International Human Rights Bodies on Unwanted Pregnancy and Abortion

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1 International Human Rights Bodies on Unwanted Pregnancy and Abortion Part 4 Country-Specific Treaty Monitoring Committee Concluding Observations, Universal Periodic Review Working Group recommendations, and recommendations by Special Rapporteurs, commissions, and courts Countries M Z COMPILATION OF CITATIONS JUNE 2014

2 Founded in 1973, Ipas is a global nongovernmental organization dedicated to ending preventable deaths and disabilities from unsafe abortion. Through local, national and global partnerships, Ipas works to ensure that women can obtain safe, respectful and comprehensive abortion care, including counseling and contraception to prevent future unintended pregnancies. At Ipas, we believe that: Every woman has a right to safe reproductive health choices, including safe abortion care. No woman should have to risk her life, her health, her fertility, her well-being or the well-being of her family because she lacks reproductive health care. Women everywhere must have the opportunity to determine their futures, care for their families and manage their fertility. Along with caring, committed health professionals and other colleagues worldwide, Ipas tackles this neglected public health problem head on in some of the world s poorest countries. While many international donors and governments have focused attention and resources elsewhere, we struggle against the fundamental social injustice that results in the deaths of so many women in the prime of their lives. Suggested citation: Ipas. June International Human Rights Bodies on Unwanted Pregnancy and Abortion Part Four: Treaty Monitoring Committee Concluding Observations, Universal Periodic Review Working Group recommendations, recommendations by Special Rapporteurs, Commissions, Courts-Countries M-Z. Chapel Hill, NC: Ipas Ipas. All rights reserved. IHRCOMPD-E14 Ipas P.O. Box 9990 Chapel Hill, NC USA ipas@ipas.org HR and abortion statements Part 4 Ipas June 2014/1

3 International Human Rights Bodies on Unwanted Pregnancy and Abortion Part 4 Treaty Monitoring Committee Concluding Observations, Universal Periodic Review Working Group recommendations, recommendations by Special Rapporteurs, Commissions, Courts Countries M-Z COMPILATION OF CITATIONS June 2014 HR and abortion statements Part 4 Ipas June 2014/2

4 Introduction Maternal mortality, unwanted pregnancy and abortion In the decades since the United Nations human rights system was established, human rights bodies have increasingly addressed issues that are important for women s and men s reproductive health. Though most human rights conventions (also known as treaties, covenants and pacts) do not directly mention unwanted pregnancy or abortion, the rights contained in these agreements are linked to reproductive health and rights, including abortion., Experts appointed by member nations of the UN to monitor State compliance known variously as Treaty Monitoring Committees, Special Procedures, Special Rapporteurs, and Commissioners have a mandate to provide guidance to States Parties on the conventions should be interpreted, to guide States on how to respect, protect and fulfill human rights. Documents issued by these human rights authorities give guidance to States Parties on how human rights which are indivisible and interrelated apply to areas such as reproductive health, including unwanted pregnancy and abortion. Treaty monitoring bodies including representatives of States themselves when they review one another s human rights records during Universal Periodic Reviews at the Human Rights Council have given recommendations in their General Comments, General Recommendations and Concluding Observations to States Parties on what governments must to do to ensure women s human rights when they experience unwanted pregnancies and unsafe abortion. These recommendations include amending laws that criminalize abortion in circumstances such as rape and danger to a woman s health and life, revising laws on abortion so that unsafe, illegal abortions no longer contribute to maternal mortality and morbidity, and withdrawing criminal penalties on women who undergo abortions. At the regional level, human rights conventions and commissions also address reproductive health,, in some cases with more explicit language. For example, the Protocol to the African Charter on Human and People s Rights on the Rights of Women in Africa explicitly grants women the right to legal abortion, as a part of the right to reproductive health. According to Professor Charles Ngwena, the Protocol has the potential to contribute toward transforming abortion law from a crime and punishment model to a reproductive health model that complements the objects of CEDAW and the broader philosophy of the International Conference on Population and Development (ICPD). While the UN conventions do not explicitly include abortion in their text, the guidance provided by the treaty monitoring bodies can move States toward the same end. With knowledge of how instruments are interpreted by human rights authorities advocates and policy makers can push governments accountable to respect, protect and fulfil women s reproductive rights. The documents can be cited in educational programs to inform individuals about their rights, in advocacy with government, through media, and in litigation at the national, regional and international level. This four-part series of documents aims information on interpretation of human rights treaties. It includes statements made in international and regional human rights conventions and by various human rights monitoring bodies that are relevant to addressing unwanted pregnancy and abortion. Part One cites relevant texts in conventions, statements and recommendations by UN human rights bodies and commissions. Part Two provides excerpts from treaties, statements and recommendations by regional human rights bodies. HR and abortion statements Part 4 Ipas June 2014/3

