Safe abortion:

Technical & policy guidance for health systems

Legal and policy considerations

Laws and policies on abortion

should protect women’s health
and their human rights

Key messages
`` Laws and policies on abortion should protect women’s health and their human rights.

`` Regulatory, policy and programmatic barriers that hinder access to and timely provision of safe
abortion care should be removed.

`` An enabling regulatory and policy environment is needed to ensure that every woman who is legally
eligible has ready access to safe abortion care.

`` Policies should be geared to respecting, protecting and fulfilling the human rights of women; to
achieving positive health outcomes for women; to providing good-quality contraceptive information
and services; and to meeting the particular needs of poor women, adolescents, rape survivors and
women living with HIV.

I. Introduction little choice but to resort to unsafe providers. This

results in a large number of unnecessary deaths and
Over the past two decades, the health evidence,
morbidities, resulting in a social and financial burden
technologies and human rights rationale for
for public health systems.
providing safe, comprehensive abortion care have
evolved greatly. However, despite these advances, Where there are few restrictions on access to safe
based on 2008 data, WHO estimates that there are abortion, deaths and illness are dramatically reduced
approximately 22 million unsafe abortions annually, (3 ). To realize women’s human rights, and to save
resulting in 47 000 deaths and 5 million complications their lives and health, programmatic, legal and policy
resulting in hospital admission (1,2 ). Nearly all unsafe aspects of the provision of safe abortion need to be
abortions (98%) occurred in low- and middle-income adequately addressed.
countries. One of the factors driving unsafe abortion is
This evidence brief highlights the inextricable link
the lack of safe abortion services, even where they are
between women’s health and human rights and the
legal.
need for laws and policies that promote and protect
Restriction in access to safe abortion services results both. It provides information on how laws, regulations
in both unsafe abortions and unwanted births. Almost and policies should be geared to respect, protect and
all deaths and morbidity from unsafe abortion occur fulfil the human rights of women, to achieving positive
in countries where abortion is severely restricted in health outcomes for women, and to meeting the
law and/or in practice. In countries where induced needs of women in particularly vulnerable situations,
abortion is legally restricted and/or otherwise including poor women, adolescents, rape survivors,
unavailable, safe abortion has frequently become refugees, women living with disabilities, and women
the privilege of the rich, while poor women have living with HIV.
 II. Ensuring comprehensive legal When there is a threat to the woman’s life:
grounds for abortion Almost all countries (95%) allow abortion to be
Whether abortion is legally restricted or not, the performed to save the life of the pregnant woman
likelihood that a woman will have an abortion for (22 ). This is consistent with the human right to life,
an unintended pregnancy is about the same. Legal which requires protection by law, including when
restrictions on abortion do not result in fewer pregnancy is life-threatening or the pregnant woman’s
abortions, nor do they result in significant increases life is otherwise endangered (23 ).
in birth rates (4,5 ). However, a lack of legal access to Even where protecting a woman’s life is the only
abortion services is likely to increase the number of allowable reason for abortion, it is essential that there
women seeking illegal and unsafe abortions, leading are trained providers of abortion services, that services
to increased morbidity and mortality (6–9 ). Legal are available and known, and that treatment for
restrictions lead many women to seek services from complications of unsafe abortion is widely available.
unskilled providers or under unhygienic conditions, Saving a woman’s life might be necessary at any point
exposing them to a significant risk of death or in the pregnancy and, when required, abortion should
disability. Legal restrictions also lead many women to be undertaken as promptly as possible to minimize
seek services in other countries/states (10,11 ), which is risks to a woman’s health.
costly, delays access and creates social inequities.
When there is a threat to the woman’s health:
Conversely, laws and policies that facilitate access to Sixty-seven per cent of countries allow women to seek
safe abortion do not increase the rate or number of abortion to preserve their physical health and 64% to
abortions. The principle effect is to shift previously preserve their mental health (22 ).
clandestine, unsafe procedures to legal and safe
Since all countries that are members of WHO accept
ones (4,12 ). The accumulated evidence shows that
its constitutional description of health as “a state of
the removal of restrictions on abortion results in a
complete physical, mental and social well-being and
reduction of maternal mortality from unsafe abortion
not merely the absence of disease or infirmity” (24:1 ),
and, thus, a reduction in the overall level of maternal
this is implied in the interpretation of laws that allow
mortality (13–16 ).
abortion to protect women’s health.
In a small number of countries, where maternal
When pregnancy is the result of rape or incest:
mortality is low despite restrictive abortion laws, many
The protection of women from cruel, inhuman
women have access to safe or relatively safe abortion
and degrading treatment requires that those who
through neighbouring countries, domestically
have become pregnant as the result of coerced or
through safe but illegal abortion care, or through self-
forced sexual acts can lawfully access safe abortion
use of misoprostol (11,17,18 ).
services (23 ). Fifty-one per cent of countries reflect
Abortion laws have been liberalized since the this standard and permit abortion in the specific
beginning of the 20th century, when the extent of the cases of rape and incest (22 ). Some countries require
public health problems caused by unsafe abortion as evidence the woman’s report of the act to legal
began to be recognized (19 ). Since 1985, over 36 authorities. Others require forensic evidence of sexual
countries have liberalized their abortion laws, while penetration or a police investigation to confirm that
only a few countries have imposed further restrictions intercourse was involuntary or exploitative. Either
in their laws (20 ). These reforms have come about situation can lead women to resort to clandestine,
through both judicial and legislative action; and/or unsafe services to terminate their pregnancy.
through broader legal interpretations and applications
Prompt, safe abortion services should be provided
(19,20 ). In some criminal and penal codes, abortion
on the basis of a woman’s complaint, rather than
throughout pregnancy, or up to a set gestational
requiring forensic evidence or police examination
limit, is no longer subject to criminal regulation. In
(25–27 ). Administrative requirements should be
these situations, abortion services have usually been
minimized and clear protocols established for both
integrated into the health system and are governed by
police and health-care providers, as this will facilitate
the laws, regulations and medical standards that apply
referral and access to care (28–30 ).
to all health services (20,21 ).

