A/HRC/45/19 vulnerability of women and girls to suffering maternal morbidities. Laws that restrict women’s sexual and reproductive health and rights, including in relation to family planning and abortion, influence both the risk of morbidity and the chance of post-partum recovery.39 For instance, restrictive abortion laws lead to higher rates of unsafe abortion. 40 Unsafe abortion is a major contributor to maternal morbidities, with about 7 million women admitted to hospitals annually in developing countries. Following unsafe abortion, women and girls may experience a range of morbidities, such as incomplete abortion, infertility, haemorrhage and infection, with some women experiencing life-threatening complications.41 2. Intersectional discrimination and maternal morbidity 56. When women face discrimination, including on the basis of age, socioeconomic status, disability, racial or ethnic background, language, religion, national or social origin, health or other status, they routinely face multiple or intersectional discrimination, which substantially heightens their risk of suffering maternal morbidities. 57. Women who, in addition to facing gender discrimination, are from marginalized groups are generally less likely to have access to adequate health care and timely interventions and services owing to numerous factors, including distance, cost, lack of information or cultural insensitivity. Furthermore, they may also be reluctant to access maternal health care because of language barriers or previous experiences of mistreatment and abuse in health-care settings. Harmful gender stereotypes can render certain groups of women, including women with disabilities, women living with HIV and indigenous and minority women, particularly vulnerable to mistreatment in pregnancy and childbirth, exposing them to potential morbidities. 3. Lack of comprehensive quality sexual and reproductive health information and services 58. Quality sexual and reproductive health services are essential for preventing and treating maternal morbidities. Where health systems lack resources, experience shortages of basic medicines and supplies and lack adequate skilled and specialized health professionals, as is the case in many parts of the world, the potential for maternal morbidities increases. For example, insufficient staff with specialist training to treat certain morbidities can lead to long waiting periods to receive treatment, which can contribute to further complications. 59. Even when health care is available, a lack of information means that many women do not know what health care they can access or what symptoms they need to be alert to. For example, Amnesty International reported that among the women it spoke with in Nepal who had uterine prolapse, the majority had not heard about the condition before they experienced it.42 Similarly, many women with obstetric fistula in Zimbabwe did not know what they suffered from and struggled to find information about the causes and treatment of their condition.43 60. Mistreatment and abuse of women in pregnancy and childbirth can also lead to maternal morbidities (see A/74/137). In some cases, human rights violations within healthcare facilities directly cause maternal morbidities, such as where women are forcibly sterilized during labour or other pregnancy-related procedures. 44 Besides having a direct 39 40 41 42 43 44 Veronique Filippi and others, “A new conceptual framework for maternal morbidity”, International Journal of Gynecology and Obstetrics, vol. 141, No. S1 (2018), p. 7. World Health Organization, Safe Abortion: Technical and Policy Guidance for Health Systems, 2nd ed. (2012), p. 17. World Health Organization, “Preventing unsafe abortion”, fact sheet (2019). Amnesty International, Unnecessary Burden, p. 46. See submission from Amnesty International. See, for example, Committee on the Elimination of Discrimination against Women, A.S. v. Hungary (CEDAW/C/36/D/4/2004). The Committee found a violation of the Convention on the Elimination of All Forms of Discrimination against Women when a woman was sterilized without her informed consent while undergoing surgery in connection with a miscarriage. 13