Constitutional Court of Ecuador
Quito, Ecuador
Subject: Human Rights Watch Amicus Curiae in Action of Unconstitutionality 22-24-IN Against Article 149 of the Criminal Code of Ecuador
Macarena Sáez and Cristina Quijano Carrasco, on behalf of Human Rights Watch, located at 350 Fifth Avenue, 34th floor, New York, NY 110118, United States, presents this amicus curiae brief to the Constitutional Court of Ecuador in the Action of Unconstitutionality with file number 22-24-IN, which discusses the unconstitutionality of Article 149 of the Criminal Code of Ecuador. For that purpose, we respectfully state:
- Purpose and Summary of this Submission
Human Rights Watch respectfully requests that the Constitutional Court of Ecuador accept this submission for its consideration regarding the international legal standards pertaining to the criminalization of abortion and its effects on women, girls and pregnant individuals.
With this amicus curiae brief, Human Rights Watch wishes to demonstrate the need, in line with international legal obligations, for Ecuador to decriminalize abortion in all circumstances and to remove all barriers that prevent access to this essential service. Ecuador’s laws and jurisprudence should comply and align with its international human rights obligations to decriminalize abortion. After providing background on Human Rights Watch and our interest in the case (Section II), we describe the facts and context of the case (Section III). Subsequently, we review international human rights law and standards related to abortion (Section IV), including with respect to:
- The right to life
- The right to health
- The right to humane treatment
- The right to nondiscrimination
Finally, considering these international law and standards, we suggest that the Constitutional Court uphold the right of effective access to legal abortion and decriminalize abortion in all circumstances. (Section V).
II. Background on Human Rights Watch and Our Interest in the Case
A. History and Mandate of Human Rights Watch
Human Rights Watch is a nonprofit, nongovernmental organization that investigates and reports on human rights violations and abuses in more than 100 countries worldwide with the goal of securing the enjoyment of those rights for all persons. By exposing and calling attention to human rights abuses committed by both state and non-state actors, Human Rights Watch seeks to bring international public opinion to bear on offending governments and others to end abusive practices.
Human Rights Watch is known for accurate and impartial fact-finding. To ensure its independence, the organization does not accept any government funding, directly or indirectly, or support from private funding that could compromise its objectivity in reporting on human rights violations and abuses.
B. Human Rights Watch’s Work on Sexual and Reproductive Rights in Ecuador
Over the past 15 years, Human Rights Watch has published several reports on the global impact of the criminalization of abortion, including in Latin America and the Caribbean, and specifically in Ecuador.[1] Human Rights Watch research has repeatedly shown how legal frameworks that criminalize abortion discriminate against women, girls and other pregnant people, disproportionately affecting their access to essential healthcare services and denying them the right to make autonomous decisions about their own bodies and reproductive health.[2] This denial of care and infringement on their bodily autonomy and reproductive self-determination violates their rights to privacy, non-discrimination, and to the highest attainable standard of health, as protected under international human rights conventions.[3] Women, girls, and people capable of becoming pregnant have the fundamental right to make autonomous decisions about their own lives and health.[4] Criminalizing abortion undermines this right and can lead to unsafe abortion due to lack of access and fear of criminalization. Fear of criminalization can also lead women, girls and pregnant people to delay or forgo necessary health care for miscarriages or obstetric emergencies, further endangering their health and well-being, as documented by Human Rights Watch in Ecuador.[5] Access to safe and legal abortion is crucial for ensuring the dignity and autonomy of women and girls, which are integral elements of their sexual and reproductive health.
In a 2021 report on Ecuador, Human Rights Watch reviewed a total of 148 cases between 2009 and 2019, documenting the severe consequences of criminalizing abortion in the country.[6] The report highlights how criminalization negatively impacts women, girls and pregnant people, increasing maternal mortality and morbidity, cutting them off from essential services and violating their rights to medical confidentiality and due process, amongst others.[7] Human Rights Watch documented that prosecution often affects those who have experienced miscarriages or obstetric emergencies, not only those seeking to terminate pregnancies.[8]
Additionally, the report emphasizes that the criminalization of abortion leads to significant barriers to accessing abortion and post-abortion care even in the exceptional cases in which abortion is legally permissible. These barriers include stigmatization, mistreatment by healthcare providers, and a narrow interpretation of legal exceptions for abortion, which, in practice, result in lack of access to abortion.[9] Human Rights Watch documented that many women and girls prosecuted under these laws are living in poverty and are often from Indigenous or Afro-descendant communities, and Ecuador's abortion restrictions disproportionately affect provinces with high Indigenous and Afro-descendant populations.[10]
Abortion restrictions, including criminalization, do not stop abortions. Instead, they push women and girls, especially those in poverty and rural areas, out of the national health system and into unregulated settings.[11] According to the World Health Organization (WHO), lack of access to safe, affordable, timely and respectful abortion care, coupled with the stigma associated with abortion, poses risks to women’s physical and mental well-being throughout their lives. [12]
States’ international legal obligations to respect, protect, and fulfill human rights include areas of sexual and reproductive health and autonomy. Where safe and legal abortion services are unreasonably restricted or not fully available, a variety of human rights may be at risk, including the rights to life; health; information; non-discrimination and equality; freedom from cruel, inhuman and degrading treatment; to privacy; decide the number and spacing of children; security of person; liberty; enjoy the benefits of scientific progress; and freedom of conscience and religion.
As part of its mandate, Human Rights Watch uses judicial and quasi-judicial tools of regional and international law to contribute to protecting and promoting human rights. Therefore, our interest in submitting this amicus brief is to provide the Court with information about international human rights law relevant to this case so that its assessment of Ecuador’s international obligations on access to abortion is conducted together with standards from other international legal sources, in particular international human rights treaties, on this issue.