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When there is fetal impairment: often more than one – of the above grounds, and they
Fifty per cent of countries allow abortion upon accept all of these as legitimate, without requiring
diagnosis of fetal impairment (22 ). Several a specific reason. This legal ground recognizes the
countries specify the kinds of impairment, such conditions for a woman’s free choice and that the
as those considered to be incompatible with life ultimate decision on whether to continue or terminate
or independent life, while others provide lists of her pregnancy belongs to the woman alone.
impairments. In some countries, no reference is
made in the law to fetal impairment; rather, health
III. Planning and managing safe
protection or social reasons are interpreted to include
distress of the pregnant woman caused by the
abortion care
diagnosis of fetal impairment (31,32 ). When performed by skilled providers using correct
medical techniques and drugs, and under hygienic
Prenatal tests and other medical diagnostic services
conditions, induced abortion is a very safe medical
cannot legally be refused because the woman may
procedure. Unsafe abortion and associated morbidity
decide to terminate her pregnancy. A woman is
and mortality in women are avoidable. Safe abortion
entitled to know the status of her pregnancy and to
services should be readily available and affordable
act on this information.
to all women to the full extent of the law. This means
For economic and social reasons: services should be available at primary care level, with
Thirty-five per cent of countries allow abortion based referral systems in place for all required higher-level
on a woman’s social and economic circumstances care.
(22 ). In countries that permit abortion for economic
Actions to strengthen policies and services related
and social reasons, the legal grounds are interpreted
to abortion should be based on the health needs
by reference to whether continued pregnancy would
and human rights of women and a thorough
affect the actual or foreseeable circumstances of the
understanding of the service-delivery system and
woman, including her achievement of the highest
the broader social, cultural, political and economic
attainable standard of health.
context.
On request:
National standards and guidelines for safe abortion
Thirty per cent of countries allow abortion upon
care should be evidence based and periodically
request of the pregnant woman (22 ). Allowing
updated, and should provide the necessary guidance
abortion on request has emerged as countries have
to achieve equitable access to good-quality care.
recognized that women seek abortions on one – and

Human rights bodies recommendations to States regarding legal

grounds for safe abortion
`` amend laws that criminalize medical procedures needed only by women, including
abortion, and/or that punish women who undergo those procedures (23, 33–46 ).

