Oregon South Dakota 2. Vermont Nebraska 3. Maryland Kansas 4. New Jersey Idaho 5. Hawaii Read More. Other Family Planning Policies and Resources Infertility treatments can increase the reproductive choices of women and men, but they are often prohibitively expensive, especially when they are not covered by insurance.
Read More See the Data. All Women 8. They must be informed and empowered to protect themselves from sexually transmitted infections. And when they decide to have children, women must have access to services that can help them have a fit pregnancy, safe delivery and healthy baby. Every individual has the right to make their own choices about their sexual and reproductive health.
UNFPA, together with a wide range of partners, works toward the goal of universal access to sexual and reproductive health and rights, including family planning.
UNFPA works to ensure sexual and reproductive health and rights remain at the very centre of development. The International Conference on Population and Development draws a clear connection between reproductive health, human rights and sustainable development. And because women bear children, and also often bear the responsibility for nurturing them, sexual and reproductive health and rights issues cannot be separated from gender equality.
Cumulatively, the denial of these rights exacerbates poverty and gender inequality. This is seen most acutely in developing countries, where reproductive health problems are a leading cause of ill health and death for women and girls of childbearing age. Impoverished women suffer disproportionately from unintended pregnancies, unsafe abortion, maternal death and disability , sexually transmitted infections STIs , gender-based violence , and other related problems.
Young people are also extremely vulnerable, often facing barriers to sexual and reproductive health information and care. Young people are disproportionately affected by HIV , for example, and every year millions of girls face unintended pregnancies , exposing them to risks during childbirth or unsafe abortions and interfering with their ability to go to school. More than a million people acquire an STI every single day. STIs can also cause pregnancy-related complications, including stillbirth, congenital infections, sepsis and neonatal death.
STIs like human papillomavirus HPV can lead to pelvic inflammatory disease, infertility and cervical cancer, a major killer of women. Reproductive health is a lifetime concern for both women and men, from infancy to old age. Evidence shows that reproductive health in any of these life stages has a profound effect on one's health later in life. UNFPA supports programmes tailored to the different challenges people face at different times in their lives, including comprehensive sexuality education , family planning , antenatal and safe delivery care , post-natal care, services to prevent sexually transmitted infections including HIV , and services facilitating early diagnosis and treatment of reproductive health illnesses including breast and cervical cancer.
To support reproductive health throughout the life cycle, services across a variety of sectors must be strengthened, from health and education systems to even transport systems — which are required to ensure health care is accessible. Rights to reproductive and sexual health include the right to life, liberty and the security of the person; the right to health care and information; and the right to non-discrimination in the allocation of resources to health services and in their availability and accessibility.
Of central importance are the rights to autonomy and privacy in making sexual and reproductive decisions, as well as the rights to informed consent and confidentiality in relation to health services. The paper is illustrated by issues that reflect systemic violation of the above rights in varied forms, including maternal mortality, lack of procedures for legal abortion, inadequate allocation of resources for family planning, coercive population programs, spousal consent to sterilization, and occupational discrimination of pregnant women.
The International Conference on Population and Development ICPD held in Cairo in marked the acceptance of a new paradigm in addressing human reproduction and health. For the first time, there was a clear focus on the needs of individuals and on the empowerment of women, and the emergence of an evolving discourse about the connection between human rights and health, linking new conceptions of health to the struggle for social justice and respect for human dignity.
The new attention to human rights in the ICPD marked a departure from the previous approach that treated women instrumentally, as tools through which to implement population programmes and policies.
The reproductive health and rights approach adopted at ICPD is premised on a view that values women intrinsically and is genuinely concerned about their health and well-being. The ICPD thus posits the human rights of women - their right to personal reproductive autonomy and to collective gender equality - as a primary principle in the development of reproductive health and population programs.
The meaning of these texts is illustrated through concrete examples of violations of the rights guaranteed thereunder, finding expression in country reports submitted within the monitoring mechanism of the Convention. The analysis is brought under two broad headings: personal autonomy, as derived from the right to liberty and including the right to life and to reproductive choice and informed consent; and gender equality as a component of social distributive justice in the allocation of resources.
The rights recognised in the ICPD are based in various international human rights treaties. The examples are taken from the reports of States Parties submitted in fulfilment of their obligations under the Convention, and considered by the Committee on the Elimination of Discrimination Against Women hereinafter - the CEDAW Committee at its 18th session in January It also took note of unofficial information provided independently by international and national non-governmental organizations - known as "shadow reports" - in accordance with the practice of the Committee, as of other human rights treaty bodies.
The issues presented in these materials include equality in the allocation of resources, the right to life, reproductive choice in relation to abortion and family planning, the right to informed consent, and equality before the law. Finally, the situation of women in vulnerable situations is given separate consideration.