III. Facts and Context
The case before the Constitutional Court of Ecuador involves an action of unconstitutionality brought by Justa Libertad, a coalition of eight Ecuadorian civil society organizations. On Tuesday, March 19, 2024, Justa Libertad filed a lawsuit before the Court seeking to eliminate article 149 of the Criminal Code, which criminalizes consensual abortion.[13] The article states that a person who induces an abortion in a woman who has consented to it shall be punished with a prison sentence of one to three years, and the woman who causes her own abortion or allows another to cause it shall be punished with a prison sentence of six months to two years.[14]
Pursuant to article 426 of the Ecuadorian Constitution,[15] the lawsuit outlines eight charges of unconstitutionality against the criminalization of consensual abortion.[16]
Abortion is criminalized in Ecuador, except when a pregnancy threatens the health or life of the person or results from rape.[17] Despite these provisions, access to abortion remains severely restricted in Ecuador and its availability within the health system is limited.[18]
In 2021, Ecuador’s Constitutional Court decriminalized abortion in cases of rape, urging the National Assembly to establish regulations.[19] The exception is now regulated by the Organic Law that Regulates the Voluntary Termination of Pregnancy for Girls, Adolescents, and Women in Cases of Rape.[20] However, this legislation includes harmful provisions that block access to abortion care for survivors of violence, including requirements that rape survivors report their cases to authorities, forced parental consent for girls and adolescents under age 18, and overly broad grounds for conscientious objection. Several international human rights and health organizations have highlighted that the current legislation does not align with international human rights law and have urged Ecuador’s government and National Assembly to ensure that abortion services are accessible and in compliance with these standards.[21]
Consequently, the law faces several legal challenges currently under review by the Constitutional Court. As of August 2024, the Court has issued five precautionary measures, including suspending requirements for rape survivors to report sexual assault, sign an affidavit, or have a physician certify signs of sexual assault under oath; parental consent requirements for girls and adolescents; institutional conscientious objection for religious institutions; and ultrasound requirements, pending further judicial review.[22]
The action of unconstitutionality filed by Justa Libertad seeks to uphold the comprehensive protection of human rights for women, girls and pregnant people by arguing that criminal regulations related to abortion are unconstitutional.[23] The coalition contends that legal barriers impede access to justice, calling for a constitutional review to ensure Ecuador’s compliance with international human rights obligations and to protect reproductive autonomy and equality.[24]
IV. International Human Rights Law and Standards Related to Abortion
1. The Right to Life
The right to life is enshrined in various international legal instruments to which Ecuador is bound. These include Article 4 of the American Convention on Human Rights and Article 6 of the International Covenant on Civil and Political Rights (ICCPR). As a party to both the American Convention and the ICCPR, Ecuador must uphold the right to life as outlined in these treaties.[25]
The Human Rights Committee (HRC), which monitors states’ compliance with the ICCPR, has underscored that restrictive abortion laws can jeopardize the lives of women and girls.[26] The HRC has frequently voiced concern over the criminalization of abortion and has called for broader access, clarifying that the right to life should not be interpreted restrictively.[27]
The HRC's general comment on the right to life emphasizes that any abortion regulation must respect the right to life and other human rights under the ICCPR. It urges states to remove barriers to safe and legal abortion, and to ensure that any restrictions do not subject pregnant women and girls to physical or mental pain or suffering. It calls on governments to “provide safe, legal and effective access to abortion where the life and health of the pregnant woman or girl is at risk, or where carrying a pregnancy to term would cause the pregnant woman or girl substantial pain or suffering.[28]
Furthermore, the HRC has also called on states to guarantee unimpeded and timely access to legal abortion services, saying that states should “ensure the availability of medical facilities and guaranteed access to those facilities for legal abortion.”[29] It has called for measures such as establishing referral systems for women seeking abortion services, publishing public health guidelines on abortion, facilitating access to information on legal abortions, lifting requirements for prior court authorization for abortions, removing requirements for multiple medical authorizations, combatting the stigma related to abortion, and considering incorporation of abortion into national health insurance schemes.[30]
In Ecuador, the criminalization of abortion and the obstacles it creates for accessing abortion services often push people out of the public healthcare system. This can sometimes lead to the practice of unsafe abortions, endangering the lives of women, girls and other pregnant people.[31] In 2015, the CEDAW Committee expressed concern about the levels of unsafe abortions in Ecuador and their impact on maternal mortality, recommending that the state offer “provide women with access to safe abortion and post-abortion services, in particular in cases of complications resulting from unsafe abortions.”[32] Despite these recommendations, the issue persists. A 2017 Ministry of Health memorandum reported that 15.6 percent of maternal deaths in Ecuador are due to unsafe abortions.[33]
The Ecuadorian Constitution, in Article 45, guarantees the right to life from the moment of conception.[34] In the landmark ruling Artavia Murillo v. Costa Rica, the Inter-American Court of Human Rights emphasizes that the state’s interest in protecting prenatal life cannot supersede its obligation to uphold human rights.[35]
In the ruling, the Inter-American Court of Human Rights held that an embryo cannot be understood as a human being for the purposes of Article 4.1 of the American Convention of Human Rights.[36] The Court concluded that, in regulating abortion, the protection of prenatal life is not absolute, stating:
it can be concluded from the words ‘in general’ that the protection of the right to life under this provision is not absolute, but rather gradual and incremental according to its development, since it is not an absolute and unconditional obligation, but entails understanding that exceptions to the general rule are admissible.[37]
The Court further acknowledged that the decision to become a parent is part of the right to private life, intertwining personal autonomy, reproductive freedom, and physical and psychological integrity. The Artavia Murillo ruling clearly states that women and girls are rights-holders whose privacy and autonomy must be respected.
Under this precedent, the criminalization of abortion in Ecuador conflicts with this interpretation of Article 4.1 of the American Convention, as it fails to recognize women’s rights to life, health, privacy, and autonomy.
2. The Right to Health
The right to health, both physical and mental, is protected in numerous international human rights treaties to which Ecuador is bound.[38] The International Covenant on Economic, Social and Cultural Rights (ICESCR) guarantees everyone the right to the highest attainable standard of physical and mental health[39]and the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) provides that “States Parties shall take all appropriate measures to eliminate discrimination against women in the field of health care in order to ensure, on a basis of equality of men and women, access to healthcare services.”[40]
The Office of the UN High Commissioner for Human Rights argues that women’s sexual and reproductive health is related to the right to health more generally, as well as multiple other human rights, including the rights to life, freedom from torture, health, privacy, education, and non-discrimination.[41] International bodies have repeatedly stated that the criminalization of abortion violates the right to health. The Committee on Economic, Social and Cultural Rights (CESCR), a treaty body that provides authoritative guidance on the obligations of states parties to the ICESCR, stated that “States must reform laws that impede the exercise of the right to sexual and reproductive health. Examples include laws criminalizing abortion.”[42]
Abortion is legally permitted in Ecuador in cases where the pregnant person’s life or health is in danger (commonly referred to as the “health exception” or “therapeutic abortion”), or in cases of rape. The World Health Organization (WHO) has defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” and “one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”[43]
Pregnant people face many barriers to accessing legal abortion in Ecuador.[44] The barriers include fear of criminal prosecution and a narrow interpretation by health providers of the health exception, including only imminent risk to the pregnant person’s physical health.
CESCR has stated that “[t]he realization of women’s right to health requires the removal of all barriers interfering with access to health services, education and information, including in the area of sexual and reproductive health.”[45] Abortion is a safe practice when performed correctly using methods recommended by the World Health Organization.[46] Safe abortions can be carried out using medication or through a simple outpatient procedure. The WHO reports that medication abortion is safe and highly effective.[47] However, abortions may become unsafe when the practice is criminalized, as it results in a lack of access to accurate and reliable information and support. Criminalization can also hinder women and girls from seeking care following an incomplete abortion, miscarriage, or obstetric emergency, for fear of prosecution or mistreatment.
