The denial of access to contraceptives including emergency contraception
Restrictions on access to contraceptives and abortion threaten women’s fundamental human rights to life, health and equality. Every woman has the right to decide when and if she wants to have a child. Denied access to contraception, emergency contraception and safe abortion services is a clear example of institutional violence.
When States’ legislation, regulation and practice restrict access to basic sexual and reproductive health services, such as access to contraceptives or emergency contraception, they are violating basic human rights and incurring in institutional violence. Such restrictions have immediate and harmful effects on women’s health. According to the UN Committee Against Torture, this is a violation of the right of women to live free from emotional, physical and psychological torture. Human rights bodies have made clear that States have an affirmative duty to “―[t]ake appropriate legislative and administrative and other appropriate measures to prevent violations of human rights.” Furthermore, it is the obligation of the state to make adequate and appropriate remedies when human rights are being violated.
In accordance with international human rights standards sexual and reproductive health services must be available, accessible, acceptable and of good quality. To this end, States have an affirmative duty to ensure access to lawful sexual and reproductive health services and to prevent legal, social and regulatory barriers from infringing on women’s ability to access sexual and reproductive health care. States must exercise due diligence to prevent harm by third parties or entities, including monitoring and regulating the provision of reproductive healthcare in both public and private facilities, and are responsible for human rights violations resulting from their failure to oversee the provision of healthcare. When governments fail to comply with these international human rights standards and push women towards violent, discriminatory and dangerous situations for their health, they are endorsing institutional violence.
Lack and/or restrictive access to sexual and reproductive health services lead to unwanted pregnancies and unsafe abortions. Clandestine abortion clinics and providers have no incentive care about women’s health and lives when providing their illegal services. Through restrictive laws, or discriminatory practices, judges, doctors and health workers deny access to contraceptives and prevent women from making independent reproductive decisions in violation of women’s internationally recognized human rights.
Young people are a particularly vulnerable group when it comes to the denial to access to contraception and emergency contraception. Despite the recognition in the Convention on the Rights of the Child of the ―evolving capacities of adolescents to make decisions in matters affecting their lives, many States require parental consent in order for adolescents to access reproductive health information and services. Such requirements can deter adolescents from seeking necessary care because they believe their parents could learn that they are—or are considering becoming—sexually active.
- 222 million women have an unmet need for contraception, 50 million of which are under the age of 25.
- An estimated 7.4 million adolescent girls across Sub-Saharan Africa, South Central and Southeast Asia, Latin America and the Caribbean experience unwanted pregnancies per year, partly due to lack of access to contraceptives, where some of them see no other choice but to resort to unsafe abortions.
- Each year 22 million unsafe abortions lead to the death of an estimated 47,000 women and around 5 million women are admitted to hospital as a result of unsafe abortion every year.
- Every year 70 000 adolescent girls die from complications from pregnancy and childbirth.
Key figures by countries
Research conducted in Yemen, has found that few women are aware of their legal right to use contraception, and even fewer are in a position to make free and independent choices about their reproductive health. It is reported that in rural areas, provision of healthcare in general is very poor, including SRH healthcare, leading to very high rates of maternal mortality.
The Philippine Supreme Court approved a landmark Reproductive Health Law in 2012, clearing the way for the government to start giving thousands of families access to contraception. The law guarantees the country’s poorest women universal and free access to modern contraceptives at government health centers. It also requires public schools to provide reproductive health and sexuality education and affirms the obligation to provide humane and comprehensive post-abortion care.
In Honduras the Supreme Court has upheld the country’s absolute ban on emergency contraception, which would criminalize the sale, distribution, and use of the “morning-after pill” — imposing punishment for offenders equal to that of obtaining or performing an abortion, which in Honduras is completely restricted.
In Argentina, after decades of government opposition to the sale or use of contraceptives, including even condoms during the 1976-83 military dictatorship, the government in 2003 began to implement a national program to distribute certain contraceptives – like hormonal contraceptives and intrauterine devices (IUDs) – for free through the national health system. However, women continue to face multiple barriers in their access to family planning, including lack of accurate information, violence in the home, economic constraints and discriminatory laws.
