picture becomes rather bleak.  “The injectable birth control shot has revolutionized women’s access to modern contraception in developing countries,” said Latanya Mapp Frett, Vice President-Global, of Planned Parenthood Federation of America. “This method allows women with infrequent access to health centers to prevent unintended pregnancy, thereby reducing rates of complicated pregnancies, unsafe abortion and maternal death. We need to seriously weigh the evidence before restricting women’s access to this life-saving resource.”

As the Times noted, the World Health Organization (WHO) plans to convene a meeting in January 2012 to review the Heffron study in light of existing evidence and examine the meaning of these findings for delivery of health services.

The possibility that one proven and highly effective health intervention–injectable hormonal contraception–is exacerbating another public health crisis is of course cause for deep concern, and raised reasonable questions among advocates as to why WHO would wait until January to convene a meeting on these issues, and whether distribution of injectable contraceptives should be halted immediately.

Experts say: “Not so fast.”

Public health and women’s rights experts are taking the study very seriously but also caution against drawing conclusions from the NYT story in part because it overstated or misrepresented some of the study’s findings while neglecting to mention several potential weaknesses. And because the stakes for women are so high, they also say it is important to take a step back and look at the broader range of evidence on this issue carefully, especially in an era when promotion of evidence-based public health interventions such as family planning and safer sex have become so politicized and misinformation spreads rapidly.

There appears to be consensus among public health experts on three basic steps:

1) Consider the effects of methodological weaknesses in the analysis and whether these may have influenced the conclusions.

2) Weigh this study against the existing evidence and conduct research specifically designed to examine these questions.

3) Balance the risks women face from both HIV and unintended pregnancy.

A discussion of each of these points follows:

1) Examine possible methodological weaknesses.

The Heffron study was originally designed to examine the effectiveness of the antiviral medication acyclovir in preventing HIV infection associated with Herpes simplex virus in both sero-discordant couples (in which one partner is HIV-positive and the other HIV-negative) and concordant couples (in which both partners have the same HIV status). It was not designed to examine the connections between hormonal contraceptives and HIV transmission. Findings on their initial research question were inconclusive so Heffron and her colleagues went back through their data to look for other outcomes including the association between hormonal contraception and HIV transmission.

While evaluating the kinds of data they collected for these outcomes is a highly complicated exercise, reviewers of the paper say the study that resulted is in several ways methodologically stronger than earlier studies examining these questions. The analysis also, however, contains weaknesses that could make the results less conclusive than initially appears to be the case and certainly less than the Times story suggested.

In a research note published in the same volume of the Lancet, Charlies Morrison and Kavita Nanda of the international health organization FHI 360, write:

The main strength of the study is that exposure to HIV was known. The study population consisted of HIV-serodiscordant couples, and analysis was limited to HIV infections genetically linked to the index partner. As such, the study was able to provide direct data on the risk of HIV-infected women using hormonal contraception transmitting the virus to their male partner. By contrast with many other studies, self-reported condom use was similar between hormonal and non-hormonal groups. Finally, the investigators used sophisticated analytical techniques and were able to adjust analyses for the plasma viral load of the infected partner.

However, they also note that:

[S]imilar to all observational studies, this study was open to aetiological pitfalls. Potential selection bias and confounding could have distorted interpretation. Furthermore, like all but two studies on this topic, this study was a secondary analysis of an HIV-prevention trial—not specifically designed to examine hormonal contraception and HIV risk. Few women used hormonal contraceptives (only 196.6 [11%] of the total person-years of follow-up were among hormonal-contraceptive users) and few HIV infections (ten for DMPA and three for oral contraceptives) occured for these users.

In selecting quotes, the Times article glazed over these and other possible limitations of the study, including the fact that contraceptive use was self-reported and not confirmed by the researchers through examination of clinical records.  Contraception was not provided in all 14 sites used in the study and therefore not consistent across them. Participants in the study often switched contraceptive methods: Almost half of the women who reported using hormonal contraceptives also used non-hormonal methods at some point, but switching was not taken into account in analyzing the data. All of these are methodological weaknesses that could skew the results.