`` take actions to prevent unsafe abortion and reduce maternal deaths related to abortion,
including by amending restrictive laws that threaten the lives of women, including
adolescents (27,33,36,40,41,47–58 ).

`` provide legal abortion in cases where the continued pregnancy endangers the health of
women, including adolescents (35,36,42,47,52,58–64 ).

`` provide legal abortion in cases of rape and incest (30,35,37,42,43,47,48,51,55,58,60,62–71 ).

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 Human rights bodies recommendations to States regarding
planning and managing safe abortion care
`` ensure timely access to a range of good-quality sexual and reproductive health services,
including for adolescents, which are delivered in a way that ensures a woman’s fully
informed consent, respects her dignity, guarantees her confidentiality and is sensitive to
her needs and perspectives (33–35,37–40,53,72–74 ).

`` reduce maternal morbidity and mortality in adolescents, particularly caused by early pregnancy
and unsafe abortion practices, and develop and implement programmes that provide access
to sexual and reproductive health services, including family planning, contraception and safe
abortion services where abortion is not against the law (37,40,43,48,58,59,61,74–77 ).

`` provide information on sexual and reproductive health, as well as mechanisms to ensure that
all women, including adolescents, have access to information about legal abortion services
(46,59 ).

IV. Eliminating regulatory policy and •• failing to assure referral in case of conscientious
objection;
access barriers to safe abortion care
The legal grounds, and the scope of their •• requiring mandatory waiting periods;
interpretation, are only one dimension of the legal and •• censoring, withholding or intentionally
policy environment that affects women’s access to safe misrepresenting health-related information;
abortion. Health system and service-delivery barriers •• excluding coverage for abortion services under
may also be codified in laws, regulations, policies and health insurance, or failing to eliminate or reduce
practices. Laws, policies and practices that restrict service fees for poor women and adolescents;
access to abortion information and services can deter
•• failing to guarantee confidentiality and privacy,
women from care seeking and create a chilling effect
including for treatment of abortion complications;
(suppression of actions because of fear of reprisals or
penalties). •• requiring women to provide the names of
practitioners of illegal abortion before providing
Examples of barriers include:
them with treatment for complications from the
•• prohibiting access to information on legal abortion procedure;
services, or failing to provide public information on
•• restrictive interpretation of legal grounds.
the legal status of abortion;
•• requiring third-party authorization from one These barriers contribute to unsafe abortion because
or more medical professionals or a hospital they:
committee, court or police, parent or guardian or a •• deter both women from seeking care and providers
woman’s partner or spouse; from delivering services within the formal health
•• restricting available methods of abortion, including system;
surgical and medical methods through, for •• cause delays in access to services, which may result
instance, lack of regulatory approval for essential in denial of services due to gestational limits on
medicines; legal grounds;
•• restricting the range of health-care providers and •• create complex and burdensome administrative
facilities that can safely provide services, e.g. to procedures;
physicians in inpatient facilities with sophisticated •• increase the costs of accessing abortion services;
equipment;
•• limit the availability of services and their equitable
geographic distribution.
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 Human rights bodies recommendations to States on
eliminating regulatory and policy barriers to safe abortion care
`` remove third-party authorization requirements that interfere with women’s and
adolescents’ right to make decisions about reproduction, including on abortion,
and to exercise control over their bodies (23,59,61).

