BRIEFING PAPER BPH/21
Modern contraception has revolutionised family life. Until the pill came into widespread use in the 1960s, sex was a lottery: there were no really safe contraceptives. Today, nearly 60 per cent of the world's couples use modern family planning and 'reproductive health', which includes the right to decide the size and spacing of the family, is recognised as a human right.
The place of reproductive and sexual rights in the human rights framework is described in The State of World Population 1997 report by the United Nations Population Fund (UNFPA). The report, The Right to Choose: Reproductive Rights and Reproductive Health, shows how internationally-agreed human rights can make a difference in people's lives by giving them the power of choice. For women, reproductive rights are especially important - guaranteeing the ability to make choices about childbearing empowers women to make choices in other areas of life.
A central theme of the report is that reproductive choice, gender equality and sustainable development are closely connected, a linkage the international community has recognised repeatedly at the 1990s series of conferences on social development issues.
Says Dr Nafis Sadik, Executive Director of the UNFPA: "The consensus means what it says: that reproductive health is a right for both women and men; that every individual has the right to decide the size and spacing of the family, and to have the means and information to do so, that there must be no coercion, either to have or not to have children; and that these rights are part of the international structure of human rights, which has its foundation the concept that all men and women are equal."
At the International Conference on Population and Development, held in Cairo in 1994, and the fourth World Conference on Women, held in Beijing in 1995, the world's nations spelled out in detail the components of reproductive rights and their implications. These rights include voluntary choice in marriage, sexual relations and childbearing, and the right to enjoy the highest attainable standards of sexual and reproductive health.
The State of World Population report shows how these understandings flow from the United Nations Charter, the Universal Declaration on Human Rights and human right treaties which are binding on states that have ratified them - the International Covenant on Civil and Political Rights, the International Covenant on Economics, Social and Cultural Rights, the Convention on the Elimination of All Forms of Discrimination Against Women and the Convention on the Rights of the Child.
In particular, these treaties obligate governments to protect individuals against violations of their reproductive rights, and to ensure that every body has access to safe and affordable services addressing a broad range of sexual and reproductive health concerns (including family planning, safe motherhood and prevention of sexually transmitted diseases, among others). The United Nations system for monitoring treaty compliance therefore offers important support for efforts to protect and promote reproductive rights.
The conference agreements themselves express a global consensus and are invaluable advocacy tools which can influence the formulation of national laws, policies and standards. The report cites numerous examples of how countries are putting the Cairo and Beijing agreements into operation.
For example, the South African constitution, adopted last year, explicitly prohibits discrimination on the grounds of gender, sex, pregnancy, marital status or sexual orientation. It also recognises that everyone has the right "to bodily and psychological integrity, which includes the right to make decisions concerning reproduction", and "to have access to health care services, including reproductive health care".
The Ugandan constitution was recently revised to recognise the priority of human rights for women over traditional and logical laws. Chile is considering a constitutional reform to establish legal equality between women and men. The government of Sri Lanka recently approved a women's Charter which acknowledges women's right to control their reproductive lives. In Columbia, a new social security law recognises women's right to sexual and reproductive health.
Brazil, Columbia, Jamaica, Haiti and Peru are among the many countries that have recently established or strengthened institutions to protect the rights of women. Laws protecting women against sexual and domestic violence have been approved in Bolivia, Costa Rica, Ecuador and Panama. Strengthening and enforcing these safe-guards will be vital for global development.
The UNPFA report lists a basic set of internationally-accepted reproductive rights, which are implied by the rights recognised in international human rights instruments:
THE RIGHT TO SURVIVAL/RIGHT TO LIFE implies that women's status and health services should be improved to reduce the 585,000 maternal deaths that occur each year from pregnancy-related causes. This involves for example, reducing early marriage and higher-risk pregnancies, expanding access to pregnancy care, trained birth attendants and emergency obstetric services, providing quality family planning services and information and reducing reliance on unsafe abortion.
THE RIGHT TO LIBERTY AND SECURITY OF THE PERSON implies the right to enjoy and control one's sexual and reproductive life, and the right to informed consent in medical interventions. Several countries' constitutional courts have held that compulsory sterilisation and abortion violate this right. The practice of female genital mutilation violates the security of the person.
THE RIGHT TO THE HIGHEST ATTAINABLE STANDARD OF HEALTH implies a right to have access to the highest-possible quality care related to sexual and reproductive health, protection from harmful practices, as well as a right to counselling and impartial information to allow informed decisions.
THE RIGHT TO FAMILY PLANNING has been acknowledged, clarified and expanded in human rights instruments and international declarations since 1968. The Cairo Programme of Action, reaffirming earlier agreements, states, "All couples and individuals have the right to decide freely and responsibly the number and spacing of their children and to have the information, education and means to do so."
THE RIGHT TO MARRY AND FOUND A FAMILY implies a government obligation to offer services for the prevention and treatment of sexually transmitted diseases, since these are a leading cause of infertility.
THE RIGHT TO A PRIVATE AND FAMILY LIFE includes the right to have access to available reproductive health care technology, including safe and acceptable contraceptive methods.
THE RIGHTS TO RECEIVE AND IMPART INFORMATION AND TO FREEDOM OF THOUGHT are applicable in demonstrating that everyone (including adolescents and the unmarried) has a right to information and counselling about family planning methods and service availability.
Fulfilment of the RIGHT TO EDUCATION is on of the most important means of empowering women with the knowledge, skills and self-confidence necessary to participate fully in the development process. Promoting the education of women and girls contributes to the postponement of the age of marriage and to a reduction in the size of families.
THE RIGHT TO NON-DISCRIMINATION ON THE BASIS OF SEX is violated by laws and practices that prevent women but not men from taking reproductive health decisions without their spouses' consent; by policies limiting girls' right to stay in school when they are pregnant; by family practices favouring sons over daughter with regard to nutrition, health care and education; and by prenatal sex selection and female infanticide.
THE RIGHT TO NON-DISCRIMINATION ON THE BASIS OF AGE implies that young people have the same rights to confidentiality with regard to reproductive health care as adults.
The State of World Population 1997 report by the United Nations Population Fund (UNFPA).