The Times also over-stated the conclusiveness of findings on condom use.  Belluck, for example, wrote:

The researchers recorded condom use, essentially excluding the possibility that increased infection occurred because couples using contraceptives were less likely to use condoms.

This is not accurate. Condom use in the study was self-reported. It is very difficult to accurately measure condom use from self-reporting because people tend to overstate to researchers the consistency with which they use condoms (a well-known phenomenon), and there was no way to measure whether couples in the study reporting condom use actually used condoms during all sex acts, some sex acts and not others, or even consistently and correctly over the three-month period. The researchers did control for condom use but based on data that were not systematically collected to answer these questions.  Because of this, Morrison and Nanda note that the researchers’ “analytical adjustment for condom use might be insufficient.” A USAID expert, speaking off the record, suggested that while the findings of this study absolutely require further examination, the analysis of condom use alone was cause for “healthy skepticism” of whether the findings were conclusive.

Also not taken into consideration in the Heffron study and not reflected in the Times article were considerations such as whether women using injectable contraceptives had more frequent sex, which may have been their motivation in seeking out long-acting contraception in the first place. More frequent sex would mean more frequent exposure to unintended pregnancy and its potential complications, but also to HIV from an infected partner, especially in the absence of consistent and correct use of condoms or “dual protection” (contraception for pregnancy prevention and condom use for prevention of infection). Sexual coercion or lack of control over the timing and nature of sex may also leave women more vulnerable to unsafe sex, HIV infection, and unintended pregnancy, and might further confound the analysis.

2) Weigh the evidence.

Experts underscore that while this study should be taken seriously, it does not, according to Heather Boonstra, Senior Public Policy Associate at the Guttmacher Institute, “change the weight of the body of evidence to date, which currently suggests no relationships between hormonal contraception and HIV transmission or acquisition.”

In a guidance memo sent to field offices after the initial presentation of the Heffron study at an AIDS conference ealrier this year, USAID states:

Previous studies have examined these issues. Some found similar associations (including one of the largest studies on this topic); most have not found HC [hormonal contraception] to be associated with HIV acquisition or transmission in a general population. The new [Heffron] findings raise concerns, particularly since the analysis involved a large sample size of serodiscordant couples, used sophisticated statistical techniques, and may provide biological support by measuring viral shedding.

Still, continues the memo, “a cautious interpretation of the findings is justified as the scientific community gathers additional information. Like previous analyses, these findings were derived from observational data, which may be biased by self-selection.”

The memo concludes that because there is as yet insufficient information and analysis on the study and its implications, “USAID does not believe that a change in contraceptive policy or programming is appropriate or necessary at this time” and stated it will:

continue to offer a wide variety of contraceptive methods, and ensure that women and couples have access to a wide variety of contraceptive methods, are counseled about the known risks and benefits of those methods (including that all methods other than male and female condoms provide no protection from sexually transmitted infections (STIs), including HIV), and are able to select the method that best fits their individual needs.

The WHO meeting in January is intended to bring together a range of experts to look at this and previous data in as many as 12 other studies, and examine the body of evidence as a whole.

Virtually everyone agrees that carrying out systematic research examining as a primary question the possible connections between hormonal contraception and HIV infection should be a high priority.

3) Balance the Risks.

In the lives of women in sub-Saharan Africa, nothing involving sex and reproduction is “risk free.” In low-resources settings characterized by extremes of gender bias, the combined lack of consistent access to basic family planning methods, prenatal care, trained birth attendants and emergency obstetric care all make pregnancy a dangerous undertaking.  Lack of access to family planning to prevent unintended pregnancy and lack of access to safe abortion services mean millions of women each year suffer dire consequences trying to exert some control over their lives. Lack of control over sex and reproduction contribute to both high rates of unintended and unwanted pregnancies, and to high rates of HIV infections.

Injectable contraceptives are widely used in sub-Saharan Africa in large part because these methods give women control over whether and when to become pregnant. Approximately 12 million women between the ages of 15 and 49–six percent of all women in this age group–depend on this method.  If it is found that use of hormonal contraception does indeed increase the risk of acquriing or transmitting HIV infection, we are faced with the potential loss of a major public health intervention. Removing the method from the mix of options leaves women vulnerable to different but also dangerous risks from unintended pregnancy, which may also increase their risk of HIV infection, or unsafe abortion or both.