`` eliminate barriers that impede women’s access to health services, such as high fees, the
requirement for preliminary authorization by spouse, parent or hospital authorities, long
distances from health facilities, and the absence of convenient and affordable public
transport; and ensure that the exercise of conscientious objection does not prevent women
from accessing services to which they are legally entitled (35,40,59,76,78–81 ).

`` implement a legal and/or policy framework that enables women to access abortion where
the medical procedure is permitted under the law (71,82,83 ).

`` ensure abortion services that are allowable by law are accessible in practice
(35,47,58,59,63,64,71,83,84 ).

`` institutional and administrative mechanisms should be in place and should protect against
unduly restrictive interpretations of legal grounds (71,83,84 ).

V. Providing treatment of abortion complications

Health-care providers are obligated to provide life-saving medical care to any woman who suffers abortion-
related complications, including treatment of complications from unsafe abortion, regardless of the legal
grounds for abortion. However, in some cases, treatment of abortion complications is administered only if the
woman provides information about the person(s) who performed the illegal abortion. This has been considered
torture and inhuman and degrading treatment (85 ).
Every service-delivery site at each level of the health system should be equipped and have personnel trained to
recognize abortion complications and to provide or refer women for prompt care, 24 hours a day, regardless of

Human rights bodies recommendations to States regarding

providing treatment of abortion complications
`` provide immediate and unconditional treatment to anyone seeking emergency
medical care (33,34,37,39,70,85).

`` provide timely treatment for abortion complications regardless of the law on induced
abortion, to protect a woman’s life and health (33,34,37,39,68,70,76,85,87 ).

`` eliminate the practice of extracting confessions for prosecution purposes from women
seeking emergency medical care as a result of illegal abortion, as well as court authorization
and the legal requirement for doctors and other health-care personnel to report cases of
women who have undergone abortion (23,73,85,88 ).

`` provide quality treatment for complications from unsafe abortion in ways that preserve
women’s privacy, confidentiality and dignity (41,46,68 ).

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 the legal grounds for abortion (33,34,37,39,70,85,86 ). The facilities and skills required to manage most abortion
complications are similar to those needed to care for women who have had a spontaneous abortion (miscarriage).

VI. Creating an enabling •• prevent and address stigma and discrimination

against women who seek abortion services or
environment
treatment for abortion complications;
An enabling environment is needed to ensure that
every woman who is legally eligible has ready access •• reduce maternal mortality and morbidity due to
to safe abortion care. The respect, protection and unsafe abortion, by ensuring that every woman
fulfilment of human rights require that comprehensive entitled to legal abortion care can access safe
laws, regulations and policies be in place to ensure and timely services, including post-abortion
that abortion is safe and accessible. contraception;

Laws, regulations and policies should aim to: •• meet the particular needs of women belonging
to vulnerable and disadvantaged groups, such as
•• respect, protect and fulfil the human rights of
poor women, adolescents, single women, refugees
women, including women’s dignity, autonomy and
and displaced women, women living with HIV, and
equality;
survivors of rape.
•• promote and protect women’s health as a state of
complete physical, mental and social well-being; While States differ in prevailing national health system
conditions and constraints on available resources,
•• minimize the rate of unintended pregnancy by
all States can take immediate and targeted steps to
providing good-quality contraceptive information
elaborate comprehensive polices that expand access
and services, including a broad range of
to sexual and reproductive health services, including
contraceptive methods, emergency contraception
safe abortion care.
and comprehensive sexuality education;
Unsafe abortion and associated morbidity and
mortality in women are avoidable. Nearly every death
and harm from unsafe abortion can be prevented
through sexuality education, use of effective
contraception, provision of safe, legal abortion and
emergency treatment of abortion complications.

