INFORMATION SERIES ON SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS

ABORTION
Human rights bodies have provided clear guidance on when there is a need to
decriminalize abortion, and have emphasized that access to abortion is a matter
of human rights. Ensuring access to these services in accordance with human rights ANNUALLY, 22 MILLION
standards is part of State obligations to eliminate discrimination against women UNSAFE ABORTIONS ARE
and to ensure women’s right to health as well as other fundamental human rights. ESTIMATED TO TAKE PLACE
The majority of countries in the world provide for certain instances when abortion is
legal.1 A handful of countries have enacted complete bans on abortion. In other States,
abortion is highly restricted, but there generally exists an exception for the procedure
in order to save a woman’s life, or in cases of rape, incest or fetal impairment. Most COMPLICATIONS FROM
countries have more lenient abortion laws, allowing the procedure without restriction or UNSAFE ABORTIONS
with restrictions that take into account the physical and mental health of the woman as ACCOUNT FOR ABOUT
well as economic or social reasons.2 47,000 PREGNANCY-
RELATED DEATHS
International human rights bodies have characterized laws generally criminalizing
EVERY YEAR
abortion as discriminatory and a barrier to women’s access to health care. They
have recommended that States remove all punitive provisions for women who have
undergone abortion. These bodies have also requested that States permit abortion in
certain cases.3 Treaty body jurisprudence has clearly indicated that denying women
access to abortion where there is a threat to the woman’s life or health, or where the
DEATHS DUE TO UNSAFE
pregnancy is the result of rape or incest violates the rights to health,4 privacy5 and, in
ABORTION ARE
certain cases, to be free from cruel, inhumane and degrading treatment.6
ENTIRELY PREVENTABLE
That legal abortion should be safe and accessible is also a position supported
by political commitments of States undertaken at the International Conference on
Population and Development (ICPD), held in Cairo in 1994. At that Conference, States
recognized unsafe abortion as a major public health concern, and pledged their
commitment to reducing the need for abortion through expanded and improved family COUNTRIES WITH LESS
planning services, while at the same time recognizing that, in circumstances where not RESTRICTIVE ABORTION
against the law, abortion should be safe.7 The Beijing Platform for Action, which was LAWS GENERALLY HAD
agreed at the 1995 Fourth World Conference on Women, also affirmed this.8 The LOWER ABORTION RATES
United Nations General Assembly review and appraisal of the implementation of ICPD THAN COUNTRIES WITH
in 1999 further agreed that, HIGHLY RESTRICTIVE
ABORTION LAWS
“in circumstances where abortion is not against the law, health systems
should train and equip health-service providers and should take
other measures to ensure that such abortion is safe and accessible. Source: WHO, Safe abortion: technical and policy
guidance for health systems (2012), p. 17.
Additional measures should be taken to safeguard women’s health.”9

KEY ISSUES

1 CRIMINALIZATION OF HEALTH SERVICES THAT ONLY WOMEN REQUIRE, INCLUDING ABORTION,

IS A FORM OF DISCRIMINATION AGAINST WOMEN

Human rights mechanisms have The Committee on the Elimination of medical procedures only needed by
regularly expressed concern Discrimination Against Women specifies women and that punish women who
that “it is discriminatory for a State undergo those procedures” are a barrier
about criminalization party to refuse to legally provide for the to women’s access to health care.11 Most
of women who performance of certain reproductive recently the Committee has requested
undergo abortions. health services for women.”10 It further States to “remove punitive measures for
establishes that “laws that criminalize women who undergo abortion.”12
INFORMATION SERIES ON SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS
ABORTION