Irrespective of whether conclusions from the Heffron study stand up to further research and examination, there is are no easy answers.

Still, to some degree, some answers are already clear.

First, at the most basic level, it is critical to the health and lives of women and their families to expand, not reduce, access to essential family planning services, continue to improve the quality of services, and continue to underscore the critical nature of dual prevention strategies, via the use of effective methods of contraception combined with correct and consistent condom use, including both male and female condoms.  Expanding integrated family planning and HIV prevention services is also critical and can not be over-emphasized.  Unprotected sex can lead to both unintended pregnancy and to HIV infection. We know how to prevent both, but we must both invest in these services while ending the stigma associated with safer sex practices.

Second, we need to invest more in expanding the range of reproductive technologies.  “What the debate over this study underscores more than anything is the need for more methods that protect couples from both unintended pregnancy and HIV,” said Vanessa Cullins, MD, Vice President of Medical Affairs at PPFA. “Until these products are developed, women and their partners need better access to condoms; and they should not have their birth control taken away.”

Third, we must greatly expand efforts to promote and secure the rights of women, economically, socially, and culturally.  High rates of maternal mortality and illness, and high rates of HIV infection among women are but symptoms of the broader social illness rooted in gender discrimination, gender-based violence, and the lack of investment in health, education, and economic power of women and girls.  Only when women’s health needs are made a priority by every government everywhere, and when women can exercise their rights will we eradicate HIV and make maternal morality a very rare event.

Women’s Reproductive Rights Under Threat in Colombia

10:32 am in Uncategorized by RH Reality Check

Written by Hanna Hindstrom for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Cross-posted with permission from The Women’s News Network (WNN).

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At 11 years of age, Nina was raped by her stepfather. Traumatized and pregnant, she sought an abortion. But every doctor she met claimed conscientious objection and refused. She was forced to travel 35 miles to another city, where she eventually tracked down an obstetrician willing to help.

She was one of the lucky ones.

Despite a landmark ruling five years ago – when Colombia’s Constitutional Court decriminalized abortion in cases of rape, fetal abnormality or to save the mother’s life – less than 0.5 percent of procedures are carried out legally each year. Many doctors simply turn girls like Nina away.

There is endemic confusion about the status of the law, especially the rules for conscientious objection, coupled with a widespread reluctance to obey it. Unsafe abortion remains the third leading cause of maternal deaths in a country where, according to government figures, over 300,000 take place each year.

Upon its inception the law has been the target of an aggressive anti-choice campaign, led by conservative political forces and supported by the Catholic Church. These forces are now threatening to unravel the little progress made.

Since coming into office in 2009, the Procurador-General, Alejandro Ordonez – the official appointed to protect the constitution and promote human rights – has led a vociferous campaign to dismantle the legislation. Read the rest of this entry →

International Human Rights Court Says Governments Must Ensure Timely Access to Maternal Health Services

9:22 am in Uncategorized by RH Reality Check

Written by Editor-in-Chief Jodi Jacobson for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

In 2002, Alyne da Silva Pimentel, a 28-year-old Afro-Brazilian woman, died after being denied basic medical care to address complications in her pregnancy. Her death might be like any one of the other hundreds of thousands of women who die of complications of pregnancy or unsafe abortion each year worldwide, but for one thing: It was taken to court.

Maternal mortality in Brazil is high, especially for a country of its relative wealth and level of development. It is even higher among women who, like Alyne, are of Afro-descent, indigenous, and/or low-income. Alyne died of complications resulting from pregnancy after her local health center mis-diagnosed her symptoms and delayed the emergency care she needed to live.

On November 30, 2007, the Center for Reproductive Rights, with Brazilian partner Advocaci, filed Alyne da Silva Pimentel v. Brazil, brought the first ever maternal mortality case before the UN’s Committee on the Elimination of Discrimination Against Women (CEDAW). The Center’s petition argued that Brazil’s government violated Alyne’s rights to life, health, and legal redress, all of which are guaranteed both by Brazil’s constitution and international human rights treaties, including CEDAW. 