5 Parts Three and Four (this document) list human rights monitoring bodies recommendations and decisions with regard to specific countries (listed in alphabetical order). They also include recommendations made by Special Rapporteurs and in Working Group Reports on Universal Periodic Reviews at the United Nations Human Rights Council. ABBREVIATIONS African Commission on Human and Peoples' Rights (ACHPR) Convention on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT) Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) Convention on the Elimination of Racial Discrimination (CERD) Covenant on Economic, Social and Cultural Rights (CESCR) Convention on the Rights of the Child (CRC) Convention on the Rights of Persons with Disabilities (CRPD) European Court of Human Rights (ECHR) Human Rights Committee (Committee monitoring the Covenant on Civil and Political Rights, CCPR) Human Rights Council (HRC) Inter-American Commission on Human Rights (IAHCR) Universal Periodic Review (UPR, reports made to the Human Rights Council) HR and abortion statements Part 4 Ipas June 2014/4

6 MACEDONIA CEDAW Committee Concluding Observations, 2013 Paragraph 33: While noting the adoption of the National Strategy on Sexual and Reproductive Health and the low maternal mortality rate, the Committee remains concerned about the high rate of abortion and the low use, availability and accessibility of modern forms of contraception, which indicates that abortion continues to be used as a method of birth control. The Committee is also concerned about the financial, cultural and physical barriers to gynaecological services faced by Roma and rural women. The Committee is further concerned about the lack of education programmes on sexual and reproductive health and rights in schools, the lack of gender perspective in national HIV and other health policies, and the lack of sex-disaggregated data. Furthermore, the Committee regrets the lack of information on health and rehabilitation services available to women and girl drug users. Paragraph 34: The Committee urges the State party to: a) Take all measures necessary to improve women s access to quality health care and health-related services, within the framework of the Committee s general recommendation No. 24 (1999) on women and health; b) Raise awareness, through public education campaigns, education on sexual and reproductive health in schools and enhanced counselling services, about the importance of using contraceptives for family planning and increase efforts to provide adequate family planning services and affordable contraceptives; and c) Integrate a gender perspective in all health interventions and policies and collect and analyse sexdisaggregated data. CRC Committee Concluding Observations, 2010 Paragraph 58: The Committee notes that the safe motherhood program prioritises ensuring access to information and counselling on preventing adolescent pregnancies and abortion and the State party's plans to introduce sex education in schools. The Committee is, nevertheless, concerned about the high rate of teenage births and abortions, particularly among girls belonging to the Roma and other minority communities, that the availability of reproductive health care for adolescent girls has dropped significantly in rural areas, and that confidentiality is not respected. In addition, the Committee is concerned about the absence of prevention measures and rehabilitation services for children using drugs or alcohol. Paragraph 59: The Committee recommends that the State party: a) ensure that adolescents have access to age-appropriate and confidential counselling services and life skills training programmes in all regions and communities of the country; b) strengthen efforts to increase information and knowledge on reproductive health and rights in order to reduce the number of teenage pregnancies, and develop adolescent-friendly programmes to assist teenage mothers and their children; c) develop prevention measures and rehabilitation services for children abusing drugs and alcohol; d) take further measures, including the allocation of adequate human and financial resources to support the development of culturally- and adolescent-sensitive and confidential counselling, care and rehabilitation for children, taking into account the Committee s General Comment No. 4 on adolescent health and development (CRC/GC/2003/4, 2003). CEDAW Committee Concluding Observations, 2006 Paragraph 31: The Committee notes with concern that, although there has been a 20 per cent decrease in the rate of abortions since 1994, abortion continues to be used as a method of birth control. It is also concerned about the limited use of contraceptives. Paragraph 32: The Committee recommends that the State party implement programmes and policies aimed at providing effective access for women to contraceptives and health-care information and services, thus avoiding the need for women to resort to abortion as a method of birth control. The Committee urges the State party to implement programmes of sexual and reproductive health education for women, men and adolescents in order to foster responsible sexual behaviour, and to further discourage abortion as a method of birth control. HR and abortion statements Part 4 Ipas June 2014/5

