The Committee notes that preventable maternal
mortality and morbidity constitute grave violations of the human rights of
women and girls and pose serious threats to their own and their children’s
right to health. Pregnancy and child birth are natural processes, with known
health risks that are susceptible to both prevention and therapeutic responses,
if identified early. Risk situations can occur during pregnancy, delivery and
the ante- and postnatal periods and have both short- and long-term impact on
the health and well-being of both mother and child.
The Committee encourages States to adopt
child-sensitive health approaches throughout different periods of childhood
such as (a) the baby-friendly hospital initiative which protects, promotes and supports rooming-in and breastfeeding; (b)
child-friendly health policies focused on training health workers to provide
quality services in a way that minimizes the fear, anxiety and suffering of
children and their families; and (c) adolescent-friendly health services which
require health practitioners and facilities to be welcoming and sensitive to
adolescents, to respect confidentiality and to deliver services that are
acceptable to adolescents.
The care that women receive before, during and
after their pregnancy has profound implications for the health and development
of their children. Fulfilling the obligation to ensure universal access to a
comprehensive package of sexual and reproductive health interventions should be
based on the concept of a continuum of care from pre-pregnancy, through
pregnancy, childbirth and throughout the post-partum period. Timely and good-quality
care throughout these periods provides important opportunities to prevent the
intergenerational transmission of ill-health and has a high impact on the
health of the child throughout the life course.
The interventions that should be made available
across this continuum include, but are not limited to: essential health
prevention and promotion, and curative care, including the prevention of
neonatal tetanus, malaria in pregnancy and congenital syphilis; nutritional
care; access to sexual and reproductive health education, information and
services; health behaviour education (e.g. relating to smoking and substance
use); birth preparedness; early recognition and management of complications;
safe abortion services and post-abortion care; essential care at childbirth;
and prevention of mother-to-child HIV transmission, and care and treatment of
HIV-infected women and infants. Maternal and newborn care following delivery
should ensure no unnecessary separation of the mother from her child.
The Committee recommends that social protection
interventions include ensuring universal coverage or financial access to care,
paid parental leave and other social security benefits, and legislation to
restrict the inappropriate marketing and promotion of breast-milk substitutes.
Given the high rates of pregnancy among
adolescents globally and the additional risks of associated morbidity and
mortality, States should ensure that health systems and services are able to
meet the specific sexual and reproductive health needs of adolescents,
including family planning and safe abortion services. States should work to
ensure that girls can make autonomous and informed decisions on their
reproductive health. Discrimination based on adolescent pregnancy, such as
expulsion from schools, should be prohibited, and opportunities for continuous
education should be ensured.
Taking into account that boys and men are
crucial to planning and ensuring healthy pregnancies and deliveries, States
should integrate education, awareness and dialogue opportunities for boys and
men into their policies and plans for sexual, reproductive and children’s
health services.