“Alyne’s story epitomizes Brazil’s violation of women’s human rights and failure to prevent women from dying of causes that, by the government’s own admission, are avoidable,” said Lilian Sepúlveda, the Center’s Legal Adviser for Latin America and the Caribbean. “We filed this case to demand that Brazil make the necessary reforms to its public health system—and save thousands of women’s lives.”

In its brief, the Center asked the Committee to require Brazil to compensate Alyne da Silva Pimentel’s surviving family, including her 9-year-old daughter, and make the reduction of maternal mortality a high priority, including by training providers, establishing and enforcing protocols, and improving care in vulnerable communities.

This week, the case was decided in a historic decision by CEDAW, establishing that governments have a human rights obligation to guarantee that all women in their countries—regardless of income or racial background—have access to timely, non-discriminatory, and appropriate maternal health services.

“Sadly,” said a statement from CRR, “Alyne’s story is one of thousands in Brazil, and all around the world, in which women are denied, and in some cases refused, basic quality medical care to address common pregnancy complications. And the countless lives lost unnecessarily as a result mean that today’s victory can only be regarded as bittersweet.”

Nonetheless, continued the statement, “today marks the beginning of a new era. Governments can no longer disregard the fundamental rights of women like Alyne without strict accountability. And while nothing can reverse Alyne’s fate, today’s decision means that Alyne’s mother and daughter will finally see justice served—and women worldwide will benefit from the ruling issued in her name.”

What Does US Policy Have to Do With Child Brides and Drought in Kenya?

10:34 am in Uncategorized by RH Reality Check

"Drought in Africa"

"Drought in Africa" by United Nations Photo on flickr

Written by Editor-in-Chief Jodi Jacobson for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

There’s a saying that if you are not part of the solution, then you are part of the problem. When it comes to news that Kenyan families, facing serious drought conditions and unable to feed their families, are now selling their young daughters off to buy food, the United States is a part of the problem.

A big part.

Why?

As we reported two weeks back, the GOP and Tea Party majorities in the United States House of Representative are hell-bent on re-imposing the Global Gag Rule on U.S. international family planning assistance in a back and forth on policy that rivals Wimbledon.  And, as we reported in December 2010, House Republicans banded together to kill the International Child Marriage Prevention Act for no apparent reason other than to be ornery and adhere to a baseless ideology. The act would have required the U.S. government to develop an integrated, strategic approach to combating child marriage by promoting the educational, health, economic, social, and legal empowerment of women and girls, using existing resources. As in revenue-neutral, one of the terms du-jour.

To top all of this off, Republican Congressmen Chris Smith (NJ), Joe Pitts (PA), and Mike Pence (IN) succeeded during the Bush Administration in forbidding the integration of family planning information and supplies into HIV and AIDS programs, though unprotected sex is the leading cause of HIV transmission and of course the cause of unintended pregnancy. This of course undermined cost savings in addressing the related problems of HIV infection and unintended pregnancy and also denied HIV-positive women in particular the right to decide whether or not to have another child. The United States Conference of Catholic Bishops was particularly incensed at the idea these women would have such power and so lobbied very hard against integration. Read the rest of this entry →

“You Are A Man. Why Are You Interested in Family Planning?”

7:32 am in Uncategorized by RH Reality Check

Written by Peter Belden for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

It happens frequently when I meet someone new.  We each say what work we do, and then he or she says, “You are a man.  Why are you interested in family planning?” 

This is a problem.  Most people perceive family planning and reproductive rights as women’s issues.  I think that is largely the fault of those of us who work in the field of family planning and reproductive rights. We talk primarily about the benefits this field has for women’s health and autonomy.  While these benefits are great, I believe that when we focus only on them, we fail explain to many audiences why they might also be interested in family planning and reproductive rights. 

Many men do, of course, care about family planning. They value the ability to plan when to become fathers. They want to be protected against sexually transmitted diseases, and they support the health and wellbeing of women.

However, it is no secret that many people–voters, leaders and politicians–are not particularly interested in women’s health and autonomy. … Read more