A/HRC/41/26 leading to maternal mortality and morbidity. 28 Use of unhygienic water and restricted mobility may also affect sexual and reproductive health rights. 14. Climate change can also directly affect pregnancy, heightening risks of maternal mortality and morbidity and threatening the enjoyment of women’s rights to health and life.29 Negative pregnancy and maternal health outcomes, such as reduced birth weight, may result from exposure to extreme temperatures. 30 Poor air quality from the combustion of fossil fuels can affect maternal and child health by causing intrauterine growth restriction and congenital defects.31 Salinization of drinking water sources as a result of sea-level rise may cause increased rates of adverse health outcomes, including preterm births and maternal and perinatal deaths.32 15. Climate change may also increase risks of sexual and gender-based violence, which constitutes a grave violation of women’s rights to health, and liberty and security of person, among others. Beyond immediate mental and physical trauma, sexual and gender-based violence can also contribute to the spread of sexually transmitted infections and impede economic productivity, which can lead to greater poverty, in turn exacerbating the effects of climate change-related disasters.33 D. Sexual and gender-based violence, and discrimination 16. The adverse effects of climate change increase the risks of sexual and gender-based violence. There are clear links between poverty, which climate change deepens, and sexual and gender-based violence. 34 Child, early and forced marriages can occur as a harmful coping strategy among those who suffer from economic stress due to disasters and the slow-onset adverse effects of climate change. 35 17. Women are also at a higher risk of sexual and gender-based violence during and after extreme weather events.36 Disaster displacement can push survivors into evacuation centres. Women in these centres, including relief workers, may feel unsafe, be subjected to sexual and gender-based violence, harassment and discrimination, and/or have limited access to reproductive and other health services. 37 After disasters, law enforcement may be less effective due to strained resources, and women subjected to sexual and gender-based violence may not report violence due to associated stigma. 38 Lesbian, gay, bisexual, transgender and intersex persons are uniquely vulnerable, due to stigmatization and discrimination. They may be excluded from recovery, relief and response efforts and may lack access to emergency shelters that satisfy their needs.39 28 29 30 31 32 33 34 35 36 37 38 39 6 Ibid. WHO, Trends in Maternal Mortality: 1990 to 2015 (2015). “Special focus: climate change and pregnant women”. Cecilia Sorensen et al., “Climate change and women’s health: impacts and policy directions”. Aneire Ehmar Khan et al., “Drinking water salinity and maternal health in coastal Bangladesh: implications of climate change”, Environmental Health Perspectives, vol. 119, No. 9 (2011), pp. 1328–1332. Annekathryn Goodman, “In the aftermath of disasters: the impact on women’s health, Critical Care Obstetrics and Gynaecology, vol. 2 (2016). See A/HRC/11/6. Human Rights Watch, “Marry before your house is swept away: child marriage in Bangladesh” (2015), available at www.hrw.org/report/2015/06/09/marry-your-house-swept-away/child-marriagebangladesh. Annekathryn Goodman, “In the aftermath of disasters”. UN-Women, “Climate change, disasters and gender-based violence in the Pacific”, available at www.uncclearn.org/sites/default/files/inventory/unwomen701.pdf. Ibid. J.C. Gaillard, Andrew Gorman-Murray and Maureen Fordham, “Sexual and gender minorities in disaster”, Gender, Place and Culture, vol. 24 (2017).