In this AO on the situation of persons deprived of their liberty, the Court establishes a specific section on "The need to adopt special measures to give effect to the rights of pregnant, postpartum and breastfeeding women or primary caregivers deprived of their freedom", and there it recognizes and defines obstetric violence.
The purpose of this law is to recognize and guarantee the rights of women during pregnancy, labor, delivery, postpartum and gestational and perinatal mourning with freedom of decision, conscience and respect; as well as to recognize and guarantee the rights of newborns.
In this report the IACHR states that although there is no legal definition of obstetric violence, the IACHR has considered that "obstetric violence encompasses all situations of disrespectful, abusive, negligent treatment, or denial of treatment, during pregnancy and the previous stage, and during childbirth or postpartum, in public or private health centers". The IACHR specifies that obstetric violence is defined as actions or omissions on the part of doctors and support personnel in public or private health services during pregnancy, childbirth and postpartum; characterized by dehumanizing or discriminatory treatment that causes physical, psychological or moral harm to the woman.
This decree regulates Article 6 of Law 19.580 on Gender-Based Violence against Women. It establishes that health service providers must adopt the necessary measures to ensure that women's care during the preconception consultation, pregnancy, birth and puerperium, as well as that of newborns, complies with the principles of the humanized-respectful care model. In particular, it determines that clinical practice should respect the right of every woman to be treated with respect, to be informed and to be accompanied by a trusted emotional support person throughout labor.
In this document, the States of the region decide to reaffirm "the Montevideo Consensus on Population and Development as the basis for a comprehensive and strategic roadmap for national and regional action on population and development, which provides specific orientations and guidelines for the region in this area beyond 2014".
The law defines gynecological and obstetric violence among the types of violence.
The Montevideo Strategy comprises 74 measures for the ten axes for implementation that are agreed upon at the regional level by the governments of Latin America and the Caribbean, and which are subsequently adapted to the priorities and needs of the countries and inserted into the sustainable development plans, although they are applicable at different levels (national, subnational, local, regional and international). In this strategic document, the States Parties agree to define that ""The Regional Gender Agenda identifies agreements for gender equality and women's autonomy in relation to multiple issues that can be grouped into critical dimensions linked to human rights, and which, therefore, recognize women as subjects of rights and the States as guarantors of these rights, while ratifying their universal, indivisible, inalienable and interdependent nature: ii) Sexual and reproductive rights in relation to: information and comprehensive sexual education; safe and quality abortion services, in cases where abortion is legal or decriminalized in national legislation; contraception; integrated social health services; maternal mortality; sexual orientation and gender identity; universal and accessible services; disability and old age; eradication of pregnancy in girls, prevention of pregnancy and teenage motherhood; sexually transmitted infections and HIV/AIDS; health emergencies; healthy motherhood; technological development; different types of families.
The purpose of this law is to establish policies and strategies for the prevention of violence against women, mechanisms for attention and measures for protection, punishment and comprehensive reparation. It defines violence against reproductive rights as the action that impedes, limits or violates the right of women to freely decide the number of children they wish to have; to receive information, guidance, comprehensive care and treatment during pregnancy or loss of pregnancy, childbirth, puerperium and breastfeeding; to exercise safe motherhood; or to choose safe contraceptive methods. In addition, it defines obstetric violence as violence exercised by health personnel over women's bodies and the physiological or pathological processes present during pregnancy, and as dehumanizing treatment that violates women's human rights.
The purpose of this standard is to establish the minimum criteria for medical care for women during pregnancy, childbirth and puerperium. It determines that care should be comprehensive and focused on considering human reproduction as an expression of reproductive rights, promoting co-responsibility in health care for the woman, her partner, the community and health personnel. Care for women during pregnancy, childbirth and puerperium and for newborns must be provided with quality and respect for their human rights, especially their dignity and cultural heritage, providing psychological support during their development. In addition, it establishes that no person providing gynecology and obstetrics services shall discriminate against or exercise any type of violence against women in labor.
Through this regulation, the Legislature amends Law No. 156 in order to clarify the scope of its provisions. In particular, it specifies the right of the woman in labor to be accompanied by a person of her choice and establishes greater safeguards to the right of the expectant mother to be informed prior to consenting any particular procedure.
The Montevideo Consensus is a milestone in the sexual and reproductive rights agenda at the regional and global level because it establishes the first definition of sexual and reproductive rights agreed upon at the intergovernmental level, and indicates a concrete regional agenda, a true roadmap with clear lines of action in addition to 130 points that recognize the need to establish accountability and follow-up mechanisms, as well as definitions based on the international human rights obligations of States.