I must stress that this paper is not intended in any way to single out the countries under discussion. In every society there exist multiple forms of violations of human rights. The presentation of the examples in this paper illustrates merely some of this diversity, and does not even exhaust the situation in the countries under consideration. The use of reports submitted to the CEDAW Committee shows how the reporting mechanism of the human rights treaties can serve to develop standards of human rights jurisprudence in international law and to sensitize us to the meaning of the rights guaranteed under the international instruments.
I must emphasise further that the views expressed in this paper are my own, and are in no way to be taken as an official statement of the CEDAW Committee as such. The Programme of Action adopted at the ICPD is a consensus document, the end product of a process of negotiation and compromise involving over States. A separate chapter addresses gender equality and empowerment of women, placing the eradication of sex discrimination as a priority objective of the international community in relation to policies and programs of population and development.
Reproductive health is defined in paragraph 7. The ICPD referred to the term "reproductive rights " as embracing "certain human rights that are already recognized in The human rights already recognized in "international human rights documents" include "the right of everyone to the enjoyment of the highest attainable standard of physical and mental health" as guaranteed by Article 12 of the International Covenant on Economic, Social and Cultural Rights ICESCR.
These include the right to life, the right to liberty and security of the person, and the right to privacy, to mention just a few. Reproductive rights, according to the ICPD, "rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health.
Reproductive rights, according to the ICPD, also include the right "to make decisions concerning reproduction free of discrimination, coercion and violence, as expressed in human rights documents.
Before proceeding to examine the Convention more closely, it is worth noting that a subsequent consensus document of the international community, that is, the Platform for Action of the Fourth World Conference on Women FWCW , held in Beijing in , reiterated the paradigm shift of the ICPD. The Beijing Declaration stated that "the explicit recognition and reaffirmation of the right of all women to control all aspects of their health, in particular their own fertility, is basic to their empowerment".
Both of these are consensus documents, expressing political will. As opposed to this, international human rights documents - treaties or conventions - are sources of international law , and as such are considered to be legally binding. In general, States Parties to the Convention undertake to pursue a policy of eliminating discrimination in all its forms, and to guarantee women the exercise and enjoyment of human rights and fundamental freedoms on a basis of equality with men.
It is composed of 23 expert members elected by States Parties from among their nationals and serving in their personal capacity.
The Committee may also make general recommendations based on the examination of reports and information received from the States Parties. Some of these general recommendations address formal matters, such as the reporting obligations of States Parties, while others are explications of substantive matters and constitute authoritative interpretations of the rights guaranteed under the Convention. As already mentioned, article 16 1 e of the Convention guarantees the right to decide on the number and spacing of children, but that is only one of the articles that address.
Article 12 is central. In addition to the aforementioned articles, the right of access to specific educational information and advice on family planning is guaranteed under article 10 h. And article 14 b specifies, in particular, the right of women in rural areas to have access to adequate health care facilities, including information, counselling and services in family planning.
Before examining concrete instances of violations of health-related rights, I would like to clarify the meaning of two key concepts: autonomy and discrimination.
Autonomy means the right of a woman to make decisions concerning her fertility and sexuality free of coercion and violence. Much turns on our understanding of coercion and violence. Key to this is the notion of choice. In health care contexts, the rights to informed consent and confidentiality are instrumental to ensuring free decision making by the client. These rights impose certain correlative duties upon health care providers and deliverers of services.
They are bound to disclose information of proposed treatments and their alternatives so as to obtain the informed consent of the client, and they must respect her right to refuse treatment. Likewise, they are bound to maintain secrecy so as to allow her to make private decisions without the interference of others whom she has not chosen to consult, and who might not have her best interests at heart. The right to autonomy in making health decisions in general, and sexual and reproductive decisions in particular, derives from the fundamental human right to liberty.
The word "autonomy" itself is not mentioned expressly in the Convention, but the value of autonomy is certainly implicit in the fundamental freedoms it guarantees to women, on a basis of equality with men.
Autonomy is intimately and intrinsically connected with many fundamental human rights, such as liberty, dignity, privacy, security of the person, and bodily integrity.
These form the basis for asserting rights to informed consent and confidentiality in relation to health services and health care. Women have the right to be fully informed of their options in health care, including likely benefits and potential adverse effects of proposed methods of treatment and available alternatives, including the option of refusing treatment.
One of the most eloquent explications of the meaning of "autonomy" is that of Isaiah Berlin in his essay, Two Concepts of Liberty. For Berlin "liberty" in the ordinary sense is a "negative" right to freedom, in that one is entitled to be free in certain areas from the interference of others. It is not merely freedom "from" but freedom "to".
I wish my life and decisions to depend on myself, not on external forces of whatever kind. I wish to be a subject, not an object; to be moved by reasons, by conscious purposes, which are my own, not causes which affect me, as it were, from outside.
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