Gender & Sexuality Law Blog

Elizabeth Sepper is the 2010-2012 Center for Reproductive Rights fellow at Columbia Law School.  Her research focuses on health, medical ethics, and human rights.  Her current paper Whose Conscience Counts?, critiques the conventional account of morality in medicine, which limits conscience to doctors and nurses who refuse to deliver controversial treatments, such as end-of-life care, abortion, and sterilization.  Cross posted from HealthLaw Prof blog:

Thanks again to Health Law Profs for the opportunity to blog.  With October at its end, I thought I’d take the opportunity to touch on subject I care about deeply – women’s health and human rights in Haiti.

Haitian women experienced the highest maternal mortality rate in the Western Hemisphere prior to the January 2010 earthquake.  Rates of contraceptive use were low and had leveled off.  Almost 40 percent of family planning needs went unmet—in large part because of lack of donor funding and interest.

Today, women and girls experience even greater challenges.  Nearly 600,000 people displaced by the earthquake still live in camps, protected only by tents and tarps.  Human Rights Watch reports that access to family planning information in the camps is rare, contributing to high rates of unplanned pregnancies, including among teenage girls.  According to a UN survey, the pregnancy rate in the camps is 3 times the average urban rate before the earthquake.

Two-thirds of these pregnancies are unplanned and unwanted.  Some are linked to gender-based violence.  According to grassroots groups, a number of women and girls they treated for rape became pregnant (in one case, a full 20 percent of those they saw in the months immediately following the earthquake).  In a survey by the Center for Human Rights and Global Justice, 14% of respondents in camps said that, since the earthquake, one or more members of their household had been victimized by either rape or unwanted touching or both.

So what does law have to do with this crisis?  First, governments have obligations under human rights law with regard women’s rights to health, autonomy, and information.  Although until recently maternal mortality and access to safe abortion were not considered a legal issue by main-line human rights groups and international organizations, these views have changed relatively quickly.  Just last week, the United Nations special rapporteur on the right to health issued a report compiling the international legal support for decriminalization of abortion and elimination of laws that reduce access to contraception.  The report, which is well worth a read and avoids the usual UN-speak, links a wide array of laws limiting abortion and contraception to the public health.

Much of what the report says is true of Haiti.  Abortion is illegal in Haiti, and unintended pregnancies are tied to lack of information, inadequate access to contraception, violence, and widespread gender inequality.  Since the earthquake, medical providers have seen increased numbers of complications from unsafe abortions, with women suffering dangerous infections.  These unsafe abortions are a significant cause of maternal mortality, accounting for 13 percent of maternal deaths.

Second, the continuing crisis in Haiti suggests the effects of U.S. domestic law and policy on its neighbor.  From the Global Gag rule to prohibitions on delivering aid through government bodies to the use of international development funds to push economic liberalization, laws passed in the United States have undermined the enjoyment of human rights in Haiti.  At the same time, U.S. legislation and policy could have positive effects on health in Haiti.  Funding of women’s health and family planning needs could be made a priority.  USAID could require recipients to actively engage in cooperation and capacity-building with government agencies, including the Ministry of Health.  More immediately, granting humanitarian parole would allow the 105,000 Haitians who had been already been approved U.S. immigrant visas prior the earthquake to join their families and deliver remittances back to Haiti.

The views expressed in this post are those of the author and should not be attributed to the Center for Reproductive Rights or the Health Law Prof Blog.