In this document there is a chapter that states that women's autonomy is an essential factor in guaranteeing the exercise of their human rights in a context of full equality and, in particular, that control over their bodies, their integral health and the right to a life free of violence (physical autonomy) is an essential factor in guaranteeing the exercise of their human rights in a context of full equality.
This law aims to guarantee women's right to a life free of violence. It establishes that women have the right to decide about their reproductive life in accordance with the law, as well as to decide the number of pregnancies and when to have them. It defines violence against reproductive freedom as that which violates the right of women to decide freely and responsibly the number of pregnancies or the interval between births. As for obstetric violence it defines it as that which is exercised by health personnel over the body and reproductive processes of women, whether expressed in abusive, dehumanizing, humiliating or rude treatment.
The law defines violence against reproductive rights as one of the types of violence.
This was the first case on maternal mortality brought before the CEDAW Committee. The Committee approached the case with reference to Article 12 of the ICESCR and General Comment 14 on the right to health developed by the CESCR to capture the scope of the rights and obligations at stake. This case represented an important step towards greater coherence in international human rights law on women's economic, social and cultural rights. Also, the CEDAW Committee's inclusion of factors that affected Pimentel's access to health services, such as poverty and race, was important in further developing an inter-sectional concept of ESC rights. (ESCR NETWORK)
The purpose of this law is to ensure the minimum conditions for the exercise of all persons' right to decide the number and frequency of the birth of their children and to receive adequate services, as well as proper assistance to the woman and the newborn during childbirth. For this purpose, resources for the provision of contraceptives and delivery kits are assured and the right of every woman to receive these supplies free of charge, according to her voluntary and informed choice, is established.
The States of the region adopted action agreements for the promotion of women's autonomy and gender equality, which include a specific chapter on "Promoting women's comprehensive health and sexual and reproductive rights" (Chapter 6).
The Committee on the Elimination of Discrimination against Women affirms that access to health care, including reproductive health care, is a basic right under the Convention on the Elimination of All Forms of Discrimination against Women.
The Timeline of Legal Milestones on Sexual and Reproductive Rights in Latin America is a virtual tool that provides a chronological and organized overview of the normative development related to the enforcement of sexual and reproductive rights in the Latin American and Caribbean region at the international, regional, and national levels. This is achieved through the identification of legal milestones that have taken place from 1994, when the V World Conference on Population and Development introduced the first agreed definition of reproductive rights, to the present day. This timeline is a dynamic tool that we aim to keep updating as new legal frameworks emerge.
The timeline was created in August 2022, with the upcoming 10th anniversary of the Montevideo Consensus in mind. This consensus, which was reached at the First Regional Conference on Population and Development in Latin America and the Caribbean in 2013, is a significant milestone in the sexual and reproductive rights agenda at the regional and global level because it established the first definition of sexual and reproductive rights agreed upon at the intergovernmental level, and set out a concrete regional agenda with more than 130 clear guidelines for action. The consensus also recognized the need to establish accountability and monitoring mechanisms, and to base definitions on the international obligations of human rights states.
Progress in the recognition of sexual and reproductive rights has been reflected in various international agreements, treaties, protocols, declarations, and conventions, which compel states to implement public policies for effective attention to these rights. These regulations often engage in dialogue, reaffirm the validity of the objectives and goals set, support national legislative reforms and result in concrete plans and programs that allow for the effective exercise of rights. The timeline makes it possible to visualize how these international, regional, and national legal advances are interconnected. It also provides a repository of the full texts of the legal milestones included.
The initial design and creation phase of this Timeline took place between August 2022 and November of the same year, when the first Spanish version was released. In May 2023, we launched a new version of the Timeline, in which we included its English translation and added representative photographs, sourced from personal and public archives, institutions, and prominent photographers from the Region, illustrating the various legal milestones that make up this Timeline.
The authors of this work in Spanish were Edurne Cárdenas and Natalia Segura Diez, who were responsible for designing the methodology, as well as identifying, systematizing and categorizing the legal milestones that make up the content of this Timeline.
The authors were supported by the CLACAI’s Legal Network Coordination team (Agustina Ramón Michel and Dana Repka) and received the valuable review of Carmen Cecilia Martínez López (Centro de Derechos Reproductivos) and Mirta Moragas Mereles (Esar).
The programming and visualization design of the legal milestones were made possible thanks to the collaborative work of Sergio Arriscal and Alejandro Sanchez Menendez.
The search, selection, and curation of the photographs that were incorporated into the various legal milestones of the Timeline were overseen by a team of photographers and art curators, consisting of Anabella Museri, Julieta Escardó, and Andrea Weber.
The English translation of the Timeline and its methodological document was done by Angélica Sánchez.