7 MADAGASCAR CEDAW Committee Concluding Observations, 2008 Paragraph 30: While welcoming the increase in the health budget for 2009, as indicated by the State party during its dialogue with the Committee, the Committee remains concerned about women s limited access to adequate and good quality health-care services, especially in rural areas. It is particularly concerned about the high maternal and infant mortality rates, resulting from, inter alia, lack of appropriate care as well as lack of utilization of existing services during pregnancy and childbirth, the limited access to adequate sexual and reproductive health services for women, especially for women in rural areas, early marriage and clandestine abortions. Paragraph 31: The Committee recommends that the State party take measures to improve women s access to health care, especially emergency obstetric care and health-related services and information, in accordance with article 12 of the Convention and the Committee s general recommendation No. 24 on women and health. It calls on the State party to improve the availability of sexual and reproductive health services, including family planning, with the aim of preventing early pregnancies and clandestine abortions. It encourages the State party to enhance all health services, especially for rural women. The Committee requests the State party to provide in its next report detailed information on measures taken to improve women s access to health-related services and information, including in regard to sexual and reproductive health and family planning, and the impact of these measures. CCPR Concluding Observations, 2007 Paragraph 14: The Committee is concerned about the law on abortion, especially in cases where the life of the mother is in danger (art. 6). The State party should amend its legislation to help women avoid unwanted pregnancies and recourse to clandestine abortion at the risk of their lives. It should also consider amending its legislation on abortion so as to bring it into line with the Covenant. MALAWI CEDAW Committee Concluding Observations, 2010 Paragraph 36: The Committee reiterates its previous concern about the high incidence of maternal mortality, particularly the number of deaths resulting from unsafe abortions. The Committee regrets that maternal health policies do not include sufficient attention to complications arising from unsafe abortion. Paragraph 37: The Committee calls on the State party to put measures in place to reduce maternal mortality by identifying and addressing causes of maternal death. The Committee further recommends that the State party review the laws relating to abortion with a view to removing the punitive provisions imposed on women who undergo an abortion, providing them with access to quality services for the management of complications arising from unsafe abortion and reducing maternal mortality rates, in accordance with the Committee s general recommendation No. 24. Report of the Working Group on the UPR, 2010 Paragraph : Intensify measures to address the problems of maternal mortality and unsafe abortions, reviewing punitive provisions regarding the latter (Austria); CRC Committee Concluding Observations, 2009 Paragraph 53: The Committee notes with appreciation the improvements made in the area of adolescent reproductive health and voluntary counselling and testing for HIV/AIDS. However, the Committee notes with concern the high levels of early pregnancy in the State party and unsafe abortions and STIs. Paragraph 54: The Committee recommends that the State party, taking into account the Committee s general comment No.4 (CRC/GC/2003/4) on adolescent health and development in the context of the Convention on the Rights of the Child, increase its efforts to establish more child-friendly programmes and services in the area of adolescent health and to obtain valid data on adolescent health concerns through, inter alia, studies on this issue. CEDAW Committee Concluding Observations, 2006 HR and abortion statements Part 4 Ipas June 2014/6

8 Paragraph 31: The Committee is alarmed at the persistent high maternal mortality rate, particularly the number of deaths resulting from unsafe abortions, high fertility rates and inadequate family planning services, especially in rural areas, low rates of contraceptive use and lack of sex education. Paragraph 32: The Committee urges the State party to continue its efforts to improve the country s health infrastructure and to ensure sufficient budgetary allocations for accessible health services. It calls on the State party to integrate a gender perspective in all health sector reforms, while also ensuring that women s sexual and reproductive health needs are adequately addressed. In particular, the Committee recommends that the State party undertake appropriate measures to improve women s access to health care and healthrelated services and information, including access for women who live in rural areas. It calls upon the State party to improve the availability of sexual and reproductive health services, including family planning information and services, as well as access to antenatal, post-natal and obstetric services to reduce maternal mortality and to achieve the Millennium Development Goal to reduce maternal mortality. It encourages the State party to seek technical support from the United Nations Population Fund in these areas. MALDIVES CRC Committee Concluding Observations, 2007 Paragraph 42: The Committee notes with concern reports suggesting that the strong social condemnation of pregnancies out of wedlock has led to abortions in unhygienic conditions and to an increasing degree to infanticide. Paragraph 43: The Committee recommends that the State party seek to fully implement article 6 of the Convention and take measures to prevent and discourage infanticide and protect infants born out of wedlock, including by supporting their mothers. In this regard, the Committee further recommends the introduction of education and awareness raising programmes to eliminate any negative consequences arising from pregnancies out of wedlock and to change societal attitudes. MALI CEDAW Committee Concluding Observations, 2006 Paragraph 33: While noting the considerable efforts made by the State party in the area of antenatal, postpartum and obstetric care, including the ten-year health and social development plan (1997), the Committee is concerned about the high maternal and infant mortality and morbidity, resulting from, inter alia, lack of appropriate care as well as lack of utilization of existing services during pregnancy and childbirth, the limited access to adequate sexual and reproductive health services for women, especially women in rural areas, female genital mutilation, the low level of education, early marriage and unsafe abortions. The Committee is concerned about the unmet demand for family planning services and the low level of contraceptive use. The Committee is also concerned at the scant information provided about women and HIV/AIDS. Paragraph 34: The Committee recommends that the State party intensify its efforts to take holistic, intersectoral measures to improve women s access to a wide range of health-care services, especially to emergency obstetric care and health-related services, and to information, in accordance with article 12 of the Convention and the Committee s general recommendation 24 on women and health. It calls upon the State party to improve the availability of sexual and reproductive health services, including family planning, also with the aim of preventing early pregnancies and clandestine abortions. It encourages the State party to enhance such services, especially for rural women. The Committee further urges the State party to study the behavioural patterns of communities, and of women in particular, that inhibit their utilization of existing services and to take appropriate action. The Committee requests the State party to provide, in its next report, detailed statistical and analytical information on the results of measures taken to improve women s access to health-related services and information, including in regard to sexual and reproductive health and family planning, and the impact of these measures. It also calls on the State party to ensure the effective implementation of its HIV/AIDS strategies and to provide detailed statistical and analytical information about women and HIV/AIDS in its next periodic report. CCPR Concluding Observations, 2003 Paragraph 14: While noting the considerable efforts made by the State party, the Committee remains HR and abortion statements Part 4 Ipas June 2014/7