Similarly, the Special Rapporteur on the right to health has argued that laws
criminalizing abortion “infringe women’s dignity and autonomy by severely restricting
decision-making by women in respect of their sexual and reproductive health.”13 He
called on States to “decriminalize abortion”14 and “consider, as an interim measure,
IN ITS STATEMENT ON THE the formulation of policies and protocols by responsible authorities imposing a
moratorium on the application of criminal laws concerning abortion.”15
ICPD BEYOND 2014 PROCESS
IN FEBRUARY 2014, THE
COMMITTEE ON THE
ESTIMATED NUMBER OF UNSAFE ABORTIONS PER 1000 WOMEN AGED
ELIMINATION OF 15–44 YEARS, 1990 AND 2008, BY MAJOR REGION
DISCRIMINATION AGAINST
WOMEN DISTINGUISHED 50 1990
45
BETWEEN LEGALIZATION OF 2008

ABORTION IN CERTAIN CASES, 40

AND REMOVING ALL PUNITIVE
31
PROVISIONS. IT STATED: 30 28 28

“States parties should

legalize abortion at least 20
in cases of rape, incest, 14
12 12
threats to the life and/or 10
health of the mother, or 2
severe foetal impairment, 0
Latin America & Africa Asia Europe
as well as provide women the Caribbean
with access to quality post-
abortion care, especially Source: World Health Organization
in cases of complications
resulting from unsafe
abortions. States parties The criminalization of doctors who provide these services violates
should also remove punitive women’s rights.
measures for women who
undergo abortion.” Human rights bodies have expressed concern about the criminalization of healthcare
providers who offer abortion services. The Human Rights Committee has stated that
imposing “a legal duty upon doctors and other health personnel to report cases of
women who have undergone abortion” fails to respect women’s right to privacy.16

2 ENSURING WOMEN’S RIGHTS REQUIRES ACCESS TO ABORTION WHERE THERE IS A THREAT TO

THE WOMAN’S LIFE OR HEALTH, OR WHERE THE PREGNANCY IS THE RESULT OF RAPE OR INCEST

Human rights mechanisms has also requested States to provide while also putting in place measures to
have requested States information on access to safe abortion ensure the elimination of discrimination
services for women who have become against persons with disabilities.23
to legalize abortion in pregnant as a result of rape.18 In their
certain circumstances. concluding observations, treaty bodies
have also recommended that States review
In its jurisprudence, the Committee
their legislation and decriminalize abortion
on the Elimination of Discrimination
in cases when the pregnancy endangers
Against Women has requested a State
the life or health of a woman,19 and in
to “review its legislation with a view
cases of pregnancy resulting from rape
to decriminalizing abortion when the
or incest.20,21 Treaty bodies have also
pregnancy results from rape or sexual
recommended ensuring access to abortion
abuse.”17 The Human Rights Committee
services in cases of fetal impairment,22
Concerning exceptions to abortion bans
to protect the life or health of the woman, THE MAPUTO PROTOCOL ON THE RIGHTS OF WOMEN IN AFRICA
the health of the woman has been
CALLS ON STATES PARTIES TO
understood broadly to include mental
health. In the case of a minor girl with “take all appropriate measures to protect the
an intellectual disability, who had reproductive rights of women by authorising medical

3
become pregnant as a result of rape by
her uncle, the Human Rights Committee abortion in cases of sexual assault, rape, incest,
found that the mental suffering caused to and where the continued pregnancy endangers the
the victim by forcing her to continue with mental and physical health of the mother or the life
an unwanted pregnancy amounted to cruel
and inhuman treatment.24 In another case,
of the mother or the foetus.” (Article 14)
the Committee similarly found that denying
a woman an abortion where it was known THE MAPUTO PROTOCOL IS THE FIRST HUMAN RIGHTS
that her baby would die shortly after birth TREATY TO EXPLICITLY CALL ON STATES TO ENSURE
caused her mental suffering, constituting ACCESS TO ABORTION IN CERTAIN CIRCUMSTANCES.
cruel and inhuman treatment.25