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References

1. Unsafe abortion: global and regional estimates of 13. David HP. Abortion in Europe, 1920–91 – a public-
the incidence of unsafe abortion and associated health perspective. Stud Fam Plann. 1992;23:1–22.
mortality in 2008, 3rd edition. Geneva: World 14. Jewkes R, Brown H, Dickson-Tetteh K, Levin J, Rees
Health Organization; 2011 (http://www.who. H. Prevalence of morbidity associated with abortion
int/reproductivehealth/publications/unsafe_ before and after legalisation in South Africa. BMJ.
abortion/9789241501118/en, accessed 7 April 2015). 2002;324:1252–3. doi:http://dx.doi.org/10.1136/
2. Singh S. Hospital admissions resulting from unsafe bmj.324.7348.1252.
abortion: estimates from 13 developing countries. 15. Jewkes R and Rees H. Dramatic decline in abortion
Lancet. 2006;368:1887–92. doi:10.1016/s0140- mortality due to the Choice on Termination of
6736(06)69778-x. Pregnancy Act. S Afr Med J. 2005;95(4):250.
3. Shah I, Ahman E. Unsafe abortion: global and 16. Suvedi BK, Pradhan A, Barnett S, Puri M, Chitrakar
regional incidence, trends, consequences and SR, Poudel P, et al. Nepal maternal mortality and
challenges. J Obstet Gynaecol Can. 2009;31:1149–58. morbidity study 2008/2009: summary of preliminary
4. Sedgh G, Singh S, Shah IH, Ahman E, Henshaw findings. Kathmandu, Nepal: Family Health Division,
SK, Bankole A. Induced abortion: incidence and Department of Health Services, Ministry of Health;
trends worldwide from 1995 to 2008. Lancet. 2009 (http://www.dpiap.org/resources/pdf/nepal_
2012;379:625–32. doi: http://dx.doi.org/10.1016/ maternal_mortality_2011_04_22.pdf, accessed 7
S0140-6736(11)61786-8. April 2015).

5. Levine PB, Staiger D. Abortion policy and fertility 17. Kulczycki A. Abortion in Latin America: changes
outcomes: the Eastern European experience. J Law in practice, growing conflict, and recent policy
Econ. 2004;XLVII:223–43. developments. Stud Fam Plann. 2011;42(3):199–220.

6. David HP. Soviet Union. In: David HP, editor. Abortion 18. Briozzo L, Vidiella G, Rodríguez F, Gorgoroso M,
research: international experience. Lexington (MA): Faúndes A, Pons JE. A risk reduction strategy to
Lexington Books, 1974:209-16. prevent maternal deaths associated with unsafe
abortion. Int J Gynaecol Obstet. 2006;95(2):221–6.
7. Serbanescu F, Morris L, Stupp P, Stanescu A. The
impact of recent policy changes on fertility, abortion, 19. Dickens BM. Human rights dynamics of abortion law
and contraceptive use in Romania. Stud Fam Plann. reform. Hum Rights Q. 2003, 25:1–59.
1995;26(2):76–87. 20. Boland R, Katzive L. Developments in laws on
8. Zhirova IA, Frolova OG, Astakhova TM, Ketting E. induced abortion: 1998–2007. Int Fam Plan Perspect.
Abortion-related maternal mortality in the Russian 2008;34:110–20. doi:10.1363/3411008.
Federation. Stud Fam Plann. 2004;35(3):178–88. 21. Cook RJ, Dickens BM. Human rights dynamics of
9. Millennium development goals in Russia: abortion law reform. Hum Rights Q. 2003;25:1–59.
looking into the future. Moscow: United Nations 22. World abortion policies 2013. New York (NY):
Development Programme; 2010. Population Division, United Nations Department for
10. Joyce TJ, Henshaw SK, Dennis A, Finer LB, Blanchard Economic and Social Affairs; 2013.
K. The impact of state mandatory counselling and 23. General Comment No. 28: The equality of rights
waiting period laws on abortion: a literature review. between men and women. Geneva: United Nations
New York (NY): Guttmacher Institute; 2009 (https:// Human Rights Committee; 2000 (CCPR/C/21/Rev.1/
www.guttmacher.org/pubs/MandatoryCounseling. Add.10).
pdf, accessed 7 April 2015).
24. WHO Constitution. 47th edition. Geneva: World
11. Payne D. More British abortions for Irish women. Health Organization; 2009:1 (http://apps.who.int/
BMJ. 1999;318(7176):77. gb/bd/PDF/bd47/EN/basic-documents-47-en.pdf,
12. Grimes D, Benson J, Singh S, Romero M, Ganatra B, accessed 13 May 2015.
Okonofua FE, et al. Unsafe abortion: the preventable
pandemic. Lancet. 2006;368:1908–19. doi:http://
dx.doi.org/10.1016/S0140-6736(06)69481-6.