The periodic update of the legal milestones of this line is now in the hands of Donatella Zalloco and Dana Repka.
To compile this information, a desk research was conducted using the official web pages of the aforementioned international organizations, as well as the resources listed in the Annex at the end of this document. In a second instance, national regulations were surveyed, using official bulletins and newspapers, as well as other resources available for the search of public information, through the use of key words in virtual search engines.
In each of the search engines, the keywords used were: "sexual rights", "reproductive rights", "reproduction", "contraception", "pregnancy", "obstetric", "abortion", "gender identity", and "childbirth".
The collected information was compiled in a database whose fields made it possible to classify and systematize the information that feeds the Timeline.
Firstly, it is important to note that this timeline focuses on “legal milestones”, which are identified as changes in the legal status of the rights that are the object of study, including the approval of treaties or laws, as well as significant jurisprudential advances. In this sense, the purpose of this timeline is to identify and display information related to normative advances, which is why public programs and policies were not included.
Regarding geographic delimitations, this project collected normative advances at the international, regional, subregional, and national levels, but information on state or provincial norms was not included.
To select relevant legal milestones, the definitions and thematic axes outlined in the following sections were considered.
The first definition of sexual and reproductive rights agreed upon by States is the one set forth in the Montevideo Consensus: "Considering that sexual rights and reproductive rights are embraced by human rights and that their exercise is essential for the enjoyment of other fundamental rights and for achieving the international development targets and poverty eradication". This agreement was adopted on the first meeting of the Regional Conference on Population and Development in Latin America and the Caribbean, held in Montevideo in August 2013, under the theme "Full integration of population dynamics into rights-based sustainable development with equality: key to the Cairo Programme of Action beyond 2014".
The definition of reproductive rights, meanwhile, was first agreed upon at the IV World Conference on Women, held in Beijing in 1995: "Reproductive Rights embrace certain human rights that are already recognized in national laws, international laws and international human rights documents and other consensus documents. These rights rest on the recognition of the basic rights of all couples and individuals to decide freely and responsibly 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".
This definition follows up on what was agreed the previous year at the Conference on Population and Development held in Cairo, where the States strongly agreed on the indissoluble link between population and development issues and human rights, and reproductive health as part of them. At this Conference, the States agreed on a common political definition of sexual and reproductive health, which is understood as the general state of physical, mental and social well-being in all aspects related to the reproductive system. This definition implies the capacity to enjoy a satisfying and safe sex life and to procreate, and the freedom to decide whether, when and how often to do so. Thus, the idea that reproductive health is essential for the enjoyment of other fundamental rights and for achieving international development and poverty elimination goals was settled. The States committed themselves to the implementation of legislation, policies, and plans to achieve this purpose.
The definitions, frameworks, and guidelines adopted in the aforementioned conferences and their subsequent review processes were cemented by the new major global consensus on a sustainable development agenda for 2030, adopted in September 2015.1
Human rights protection bodies have also contributed to the understanding of the elements and scope of sexual and reproductive rights. Thus, the Committee on Economic, Social and Cultural Rights (ESCR) outlined the right to sexual and reproductive health in its General Comment 22 (2016). It established in Article 12 of the Covenant that "The right to sexual and reproductive health entails a set of freedoms and entitlements. The freedoms include the right to make free and responsible decisions and choices, free of violence, coercion, and discrimination, regarding matters concerning one’s body and sexual and reproductive health. The entitlements include unhindered access to a whole range of health facilities, goods, services and information, which ensure all people full enjoyment of the right to sexual and reproductive health [...]" (E/C.12/GC/22, Paragraph 5).
Moreover, the Committee on the Elimination of Discrimination against Women of the Convention on the Elimination of All Forms of Discrimination against Women has stated in its General Recommendation number 35, referring to gender-based violence against women, that: "[...] Violations of women’s sexual and reproductive health and rights, such as forced sterilization, forced abortion, forced pregnancy, criminalization of abortion, denial or delay of safe abortion and/or post-abortion care, forced continuation of pregnancy, and abuse and mistreatment of women and girls seeking sexual and reproductive health information, goods and services, are forms of gender-based violence that, depending on the circumstances, may amount to torture or cruel, inhuman or degrading treatment" (CEDAW/C/GC/35, Paragraph 18).
To outline the scope of this project, we have used the definition and contents outlined in the Montevideo Consensus on Population and Development (2013) and its Operational Guide (2015) as a guide, as it is one of the most comprehensive and forward-looking sources available.