9 concerned by the high maternal and infant mortality rate in Mali, due in particular to the relative inaccessibility of health and family planning services, the poor quality of health care provided, the low educational level and the practice of clandestine abortions (article 6 of the Covenant).So as to guarantee the right to life, the State party should strengthen its efforts in that regard, in particular in ensuring the accessibility of health services, including emergency obstetric care. The State party should ensure that its health workers receive adequate training. It should help women avoid unwanted pregnancies, including by strengthening its family planning and sex education programmes, and ensure that they are not forced to undergo clandestine abortions, which endanger their lives. In particular, attention should be given to the effect on women's health of the restrictive abortion law. MALTA CRC Committee Concluding Observations, 2013 Paragraph 49: The Committee is concerned that unplanned adolescent pregnancies continue to be a significant problem in the State party. Furthermore, the Committee is gravely concerned that abortion is illegal in all cases and with no exception under the law of the State party and that girls and women who choose to undergo abortion are subject to imprisonment. In this context, the Committee is also concerned at this frequently resulting in girls and women in these situations seeking risky illegal abortions. Paragraph 50: Referring to its general comment No. 4 on adolescent health (CRC/GC/2003/4), the Committee recommends that the State party: a) Develop and implement a policy which addresses the issues faced by adolescent mothers and protects them and their children from discrimination and violations of their rights; and in so doing, pay particular attention to ensuring that pregnant adolescents and adolescent mothers are supported and assisted in continuing their education; and b) Review its legislation concerning abortion, and consider including specific exceptions which allow for abortions with appropriate counselling and aftercare when this is in the best interests of the pregnant adolescent. CEDAW Committee Concluding Observations, 2010 Paragraph 34: While noting the free access to health care, the Committee is concerned about the insufficient access to reproductive health-care services for women. The Committee notes with concern that education on sexual and reproductive health and rights is not part of the curriculum. The Committee is further concerned that abortion is illegal in all cases under the law of the State party and that women who choose to undergo abortion are subject to imprisonment. The Committee further regrets that the data provided by the State party on the health and health care, including mental health care, of its population in its periodic report was not disaggregated by sex. Paragraph 35: The Committee calls on the State party to increase its efforts to improve the availability of sexual and reproductive health services, including family planning, to mobilize resources for that purpose and to monitor the actual access to those services by women. It further recommends that the National Policy on Sexual Health, which is being finalized, ensure that family planning and reproductive health education are widely promoted and targeted at girls and boys, with special attention to the prevention of early pregnancies of underage girls including the control of sexually transmitted diseases and HIV/AIDS. The Committee urges the State party to review its legislation on abortion and consider exceptions to the general prohibition of abortion for cases of therapeutic abortion and when the pregnancy is the result of rape or incest. It further urges the State party to remove from its legislation the punitive provisions for women who undergo abortion, in line with the Committee s general recommendation No. 24 (1999) on women and health and the Beijing Declaration and Platform for Action. The Committee also requests the State party to provide, in its next report, sex-disaggregated data on health and the provision of health care, including mental health care. Report of the Working Group on the UPR and responses to the report, 2009 Paragraph 38: On reproductive rights, the delegation stated that the right to life is an inherent right of every human being and Malta believes this includes the unborn child, from its conception. Abortion is a direct contradiction to the right to life. According to the International Conference on Population and Development, in no case should abortion be promoted as a method of family planning. Malta agreed that HR and abortion statements Part 4 Ipas June 2014/8