This is the case for many women and girls in Ecuador, as Human Rights Watch has documented.[48]Human Rights Watch research has shown that enforcing criminalization has resulted in instances where women seeking emergency medical care due to pregnancy complications were reported to authorities and subsequently prosecuted, even when their situation did not involve seeking an abortion.[49] Fear of prosecution in Ecuador can drive women, girls and other pregnant people away from seeking medical care when they urgently need it, whether due to complications from an unsafe abortion or even when experiencing a miscarriage, thereby increasing their health risks.[50] Moreover, women experiencing obstetric emergencies or spontaneous abortions are often unjustly suspected of illegally induced abortions, leading to their criminalization and denial of essential medical care.
The experience of Monica, a 17-year-old girl, shows how criminalization of abortion is a barrier to accessing essential medical attention when needed. In 2010, Monica, who was four weeks pregnant, took medication to induce an abortion. She found information on the internet about how to use pills and bought them for 30 dollars. An hour after taking them, she began experiencing vaginal bleeding and contractions. Frightened, Monica called a friend who accompanied her to the hospital. Instead of giving her the care and support she needed, the medical personnel at the hospital called the police. Monica was charged with abortion with consent and, because she was under 18, was sentenced to three months of orientation and family support in accordance with the Children and Youth Code.[51]
In Ecuador, women who undergo miscarriages or are victims of gender-based violence are also subject to criminalization. A case reviewed by Human Rights Watch describes a woman who had apparently been physically attacked by an intimate partner, causing fetal death; she was nonetheless convicted of consensual abortion.[52]
Human Rights Watch has documented that people who should be eligible to access therapeutic abortion under the current law cannot always do so. Ecuador has a clear protocol outlining when and how therapeutic abortion is permitted under existing law, and references a comprehensive understanding of “health” that includes “physical, mental, and social wellbeing” and recognizes it as a human right that the state is obligated to protect.[53] However, as documented by Human Rights Watch, doctors often ignore this guidance, interpreting the therapeutic exception in the narrowest way possible, to include only imminent risks to the pregnant person’s physical health.[54]
Additionally, rape survivors may face severe psychological consequences if forced to continue a pregnancy against their will.[55] Criminalizing access to abortion forces women and girls to continue pregnancies against their will, undermining their autonomy and their right to privacy.[56] This can result in severe negative impacts on the health of girls and women.[57] According to CEDAW, the denial or delay of safe abortion and forced continuation of pregnancy constitute a violation of women’s sexual and reproductive rights and a form of gender-based violence which, depending on the circumstances, may amount to torture or cruel, inhuman or degrading treatment.[58]
Blocking access to safe and legal abortion has a devastating and often lifelong impact on women and girls who face an unwanted pregnancy.[59] High rates of sexual violence paired with minimal access to sexual and reproductive health services mean that women and girls are frequently forced to carry unwanted pregnancies to term, as documented by Human Rights Watch.[60]
Carrying unwanted pregnancies and forced motherhood has a negative impact on girls’ mental, physical, and social health and leaves them vulnerable to higher risks of maternal mortality, anxiety, depression, post-traumatic stress disorder, and suicide.[61] In Ecuador, a 2015 study reviewed the medical records of 139 girls who were forced into motherhood before the age of 14 and found that over 90 percent of them showed “depressive symptoms” and “adjustment disorder.”[62]
The UN Committee on the Rights of the Child has warned of the danger of unsafe abortion to adolescent girls’ health. It has often urged states to decriminalize abortion in all circumstances, and to ensure that adolescent girls have access to safe abortion and post-abortion care.[63] It has also called on states to “review legislation with a view to guaranteeing the best interests of pregnant adolescents and ensure that their views are always heard and respected in abortion-related decisions.”[64] Similarly, the CEDAW Committee has stated that “it is the duty of States parties to ensure women’s right to safe motherhood and emergency obstetric services and they should allocate to these services the maximum extent of available resources.”[65] It explained that “barriers to women’s access to appropriate health care include laws that criminalize medical procedures only needed by women and that punish women who undergo those procedures,”[66] and argued that,“[w]hen possible, legislation criminalizing abortion should be amended, in order to withdraw punitive measures imposed on women who undergo abortion.”[67]
According to the latest available statistics from the National Statistical Institute (Instituto Nacional de Estadísticas y Censos-INEC), in 2023 there were 547 cases in which an abortion was determined to be legally permitted.[68] However, abortion—including abortions prohibited under Ecuador’s current law and interpretation of that law—is a common procedure in Ecuador. According to official INEC data, in 2023, 12,413 abortions took place in Ecuador.[69]
Conscientious objection
Individual healthcare personnel may in some cases assert conscientious objection to refuse to perform treatments or procedures on moral or religious grounds. However, international law does not require states to provide for conscientious objection in health care, and a state's primary duty of care is to the individual seeking health care. That means that an assertion of conscientious objection should never result in the limitation or denial of access to health care -including abortion care- for others. If a state permits conscientious objection in health care, it must be exercisable only by individual healthcare providers, only if there are effective referral mechanisms so that it is not a barrier to accessing healthcare services. It should not be exercisable in emergency or urgent care situations and should not cause distress to those seeking medical care.
The United Nations Human Rights Committee (UNHRC), in its General Comment Number 36, stated that states parties should remove existing barriers to women and girls' effective access to safe and legal abortion, including those arising from the exercise of conscientious objection by individual medical service providers.[70]
Former UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Anand Grover, referred to conscientious objection laws as one of the main restrictions on legal abortion, noting that they “create barriers to access by permitting health-care providers and ancillary personnel, such as receptionists and pharmacists, to refuse to provide abortion services, information about procedures and referrals to alternative facilities and providers.”[71] In response to this issue, he recommended that states “[e]nsure that conscientious objection exemptions are well-defined in scope and well-regulated in use and that referrals and alternative services are available in cases where the objection is raised by a service provider.”[72]
In the Constitution of Ecuador conscientious objection is recognized as “[a] right (…) which may not impair other rights, nor cause harm to persons or to nature.”[73] However, the Law that Guarantees the Voluntary Interruption of Pregnancy for Girls, Adolescents and Women in case of Rape established a model of conscientious objection that contradicts international standards, including by allowing for collective and institutional conscientious objection.[74] This model was challenged through a constitutional lawsuit (93-22IN),[75] and the Constitutional Court temporarily suspended parts of the articles regarding conscientious objection, considering that they could severely and imminently affect the rights of sexual violence victims seeking these services, while it considered the lawsuit.[76] Following the Court's resolution, the Ministry of Public Health issued guidelines for abortion due to rape, which set requirements and limits on conscientious objection. Despite these guidelines, women, girls and pregnant individuals are often denied services in public health facilities because the staff claim that all personnel are objectors.[77] The CEDAW Committee has “note[d] with concern […] the lack of access to safe abortion and post-abortion services and the shortfall in health professionals trained in providing such services,” in its concluding observations to Ecuador.[78]
Ecuador's primary obligation of care is towards individuals seeking health services and their right to health.[79]
3. The Right to Humane Treatment
The right to humane treatment, including the right to be free from torture or from other cruel, inhuman, or degrading treatment or punishment, is protected under various international human rights instruments, including the American Convention on Human Rights; the International Covenant on Civil and Political Rights; and the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT).[80] The criminalization and inaccessibility of abortion in Ecuador are incompatible with the right to freedom from torture and other cruel, inhuman, or degrading treatment or punishment.