The Montevideo Consensus, in addition to providing the first agreed definition of sexual and reproductive rights, as mentioned above, has a specific chapter on access to sexual and reproductive health, where sexual and reproductive rights are recognized as an integral part of human rights that contribute to the "full fulfillment of people and social justice" (MP 33), which places Latin America and the Caribbean in an avant-garde position in terms of recognition of rights (ECLAC, 2015). In addition, it constitutes a fundamental guide for the revision process of the Programme of Action of the International Conference on Population and Development, adopted in Cairo in 1994.
This chapter covers fourteen priority actions related to:
This highly comprehensive characterization also has a diversity, intergenerational, multicultural, and cross-cutting approach. Indeed, this chapter is related to other chapters of the Montevideo Consensus on Population and Development, including Chapter B on the rights, needs, responsibilities and requirements of girls, boys, adolescents and youth, Chapter F on migrants, Chapter H on indigenous peoples and Chapter I on Afro-descendant populations.
Within this broad conceptualization of sexual and reproductive rights is priority action 37, whereby States agree to "Guarantee universal access to good-quality sexual health and reproductive health services, bearing in mind the specific needs of men and women, adolescents and young people, lesbian, gay, bisexual, and transgender persons, older persons and persons with disabilities, with special attention to vulnerable persons, persons living in rural and remote areas […]”
The described framework guided the selection of legal milestones at the international, regional and subregional levels, identifying decisions that constitute state commitments in the area of sexual and reproductive rights. In line with this approach, we reviewed agreements adopted at world conferences, such as the World Conference on Population and Development and the World Conference on Women, regional bodies, such as the Regional Conference on Women and the Regional Conference on Population and Development of Latin America and the Caribbean, and resolutions adopted at the General Assembly of the Organization of American States, and subregional decisions, such as those adopted at the MERCOSUR Common Market Council (Consejo del Mercado Común del MERCOSUR, or MERCOSUR Council).
Initially, reports by special rapporteurs, independent experts, and working groups were not included, as they are not direct sources of state commitments, despite their importance for examining, monitoring, advising, and reporting on human rights issues affecting vulnerable groups.
However, we made exceptions for two rapporteurships reports: the Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health (2011) and the Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment (2013), because they address key issues that contribute to the normative development of sexual and reproductive rights. In the first case, the rapporteur examines the interaction between criminal laws and other legal restrictions related to sexual and reproductive health and the right to health. In the second, a number of commonly reported abusive practices in health care settings are addressed and the link between the prohibition of practices such as abortion and torture is exposed. Additionally, we included the First Hemispheric Report on the Implementation of the Convention of Belém do Pará of the Follow-up Mechanism of the Convention (MESECVI).
Furthermore, we identified significant documents from human rights protection bodies of both the regional system and the universal human rights protection systems, including recommendations and general observations of treaty bodies, individual case decisions regarding cases from the region issued by United Nations treaty bodies, case decisions of the Inter-American Court of Human Rights and in-depth decisions and thematic reports of the Inter-American Commission on Human Rights.
At the national level, we used the conceptual framework provided by the Montevideo Consensus on Population and Development (2013) and its Operational Guide (2015) to guide the topics to be covered in the collection of information, including:
For length reasons, the methodological decision was made to prioritize these topics over others such as Comprehensive Sex Education and Sexual Orientation, which, although they are undoubtedly fundamental elements of sexual and reproductive rights, have their own normative development that exceeds the limits of this project.
The timeline is oriented vertically, which allows for international and regional milestones to be displayed in parallel on the left margin of the screen, while national milestones are shown on the right margin.
Each entry includes a description and thematic labels that engable the identification of the main topics addressed by the milestone.
In each section, the available buttons provide access to the relevant paragraphs, as well as to the repository where the full text of the source document is available.
2030 Agenda for Sustainable Development (2015). United Nations General Assembly (A/RES/69/315).
ECLAC (2013) Montevideo Consensus on Population and Development. First meeting of the Regional Conference on Population and Development of Latin America and the Caribbean.
ECLAC (2015) Operational guide for implementation and follow-up of the Montevideo Consensus on Population and Development. Second Meeting of the Regional Conference on Population and Development in Latin America and the Caribbean.
Committee on Economic, Social and Cultural Rights (2016) General Comment No. 22, on the right to sexual and reproductive health (article 12 of the International Covenant on Economic, Social and Cultural Rights) (E/C.12/GC/22).
Committee on the Elimination of Discrimination against Women (2017) General recommendation number 35 (CEDAW/C/GC/35).
Beijing Declaration and Platform for Action (1995) Fourth World Conference on Women.
Programme of Action of the International Conference on Population and Development (1994). Cairo International Conference on Population and Development.
See A/RES/69/315. Sustainable Development Goals 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.