10 action towards the fulfilment of sexual and reproductive rights should focus on the positive aspects of education, social welfare and health care. Paragraph 67: Slovenia noted that Malta is party to most core human rights documents, but ratified CEDAW with reservations. While commending legal efforts undertaken since ratification of the Convention, Slovenia asked if Malta intended to review and withdraw the reservations to articles 11, 14, 15 and 16 and recommended it (a) do so. It also recommended (b) ratification of the CEDAW-OP and the CRC-OP. Bearing in mind its constitutional and legal framework and its strong position on abortion, Slovenia suggested Malta consider reviewing its legislation and that exceptions be made to the general prohibition in cases of rape, incest and therapeutic abortion. Views expressed by the State under review on the recommendations and/or conclusions as well as on its voluntary commitments and on the outcome Paragraph 317: Malta would also retain its reservations to articles 11 and 16 of the Convention on the Elimination of All Forms of Discrimination against Women. The delegation reiterated Malta s position that the right to life was an inherent right of every human being, including the unborn child from its conception. It would thus retain existing national legislation on abortion. On the question of legislating to recognize the relationship between two partners irrespective of their sex, Malta believed that this was a matter of national competence. CESCR Committee Concluding Observations, 2004 Paragraphs 23 and 24: The Committee observes with concern that abortion is illegal in all cases under the law of the State party. The Committee is concerned at the lack of sexual and reproductive health-care services in the State party. Paragraphs 41 and 42: The Committee urges the State party to review its legislation on abortion and consider exceptions to the general prohibition of abortion for cases of therapeutic abortion and when the pregnancy is the result of rape or incest. The Committee recommends that the State party strengthen education programmes on sexual and reproductive health and support sexual and reproductive health services. MAURITIUS CEDAW Committee Concluding Observations, 2011 Paragraph 32: While welcoming the State party s efforts to include education on sexual and reproductive health and rights at both primary and secondary school levels, the enactment of the HIV and AIDS Act (2006), and the Criminal Code Amendment Bill which seeks to revise section 235 of the Criminal Code on abortion, the Committee reiterates its deep concern about the prevalence of teenage pregnancies in the country, which leads to unsafe abortions among girls and women. The Committee is also concerned about the maintenance of the provision in the Criminal Code criminalizing abortion, despite its previous concluding observations, and about punitive measures faced by women and girls if they pursue an abortion. The Committee is deeply concerned about the prevalence of clandestine abortions and the ensuing high rate of health complications among women and girls. The Committee is also concerned about the vulnerability of sex workers to contraction and transmission of HIV/AIDS and other sexually transmitted diseases. Paragraph 33: In line with its previous concluding observations (CEDAW/C/MAR/CO/5, para. 31) and its general recommendation No. 24 (1999) on women and health, the Committee calls upon the State party to: a) Expedite the enactment of the Criminal Code Bill which seeks to amend section 235 of the Criminal Code on abortion in order to remove punitive measures imposed on women who undergo abortion and decriminalize abortion under certain conditions specifically when pregnancy is harmful to the mother s life and health, and also in cases of rape and incest; hasten the consultation process with the relevant stakeholders while ensuring that women are included in this consultation; b) Accelerate its efforts in raising awareness among pregnant teenagers and their families about the serious health risks of clandestine abortions; c) Ensure the provision of skilled medical aid and access to health facilities for women and girls HR and abortion statements Part 4 Ipas June 2014/9

11 suffering from health complications due to unsafe abortions; d) Provide age-disaggregated data on abortion health complications due to unsafe abortions, teenage pregnancies, and also provide sex-disaggregated data on HIV/AIDS; e) Ensure provision of effective and age-appropriate education on sexual and reproductive health and rights at all school levels and incorporate it in the school curricula, in order to combat teenage pregnancies and inform youth about the high risks associated with unsafe sex; f) Provide medical check-ups and contraceptives and also develop counselling programmes and provide vocational training aimed at availing sex workers with options to leave the sex trade; and g) Adopt all measures to implement the national plan to combat HIV/AIDS, and update the Committee in its next periodic report on all measures adopted, and their impact on achieving the stated aims. CESCR Committee Concluding Observations, 2010 Paragraph 25: The Committee is concerned that abortion is criminalized in all settings, including when the mother s life is at risk, and when the pregnancy is the result of rape. It is further concerned by the failure of the State party to provide exact information on sexual and reproductive health services and education. (art 10 and 12) The Committee recommends that the State party amend section 235 of the criminal code in order to allow for abortion in cases of therapeutic abortion and when pregnancy is result of rape or incest. It further recommends that the State party make sexual and reproductive health services widely available, and mainstream sexual and reproductive health education in schools. CEDAW Committee Concluding Observations, 2006 Paragraph 30: The Committee is concerned about the rising incidence of teenage pregnancy and its implications for the health and education of girls. The Committee is also concerned that abortion is criminalized in all circumstances. The Committee is further concerned about the increasing HIV/AIDS infection rates of women. Paragraph 31: The Committee urges the State party to step up the provision of family planning information and services to women and girls, in particular regarding reproductive health and affordable contraceptive methods, and to promote widely sex education targeted at girls and boys, with special attention to the prevention of teenage pregnancy. The Committee recommends that the State party consider reviewing the law relating to abortion for unwanted pregnancies with a view to removing punitive provisions imposed on women who undergo abortion, in line with the Committee s general recommendation 24, on women and health, and the Beijing Declaration and Platform for Action. The Committee urges the State party to expedite the work being done by the Ministry of Health and other stakeholders in reviewing those circumstances under which abortion could be permitted in the country. The Committee also urges the State party to provide women with access to quality services for the management of complications arising from unsafe abortions and to reduce women s maternal mortality rates. The Committee recommends the full implementation of the National Strategic Plan to Combat Sexually Transmitted Diseases and HIV/AIDS, with a view to decreasing the infection rates of women. CCPR Concluding Observations, 2005 Paragraph 9: The Committee notes with concern that section 235 of the Penal Code penalizes abortion even when the mother's life is in danger, and thus may encourage women to resort to unreliable and illegal abortion, with inherent risks for their life and health (Covenant, art. 6). The State party should review its legislation to ensure that women are not forced to carry pregnancies to term in violation of the rights guaranteed by the Covenant. MEXICO CEDAW Committee Concluding Observations, 2012 Paragraph 13: The Committee notes the State party s federal legislative advances, such as the constitutional reform on human rights (2011). However, it is concerned that the different levels of authority and competences within the State party s federal structure result in a differentiated application of the law depending on whether or not appropriate harmonization of the relevant legislation has been conducted at the state level, such as with respect to the principle of non-discrimination and equality HR and abortion statements Part 4 Ipas June 2014/10