Where access to reproductive health, including abortion services, is not available it can pose risks to mental health, including severe anguish and risk of suicide. The United Nations Committee against Torture (CAT) has expressed concern at the severe physical and mental anguish and distress women and girls may experience due to abortion restrictions and concluded that criminalization and inaccessibility of abortion can be incompatible with a government’s duty to uphold the right to freedom from torture and other cruel, inhuman or degrading treatment or punishment.[81]
The CEDAW Committee has also described the criminalization of abortion and denial or delay of access to legal abortion as “forms of gender-based violence that, depending on the circumstances, may amount to torture or cruel, inhuman or degrading treatment.”[82] Similarly, the Committee on Economic, Social and Cultural Rights has also said that denial of abortion “in certain circumstances can amount to torture or cruel, inhuman or degrading treatment.”[83]
The Human Rights Committee has found in individual cases against Ireland, Peru, and Argentina that the governments violated the right to freedom from torture or other cruel, inhuman, or degrading treatment by failing to ensure access to abortion services in these cases.[84] It pointed out that this right relates not only to physical pain but also to mental suffering.
Through its ruling in the case KL v. Peru, the United Nations Human Rights Committee found a violation of article 7 of the ICCPR, which prohibits torture and cruel, inhuman, or degrading treatment or punishment, where Peruvian authorities denied a request from a 17-year-old for a therapeutic abortion due to fetal anencephaly. The Committee emphasized that Peru’s refusal to provide abortion services caused significant mental suffering and highlighted Peru's failure to offer adequate medical and psychological support.[85]
The UN Special Rapporteur on Torture has criticized highly restrictive abortion laws.[86] He continued:
The denial of safe abortions and subjecting women and girls to humiliating and judgmental attitudes in such contexts of extreme vulnerability and where timely health care is essential amount to torture or ill-treatment. States have an affirmative obligation to reform restrictive abortion legislation that perpetuates torture and ill-treatment by denying women safe access and care.[87]
Furthermore, the Committee of Experts of the Follow-up Mechanism to the Inter-American Convention on the Prevention, Punishment and Eradication of Violence against Women (Belem do Pará) noted that laws that prohibit or restrict access to safe abortion “perpetuate the exercise of violence against women, girls and adolescents […] and violate the prohibition of torture and mistreatment.”[88]
Denial of access to abortion can have serious and lasting consequences for a pregnant person’s health and well-being.[89] Human Rights Watch documented various cases of women and girls who have suffered physical and mental anguish due to criminalization in Ecuador.[90] For instance, Fernanda, aged 15, became pregnant as a result of rape and had a medical abortion. She was sentenced to three months of psychological therapy and a verbal warning for an abortion with consent. She told her therapist, “I'm the one who suffered—why do they want to make me suffer again?”[91]
5. Rights to Nondiscrimination and Equal Protection
The rights to nondiscrimination and equal protection before the law are set forth in all major international human rights treaties.[92] CEDAW prohibits discrimination against women in all spheres, including in the field of health care. It requires that states “take all appropriate measures, including legislation, to modify or abolish existing laws, regulations, customs and practices which constitute discrimination against women.”[93] Article 12 of the CEDAW Convention establishes that states parties must take all appropriate measures to eliminate discrimination against women in the field of health care, ensuring equality between men and women.[94]Furthermore, Article 12.2 of the Convention provides that states parties must ensure appropriate services in connection with pregnancy, confinement, and the post-natal period.[95]
The CEDAW Committee observed that “failure of a State party to provide services and the criminalization of some services that only women require is a violation of women's reproductive rights and constitutes discrimination against them.”[96] In its General Recommendation on women and health, the CEDAW Committee noted again that “barriers to women’s access to appropriate health care include laws that criminalize medical procedures only needed by women and that punish women who undergo these procedures.”[97]
The Committee on Economic, Social and Cultural Rights has also noted that a wide range of laws, policies, and practices undermine autonomy and the right to equality and nondiscrimination in the full enjoyment of sexual and reproductive health, citing criminalization of abortion or restrictive abortion laws as examples.[98] It also noted that states parties should “ensure that all individuals and groups have equal access to the full range of sexual and reproductive health information, goods and services, including by removing all barriers that particular groups may face.”[99] It further highlighted that abortion restrictions particularly affect women experiencing poverty and those with less education.[100]
The Inter-American Commission on Human Rights has expressed that limitations on accessing health services that are required only by women generate inequalities between men and women with respect to the enjoyment of their rights.[101]
Criminalizing abortion discriminates against women, girls, and pregnant people by denying them the ability to make fundamental decisions concerning their bodies and lives. By criminalizing abortion, the state imposes a discriminatory standard that reinforces the gender stereotype that women’s and girls’ role is motherhood. It also serves to discipline their sexuality and punish those who do not comply with their stereotypically assigned role in society, disregarding their rights to privacy, non-discrimination and reproductive freedom.[102] This not only limits their reproductive freedom but also imposes an unjust burden on them to bear the consequences of unwanted pregnancies, often in contexts where they may lack the necessary support and resources.
The criminalization of abortion in Ecuador affects all women and girls, but it does not affect them all equally.[103] It has particularly harsh consequences for women and girls from economically disadvantaged backgrounds, Indigenous, and Afro-descendant communities. These groups encounter significant barriers to accessing safe abortion services and health care in general.
Girls who are forced into motherhood often drop out of school and suffer greater levels of violence and poverty.[104] Forced motherhood in girls perpetuates cycles of discrimination and poverty.[105] In essence, the criminalization of abortion institutionalizes discrimination by denying women, girls, and pregnant people the agency to make decisions about their reproductive health and life paths, perpetuating systemic gender-based inequalities.