3 LEGAL ABORTION SERVICES MUST BE SAFE, ACCESSIBLE, AFFORDABLE AND OF GOOD QUALITY

Where abortion is legal, States Women has explained that the legal parent, caregiver, or guardian, such as
must put in place the procedures framework for access to abortion must HIV testing and sexual and reproductive
“include a mechanism for rapid decision- health services, including education and
for making these services safe making, with a view to limiting to the guidance on sexual health, contraception
and accessible to women without extent possible risks to the health of the and safe abortion.”29
discrimination. pregnant mother, that her opinion be
taken into account, that the decision be Concientious objection cannot
The Committee on Economic, Social well-founded and that there is a right
and Cultural Rights has established that prevent women or adolescent girls
to appeal.”28
the right to health—which comprises from accessing health services.
reproductive and sexual health—requires
health services, including legal abortion
States should take steps to States must organize health services to
services, which are available, accessible, remove barries to the provision of ensure that “the exercise of conscientious
acceptable and of good quality.26 The abortion services. objection by health professionals does
Committee on the Rights of the Child has not prevent women from obtaining access
recommended that “States ensure access Third party authorization provisions to health services.”30 The Committee on
to safe abortion and post-abortion care are particularly common with respect the Elimination of Discrimination Against
services, irrespective of whether abortion to abortion, and other sexual and Women has stated that “if health service
itself is legal.”27 reproductive health services. The providers refuse to perform such services
Committee on the Rights of the Child based on conscientious objection,
In many countries, abortion laws have has especially emphasized the right of measures should be introduced to ensure
been liberalized, but the liberalization is the child, in accordance with evolving that women are referred to alternative
not accompanied by clear regulations to capacities, to confidential counseling health providers.”31 The Committee on the
implement the law. In these circumstances, and to access to information without Rights of the Child has also requested
health care providers sometimes refuse parental or guardian consent. It has States to ensure that “adolescents are not
to provide legal services. Thus legal also recommended that “States should deprived of any sexual and reproductive
reform alone is not enough to fulfil human review and consider allowing children to health information or services due to
rights obligations. The Committee on consent to certain medical treatments and providers’ conscientious objections.”32
the Elimination of Discrimination Against interventions without the permission of a

4 STATES MUST ALWAYS PROVIDE POST-ABORTION MEDICAL SERVICES

Post-abortion medical services be provided, including guidance on reprisals.”34 Significantly, the Committee
must always be available, safe contraceptive methods to avoid unwanted against Torture, in its Concluding
pregnancies.”33 The Special Rapporteur on Observations, has called on a State
and accessible. torture has also called on “States to ensure to “eliminate the practice of extracting
The High Commissioner has explained that women have access to emergency confessions for prosecution purposes from
that “regardless of the legality of abortion, medical care, including post-abortion women seeking emergency medical care
humane post-abortion services must care, without fear of criminal penalties or as result of illegal abortion.”35
INFORMATION SERIES ON SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS
ABORTION

STATES HAVE OBLIGATIONS TO RESPECT, PROTECT AND FULFIL WOMEN’S

RIGHTS RELATED TO ABORTION SERVICES
RESPECT States should remove legal provisions which penalize women who have undergone
abortion or medical practitioners who offer these services.

PROTECT States must organize their health system to ensure that women are not prevented from accessing
health services by health professionals’ exercise of conscientious objection. For example, where abortion
is legal, if a doctor refuses to perform it, the health system must refer women to an alternative health care provider.

FULFIL States must take steps to ensure access to appropriate health-care services for women and
“to eliminate such barriers to the provision of abortion services and that lead women to resort to unsafe
abortions, including eliminating unacceptable delays in providing medical attention.”36