7
 25. Clinical management of rape survivors: developing 38. Concluding comments: Liechtenstein. New York
protocols for use with refugees and internally (NY): United Nations Committee on the Elimination
displaced persons. Revised edition. Geneva: of Discrimination against Women; 2007 (CEDAW/C/
World Health Organization/United Nations High LIE/CO/3).
Commissioner for Refugees; 2004 (http://whqlibdoc.
39. Concluding comments: Mauritius. New York (NY):
who.int/publications/2004/924159263X.pdf,
United Nations Committee on the Elimination of
accessed 7 April 2015).
Discrimination against Women; 2006 (CEDAW/
26. Cook RJ, Dickens BM, Fathalla MF. Reproductive CMAR/CO/5).
health and human rights: integrating medicine,
40. Concluding comments: Nicaragua. New York (NY):
ethics and law. Oxford: Oxford University Press; 2003.
United Nations Committee on the Elimination of
27. Concluding observations: Argentina. New York (NY): Discrimination against Women; 2007 (CEDAW/C/NIC/
United Nations Committee on the Rights of the CO/6).
Child; 2010 (CRC/C/ARG/CO/3–4).
41. Concluding comments: Paraguay. New York (NY):
28. Billings D, Moreno C, Ramos C, González de León D, United Nations Committee on the Elimination of
Ramírez R, Villaseñor Martínez L, et al. Constructing Discrimination against Women; 2011 (CEDAW/C/
access to legal abortion services in Mexico City. PRY/CO/6).
Reprod Health Matters. 2002;10:87–95.
42. Concluding comments: United Kingdom of Great
29. Villela WV, Oliveira Araujo M. Making legal abortion Britain and Northern Ireland. New York (NY):
available in Brazil: partnership in practice. Reprod United Nations Committee on the Elimination of
Health Matters. 2000;8:77–82. Discrimination against Women; 2013 (CEDAW/C/
GBR/CO/7).
30. Concluding observations: Peru. New York (NY):
United Nations Committee on Economic Social and 43. Concluding observations: Costa Rica. New York (NY):
Cultural Rights; 2012 (E/C.12/PER/CO/24). United Nations Committee on the Elimination of
Discrimination against Women; 2011 (CEDAW/C/CRI/
31. Cook RJ, Ngwena CG. Women’s access to health
CO/5–6).
care: the legal framework. Int J Gynaecol Obstet.
2006;94:216–25. 44. Concluding observations: El Salvador. New York (NY):
United Nations Committee on the Elimination of
32. Cook RJ, Erdman JN, Hevia M, Dickens BM. Prenatal
Discrimination against Women; 2008 (CEDAW/C/SLV/
management of anencephaly. Int J Gynaecol Obstet.
CO/7).
2008;102:304–8. doi:10.1016/j.ijgo.2008.05.002.
45. Concluding observations: Guatemala. New York
33. Concluding comments: Brazil. New York (NY):
(NY): United Nations Committee on the Elimination
United Nations Committee on the Elimination of
of Discrimination against Women; 2001 (CEDAW/C/
Discrimination against Women; 2007 (CEDAW/C/
GUA/CO/6).
BRA/6).
46. Concluding observations: Kenya. New York (NY):
34. Concluding comments: Chile. New York (NY):
United Nations Committee on the Elimination of
United Nations Committee on the Elimination of
Discrimination against Women; 2011 (CEDAW/C/
Discrimination against Women; 2006 (CEDAW/C/CHI/
KEN/Q/7).
CO/4).
47. Concluding comments: Dominican Republic.
35. Concluding comments: Colombia. New York (NY):
New York (NY): United Nations Committee on the
United Nations Committee on the Elimination of
Elimination of Discrimination against Women; 2013
Discrimination against Women; 1999 (A/54/38/REV.
(CEDAW/C/DOM/CO/6–7).
1[SUPP] paras. 337–401).
48. Concluding observations: Chile. New York (NY):
36. Concluding comments: Democratic Republic of
United Nations Committee on the Rights of the
Congo. New York (NY): United Nations Committee
Child; 2007 (CRC/C/CHL/CO/3).
on the Elimination of Discrimination against Women;
2013 (CEDAW/C/COD/CO/6–7). 49. Concluding observations: Chile. Geneva: United
Nations Human Rights Committee; 2007 (CCPR/C/
37. Concluding comments: Honduras. New York (NY):
CHL/CO/5).
United Nations Committee on the Elimination of
Discrimination against Women; 2007 (CEDAW/C/
HON/CO/6).