Human Rights Watch's analysis revealed that a majority of those accused of abortion-related crimes were young women, with a significant percentage from regions with high poverty rates and predominantly Indigenous or Afro-descendant populations.[106] From the 78 cases of women and girls where their age could be determined, the majority, 48 (61 percent), were ages 18-24, 16 (21 percent) were ages 25- 29, 5 (6 percent) were ages 30-39, and 9 (12 percent) were girls under age 18. A disproportionate number were from rural areas of the country.[107]
The prosecution of women seeking emergency medical care for pregnancy complications—regardless of whether they are seeking an abortion— exacerbates existing social inequalities.[108] This discriminatory practice not only undermines women's sexual and reproductive rights but also jeopardizes their health and well-being, perpetuating cycles of poverty and inequality.
Ecuador's criminalization of abortion worsens social inequities and violates fundamental human rights. It underscores the urgent need for the decriminalization of abortion to ensure equitable access to reproductive healthcare and uphold the rights of all individuals, regardless of their economic status or ethnic background. Upholding legal equality between men and women requires rejecting scenarios that confine individuals to predetermined roles, implying their inferiority, and instead promoting equal opportunities for all. Therefore, decriminalizing abortion is crucial to combatting gender inequality, dismantling discriminatory gender roles, and ensuring that women, girls and other pregnant people have autonomy over their reproductive decisions, free from societal norms and restrictions imposed by law.
V. Conclusions
Ecuador has the obligation under international human rights standards to provide women, girls, and other pregnant people with access to safe and legal abortion. The criminalization of abortion in Ecuador, as evidenced by its enforcement, and barriers to abortion care, infringe upon the human rights of women and girls as recognized under international law. These rights include the right to life, physical integrity, and health; freedom from torture or cruel, inhuman, or degrading treatment; equality and non-discrimination; privacy; and protection from violence.
By imposing severe restrictions on reproductive health care, Ecuadorian law fails to protect women and girls from violence and discrimination, undermining their autonomy and perpetuating gender inequality. The denial of access to safe abortion services not only violates their right to make informed decisions about their bodies but also restricts their ability to pursue educational, economic, and social opportunities on an equal basis.
Petition
For the abovementioned reasons, we respectfully request this Court to:
1. Accept Human Rights Watch as a Friend of the Court in this case, and
2. Decriminalize abortion in all circumstances in alignment with international human rights standards.
Sincerely,
Macarena Sáez
Executive Director
Women’s Rights Division
Human Rights Watch
Cristina Quijano Carrasco
Researcher
Women’s Rights Division
Human Rights Watch
[1] See for example, Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”: The Impact of Abortion Prosecutions in Ecuador, “ 2021, https://www.hrw.org/report/2021/07/14/why-do-they-want-make-me-suffer-again/impact-abortion-prosecutions-ecuador#:~:text='%20The%20Impact%20of%20Abortion%20Prosecutions,to%20promote%20sexual%20and%20reproductive; Human Rights Watch, “Es hora de saldar una deuda” Argentina, 2020, https://www.hrw.org/es/news/2020/08/31/argentina-debe-legalizar-el-aborto; Human Rights Watch,“Es tu decisión, es tu vida": La criminalización total del aborto en la Republica Dominicana”, Republica Dominicana, 2018, https://www.hrw.org/es/report/2018/11/19/es-tu-decision-es-tu-vida/la-criminalizacion-total-del-aborto-en-la-republica; Human Rights Watch, “Relegadas y desprotegidas: Impacto del brote del Zika en mujeres y niñas en el noreste de Brasil”, Brasil, 2017, https://www.hrw.org/report/2017/07/13/neglected-and-unprotected/impact-zika-outbreak-women-and-girls-northeastern; Human Rights Watch “Criminalización de las víctimas de violencia sexual: el aborto ilegal luego de una violación en Ecuador” Ecuador, 2013, https://www.hrw.org/es/report/2013/08/23/criminalizacion-de-las-victimas-de-violacion-sexual/el-aborto-ilegal-luego-de-una; Human Rights Watch, “Derecho o ficción: La Argentina no rinde cuentas en materia de salud reproductiva”, Argentina, 2010, https://www.hrw.org/es/report/2010/08/10/derecho-o-ficcion/la-argentina-no-rinde-cuentas-en-materia-de-salud-reproductiva; Human Rights Watch,“Un Estado de aislamiento: el acceso al aborto para las mujeres en Irlanda”, Irlanda, 2010, https://www.hrw.org/report/2010/01/28/state-isolation/access-abortion-women-ireland; Human Rights Watch,“Por sobre sus cadáveres: denegación de acceso a la atención obstétrica de emergencia y al aborto terapéutico en Nicaragua”, Nicaragua, 2007, https://www.hrw.org/es/report/2007/10/01/por-sobre-sus-cadaveres/denegacion-de-acceso-la-atencion-obstetrica-de-emergencia; Decisión prohibida: acceso de las mujeres a los anticonceptivos y al aborto en Argentina”, Argentina, 2005, https://www.hrw.org/es/report/2005/06/15/decision-prohibida/acceso-de-las-mujeres-los-anticonceptivos-y-al-aborto-en; Human Rights Watch, “Tengo derechos, y tengo derecho a saber: la falta de acceso al aborto terapéutico en el Perú”, Perú, 2008, https://www.hrw.org/reports/peru0708spweb.pdf.
See also other Human Rights Watch reports that analyze the issue, Human Rights Watch, “Las Mujeres afectadas por la prohibición del aborto en Honduras se ven obligadas a decidir entre la vida y la muerte”, Honduras, 2019, https://www.hrw.org/es/news/2019/06/06/las-mujeres-afectadas-por-la-prohibicion-del-aborto-en-honduras-se-ven-obligadas; Human Rights Watch, “Covid-19 agrava los obstáculos al aborto legal: Las medidas inadecuadas aumentan los riesgos existentes para la salud y la vida” Italia, 2020, https://www.hrw.org/news/2020/07/30/italy-covid-19-exacerbates-obstacles-legal-abortion; Human Rights Watch, “Nadie nos recuerda: La falta de protección del derecho de las mujeres y las niñas a la salud y la seguridad en Haití después del terremoto”, Haití, 2011, https://www.hrw.org/report/2011/08/19/nobody-remembers-us/failure-protect-womens-and-girls-right-health-and-security#; Human Rights Watch “Derechos fuera de alcance: Obstáculos a la salud, a la justicia y la protección para mujeres desplazadas víctimas de violencia de género en Colombia”, Colombia, 2012, https://www.hrw.org/es/report/2012/11/08/derechos-fuera-de-alcance/obstaculos-la-salud-la-justicia-y-la-proteccion-para; Human Rights Watch, “Detenida y destituida: La lucha de las mujeres por obtener atención médica en centros de detención para inmigrantes de los Estados Unidos”, Estados Unidos, 2009, http://www.admin.hrw.org/report/2009/03/17/detained-and-dismissed/womens-struggles-obtain-health-care-united-states; Human Rights Watch, “No debería suceder: El fracaso de Alabama en la prevención de la muerte por cáncer cervical en el cinturón negro”, Estados Unidos, 2018, https://www.hrw.org/report/2018/11/29/it-should-not-happen/alabamas-failure-prevent-cervical-cancer-death-black-belt.
