A/HRC/21/41 insecure and submissive. Such abuse is accompanied by the other violations described below. A. Domestic servitude 73. Women and girls in servile marriage are required to perform all domestic household tasks and, in some cases, to work outside the home in shops or on farms and to have sex with their husbands. If they do not perform their duties adequately, they face physical and psychological abuse from their husbands or their husbands’ families. In many such cases, the girl or woman is also a victim of marital rape. 74. The domestic servitude inherent to child marriage disempowers girls by denying them educational opportunities and the chance to form protective networks of friends and peers. B. Sexual slavery 75. Sexual slavery is a situation in which absolute control over one person is imposed on another, either by the use or threat of force. Servile marriage results in sexual slavery. As mentioned previously, girls in ritual slavery are forced to have sex with the priest who consummates the marriage between the girl and the deity. A ritually enslaved girl may also be forced to have sex with multiple sexual partners who believe that they become cleansed by having sex with her. The girls are also rendered physically weak by the pregnancies, births and, on occasion, abortions that they undergo. As a result of having multiple sexual partners the girls suffer from reproductive tract infections and sexually transmitted diseases. Unable to leave or seek help, they are often socially marginalized, with few support systems. This contributes to a lack of confidence and low self-esteem, perpetuating subordination. C. Violations of the right to health 76. A UNICEF study on early marriage indicates that girls under the age of 15 years are five times more likely to die during delivery as a result of haemorrhage, sepsis, preeclampsia or eclampsia and obstructed labour than women between the ages of 20 and 24 years.3 77. The younger the bride, the more likely it is that she will face serious health complications owing to the physical immaturity of her body at the time of childbirth. A girl with underdeveloped physiology risks incurring an obstetric fistula, a rupture of the vagina, bladder and/or rectum during childbirth that causes persistent leakage of urine and faeces. Girls face a greater risk of health problems associated with repeated pregnancies and childbirth. They also have limited access to information concerning their reproductive health and health care. 78. According to Save the Children in the 2004 edition of its annual publication, State of the World’s Mothers, once born, children of girl brides are twice as likely to die before the age of 1 year as the children of a woman in her twenties. If they survive, the children are more likely than those born to older mothers to have poorer health care and inadequate nutrition as a result of the mother’s poor feeding behaviour. 79. In countries with a high incidence of HIV/AIDS, some adult men prefer to marry girls as their virginity and HIV-negative status is assured. Early marriage to older, more 14