In a Call to Action, the Center for Reproductive Rights joined more than 60 human rights organizations to urge the European Union, Member State governments, the United Nations, other donor governments, and the broader international community to urgently implement measures protecting the sexual and reproductive health and rights of people fleeing the war in Ukraine.
The Call to Action urges European decisionmakers to include SRHR services, such as maternal health care, emergency contraception, and medication abortion in their measures to meet the needs of people in Ukraine and refugees in five neighboring countries.
“It is imperative that European governments and the international community ensure that their humanitarian assistance prioritizes the sexual and reproductive health of women and girls,” said Leah Hoctor, Senior Regional Director for Europe for the Center. “Robust financial support and political will is vital to address serious risks of harm to the health of women and girls and to ensure protection from gender-based violence.”
The Impact of the War in Ukraine on Women and Girls
The invasion of Ukraine by the Russian Federation is having a severe impact on women and girls as military strikes are damaging maternity hospitals and other health care facilities and have killed women and infants.
With the health system in collapse, the risk of maternal and infant mortality and morbidity is expected to increase rapidly in coming months. The conflict is also expected to increase the risk of gender-based and sexual violence, including trafficking and sexual exploitation.
There are now over 1.8 million internally displaced persons (IDPs) and over 3 million refugees, the majority of whom are women and children, who have fled their homes in Ukraine. They face increased risks of gender-based violence including sexual violence and their sexual and reproductive health and rights are under threat.
In Hungary, Poland, Romania and Slovakia a range of pre-existing legal and policy restrictions on SRHR and cost barriers are severely impeding access to urgent and essential sexual and reproductive health care for those fleeing Ukraine. In particular, these barriers are undermining access to emergency contraception and other contraceptive methods, abortion care including medical abortion, antenatal care, post-exposure prophylaxis, STI treatment and antenatal care.
An Urgent Call to Action
The document calls on the European Union, donor governments, and broader international community to take a number of urgent steps, including to:
- Ensure that all humanitarian response plans, financing and assistance respect human rights and prioritize the SRHR of all women and girls and marginalized populations in Ukraine and in transit and refugee host countries.
- Ensure that humanitarian packages and convoys to Ukraine and to transit and refugee host countries include adequate numbers of inter-agency reproductive health kits, including a full range of essential sexual and reproductive health goods and medicines like emergency contraception, contraceptive goods and medicines, menstrual hygiene products, lactation-assisting products and formula and postpartum care, post-exposure prophylaxis and mifepristone and misoprostol for medical abortion.
- Offer urgent political support, guidance and technical assistance to the Governments of Hungary, Poland, Romania and Slovakia to facilitate the removal of legal and policy barriers that are impeding the provision of essential sexual and reproductive health care.
The Call to Action also urges the Governments of Hungary, Moldova, Poland, Romania and Slovakia to implement several measures, including to:
- Ensure that quality sexual and reproductive health care and adequate water, sanitation and hygiene facilities (WASH) are made available to all those fleeing Ukraine without discrimination.
- Issue policy guidance clarifying that sexual and reproductive health care, including emergency contraception, contraception and abortion care, and all forms of maternal health care, including antenatal care, is essential health care that should be provided free of charge and that health-care providers will be fully reimbursed, under existing regulations, for the provision of this care to all those fleeing Ukraine.
- Ensure that emergency contraception can be provided without a prescription and free of charge without delay to all those fleeing Ukraine, including by moving national policies on emergency contraception into line with international and regional best practice and EU guidelines.
- Ensure that medical abortion in early pregnancy is legal and accessible for all those fleeing Ukraine, including by removing barriers to abortion care and aligning national policies on abortion with WHO guidelines.
- Take effective action to prevent gender-based violence, including sexual violence, and to prevent trafficking for sexual exploitation, especially around borders and other main transit points. Ensure free access to comprehensive medical treatment and psycho-social and other support for all those fleeing Ukraine who have survived sexual and gender-based violence and undertake effective human rights compliant investigations into all incidents and threats of gender-based violence within their jurisdiction.