As the United States (“US”) approaches its 4th Universal Periodic Review (“UPR”), individuals’ sexual and reproductive health and rights have significantly deteriorated across the country, particularly with regard to abortion and related healthcare. Following the Supreme Court’s 2022 decision, Dobbs v. Jackson Women’s Health Organization,1 a growing number of states have implemented complete bans or aggressive restrictions on abortion, resulting in millions without access to care. Many seeking care, particularly in the South, are now forced to travel long(er) distances, seek medication through additional formal and informal means, or continue pregnancies against their will. Simultaneously, states are increasingly hostile to and criminalizing abortion seekers and providers, third parties who help individuals access care, and/or circumstances surrounding pregnancy, with laws that impose harsh penalties including fines, prosecution, and imprisonment.

Around 80 countries expressly allow healthcare providers to refuse to provide abortion care based on their conscience, religion, or belief. This practice is referred to as ‘conscientious objection’. Conscientious objection is often unregulated or insufficiently regulated, which can create a significant barrier to care. Inadequate regulatory regimes violate international human rights law and standards, endanger the health and wellbeing of persons seeking care, overburden healthcare providers and systems, and reinforce harmful stereotypes that stigmatize patients and professionals who provide abortion services. Because conscientious objection has become a significant barrier to abortion care, the United Nations Working Group on Discrimination against Women and Girls (WGDAWG) has issued new guidance on the obligation of governments that permit conscientious objection to ensure it does not create barriers to the realization of women’s and girls’ sexual and reproductive health rights.

Health and care workers play an essential role in realizing the human right to health for all people globally. In fact, the right to “the highest attainable standard of physical and mental health” enshrined in Article 12 of the International Covenant on Economic, Social and Cultural Rights would be meaningless without health and care workers. As noted by the UN Special Rapporteur on the Right to Health, these individuals are “key protectors of the right to health” and should be protected as human rights defenders. The Global Justice Center (GJC) submits the following information for consideration as the UN Special Rapporteur on the Right to Health prepares her report to the Human Rights Council, 59th Session, focusing on “health and care workers as key protectors of the right to health.”  GJC applauds the Special Rapporteur for identifying the human rights of healthcare workers and their ability to protect the rights of others as strategic priorities.

Idaho’s “Defense of Life Act” (“Act” or “Idaho’s Law”), a near-total abortion ban, restricts access to necessary emergency reproductive healthcare, exacerbating preventable maternal mortality and morbidity and otherwise negatively impacting pregnant people. The law’s narrow exception for life-saving care will not prevent or mitigate these harms and will leave patients without access to emergency reproductive healthcare. The United States has ratified several human rights treaties that require it to guarantee access to safe and legal reproductive health services, in particular in emergencies or acute medical crises governed by the Emergency Medical Treatment and Active Labor Act (“EMTALA”). Under these treaties, the U.S. is required to respect, protect and fulfil the rights to life; freedom from torture and cruel, inhuman and degrading treatment; non-discrimination; and privacy. Idaho’s draconian abortion law fails to respect these rights and violates the U.S.’s treaty obligations. This violation of the U.S.’s treaty obligations militates in favor of affirming the preliminary injunction issued by the District Court. Causing the U.S. to violate its international obligations will result in irreparable harm and is not in the public interest.

Reproductive violence is a distinct form of sexual and gender-based violence (SGBV) targeting reproductive autonomy, a right protected under international law. The impacts of reproductive violence can be as profound, damaging, and long-lasting as those accompanying other forms of violence and can compound the pain of other forms of SGBV. Yet recognition of reproductive violence as a distinct harm has been overlooked historically, including in international investigations of atrocities, conflict, humanitarian crises, or other instability. International investigations often play a key role in guiding international responses to crises, and the omission of reproductive violence can thus have significant ripple effects.