A/HRC/45/19 is often on the newborn’s health rather than the mother’s, and/or health professionals may lack awareness of the signs and symptoms of postpartum depression. 50. Untreated postpartum depression can have adverse consequences for women, their infants and families. It can be the precursor of chronic recurrent depression and, in severe cases, can lead to suicide. In most societies, mental health problems are stigmatized, which has consequences for many aspects of women’s lives, including within the family, in the community and at work. It can also negatively affect the mother-infant relationship and infant development. 4. Infertility 51. Infertility is another condition that can be associated with maternal morbidities, as it can result from complications of unsafe abortion and other maternal morbidities, such as sepsis. Infertility is defined by WHO as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse”. 34 WHO has also estimated that 34 million women, mainly from developing countries, have infertility as a result of either maternal sepsis or unsafe abortion.35 Coercive practices such as involuntary sterilization also lead to infertility, and have been documented particularly among women and girls living with disabilities, women and girls living with HIV, indigenous and ethnic minority women and girls, and women and girls living in poverty.36 52. The consequences of infertility can be severe. Women are frequently blamed for fertility issues, regardless of whether the medical issue is actually in their body or their partner’s body. They may be stigmatized and alienated from their families and communities, and can also face a higher risk of violence. D. Human rights causes and consequences of maternal morbidities 1. Gender-based discrimination 53. Gender-based discrimination is both a cause and a consequence of maternal morbidity. The ability of women and girls to make choices about when and with whom they have sex is connected to whether they will go through pregnancy and childbirth safely. Discrimination against women and girls also influences their access to health-care services, or lack thereof. 54. Harmful practices are a violation of human rights that constitute discrimination against women and girls,37 and they are connected to a higher risk of maternal morbidities. Girls who are victims of child and forced marriage are more likely to have more children and likely have them earlier, which increases their likelihood of suffering a maternal morbidity. Similarly, girls who are forced to undergo female genital mutilation face a higher probability of complications in pregnancy and childbirth, and a particular risk of suffering obstetric fistula. WHO identifies the cessation of harmful practices, and delaying the age of first pregnancies, as fundamental actions for preventing maternal morbidities. 38 55. A critical part of enabling women and girls to go through pregnancy and childbirth safely is ensuring that they are able to make decisions about their sexual and reproductive health, and that they have access to the information they need to make healthy decisions. Discriminatory laws and practices that undermine women’s and girls’ abilities to make such decisions, including those based on age or marital status, contribute towards the 34 35 36 37 38 12 See www.who.int/reproductivehealth/topics/infertility/definitions/en/. Ibid. OHCHR and others, Eliminating Forced, Coercive and Otherwise Involuntary Sterilization: An Interagency Statement (World Health Organization, 2014). See also A/73/161. Joint general recommendation No. 31 of the Committee on the Elimination of Discrimination against Women/general comment No. 18 of the Committee on the Rights of the Child (2019) on harmful practices, para. 16. See www.who.int/news-room/facts-in-pictures/detail/10-facts-on-obstetric-fistula.