This week, for the first time, the United States submitted a report to the U.N. Human Rights Council, a rotating body of countries that peer-review U.N. member countries’ human rights records. This submission is historic. Where the Bush administration spent years criticizing the U.N. and human rights processes, in this report the Obama administration has stressed an end to U.S. human rights exceptionalism, quoting Hillary Clinton’s statement that “[h]uman rights are universal . . . . That is why we are committed to “holding everyone to the same [human rights] standards, including ourselves.”
But the euphoria wears off when you read the administration’s report. Once again, a U.S. administration has failed to take women’s reproductive rights seriously. U.N. human rights bodies have repeatedly criticized the U.S. on racial disparities in the availability of reproductive healthcare within the country and the barbaric practice of shackling incarcerated pregnant women during delivery. We raised these issues and the issue of discriminatory government policies that undermine women’s access to abortion with the State Department. But the only reference to reproductive health in the State Department report is a couple of sentences on the high cervical cancer rates in Hispanic women and rates of HIV and AIDS diagnoses.
In order to make sure that the U.N. Human Rights Council doesn’t make the same mistake when it reviews the U.S. performance on human rights in November, the Center for Reproductive Rights, SisterSong Women of Color Reproductive Justice Collective, Rebecca Project for Human Rights, Law Students for Reproductive Justice, National Asian Pacific American Women’s Forum, National Abortion Federation and Women on the Rise Telling HerStory submitted our own report to the Council. We focus on three key issues:
Racial Discrimination in Reproductive Health
First, women of color are considerably worse off than white women in every aspect of reproductive health. And the government’s continued failure to tackle these issues raises serious human rights concerns. Today, and for the last fifty years, African American women die in pregnancy or childbirth at a rate up to four times that of white women. Just two years ago, the committee that oversees countries’ compliance with the U.N. human rights treaty to eliminate racial discrimination criticized the U.S. for failing to adequately address the high incidence of maternal deaths to no avail.
In addition, women of color contract sexually transmitted infections at much higher rates than the majority white population. And while the overall unintended pregnancy rate has declined over the last fifteen years, it has remained consistently high among poor women of color. The committee called on the U.S. government to take specific actions to eliminate these disparities, including by increasing access to contraception and sexuality education. The causes of racial disparities are complex and systemic, and long-term interventions are likely needed to eradicate them, but the U.S. can—and should— do more to improve access to reproductive and sexual healthcare in the short term. The U.S.’s report claims that healthcare reform will reduce racial disparities, but as we wait to see how healthcare reform will be implemented, the outcome is far from clear. An important first step would be the inclusion of contraception in the list of benefits that insurance plans must contain, so that the barrier of out-of-pocket costs does not threaten women’s access to contraception.
Lack of Access to Abortion
Second, the U.S. report is completely silent on the issue of women’s ability to obtain abortion. Although abortion has been legal in the U.S. for almost forty years, the availability of abortion care has been dramatically reduced. Today 25 percent fewer abortion providers exist than they did in the 1990s. The threat of violence and an ongoing barrage of medically unnecessary restrictive laws severely limit existing doctors’ ability to provide services. And the shortage of providers makes it extremely difficult for women, especially poor and rural women, to access abortion, a legal medical service. Policies restricting the use of Medicaid funds for abortions in most cases, even where necessary to protect a woman’s health, and restricting the way that private funds can be spent on health insurance coverage on the new exchanges narrow access even further. One of our clients, the owner of abortion clinics, testified to the State Department about abortion providers operating under a constant state of siege, legal and physical. In thirty years of providing services, she’s seen acid attacks, anthrax threats, picketing, and two suspicious fires that effect healthcare providers and ultimately harm patients, frequently preventing them from seeking routine healthcare.
Shackling Pregnant Inmates
Finally, the U.S. report totally ignores the outrageous practice of shackling pregnant incarcerated women. Pregnant women who are detained in U.S. prisons, jails, and immigration facilities continue to be shackled during transportation to medical appointments and while giving birth. Human rights experts have expressed concern about this barbaric practice, and the treatment of detained women generally, calling on the government to prohibit the practice. Disappointingly, while the U.S. report’s section on “dignity and incarceration” discusses the government’s efforts to address sexual assault in detention facilities, it doesn’t mention shackling.
It’s now even more important that the U.N. Human Rights Council raises these issues on November 5, when it discusses the U.S. report with U.S. government representatives. A woman’s right to make fundamental decisions about her life and her family, her right to access reproductive health services and her ability to decide when and whether to have children are strongly rooted in a number of fundamental human rights. And the U.S. government is obliged to respect, protect, and fulfill those rights.