Brazilian Lawmakers Hear Testimony Regarding Discrimination Against Women Seeking Maternal Health Care

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(PRESS RELEASE) Two years after the United Nations declared Brazil responsible for the death of an Afro-Brazilian woman —calling on the State to provide access to quality maternal health care without discrimination—pregnant women are still dying, and Brazil has not implemented the decision by the United Nations Committee on the Elimination of Discrimination against Women (CEDAW Committee).

Today the Human Rights Commission in the Brazilian Senate held a congressional hearing on the implementation of the Alyne da Silva v. Brazil case. Local and international human rights experts offered testimony, including Monica Arango, regional director for Latin America and the Caribbean at the Center for Reproductive Rights (Center), as well as members of the Brazilian Platform of Economic, Social, Cultural and Environmental Human Rights (DHESCA platform) and the Public Ministry.

“All women—regardless of where they live, how much money they have, or their race—have a fundamental right to timely and appropriate maternal health services without discrimination,” said Arango. “Alyne was denied that right. As recognized by the CEDAW Committee in its decision, the government must provide individual reparations as well as implement the policy recommendations set forth in the decision”.

Alyne, a 28-year-old Afro-Brazilian woman, six-months pregnant with her second child, was admitted to the private Health Centre Belford Roxo complaining of nausea in November 2002. Although she presented signs of a high-risk pregnancy, she was discharged without any medical treatment. Two days later, she returned to the private clinic in worse health condition. Doctors discovered that the fetus had died. After the fetus extraction, Alyne´s health continued deteriorating. She had to wait for an ambulance for more than 8 hours before she was finally delivered to the Hospital Geral de Nova Iguaçu. There was a more than 24-hour delay in receiving medical treatment. Alyne later slipped into a coma and died five days later on November 16, 2002.

The Center and Advocacia Cidadã Pelos Direitos Humanos submitted a petition on behalf of Alyne’s family before the CEDAW Committee in November 2007—the first maternal mortality case brought to the human rights body. The CEDAW Committee declared Brazil responsible for violating Alyne’s human rights and recommended the State to provide individual reparations to her family and also to implement measures to avoid preventable maternal deaths. 

The State has taken various steps to implement the decision by agreeing on an amount with the legal representatives for financial compensation, as wells as symbolic reparation, but has still not set a date to pay the amount offered. Brazil did create an Interministerial working group for the implementation of the recommendations and was slated to set a work plan and indicators of compliance, but the group’s term expired last October without having set indicators or a work plan.

More alarming, the DHESCA platform reported that the two health care institutions that Alyne sought care from remain in precarious quality conditions, 11 years after Alyne’s death. In response, the Attorney General (Procurador General) ordered a public civil inquiry (Inquérito Público) to assess whether the obstetric and neonatal services provided by these facilities comply  with the CEDAW Comittee´s decision.

According to the World Health Organization, approximately 800 women die every day worldwide from pregnancy complications. Brazil accounts for a quarter of all maternal deaths in Latin America and ninety percent of them could be prevented with prenatal care. Although Brazil has reduced its maternal mortality rate in the last decade, maternal mortality remains the leading cause of death among women of childbearing age, disproportionately affecting low-income, Afro-Brazilian, indigenous women, and those living in rural areas and the Brazilian North and Northeast.

Today’s public hearing aimed to advance implementation of the decision not only to ensure Alyne’s family is compensated, but also to improve the provision of health services to all pregnant Brazilian women. “Alyne was denied basic medical care to address pregnancy complications and her death was preventable. Almost eleven years since her death, pregnant women continue to die from lack of quality health care. We demand justice for Alyne’s family and that Brazil finally take steps to fix the public health care system so that all women can receive maternal health care without discrimination,” said Carmen Hein de Campos, feminist lawyer in Brazil.