In this piece, guest blogger Maria Pawlowska outlines the major arguments for why access to contraception should be treated as a human right. Also highlighted are the different implications of realizing this right in both the developed North and global South. Maria is a healthcare analyst with a passion for reproductive health and gender issues in health care provision. Maria has a PhD from Cambridge, where she was a Gates scholar, and has worked with the Global Poverty Project and RESULTS UK.
Margaret Sanger, an American sex educator, nurse, and legendary birth control activist once said that “No woman can call herself free who does not own and control her body. No woman can call herself free until she can choose consciously whether she will or will not be a mother.” Nowadays, these words are true as ever and encapsulate the main premise behind a recent joint publication by the UN Population Fund (UNPF) and the Center for Reproductive Rights (CRR) – that the right to contraception is a human right.
Michele Bachmann’s recent foray into damning a public HPV vaccination program for potentially harming ‘innocent girls’ shows how much politicians can get away with when it comes to reproductive health. When have you last heard anyone complaining about polio vaccinations? Oh right, it’s not a sexually transmitted disease…
It would have probably been even worse today if not for The Programme of Action from the 1994 Cairo International Conference on Population and Development (tellingly rejected by the Vatican). This document was an important milestone in changing the perception about reproductive health which is no longer a shameful issue to be dealt with in secrecy, but an important public health concern and a domain in which states should work to improve their citizens’ quality of life. Therefore, the current perception of the importance of contraceptives in particular and reproductive rights and health in general should not be taken for granted. Most governments nevertheless still hate mentioning anything that can be interpreted to even mildly refer to sex about as much as they dread the thought of having to raise taxes 6 months before a major election. However, the The Programme of Action has made its mark. Importantly, it was also the first to suggest that access to contraceptives is a human right.
You may be thinking “What? I can’t remember condoms and the Pill being mentioned anywhere in the Universal Deceleration of Human Rights (UDHR)?!” You’re right – it isn’t explicitly mentioned (in the UDHR at least). However, the issue is a little bit more complicated than that, but really pretty straightforward.
Let’s deal with the more complicated things first (and not to worry, they really aren’t that difficult to grasp). As I mentioned in my previous post, the UDHR is not the only ‘UN-approved’ human rights document out there. There are actually a number of declarations (non-binding) and covenants and conventions (binding) which are part of the human rights legal framework and include, for example, the International Covenant on Economic, Social and Cultural Rights (ICESCR) and the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW). When stating that access to contraception is a human right, UNPF and CRR drew on all these documents and did not limit their analysis to the UDHR.
And now for the straightforward part, in which we will see that access to contraceptives really is a human right – one grounded in the basic principles behind the very notion of human rights. Women’s right to contraceptive information and services is, in fact, an element of a number of key basic human rights such as the right to life, the right to the highest attainable standard of health, the right to decide the number and spacing of one’s children, the right to privacy, the right to information, and the right to equality and non-discrimination. Not only is guaranteeing access to contraception an integral part of these rights, but it is also a means to securing their fulfilment.
Moreover, guaranteeing access to available, acceptable, and good quality contraceptive information and services free from coercion, discrimination, and violence is critical for achieving gender equality and ensuring that women can participate as full members of society. The importance of contraceptives is highlighted by the fact that a range of them is included in the World Health Organization (WHO) Model List of Essential Medicines. UN bodies (such as the Committee on Economic, Social and Cultural Rights) have indicated that provision of the drugs on this list is a core minimum obligation of states in realizing the right to health. Importantly, the obligation to provide contraceptives is classified as “immediate” – often also called the “minimum core obligations” – meaning that this obligation is not dependent on the socioeconomic context and thus should be fulfilled immediately.
A rights-based approach (RBA) to the provision of reproductive healthcare and contraceptive information and services can guarantee the fulfilment of states’ obligation and the concomitant realization of women’s fundamental human rights. And it’s really crucial to understand that access to contraception is mostly about preventing unwanted pregnancies in the developed North, but in the global South it really is a life-and-death matter. While the life-quality enhancement and human rights fulfilment related to the provision of appropriate family planning is difficult to overestimate, the tragic and potentially life-threatening consequences of restricting access to contraceptives may result in devastating social, economic, and public health consequences. For example, of the approximately 80 million women who annually experience unintended pregnancies, 45 million have abortions. As a result, approximately 68,000 women die from botched back-alley abortions each year and complications from unsafe procedures are a leading cause of maternal morbidity. Research has shown that satisfying the current unmet need for contraceptives could prevent roughly 150,000 maternal deaths and 25 million induced abortions worldwide annually.
It really is a no-brainer – preventing unwanted pregnancies allows women and families to lead a measurably better life and prevents deaths (of mothers as well as children). Access to contraceptives is a human right and it’s important to keep that in mind, when we veer towards perceiving it as a privilege of the richer or better educated.