New UN Report Supports Reproductive Justice and Birth Justice

By Fallon Parker (July 13, 2021)

In April 2021, in the midst of the global COVID-19 pandemic, the United Nations Working Group on discrimination against women and girls released a report on “women’s and girl’s sexual and reproductive health rights in crisis.” The report encourages a “radical shift” in how States manage and address crises of sexual and reproductive health and recognizes "reproductive and birth justice" as a promising advocacy framework to ensure that laws and policies comply with international human rights standards.

The Working Group is composed of five independent experts appointed by the UN Human Rights Council who are charged with reporting on discrimination against women and girls throughout the world and identifying and promoting best practices to end discrimination and promote human rights. The report summarizes international standards recognizing that sexual and reproductive health rights are “an integral part of a number of civil and political rights that underpin the physical and mental integrity of individuals and their autonomy.” These rights include “the rights to life, liberty and security of person, freedom from torture and other cruel, inhuman or degrading treatment, privacy and respect for family life, as well as economic, social and cultural rights, such as the rights to health, education and work and the right to enjoy benefits of scientific progress, and the cross-cutting rights of non-discrimination and equality.” As a result, States have an immediate obligation ensure that sexual and reproductive health rights are realized and cannot refuse to legally provide reproductive health services for women or girls.

State obligations to ensure sexual and reproductive health rights become more critical during times of crisis. However, the report notes that the focus on “crisis” as a singular event or series of events fails to address the sexual and reproductive health crises that women and girls face every day as a result of gender inequality and gender based violence.

The report emphasizes that the sexual and reproductive health is systematically neglected because of a disregard for the dignity and autonomy of women and girls. Sexual and reproductive health is necessary in order to achieve equality in other areas of life, and States have an obligation to be better prepared for both sudden and long-term crises that jeopardize this human right.

The report describes several factors that exacerbate risks and threats to sexual and reproductive health. Discriminatory laws, policies, and practices, such as denial of access to forms of reproductive care and structural discrimination that results in violations of sexual and reproductive health rights, put the health and well-being of women and girls at risk. States’ failure to prioritize and fund sexual and reproductive health, before, during, and after times of crisis, leads to inadequate services and discrimination against women and girls as second class citizens. The report also emphasizes the importance of including women and girls in decision making around sexual and reproductive health and holding people, particularly men, accountable for violations to a person’s sexual and reproductive autonomy.

Furthermore, the report includes analysis of other identities women and girls face that put them at increased risk of violation of their sexual and reproductive health rights. These identities include young and adolescent girls, rural women and girls, women and girls with disabilities, migrant, refugee, and internally displaced women and girls, indigenous women and girls, Roma women and girls, and women and girls of African descent.

The report provides international human rights analysis which could be useful to integrate into legal and political reproductive justice advocacy within the United States. The report specifically denounces the criminalization and prosecution of individuals for abortions, miscarriages and stillbirths and “condemns reporting requirements that contribute to a ‘hospital to prison pipeline” for women who have had or who are suspected of having abortions.”  It also criticizes the mistreatment of pregnant women of African descent in health care settings and notes that “[r]acism within the health system can be intensified by widespread State policing and surveillance and mandatory reporting requirements in relation to suspicions of drug use and child abuse or neglect, which often deters pregnant women from seeking reproductive health care and undermines their trust in health service providers.” The report’s recommendations specifically endorse providing timely and accessible maternal health services “without surveillance and reporting requirements that violate individual privacy.”

Additional recommendations include addressing the “overmedicalization and paternalistic approach to sexual and reproductive health services,” and promoting midwifery and other forms of community based care for pregnancy and childbirth, and recommendations focusing on increasing telemedicine, mobile clinics, and investing in resilient physical infrastructure in order to ensure equal distribution of services and access for diverse and hard-to-reach populations. This is particularly relevant for U.S. advocates as President Biden attempts to negotiate an infrastructure package that includes priorities like healthcare and childcare.