NOTES
1 United Nations Population Division, World Abortion Policies 2013 (providing a table of abortion policies in every country of the world).
2 Ibid.
3 Committee on the Elimination of Discrimination Against Women, Concluding Observations on Peru, CEDAW/C/PER/CO/7-8 (2014), para 36; Statement on sexual
and reproductive health and rights: Beyond 2014 ICPD Review (2014).
4 Committee on the Elimination of Discrimination Against Women, L.C. v. Peru, CEDAW/C/50/D/22/2009, para. 8.15.
5 Human Rights Committee, K.L. v. Peru, CCPR/C/85/D/1153/2003, para. 6.4; V.D.A. v. Argentina, CCPR/C/101/D/1608/2007, para. 9.3.
6 K.L. v. Peru, para. 6.3; V.D.A. v. Argentina, para. 9.2.
7 International Conference on Population and Development, Programme of Action (1994), para. 8.25.
8 Fourth World Conference on Women, Platform for Action (1995), para. 106(k).
9 General Assembly Resolution S-21/2, Key actions for the further implementation of the Programme of Action of the International Conference on Population and
Development, A/RES/S-21/2 (1999), para. 63(iii).
10 General Recommendation 24 (1999) on women and health, para. 11.
11 Ibid., para. 14.
12 Concluding Observations on Peru, CEDAW/C/PER/CO/7-8 (2014), para. 36; Statement on sexual and reproductive health and rights: Beyond 2014 ICPD Review
(2014).
13 A/66/254, para. 21.
14 Ibid., para. 65(h).
15 Ibid., para. 65(i).
16 General Comment 28 (2000) on the equality of rights between men and women, para. 20.
17 L.C. v. Peru, para. 9(b)(i).
18 General Comment 28, para. 11.
19 Committee on the Rights of the Child, Concluding Observations on Chad, CRC/C/15/Add.107 (1999), para. 30.
20 Human Rights Committee, Concluding Observations on Guatemala, CCPR/C/GTM/CO/3 (2012), para. 20; Panama, CCPR/C/PAN/CO/3 (2008), para. 9;
Committee against Torture, Concluding Observations on Peru, CAT/C/PER/CO/4 (2006), para. 23; Committee on Elimination of Discrimination Against Women,
Concluding Observations on Sri Lanka, A/57/38 (2002), para. 283.
21 Committee on the Elimination of Discrimination Against Women, Concluding Observations on Angola, CEDAW/C/AGO/CO/6 (2013), para. 32(g); Human
Rights Committee, Concluding Observations on Dominican Republic, CCPR/C/DOM/CO/5 (2012), para. 15; Philippines, CCPR/C/PHL/CO/4 (2012), para.
13; Committee on the Rights of the Child, Concluding Observations on Chile, CRC/C/CHL/CO/3 (2007), para. 56; Committee on Economic, Social and Cultural
Rights, Concluding Observations on Costa Rica, E/C.12/CRI/CO/4, (2008), para. 46; Chile, E/C.12/1/Add.105 (2004), para. 53; Nepal, E/C.12/1/Add.66
(2001), para. 55.
22 Committee on the Elimination of Discrimination Against Women, Concluding Observations on Dominican Republic, CEDAW/C/DOM/CO/6-7 (2013), para. 37(c);
Committee on the Rights of the Child, Concluding Observations on Costa Rica, CRC /C/CRI/CO/4 (2011), para. 64(c); Committee on Economic, Social and
Cultural Rights, Concluding Observations on United Kingdom of Great Britain and Northern Ireland, E/C.12/GBR/CO/5 (2009), para. 25.
23 Committee on the Rights of Persons with Disabilities, Concluding Observations on Austria, CRPD/C/AUT/CO/1 (2013), paras. 14-15.
24 V.D.A. v. Argentina, CCPR/C/101/D/1608/2007, para. 9.2.
25  K.L. v. Peru, CCPR/C/85/D/1153/2003, para. 6.3.
26 General Comment 14 (2000) on the right to the highest attainable standard of health, paras. 8, 12.
27 General Comment 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health, para. 70.
28 L.C. v. Peru, CEDAW/C/50/D/22/2009, para. 8.17 (referencing Tysiac v. Poland, European Court of Human Rights).
29 General Comment 15, para. 31.
30 Office of the United Nations High Commissioner for Human Rights, Practices in adopting a human rights-based approach to the eliminate preventable maternal
mortality and morbidity, A/HRC/18/27 (2011), para. 30.
31 General Recommendation 24, para. 11.
32 General Comment 15, para. 69.
33 A/HRC/18/27, para. 29.
34 A/HRC/22/53 (2013), para. 90.
35 Concluding Observations on Chile, CAT/C/CR/32/5 (2004), para. 7(m).
36 A/HRC/18/27, paras. 29-30.

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