[2] Ibid.
[3] International Covenant on Civil and Political Rights, adopted December 16, 1966, UN General Assembly resolution 2200A (XXI), art. 17, ratified by Ecuador on March 6, 1969, https://www.ohchr.org/en/instruments-mechanisms/instruments/international-covenant-civil-and-political-rights (accessed August 14, 2024); American Convention on Human Rights, adopted November 22, 1969, at the Inter-American Specialized Conference on Human Rights, art. 11, ratified by Ecuador on December 8, 1977, https://www.cidh.org/basicos/english/Basic3.American%20Convention.htm (accessed August 14, 2024); Convention on the Elimination of All Forms of Discrimination Against Women, adopted December 18, 1979, UN General Assembly resolution 34/180, art. 12, ratified by Ecuador on November 9, 1981, https://www.ohchr.org/en/instruments-mechanisms/instruments/convention-elimination-all-forms-discrimination-against-women (accessed August 14, 2024); International Covenant on Economic, Social and Cultural Rights, adopted December 16, 1966, UN General Assembly resolution 2200A (XXI), art. 12, ratified by Ecuador on June 6, 1969, https://www.ohchr.org/en/instruments-mechanisms/instruments/international-covenant-economic-social-and-cultural-rights (accessed August 14, 2024).
[4] Committee on Economic, Social and Cultural Rights (CESCR). General Comment No. 22 (2016) on the Right to Sexual and Reproductive Health. 2016. par. 25, “Due to women’s reproductive capacities, the realization of the right of women to sexual and reproductive health is essential to the realization of the full range of their human rights. The right of women to sexual and reproductive health is indispensable to their autonomy and their right to make meaningful decisions about their lives and health. Gender equality requires that the health needs of women, different from those of men, be taken into account and appropriate services provided for women in accordance with their life cycles,” https://docstore.ohchr.org/SelfServices/FilesHandler.ashx?enc=4slQ6QSmlBEDzFEovLCuW1a0Szab0oXTdImnsJZZVQfQejF41Tob4CvIjeTiAP6sGFQktiae1vlbbOAekmaOwDOWsUe7N8TLm%2BP3HJPzxjHySkUoHMavD%2Fpyfcp3Ylzg (accessed August 14, 2024)
[5] See, Human Rights Watch, ““Why Do They Want To Make Me Suffer Again?” The impact of abortion prosecution in Ecuador, 2021, p. 5.
[6] Human Rights Watch, ““Why Do They Want To Make Me Suffer Again?” The impact of abortion prosecution in Ecuador, 2021, p. 77.
[7] Ibid.
[8] Human Rights Watch, ““Why Do They Want To Make Me Suffer Again?”, p. 37.
[9] Human Rights Watch, ““Why Do They Want To Make Me Suffer Again?”, p. 21.
[10] Ibid.
[11] Human Rights Watch, “Human Rights Watch Amicus Curiae in Case Beatriz and others V. El Salvador,” 2023, https://www.hrw.org/sites/default/files/media_2024/06/HRW%20Amicus%20Curiae%20Beatriz%20and%20others%20V.%20El%20Salvador.pdf (accessed July 9, 2024).
[12] World Health Organization, Abortion Fact Sheet, November 25, 2021, Abortion (who.int)
[13] Human Rights Watch, “Justa Libertad: Movimiento busca despenalizar el aborto en Ecuador,” 2024, https://www.hrw.org/es/news/2024/04/15/justa-libertad-movimiento-busca-despenalizar-el-aborto-en-ecuador (accessed July 30, 2024).
[14] Criminal Code of Ecuador, Código Orgánico Integral Penal, National Assembly, 2014, art. 149.
[15] Constitution of the Republic of Ecuador, art. 426, https://www.oas.org/juridico/pdfs/mesicic4_ecu_const.pdf
[16] Justa Libertad, Action of Unconstitutionality 22-24-IN
[17] Criminal Code of Ecuador, art. 150.
[18] “Estereotipos de género en el juzgamiento del delito de aborto consentido en el Ecuador,” Surkuna, Centro de Apoyo y Protección de los Derechos Humanos, 2024, https://surkuna.org/wp-content/uploads/2024/05/Final-Estereotipos-de-Genero-en-el-Juzgamiento-del-delito-de-aborto-consentido-en-el-Ecuador-2024-.pdf (accessed July 12, 2024)
[19] Constitutional Court of Ecuador, Sentencia 34-19-IN/21, 2021, https://www.corteconstitucional.gob.ec/sentencia-34-19-in-21/ (accessed July 30, 2024).
[20] Organic Law that Regulates the Voluntary Termination of Pregnancy for Girls, Adolescents, and Women in Cases of Rape, 2022, https://www.lexis.com.ec/biblioteca/ley-regula-interrupcion-voluntaria-embarazo-caso-violacion (accessed July 17, 2024).
[21] See, Committee on the Elimination of Discrimination against Women (CEDAW), Concluding Observations on the Tenth Periodic Report of Ecuador, CEDAW/C/ECU/CO/10, 2021, para. 34, https://www.igualdadgenero.gob.ec/wp-content/uploads/2022/05/observaciones_finales_sobre_el_decimo_informe_periodico_del_ecuador_-cedaw-1.pdf (accessed July 24, 2024); Human Rights Watch, Carta de HRW a la Comisión de Justicia de la Asamblea Nacional de Ecuador ,2022, https://www.hrw.org/es/news/2022/01/10/carta-de-hrw-la-comision-de-justicia-de-la-asamblea-nacional-de-ecuador#x_x_x_x__ftn17 (accessed July 25, 2024); and“Estereotipos de género en el juzgamiento del delito de aborto consentido en el Ecuador,” Surkuna, Centro de Apoyo y Protección de los Derechos Humanos, 2024, https://surkuna.org/wp-content/uploads/2024/05/Final-Estereotipos-de-Genero-en-el-Juzgamiento-del-delito-de-aborto-consentido-en-el-Ecuador-2024-.pdf (accessed July 12, 2024)
[22] “Estereotipos de género en el juzgamiento del delito de aborto consentido en el Ecuador,” Surkuna, Centro de Apoyo y Protección de los Derechos Humanos, 2024, https://surkuna.org/wp-content/uploads/2024/05/Final-Estereotipos-de-Genero-en-el-Juzgamiento-del-delito-de-aborto-consentido-en-el-Ecuador-2024-.pdf (accessed July 12, 2024)
[23] Action of unconstitutionality of Article 149 of the Criminal Code, Justa Libertad, March 19, 2024.
[24] Ibid.