12 between men and women. The Committee notes with concern that this situation results in discriminatory provisions against women or to different definitions and sanctions related to, inter alia, rape, abortion, forced disappearances, trafficking, injuries and homicide for reasons of so-called honour, as well as on adultery across the 32 states of the State party. It is further concerned about the lack of consistent harmonization of the State party s legislation, for example, civil, penal and procedural laws at the federal and state level, with the General Act and/or local laws on women s access to a life free of violence and with the Convention. It is concerned about the lack of effective mechanisms to implement and monitor the laws on women s access to a life free of violence and relevant legislation and regulations related to women s access to health-care services and education. The Committee is also concerned about the effects of the reform of the criminal justice system (2008) and its progressive implementation on the situation of women before the judicial authorities as well as about the lack of official data on the number of prosecutions, convictions and sentences inflicted against perpetrators of violence against women. Paragraph 14: The Committee urges the federal authorities of the State party: a) To take the measures necessary to ensure, particularly through effective coordination, the coherent and consistent harmonization of the relevant legislation at all levels with the constitutional reforms on human rights (2011) and of the criminal justice system (2008); b) To take the necessary actions to eliminate the inconsistencies in the legal frameworks among the federal, state and municipal levels, including by integrating in relevant state and municipal legislation the principle of non-discrimination and equality between men and women and by repealing discriminatory provisions against women, in line with article 2 (g) of the Convention, and by providing consistent definitions and sanctions, related to, inter alia, rape, abortion, forced disappearances, trafficking, injuries and homicide for reasons of so-called honour, as well as on adultery; c) To accelerate its efforts to consistently harmonize, inter alia, its civil, penal and procedural legislation with the General Act and/or local laws on women s access to a life free of violence and with the Convention; d) To establish effective mechanisms at the federal and state levels to monitor the implementation of women s access to a life free of violence laws, and legislation related to women s access to health-care services and education; e) To put in place mechanisms to monitor and sanction law officials, including the judiciary, who discriminate against women and who refuse to apply legislation protecting women s rights. Paragraph 32: The Committee notes that abortion is decriminalized in Mexico City and that in the rest of the country, abortion is legal in cases of rape. It also notes inconsistencies with respect to other legal grounds for abortion in the legal frameworks of the 32 states. It is concerned that women s enjoyment of their sexual and reproductive health and rights, including access to legal abortion, have been jeopardized as a result of the amendments in local constitutions that protect life from the moment of conception, even though those amendments have not modified the already established legal grounds for abortion. It is further concerned about cases of women who have been denied access to legal abortion, even when they fulfil the restrictive legal criteria, and who have been reported to the judicial authorities by medical care providers and social workers and consequently sentenced to long prison terms on grounds of infanticide or murder. Paragraph 33: The Committee urges the State party: a) To harmonize the federal and state legislations relating to abortion with a view to eliminating the obstacles faced by women seeking legal abortions and also to extend access to legal abortion in the light of the constitutional human rights reform and the Committee s general recommendation No. 24 (1999); b) To inform medical care providers and social workers that the local constitutional amendments have not repealed the grounds for legal abortion and also inform them of their responsibilities; c) To ensure that in all states, women whose cases fall under any of the legal grounds for abortion have access to safe health-care services, and ensure the proper implementation of the Mexican Official Standard NOM-046-SSA2-2005, in particular access of women victims of rape to emergency d) contraception, abortion and the treatment of sexually transmitted diseases and HIV/AIDS. CCPR Concluding Observations, 2010 HR and abortion statements Part 4 Ipas June 2014/11