8
50. Concluding observations: Colombia. Geneva: United 63. Concluding observations: Malta. New York (NY):
Nations Human Rights Committee; 2004 (CCPR/ United Nations Committee on Economic Social and
CO/80/COL). Cultural Rights; 2004 (E/C.12/1/Add.101).
51. Concluding observations: Costa Rica. New York (NY): 64. Concluding observations: Monaco. New York (NY):
United Nations Committee on Economic Social and United Nations Committee on Economic Social and
Cultural Rights; 2008 (E/C.12/CRI/CO/4/CORR.1). Cultural Rights; 2006 (E/C.12/MCO/CO/1).
52. Concluding observations: Ecuador. Geneva: United 65. Concluding comments: Algeria. New York (NY):
Nations Human Rights Committee; 1998 (CCPR/C/79/ United Nations Committee on the Elimination of
Add.92). Discrimination against Women; 2012 (CEDAW/C/
DZA/CO/3–4).
53. Concluding observations: Guatemala. Geneva:
United Nations Human Rights Committee; 2001 66. Concluding observations: Andorra. New York (NY):
(CCPR/CO/72/GTM). United Nations Committee on the Rights of the
Child; 2012 (CRC/C/AND/CO/2).
54. Concluding observations: Madagascar. Geneva:
United Nations Human Rights Committee; 2007 67. Concluding observations: Chile. New York (NY):
(CCPR/C/MDG/CO/3). United Nations Committee on Economic Social and
Cultural Rights; 2004 (E/C.12/1/Add.105).
55. Concluding observations: Nepal. New York (NY):
United Nations Committee on Economic Social and 68. Concluding comments: Costa Rica. New York (NY):
Cultural Rights; 2001 (E/C.12/1/Add.66). United Nations Committee on the Rights of the
Child; 2011 (CRC/C/CRI/CO/4).
56. Concluding observations: Poland. Geneva: United
Nations Human Rights Committee; 2004 (CCPR/ 69. Concluding observations: Djibouti. Geneva: United
CO/82/POL). Nations Human Rights Committee; 2013 (CCPR/C/
DJI/CO/1).
57. Karen Noella Llantoy Huaman v. Peru.
Communication no. 1153/2003. Special Rapporteur’s 70. Concluding comments: Sri Lanka. New York (NY):
rule 91 decision, transmitted to the State party United Nations Committee on the Elimination of
on 8 January 2003 (not issued in document form). Discrimination against Women; 2011 (CEDAW/C/
Geneva: United Nations Human Rights Committee; LKA/CO/7).
2005 (CCPR/C/85/D/1153/2003).
71. LC. v. Peru. Communication No. 22/2009, decided on
58. Protocol to the African Charter on Human and 4 November 2011. New York (NY): United Nations
Peoples’ Rights on the Rights of Women in Africa. Committee on the Elimination of Discrimination
Article 14.2. Maputo, Mozambique: African against Women; 2011 (CEDAW/C/50/D/22/2009).
Commission on Human and People’s Rights; 2003
72. Concluding observations: Dominican Republic.
(http://www.achpr.org/files/instruments/women-
Geneva: United Nations Human Rights Committee;
protocol/achpr_instr_proto_women_eng.pdf,
2012 (CCPR/CO/71/DOM).
accessed 7 April 2015).
73. Concluding observations: El Salvador. Geneva:
59. General Recommendation No. 24: Article 12:
United Nations Human Rights Committee; 2010
Women and health. New York (NY): United Nations
(CCPR/C/SLV/CO/6).
Committee on the Elimination of Discrimination
against Women; 1999 (A/54/38/Rev.1, Chapter I). 74. Concluding observations: Liberia. New York (NY):
United Nations Committee on the Rights of the
60. Concluding observations: El Salvador. New York (NY):
Child; 2012 (CRC/C/LBR/CO/2–4).
United Nations Committee on Economic Social and
Cultural Rights; 2007 (E/C.12/SLV/CO/2). 75. General Comment No. 4: Adolescent health and
development in the context of the Convention
61. Concluding comments: Indonesia. New York (NY):
on the Rights of the Child. New York (NY): United
United Nations Committee on the Elimination of
Nations Committee on the Rights of the Child; 2003
Discrimination against Women; 2012 (CEDAW/C/IDN/
(CRC/GC/2003/4).
CO/6–7).
76. General Comment No. 15: The rights of the child to
62. Concluding observations: Ireland. Geneva: United
the highest attainable standard of health. Geneva:
Nations Human Rights Committee; 2014 (CCPR/C/
United Nations Committee on the Rights of the
IRL/CO/4).
Child; 2013 (CRC/C/GC/15).

