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Forced Pregnancy Testing: Blatant Discrimination and a Gross Violation of Human Rights

10:38 am in Uncategorized by RH Reality Check

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

Earlier this month, news spread of a Louisiana charter school’s policy that would have allowed faculty to force any student suspected of being pregnant to take a pregnancy test — and, if the test came back positive, to force her to go on home study.

Forced pregnancy testing in schools is a gross violation of young women’s fundamental human rights. Through legal advocacy, I have been working to get it recognized as such and outlawed — in Tanzania, Kenya, Uganda, in my home country of Nigeria, and in other countries in the African region where it occurs. It is a shock to see a practice I’ve come to associate with schools in the developing world being replicated in the United States.

I have seen the consequences firsthand, and they are devastating. In secondary school, the older sister of a classmate, who was a year ahead of us, was found to be pregnant and expelled by school administrators. We eventually learned that she was the victim of a rape which occurred in her home, but she was too terrified to tell anyone what had happened. As is the case with many victims of this injustice, no other schools would accept her. Her hopes for a better future were doomed.

In Tanzania, where nearly 44 percent of girls have either given birth or are pregnant by the age of 19, school administrators across the country force schoolgirls to undergo demeaning pregnancy tests often just before completing primary school — around the age of 11 — and with increasing, and random, frequency throughout secondary school. Some girls must strip to their underwear to reveal physical signs of pregnancy. Others are coerced into taking urine-based pregnancy tests. No one can refuse to be examined or tested.

The impact is staggering, long-lasting, and far-reaching. About 8,000 girls are expelled or drop out because of pregnancy in Tanzania every year. Too often families abandon their pregnant teen daughters, forcing them to live on the streets with their babies. Faced with the possibility of homelessness, some young women succumb to pressure from their families to seek financial support through early or arranged marriages. The impact of these violations to their rights to health, education, privacy, and freedom from discrimination ripples throughout young women’s lives. Many female leaders of human rights advocacy groups still remember, over twenty years later, how humiliating and disempowering it was to experience forced testing even though they did not turn out to be pregnant.

Government officials do next to nothing to improve the situation despite its epidemic proportions; nearly 60 percent of the country’s adolescents have sex before 18. And in a double standard that’s all too common in many places throughout the world, while young women are stigmatized and penalized for pregnancy, the men and boys involved are rarely identified and face few consequences for their role.

In the United States, the reaction to the news about the Louisiana charter school was swift. Under threat of a lawsuit by the ACLU, the school reversed course and amended its student pregnancy policy, which no longer includes the invasive forced pregnancy testing it initially announced. The revised policy now assures female students the opportunity to continue schooling on campus throughout pregnancy and the option for homeschooling. This is a just and appropriate result.

Nevertheless, the emergence of this idea in an American school should trouble anyone concerned with the protection of our fundamental constitutional and human rights. And it should serve as a reminder of the importance of guarding vigilantly against violations of these rights not just in the developing world, but also — sadly, it seems — in the U.S.

Addressing Obstetric Fistula: Towards a Just and Healthy Life for All

8:56 am in Uncategorized by RH Reality Check

Written by Kelly Castagnaro for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

This article is part of a series by RH Reality Check in collaboration with EngenderHealth, Guttmacher Institute, the International Women’s Health Coalition, the Fistula Foundation, the United Nations Population Fund (UNFPA), and the Campaign to End Fistula.  All articles in this series can be found at this link.

The series is being published during a time of renewed efforts by advocates and the public health community to increase U.S. international support for efforts to address obstetric fistula, a wholly preventable but debilitating and sometimes deadly condition caused most immediately by prolonged labor and too early or too frequent childbearing, but generally rooted in lack of access to health care and discrimination against women.  Fistula affects the lives of individual women, their children and families, and also grossly undermines women’s economic productivity and participation in society. The global public health community has called for comprehensive strategies both to prevent new cases and treat existing cases of fistula.  Congresswoman Carolyn Maloney (D-NY) will soon introduce legislation intended to support a comprehensive U.S. approach to fistula as part of a broader commitment to reducing maternal mortality and morbidity worldwide.

It has been said that in an unequal world, women are the most unequal among equals.  Obstetric fistula—a condition driven by a range of inequities in access to basic health services, nutrition, education and other basic elements— is a living example of this statement.

Obstetric fistula is a tear or hole in the birth canal through to the urinary tract and/or rectum and caused by obstructed labor; left untreated, women become incontinent and may uncontrollably leak urine and feces.  With more than two million women living with obstetric fistula and between 50,000 to 100,000 new cases each year, we must do more collectively to prevent and treat this condition.

This requires a focus on the human rights dimensions of public health problems. 

Whether by choice, persuasion or coercion, many girls in the developing world have had sex before their 15th birthdays, often without adequate information or protection from unintended pregnancy or sexually transmitted infections (STIs), including HIV. For example, an estimated 60 million women between the ages of 20 and 24 in developing countries were married before 18.  The Population Council estimates that this number will increase by 100 million over the next decade if current trends continue.

For girls, sexual initiation is more likely to occur in the context of sexual violence and forced marriage, both of which place them at high risk of pregnancy, and STIs, including  HIV.  In Ethiopia, for example, nearly 70 percent of young married girls are forced to have sex before they have begun to menstruate. Because their bodies are not fully developed and ready to bear children, these young girls are at high risk for injury and death during pregnancy and childbirth. In fact, complications from pregnancy and childbirth are the leading causes of death among girls between the ages of 15 and19 in the developing world.

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