[25] American Convention on Human Rights, Pact of San José, Costa Rica, art. 4(1), 1969, "Every person has the right to have his life respected. This right shall be protected by law and, in general, from the moment of conception. No one shall be arbitrarily deprived of his life;" International Covenant on Civil and Political Rights, adopted December 16, 1966, UN General Assembly resolution 2200A (XXI), art. 6, ratified by Ecuador on March 6, 1969.
[26] See, for example, Human Rights Committee (HRC), “Concluding observations on the seventh periodic report of El Salvador,” CCPR/C/SLV/CO/7, May 9, 2018, https://undocs.org/sp/CCPR/C/SLV/CO/7 (accessed June 16, 2021), paras. 15 and 16; HRC, “Concluding observations on the fourth periodic report of Guatemala,” May 7, 2018, CCPR/C/GTM/CO/4, https://undocs.org/en/CCPR/C/GTM/CO/4 (accessed June 16, 2024); HRC, “Concluding observations on the third periodic report of Lebanon,” CCPR/C/LBN/CO/3, May 9, 2018, https://undocs.org/en/CCPR/C/LBN/CO/3 (accessed June 16, 2024), para. 25; HRC, “Concluding observations on the fifth periodic report of Cameroon,” CCPR/C/CMR/CO/5, November 30, 2017, https://undocs.org/en/CCPR/C/CMR/CO/5 (accessed June 16, 2024), para. 21.
[27] UN Human Rights Committee (HRC), General Comment No. 6 on the right to life, UN Doc HRI/GEN/1/Rev.9 (2008), para. 5.
[28] HRC General Comment on the right to life, para. 8. Adopted by the Committee at its 124th session (8 October–2 November 2018). https://tbinternet.ohchr.org/_layouts/15/treatybodyexternal/Download.aspx?symbolno=CCPR/C/GC/36&Lang=en (accessed June 19, 2024).
[30] See, for example, HRC concluding observations on Lebanon, UN Doc. CCPR/C/LBN/CO/3 (2018); Cameroon, UN Doc. CCPR/C/CMR/CO/5 (2017); Democratic Republic of the Congo, UN Doc. CCPR/C/COD/CO/4 (2017); Italy, UN Doc. CCPR/C/ITA/CO/6 (2017); Poland, UN Doc. CCPR/C/POL/CO/7 (2016); Burkina Faso, UN Doc. CCPR/C/BFA/CO/1 (2016); and Ghana, UN Doc. CCPR/C/GHA/CO/1 (2016).
[31] See, Action of unconstitutionality of Article 149 of the Criminal Code, Justa Libertad, March 19, 2024; Human Rights Watch, ““Why Do They Want To Make Me Suffer Again?” The impact of abortion prosecution in Ecuador, 2021, p. 78.
[32] Committee on the Elimination of Discrimination against Women. Concluding Observations on the Tenth Periodic Report of Ecuador. CEDAW/C/ECU/CO/10, 2021, paragraph 34(a), https://documents.un.org/doc/undoc/gen/n21/353/95/pdf/n2135395.pdf (accessed Auugst 26, 2024).
[33] Ecuadorian Ministry of Health, “Memorandum Number MSP-2017-0790-M,” August 4, 2017, https://docs.google.com/document/d/16qMHmp8LJkWoxyMzmHkNd4Z9zXsoUxZ9SiuwZDsfHDc/edit (accessed August 14, 2024).
[34] Constitution of Ecuador, art. 45.
[35] Inter-American Court of Human Rights, Artavia Murillo Case, Judgment of November 28, 2012, Inter-Am.Ct.H.R., Ser. C) No. 257 (2012), https://www.corteidh.or.cr/docs/casos/articulos/seriec_257_esp.pdf (accessed July 10, 2024).
[36] Corte Interamericana de Derechos Humanos, caso Artavia Murillo, sentencia del 28 de noviembre de 2012, Corte I.D.H, (Ser. C) N.º 257 (2012), párrs. 186-89 y 223; Convención Americana sobre Derechos Humanos (“CADH”), adoptada el 22 de noviembre de 1969, Serie de Tratados de la OEA N.º 36, 1144 U.N.T.S. 123, en vigor desde el 18 de julio de 1978, reimpresa en los Documentos Básicos en Materia de Derechos Humanos en el Sistema Interamericano, OEA/Ser.L.V/II.82 doc.6 rev.1 en 25 (1992), art. 4,1.
[37] Ibid., para. 264.
[38] International Covenant on Economic, Social and Cultural Rights (ICESCR), 1966, ratified by Ecuador on June 6, 1969, art. 12(1); Convention on the Rights of the Child (CRC), (1989), ratified by Ecuador on March 23, 1990, art. 24; Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), ratified by Ecuador on November 9, 1981, art. 12.
[39] Convention on the Rights of the Child, 1990, art. 24, para. 1.
[40] CEDAW, art. 12.
[41] United Nations Office of the High Commissioner for Human Rights, “Sexual and Reproductive Health and Rights,” https://www.ohchr.org/EN/Issues/Women/WRGS/Pages/HealthRights.aspx (accessed June 17, 2021)
[42] Committee on Economic, Social and Cultural Rights, General comment No. 22 on the right to sexual and reproductive health (article 12 of the International Covenant on Economic, Social and Cultural Rights), U.N. Doc. No. E/C.12/GC/22. (2016), para. 40.
[43] WHO, “Constitution,” https://www.who.int/about/governance/constitution (accessed August 26, 2024).
[44] See, Kaleidos, “Estudio cualitativo sobre principales rutas de acceso y barreras al aborto legal en Ecuador,”2022, https://clacaidigital.info/bitstream/handle/123456789/1693/Estudio%20sobre%20rutasy%20barreras%20de%20acceso%20al%20aborto%20legal%20Ecuador.pdf?sequence=1&isAllowed=y (accessed July 29, 2024); Larrea, Sara, "Conocimientos, actitudes y prácticas sobre aborto legal de personal de salud y operadores de justicia en el Ecuador," 2022, in collaboration with Planned Parenthood Global, https://clacaidigital.info/bitstream/handle/123456789/1694/Estudio%20CAP%20aborto%20legal%20Ecuador%202022%20%282%29.pdf?sequence=1&isAllowed=y (accessed July 29, 2024); Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”.
[45] CESCR, General Comment No. 14, para. 21, unofficial translation by Human Rights Watch, https://docstore.ohchr.org/SelfServices/FilesHandler.ashx?enc=4slQ6QSmlBEDzFEovLCuW1AVC1NkPsgUedPlF1vfPMJ2c7ey6PAz2qaojTzDJmC0y%2B9t%2BsAtGDNzdEqA6SuP2r0w%2F6sVBGTpvTSCbiOr4XVFTqhQY65auTFbQRPWNDxL (accessed July 29, 2024).
