As women, many of us have navigated through the uncomfortable changes of puberty with an incomplete understanding of their implications and faced challenging pregnancies without adequate information or healthcare.
Our experiences vary based on geographical location, income, and ethnicity. Yet, a shared absence of a rights-based discourse on access to sexual and reproductive healthcare persists.
Women’s right to sexual and reproductive health is a fundamental human right under international law, intricately linked to the rights to life, dignity, education, information, and equality before the law.
Defined as the right to achieve complete physical, mental, and social well-being in all matters related to reproduction (International Conference on Population and Development), it guarantees autonomy in decisions regarding one’s body, including family planning, without coercion or discrimination (General Comment No. 22, International Covenant on Economic, Social and Cultural Rights; Article 16, Convention on the Elimination of All Forms of Discrimination Against Women [CEDAW]). It also ensures affordable, non-discriminatory access to healthcare, family planning services, and information (General Comment No. 22, ICESCR).
A recent UNFPA report titled “Interwoven Lives, Threads of Hope: Ending Inequalities in Sexual and Reproductive Health and Rights (2024)” paints a grim picture in Pakistan: less than 33% of women have autonomy in sexual and reproductive health decisions; only 52% can decide on their general health; and 55% exercise decision-making in sexual relations. Despite some autonomy in contraceptive use, only 40% of married women aged 15 to 49 use modern methods. The maternal mortality rate is 154 per 100,000 births, with one woman dying every 50 minutes due to pregnancy-related complications. Achieving zero maternal deaths and fulfilling family planning needs seem distant goals for Pakistan.
Most women lack autonomy over their sexual and reproductive health decisions, face barriers to necessary information and services, and suffer high mortality rates during childbirth.
In response, a rights-based discourse on reproductive and maternal health is emerging in Pakistan’s legal landscape. In Human Rights Case No. 17599/2018, the Supreme Court recognized a woman’s right to well-informed and controlled pregnancies as rooted in constitutional rights to life, equality, education, information, and due process, emphasizing the state’s duty to provide family planning information. In a recent case (Sabeen Asghar vs Punjab) on maternity leave provision, the Lahore High Court invoked international law obligations to assert that safe motherhood is a right to health and life, demanding necessary care during pregnancy and childbirth. Violating this right infringes on constitutional guarantees of equal treatment and dignity.
While judicial pronouncements advance women’s reproductive rights in the context of childbirth, the international human rights framework extends these rights more broadly. Past efforts to legislate reproductive rights (CEDAW) at the national level, like the 2019 Punjab draft bill, aimed to ensure comprehensive reproductive healthcare, sexuality education, family planning, safe abortion, and healthcare protocols. However, these efforts often face obstacles in adoption.
Does framing women’s sexual and reproductive health as a human rights issue in law make a difference? It elevates these issues, compelling the state to act decisively amidst resource constraints, education gaps, patriarchy, taboos, and political priorities. It empowers women to hold the state accountable for failing to protect and provide for their sexual and reproductive health needs.
Acknowledgment: (Opinion) Published in Dawn News on 4th July 2024.