13 Paragraph 10:; The Committee is concerned that, despite Federal Norm 046 (NOM-046), issued by the Ministry of Health, and the Supreme Court s ruling on the constitutionality of the decriminalization of abortion in 2008, abortion is still illegal in all circumstances under the constitutions of many states (articles 2, 3, 6 and 26 of the Covenant). The State party should bring the abortion laws in all states into line with the Covenant and ensure the application of Federal Norm 046 (NOM-046) throughout its territory. It should also take measures to help women avoid unwanted pregnancies so that they do not have to resort to illegal or unsafe abortions that could put their lives at risk (article 6 of the Covenant). Response to the Report of the Working Group on the UPR, 2009 General comments made by other relevant stakeholders Paragraph 622: The Centre for Reproductive Rights recalled the 1,200 women victims of femicide and the situation of thousands of women and girls suffering from regressive reforms that criminalize abortion under any circumstance in 13 Mexican States. It stressed that access to justice remained a mere hope for women. It supported the recommendations to bring State and federal legislation in line with the general law for women s access to a life free of violence, and for all federal, State and municipal authorities to implement the law. It also supported the recommendation that effective measures be taken to ensure that femicides were duly investigated. CEDAW Committee Concluding Observations, 2006 Paragraph 32: The Committee remains concerned about the level of maternal mortality rates, particularly those of indigenous women, which are a consequence of the insufficient coverage of, and access to, health services, including sexual and reproductive health care. The Committee notes with concern that abortion remains one of the leading causes of maternal deaths and that, in spite of the legalization of abortion in specific cases, women do not have access to safe abortion services and to a wide range of contraceptive measures, including emergency contraception. The Committee is also concerned about the insufficient efforts to prevent teenage pregnancies. Paragraph 33: The Committee urges the State party to expand the coverage of health services, including re productive health care and family planning services, and to address the obstacles that prevent women from having access to such services. The Committee also recommends that sex education be widely promoted and provided, targeting men and women and adolescent boys and girls. The Committee requests the State party to harmonize legislation pertaining to abortion at the federal and State levels. The Committee urges the State party to implement a comprehensive strategy which should include the provision of effective access to safe abortion in situations provided for under the law and a wide range of contraceptive measures, including emergency contraception, awareness-raising measures about the risks of unsafe abortions and nationwide sensitization campaigns about women s human rights, targeting in particular health personnel, as well as the general public. CESCR Committee Concluding Observations, 2006 Paragraph 25: The Committee is concerned about the high rate of maternal mortality caused by unsafe abortions, in particular as regards girls and young women, about reports on obstruction of access to legal abortion after rape, e.g. by misinformation, lack of clear guidelines, abusive behaviour directed at pregnant rape victims by public prosecutors and health personnel, and legal impediments in cases of incest, and about the lack of access to reproductive health services and education, especially in rural areas and in indigenous communities. Paragraph 44: The Committee recommends to the State party to ensure and monitor the full access of rape victims to legal abortion, to implement the Equal Start in Life Programme in all of its states, to ensure full access by everyone, especially by girls and young women, to reproductive health services and education, especially in rural areas and in indigenous communities, and to allocate sufficient resources for these purposes. CESCR Committee Concluding Observations, 1999 Paragraphs 29 and 43: The Committee is also concerned to learn that the fourth highest cause of death among women in Mexico is illegal abortion.the Committee calls upon the State party to monitor closely the female mortality rate and to take steps to reduce the incidence of death caused by illegal HR and abortion statements Part 4 Ipas June 2014/12

14 abortion. CEDAW Committee Concluding Observations, 1998 Paragraph 408: The Committee recommends that the Government consider the advisability of revising the legislation criminalizing abortion and suggests that it weigh the possibility of authorizing the use of the RU486 contraceptive, which is cheap and easy to use, as soon as it becomes available. MOLDOVA (REPUBLIC OF) CEDAW Committee Concluding Observations, 2013 Paragraph 31: The Committee is concerned about the high rate of abortion and the low use, availability, affordability and accessibility of modern forms of contraception, in particular in the Transnistrian region and rural areas, which indicate that abortion is used as a method of birth control. The Committee is particularly concerned about reports of practices of coercive sterilization, affecting in particular women with disabilities, women in rural areas and Roma women. The Committee notes with concern that the current Ministry of Health regulation on sterilization specifies mental disability as an indicator for sterilization. The Committee is also concerned about the lack of educational programmes on sexual and reproductive health and rights in schools and about the lack of sex-disaggregated data. The Committee is further concerned at the limited access of older women to affordable health care. Paragraph 32: The Committee urges the State party: a) To ensure the availability, accessibility and affordability of modern methods of contraception for girls and women; b) To expand the availability of medically safe modern methods of abortion, including in the Transnistrian region and rural areas; c) To raise awareness of the importance of using contraceptives for family planning and consider including abortion and contraceptives in the basic insurance package; d) To amend and develop the regulatory framework, in addition to the guidance provided to medical practitioners, to ensure that sterilization is carried out only in conformity with international law, in particular with the free and informed consent of the women concerned; e) To introduce age-appropriate education on sexual and reproductive health and rights, including responsible sexual behaviour, in the school curricula; f) To ensure that older women have access to affordable health care and train health workers on geriatric care; g) To integrate a gender perspective into all health interventions and policies and collect and analyse sex-disaggregated data. CRC Committee Concluding Observations, 2009 Paragraph 54: The Committee welcomes the adoption of the National Reproductive Health Strategy (2005) to improve adolescent sexual and reproductive health, and the establishment of the Network of Healthcare Services for Adolescents (2005). The Committee is concerned at the absence of an effective adolescent health promotion strategy and programme and a comprehensive child and adolescent mental health policy. Furthermore, the Committee notes with concern the increasing alcohol consumption and drug abuse among adolescents, the high rates of teenage pregnancies and abortions as well as the rates of suicide. Paragraph 55: The Committee recommends that the State party: a) fully implement the National Reproductive Health Strategy; b) continue extending the Network of Healthcare Services for Adolescents and undertake a comprehensive study in order to understand the nature and extent of adolescent health problems, with the full participation of adolescents; c) ensure that adolescents have access to age-appropriate and confidential counselling services and life skills training programmes; d) strengthen efforts in adolescent sex and reproductive health education to reduce the number of teenage pregnancies and develop child-friendly programmes to assist teenage mothers and their children; e) develop an effective and gender-sensitive strategy of education and awareness-raising for the general public with a view to reducing teenage pregnancies; HR and abortion statements Part 4 Ipas June 2014/13

