We work so that women and people with gestational capacity have access to quality reproductive health services, including during pregnancy, childbirth and the puerperium, and that their decisions are respected without discrimination.All people have the right to choose if they want to have children, when and with whom. To this end, the Mexican government is obliged to provide a variety of contraceptive methods and the pertinent information so that each person can choose the best option for their needs and life goals.
a) Obstetric Violence
Obstetric violence is a specific form of violence against women and people with gestational capacity that constitutes a human rights violation. It is experienced in the obstetric care field, in both the public and private sectors. It consists of any action or omission by National Health System staff that causes physical or psychological harm during pregnancy, childbirth and puerperium. Any action or omission that results in a lack of access to reproductive health services, cruel, inhuman or degrading treatment, or an abuse of medicalization.Obstetric violence can be physical and/or psychological. Among the most common examples are invasive practices, such as cesarean sections when performed without justification, non-consensual or forced sterilization, the unjustified supply of medications, the delay in emergency medical care or the lack of respect for delivery times. Among the second are discriminatory acts, use of offensive, humiliating or sarcastic language, lack of timely information about the reproductive process and dehumanizing treatment.GIRE was one of the first organizations to use the term obstetric violence and to document cases of behaviors and omissions that fall under this concept. To highlight the problem, we have implemented multiple national and international campaigns.In 2014, together with other organizations, we registered the first obstetric violence cases before the Inter-American Commission on Human Rights.In 2016 we organized a “Symbolic Court on Maternal Mortality and Obstetric Violence”, where 27 women and families denounced the human rights violations they suffered.In 2018 we disseminated the collective struggle of Nahá, a community located in the heart of the Chiapas jungle, to ensure that pregnant women receive medical care.A fundamental part of our work has been to make visible the fact that imposing contraceptive methods is a way of annulling women and people with gestational capacity’s freedom and choices. A case that we accompany reached the Supreme Court, setting a highly relevant precedent on this issue:
Sonia / Sterilization without consent / 2021
With manipulation, threats and by conditioning medical attention, IMSS medical personnel in Jalisco obtained Sonia’s consent to perform a bilateral tubal occlusion (TBO), a permanent contraceptive method. The Court determined that the consent obtained by the health personnel was not prior, free, full or informed. It also concluded that Sonia was a victim of non-consensual sterilization, gender violence, obstetric violence, and cruel, inhuman, and degrading treatment.GIRE believes that the response to obstetric violence implies transforming the structural conditions of the health system at all levels. For this reason, we have questioned the use of criminal law as a mechanism to eradicate it, and have insisted on the importance of creating mechanisms for access to justice and comprehensive reparation.
b) Maternal mortality
Maternal mortality occurs during pregnancy, childbirth or the puerperium due to any cause related to or aggravated by its handling, excluding accidental causes. Its structural and preventable nature makes it a violation of women and pregnant people’s human rights, as well as a matter of reproductive justice that is the government’s responsibility.In Mexico, there is a regulatory and public policy framework that, if properly implemented, would allow for progress in reducing maternal deaths. However, structural problems make it difficult for women and other pregnant people to receive adequate care, so that their health and lives are not in danger.While first level health care for low-risk births has remained underutilized, second and third levels are saturated. This results in a high number of unjustified cesarean sections, and insufficient infrastructure, equipment, supplies, and trained personnel. These structural flaws in the health sector, including the lack of medical personnel and their consequent work overload, are the cause of preventable deaths that disproportionately affect certain population groups, such as indigenous women, girls and adolescents, and people living in poverty and marginalization. In this sense, maternal mortality is also a matter of justice.For the relatives of maternal mortality victims, important precedents have been achieved over the last ten years in terms of accessing comprehensive reparations, making it possible to visualize the scope that mechanisms of access to justice can reach. However, obstacles and difficulties in the processes persist. Processes can last several years, and more often than not, victims’ needs and participation in establishing comprehensive reparation measures as well as in the implementation of non-repetition guarantees, represent a challenge. With this, the modification of conditions that allow maternal mortality to persist is a continued missed opportunity.Two campaigns, “Chiapasiónate? Justice for Susana” and “María Ligia. A preventable death” highlight the seriousness of human rights violations, as well as obstacles that relatives of maternal mortality victims face, in accessing justice.
c) Assisted reproduction
Assisted Human Reproduction Techniques enable the birth of thousands of children around the world every year. These interventions include in vitro handling of human oocytes and sperm or embryos for reproduction. The use of assisted reproduction techniques in response, originally, to a medical problem, infertility or sterility, is currently limited. Access to these techniques is not only relevant for those who have health issues, but also for people who, for different reasons, cannot achieve a pregnancy without assistance, such as same-sex couples or single people.In Mexico, despite the fact that assisted reproduction techniques have been performed in public and private clinics and hospitals for more than four decades, there is still no comprehensive framework that regulates, at a general level, access to these reproductive procedures and their practice. This produces legal uncertainty for the parties involved, and opens the door to arbitrary and discriminatory acts against those seeking assisted reproduction services.It is essential that regulations adopted are implemented using a democratic gender perspective, respectful of human rights and scientific progress, in accordance with the highest protection standards recognized in the Constitution and in international treaties ratified by Mexico. In addition, that regulation of the provision of assisted reproduction services provides for the medical and technical aspects of the practice, and that local congresses regulate the civil and family consequences that derive from the use of assisted reproduction services.One of the cases that we accompanied and that was resolved by the Supreme Court shows the need to regulate this issue:
Maria Teresa / Denial of access to Assisted Human Reproduction Techniques / 2017
María Teresa, who was diagnosed with primary infertility, was repeatedly denied admission to the National Medical Center November 20’s Comprehensive Reproduction Program because she was over the age limit. The Court determined the unconstitutionality of specific criteria for admission to said program: the 35 year age limit, legally married couples and not having inheritable genetic anomalies.At GIRE we fight for regulations that guarantee the rights of women and people with gestational capacity, as well as same-sex couples or single people, so that all of them have access to assisted reproduction procedures without discrimination.
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