Around the world:
While there have been significant anti-choice efforts to restrict access to emergency contraception worldwide and specifically in Central and Latin America — including in Argentina, Chile, Ecuador, and Peru— The Honduras’ ban is the most extensive so far. The extreme bans on emergency contraception have been widely recognized by international and regional human rights bodies, like the Inter-American Commission on Human Rights, as violations of a woman’s ability to exercise her fundamental human rights.
Access to emergency contraception can be a critical tool in preventing unwanted pregnancies — especially in countries where regular birth control can be difficult to obtain. Up to half of the sexually active young women in Guatemala, Honduras, Nicaragua, and El Salvador have experienced challenges obtaining modern contraceptives — a figure that is much higher for single women than married women and especially high among adolescent women The limited access to emergency contraception has resulted in high rates of clandestine abortions and increased incidence of teenage pregnancy, often the result of sexual violence and suicides among adolescent girls. The Inter American Commission on Human Rights emphasizes that States have the duty to eliminate all barriers of fact and law that impede women’s access to maternal health services they need, and keep in mind that restrictive laws tend to especially affect girls and women in poverty, low levels of education and living in rural areas.
In absolute figures, more than 220 million women have unmet need for family planning. The women affected are unable to decide freely on whether to have children or not, the number and timing of child bearing and are more at risk of contracting HIV/AIDS and other sexually transmitted infections. Lack of access to family planning services also increases the rate of abortions, including unsafe abortions. Of the estimated 80 million unwanted or unintended pregnancies each year, an estimated 45 million are terminated. Of these 45 million abortions, 22 million are unsafe with 40 percent done on women below 25 years of age. About 47000 women die every year from complications of unsafe abortion. The full responsibility of these preventable deaths lies within the governments.
 Basic Principles and Guidelines on the Right to a Remedy and Reparation for Victims of Gross Violations of International Human Rights Law and Serious Violations of International Humanitarian Law, http://www.ohchr.org/EN/ProfessionalInterest/Pages/RemedyAndReparation.aspx
 ICPD Beyond 2014 International Conference on Human Rights, http://www.ohchr.org/Documents/Issues/Women/WRGS/ICP_%20Beyond_2014_International_Thematic_Conference/Report_of_the_ICPD_Beyond_2014_International_Conference_on_Human_Rights.pdf
 United Nations. Millennium Development Goals Report, 2011, www.un.org/ millenniumgoals/11_MDG%20Report_EN.pdf.
 UNFPA Report, Adolescent Pregnancy: A review of the evidence, http://www.unfpa.org/sites/default/files/pub-pdf/ADOLESCENT%20PREGNANCY_UNFPA.pdf
 WHO, Unsafe abortion Global and regional estimates of the incidence of unsafe abortion and associated mortality http://whqlibdoc.who.int/publications/2011/9789241501118_eng.pdf
 UNFPA, Don’t forget the girls, http://www.unfpa.org/news/dont-forget-girls
 IPPF Qualitative research on legal barriers to young people’s access to sexual and reproductive health services, http://www.childrenslegalcentre.com/userfiles/file/ippf_coram_final_inception-report_eng_web.pdf
 Philippines Passes Reproductive Health Bill that Guarantees Access to Modern Contraceptives, http://www.reproductiverights.org/feature/philippines-passes-reproductive-health-law-birth-control
 Honduras upholds absolute ban on emergency contraception, http://www.rhmjournal.org.uk/news.php?newsID=1040
Argentina: Limits on Birth Control Threaten Human Rights, http://www.hrw.org/news/2005/06/15/argentina-limits-birth-control-threaten-human-rights
Patters of Violence Against Women in Latin America and the Caribbean http://www.cladem.org/pdf/Informe-Relatoria-de-Violencia-ing.pdf
 World Health Organization, Journal Paper. The Lancet: Anna Glasier, A Metin Gülmezoglu, George P Schmid, Claudia Garcia Moreno, Paul FA Van Look. “Sexual and reproductive health: a matter of life and death.” The Lancet Sexual and Reproductive Health Series, October 2006.