RH REALITY CHECK: Birth Control Alone Isn’t Enough

In 1996, a Peruvian woman named María Mamérita Mestanza Chávez died from complications of a forced sterilization in Peru. She was a low-income, indigenous Peruvian woman, who was coerced into agreeing to sterilization by government officials and was repeatedly denied follow-up medical care when complications ensued. María died from post-surgical medical complications seven days after her surgery.

María’s story was only one of many cases of coercive sterilizations in Peru—the tragic and cruel consequences of family planning practices that leave women’s human rights out of the equation. Her story reminds us how important it is that the government officials, global advocates and donors participating in this week’s Family Planning Summit in London keep stories like María’s in mind.

This week’s summit is a crucial opportunity to re-invigorate international efforts to provide millions of women with access to the contraception they so desperately need. Yet increasing the availability of contraception is just one aspect of ensuring reproductive health, and cannot be seen in isolation. The summit must recognize women’s right to a full range of comprehensive sexual and reproductive health services. Without access to sexuality education, safe and legal abortion, and a range of other essential services, women’s reproductive rights will still be far from being achieved.

Last month, the Center for Reproductive Rights joined 326 other organizations and individuals from around the world to issue a joint statement highlighting the urgent need for family planning policies to recognize and protect women’s autonomy and human rights. For 20 years, the Center has documented the devastating consequences—both intended and unintended—of reproductive health policies that fail to do so.  And we have fought legal battles in courts and the UN on behalf of the women who have suffered egregious human rights abuses and violations of their basic reproductive rights, including discrimination against marginalized women seeking access to care, mistreatment by health workers, not being provided information on family planning and involuntary sterilization of women.

While contraceptive information and services are an essential part of the health services that women need throughout their lives, efforts to simply increase the use of contraceptives can have negative consequences if women are not empowered to decide for themselves when and how to use them. If the initiative put forth in London this week fails to tackle the myriad obstacles women face in accessing sexual and reproductive health services—lack of information, requirements that their spouses or parents give their consent, bans on certain methods, discrimination, unavailability of services in certain areas, inadequate systems to deliver services—it will stop far short of addressing the real barriers to women’s reproductive rights.

And international human rights bodies agree.

In María’s case, the Center for Reproductive Rights filed a case with local and regional partners on behalf of her family at the Inter-American Commission on Human Rights (IACHR). As a result, the Peruvian government agreed to pay moral damages to María’s husband and seven children, as well as significant compensation for their health care, education and housing. The government also agreed to conduct an in-depth investigation and to punish those responsible for the violations of Peruvian and international legal standards.

But Peru isn’t the only place these violations have occurred. In 2009, the Center filed a complaint against Chile before the IACHR on behalf of F.S., a young woman living with HIV who was sterilized without her knowledge or consent. F.S. was diagnosed with HIV in 2002 soon after learning she was pregnant. She was referred to a state hospital for HIV treatment during pregnancy. She and her husband had plans to have more children and F.S. never requested sterilization. She was forcibly sterilized at the hospital immediately after giving birth. This is another example of a government failing to protect a woman’s reproductive rights, her human rights.

States must ensure that women can exercise their reproductive rights.  The decision to use contraceptive methods is voluntary and should never be forced on any woman, no matter her ethnicity or socioeconomic background.

But local activists, global advocates and civil society organizations cannot act alone as a watchdog for reproductive rights. States—as donors and implementers of family planning policies—and international donors must ensure that there are monitoring and accountability systems in place to ensure the kinds of violations María suffered are not repeated. I’ll be in attendance at this week’s Family Planning Summit and will be calling for human rights to be front and center of the discussions, moving the conversation from contraceptives alone to reproductive rights as human rights.