This article is part of a feature series exploring how the Covid-19 pandemic and the measures to prevent its spread are impacting the human rights of under-18s. 

Health systems around the world are prioritising health care services and equipment to treat people diagnosed with Covid-19, which means that many procedures deemed to be elective and non-essential are being suspended or simply not provided. Abortion, for instance, has been categorised as a non-essential health service by some States, while others have removed certain restrictions to accessing abortion. 

To find out more about the current state of women and girls’ reproductive rights, and how activists are responding, CRIN’s Regional Advisor for the Middle East and North Africa, Sabine Saliba, spoke with Paola Salwan Daher, a feminist activist from Lebanon and Senior Global Advocacy Advisor at the Center for Reproductive Rights office in Geneva. 

Some countries are trying to impose restrictions on access to abortion, including the US and Poland, among others. Can you tell us more about these measures, and how is the Center for Reproductive Rights and its partners responding?

The Covid-19 response has created a lot of violations of sexual and reproductive health rights, including in the US where we are seeing a lot of bills being pushed to try to restrict abortions. States like Texas, Oklahoma, Ohio, Idaho and others have decided that abortion is a non-essential health service. That is something that we are challenging in court. 

In the majority of cases courts have sided with us, but it has happened that courts haven't. We continue pushing against these restrictions because we are talking about States that already have very shaky access to abortion with very limited options for women and very few clinics that have remained open. 

We also know that there were instances of hospitals in Sao Paolo, Brazil that are not categorising abortions as an essential medical service. It's also happening in other countries but it's been less documented than cases in the US and Poland.

There are also good examples where States are saying that abortion is an essential health service. In France, activists have been able to push the goverment to extend the [time] limit to access medical abortion, extending it from seven to nine weeks in response to the delay in accessing services because of how the health system is overwhelmed by Covid-19 cases. In the UK, they are also facilitating access to medical abortion via tele-medicine. However, this easing of these barriers is not enough, and activists are still pushing further for the removal of barriers to access abortion. 

In your opinion, why is abortion seen as a non-essential procedure? 

Where there have been attempts at taking off abortion from the list of essential services, it has been done mainly in places where abortion access was already restricted and the Covid-19 crisis provided an excellent political opportunity to further restrict access. Drugs used for medical abortion are listed as essential medicines by the World Health Organization (WHO), [which] reiterated the message contained in the 1994 International Conference on Population and Development (ICPD), that every woman has the recognised human right to decide freely and responsibly, without coercion and violence, the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. Access to legal and safe abortion is essential for the realisation of these rights. Not recognising the essential character of access to abortion care is to go against international human rights law and WHO guidance.

How is the Covid-19 pandemic impacting other areas of your work? And how were you able to respond?

“The issue with girls is that whenever there’s a restrictive legal framework with respect to abortion... for girls there are always additional barriers because of their age, like third party authorisation.”

We are also seeing violations of the right to maternal health care. Under the pretext of the Covid-19 response, some hospitals are denying women birth partners despite [the] WHO's recommendation that there are better maternal health and infant health outcomes when women have the ability to have a partner [present] when they are giving birth. 

We have also seen instances of scheduling unnecessary c-sections, sometimes going against the wishes of the person, or discharging women earlier than they would normally, saying it's a measure to avoid contamination. It's a very fine balance between the excuses given of wanting to protect women and infants and punishing women and curtailing their rights. What we really should be interrogating is the state of health systems and why they are built in a way that countries cannot respond to a pandemic without curtailing women's rights. 

Have you seen anything specific to girls?

No, not that I have heard of. The issue with girls is that whenever there's a restrictive legal framework with respect to abortion, for them it's even worse. Even when the abortion law for women isn't very restrictive, for girls there are always additional barriers because of their age, like third party authorisation, which contravenes legal obligations of States under human rights law. One of the recommendations that came out of the UN Committee on the Rights of the Child's General Comment on children’s rights during adolescence is that States should include a presumption of legal capacity of adolescents to access sexual reproductive services.

We don't often hear about reproductive rights explicitly in terms of children's rights. Why might that be? 

Human rights standards are very clear on the right to sexual and reproductive health being applicable to both women and girls (see the UN Committee on Economic, Social and Cultural Rights General Comment 22). Also as per the UN Committee on the Rights of the Child, General Comment 20, “The risk of death and disease during the adolescent years is real, including from preventable causes such as childbirth, unsafe abortions, road traffic accidents, sexually transmitted infections, including HIV, interpersonal injuries, mental ill health and suicide, all of which are associated with certain behaviours and require cross-sectoral collaboration.”

Girls have sexual and reproductive rights because they are sexual beings that will have sex, might want to get pregnant, but also might be at a higher risk of violence, rape and sexual abuse, that would require access to sexual and reproductive information and services.

The reason why some are reluctant to recognise girls’ reproductive rights is because of pervasive stereotypes that cast girls as non-sexual persons, or who at least shouldn’t be having sex. These stereotypes are deeply harmful and refuse to take into account girls’ agency, right to bodily autonomy, as well as the need for accountability when girls’ sexual and reproductive rights are violated.

Even though the answer to this question may be evident, can you explain why governments are trying to restrict women and girl's access to reproductive rights?

It's this willingness to control women's bodies. Reproductive justice and women's right to bodily autonomy is one of the foundations of women's equality. When a woman is able to decide for herself how many children she wants to have - if [any] at all - and the spacing of these children and with whom she wants to have them, it puts her at the same level as a man. She will then want the same rights, which is a problem for the establishment. It's social control over women to make sure that we are continuing to provide free reproductive labour, we continue to be the primary caregiver of children, thus limiting our ability to take up more of a productive role and more community and political roles. The rise of fundamentalism and of populism and the conservative idea that women and their bodies need to be controlled along with gender stereotypes are the root causes of restrictions to reproductive rights. 

Do you believe that governments will increase these regressive proposals/measures? 

In times of crisis it's women and marginalised groups that are the worst hit and primary target of restrictive policies. It might very well be that we see an increase of the backlash that we have been witnessing on women's rights for the past couple of years because of the crisis. It's also an opportunity for women and marginalised groups because the workers on the frontlines are disproportionately women. Reproductive health work is the kind of work that is holding societies together. We're not in need of bankers, we're not in need of people in advertising right now, we are actually in need of people who provide care work and health work. These people are disproportionately women and I see a window of opportunity for women and marginalised groups to organise and mobilise because they're the worst hit. I see a window of opportunity to ask for changes.