9
 77. Concluding observations: Jamaica. Geneva: United 83. Tysiąc v. Poland. Application No. 5410/03, decided
Nations Human Rights Committee; 2011 (CCPR/C/ on 24 September 2007. Strasbourg: European Court
JAM/CO/3). of Human Rights; 2007.
78. Concluding comments: Hungary. New York (NY): 84. Paulina del Carmen Ramírez Jacinto, Mexico. Friendly
United Nations Committee on the Elimination of Settlement, Report No. 21/07, Petition 161–01,
Discrimination against Women; 2013 (CEDAW/C/ 9 March 2007. Washington (DC): Inter-American
HUN/CO/7-8/Corr.1). Commission on Human Rights; 2007.
79. Concluding observations: Zambia. Geneva: United 85. Concluding observations: Chile. Geneva: United
Nations Human Rights Committee; 2007 (CCPR/C/ Nations Committee against Torture; 2004 (CAT/C/
ZMB/CO/3). CR/32/5).
80. P. and S. v. Poland. Application No. 57375/08, 86. Clinical management of abortion complications: a
decided on 30 October 2012. Strasbourg: European practical guide. Geneva: World Health Organization;
Court of Human Rights; 2012. 1994.
81. RR. v. Poland. Application No. 27617/04, decided on 87. Concluding comments: Samoa. New York (NY):
28 November 2011. Strasbourg: European Court of United Nations Committee on the Elimination of
Human Rights; 2011. Discrimination against Women; 2012 (CEDAW/C/
WSM/CO/4–5).
82. A.B. and C. v. Ireland. Application No. 25579/05,
decided on 16 December 2010. Strasbourg: 88. Concluding observations: Plurinational State of
European Court of Human Rights; 2010. Bolivia. Geneva: United Nations Human Rights
Committee; 2013 (CCPR/C/BOL/CO/3).

For more information, please contact:

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