15 f) implement measures to discourage the use of alcohol and drugs by adolescents, paying particular attention to pregnant adolescents; and g) undertake further measures, including the allocation of adequate human and financial resources to support the development of youth-sensitive and confidential counselling, care and rehabilitation facilities, taking into account the Committee s General Comment No. 4 on adolescent health (CRC/GC/C/2003/4). CCPR Concluding Observations, 2009 Paragraph 4: The Committee expresses its concern at the lack of significant progress in the implementation of many of the Committee s previous recommendations, particularly those relating to conditions in detention facilities; trafficking in human beings; the duration of pre-trial detention; the independence of the judiciary; the exercise of the right to religious freedom; the participation of women in senior decision-making positions in the public and private sectors; reliance on abortion as a method of contraception; and the discrimination faced by minorities such as the Roma. The State party should strengthen its efforts to implement the Committee s recommendations in these areas. Paragraph 17: The Committee is concerned that, despite the National Strategy for Health ( ), the use of abortion as a contraceptive measure is widespread. It notes, in this respect, that the law on compulsory medical insurance, which provides for the inclusion of contraceptives in the Basic Benefits Package, has not been implemented. Furthermore, the Committee is concerned that, although abortion is not prohibited by law, there have been instances where women have been prosecuted for murder or infanticide after having had an abortion and that no after-abortion healthcare is provided to them in prison. (arts. 3, 9 and 10). The State party should: a) Take steps to eliminate the use of abortion as a method of contraception by, inter alia, ensuring the provision of affordable contraception and introducing reproductive and sexual health education in school curricula and for the broader public; b) Consistently apply the law so that women who undergo abortions are not prosecuted for murder or infanticide; c) Release any women currently serving sentences on such charges; and d) Provide appropriate health care in prison facilities to women who have undergone abortions. CEDAW Committee Concluding Observations, 2006 Paragraph 30: The Committee expresses its concern about the health situation of women, especially women s reproductive health. While appreciating recent declines in the maternal mortality rate, it notes that this indicator is still high compared to other countries in the region, in particular for rural women. It is also concerned about the high abortion rates and the use of abortion as a means of fertility control, and especially about the situation of unsafe abortion, which increases the risk of maternal mortality. It is further concerned about the high percentage of women with anaemia and the increase in HIV/AIDS infection rates and in sexually transmitted diseases. The Committee expresses its concern about the increase of women s consumption of tobacco and narcotic drugs. Paragraph 31: The Committee recommends that increased efforts be focused on improving women s reproductive health. In particular, it calls upon the Government to improve the availability, acceptability and use of modern means of birth control to eliminate the use of abortion as a method of family planning. It encourages the State party to provide sex education systematically in schools, including vocational training schools. The Committee urges the State party to undertake appropriate measures to ensure women s access to safe abortion, in accordance with domestic legislation. It also urges the State party to target high-risk groups for strategies to prevent HIV/AIDS and the spread of sexually transmitted diseases. It encourages the State party to increase its cooperation with non-governmental organizations and international organizations in order to improve the general health situation of Moldovan women and girls. It requests that the State party provide in its next report detailed information on women s tobacco use and statistics on their alcohol, drug and other substance abuse. CESCR Committee Concluding Observations, 2000 Paragraph 49: The Committee urges the State party to reinforce its efforts to reduce infant and maternal mortality by increasing health coverage for women and children. The Committee calls upon the State party to strengthen efforts to promote awareness of sexual and reproductive health, safe contraceptive methods and the health risk of using abortion as a method of birth control, and to report on the results of HR and abortion statements Part 4 Ipas June 2014/14