[46] Elizabeth G. Raymond y David Grimes, “The Comparative Safety of Legal Induced Abortion and Childbirth in the United States”, Obstetrics & Gynecology, vol. 119, no. 2 (2012): 215–219.
[47] World Health Organization (WHO), Tratamiento médico del aborto, 2018, https://apps.who.int/iris/bitstream/handle/10665/328166/9789243550404-spa.pdf?ua=1
[48] See, Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”.
[49] Human Rights Watch, “Why Do They Want to Make me Suffer Again?”, p. 48.
[50] Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”, p. 83.
[51] Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”, p. 83.
[52] Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”, p. 55.
[53] Ecuador Ministry of Public Health, “Atención del aborto terapéutico: Guía de Práctica Clínica,” 2015, https://www.salud.gob.ec/wp-content/uploads/2016/09/Aborto-terapéutico.pdf (accessed July 29, 2024), p. 17; See, Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”, p. 23.
[54] Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”, p. 23.
[55] Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”, p. 83.
[56] See, International Covenant on Civil and Political Rights, General Comment No. 36, par. 8, “(…) restrictions on the ability of women or girls to seek abortion must not, inter alia, jeopardize their lives, subject them to physical or mental pain or suffering that violates article 7 of the Covenant, discriminate against them or arbitrarily interfere with their privacy. States parties must provide safe, legal and effective access to abortion where the life and health of the pregnant woman or girl is at risk, or where carrying a pregnancy to term would cause the pregnant woman or girl substantial pain or suffering (…),” https://documents.un.org/doc/undoc/gen/g19/261/15/pdf/g1926115.pdf (accessed August 23, 2024); CEDAW, General Recommendation No. 24.
[57] Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”, p. 54; UN Human Rights Council, Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Dainius Pūras, Visit to Ecuador, A/HRC/44/48/Add.1, May 6, 2020, para. 48, the right to sexual and reproductive health is a “fundamental part of the right to health, which includes access to safe, legal abortion. Access to safe, legal abortion guarantees the dignity and autonomy of girls and women as elements of their sexual and reproductive health. If not provided, this has severe negative impacts on the health of girls and women. Those negative impacts are made worse in cases of unwanted pregnancies and forced motherhood as a result of sexual violence.”
[58] CEDAW, General Comment No. 35, par. 18, https://docstore.ohchr.org/SelfServices/FilesHandler.ashx?enc=6QkG1d%2FPPRiCAqhKb7yhsldCrOlUTvLRFDjh6%2Fx1pWAeqJn4T68N1uqnZjLbtFua2OBKh3UEqlB%2FCyQIg86A6bUD6S2nt0Ii%2Bndbh67tt1%2BO99yEEGWYpmnzM8vDxmwt (accessed August 14, 2024).
[59] Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”, p. 84.
[60] Ibid.
[61] Pan American Health Organizations et al., “Accelerating Progress toward the reduction of Adolescent Pregnancy in Latin America and the Caribbean,” 2017, https://lac.unfpa.org/sites/default/files/pub-pdf/Accelerating%20progress%20toward%20the%20reduction%20of%20adolescent%20pregnancy%20in%20LAC%20-%20FINAL.pdf (accessed July 12, 2024), p. 2.
[62] Fundación Desafío, “Lives Stolen, between omission and premeditation: the situation of forced motherhood in Ecuadorian girls” (“Vidas Robadas, entre la omisión y la premeditación: La situación de las maternidades forzadas en niñas del Ecuador”), 2016, http://repositorio.dpe.gob.ec/bitstream/39000/2410/1/PE-004-DPE-2019.pdf (accessed July 12, 2024). ; Planned Parenthood, “Stolen Lives: a multicountry study on the health effects of forced motherhood on girls 9-14 years old,” 2015, https://www.plannedparenthoodaction.org/uploads/filer_public/db/6d/db6d56cb-e854-44bb-9ab7-15bb7fc147c5/ppfa-stolen-lives-english.pdf (accessed August 26, 2024), p.25.
[63] Committee on the Rights of the Child, General Comment No. 20 on the implementation of the rights of the child during adolescence, U.N. Doc. CRC/C/GC/20 (2016), https://documents.un.org/doc/undoc/gen/g16/404/44/pdf/g1640444.pdf (accessed August 14, 2024), paras. 13 and 60; see, for example, Committee on the Rights of the Child, “Concluding observations on the combined fifth and sixth periodic reports of Guatemala,” February 28, 2018, https://documents.un.org/doc/undoc/gen/g18/053/17/pdf/g1805317.pdf (accessed August 14, 2024), para. 34 (b); Committee on the Rights of the Child, “Concluding observations on the combined third and fourth periodic reports of the Marshall Islands,” February 27, 2018, https://documents.un.org/doc/undoc/gen/g18/051/70/pdf/g1805170.pdf (accessed August 14, 2024), para. 31(c); and Committee on the Rights of the Child, “Concluding observations on the second periodic report of Palau,” February 28, 2018, https://documents.un.org/doc/undoc/gen/g18/052/08/pdf/g1805208.pdf (Accessed 14 August, 2024), para. 44(b).
[64] Committee on the Rights of the Child, General Comment No. 20 on the implementation of the rights of the child during adolescence, UN Doc. CRC/C/GC/20 (2016), para. 60, https://www.ohchr.org/en/documents/general-comments-and-recommendations/general-comment-no-20-2016-implementation-rights (accessed July 25, 2024).
[65] CEDAW Committee, General Recommendation No. 24, Women and Health, U.N. Doc. A/54/38/Rev.1 (1999), para. 27.
[66] Ibid., para. 14.
[67] Ibid, para. 31.c.
[68] Anuario camas y egresos. Lamina 3.1.11. Columna B y C, filas 1039, “Camas y Egresos Hospitalarios,” Instituto Nacional de Estadísticas y Censos (INEC), https://www.ecuadorencifras.gob.ec/camas-y-egresos-hospitalarios/, (accessed July 25, 2024).
[69] Ibid.
[70] UN Human Rights Committee, General Comment No. 36, The Right to Life, UN Doc. CCPR/C/GC/36 (2018), para. 8
[71] United Nations General Assembly, Interim Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, A/66/254, August 3, 2011, para. 24. emphasis added, https://www.ossyr.org.ar/PDFs/2011_Informe_Relator_derecho_salud.pdf (accessed March 18, 2024).
[72] Ibid, par. 65 (m).
[73] Constitution of Ecuador, art. 66.12., “El derecho a la objeción de conciencia, que no podrá menoscabar otros derechos, ni causar daño a las personas o a la naturaleza.”
[74] See, Constitutional Lawsuit 93-22IN, Admission Chamber of the Constitutional Court of Ecuador, December 16, 2022, p. 2, http://esacc.corteconstitucional.gob.ec/storage/api/v1/10_DWL_FL/e2NhcnBldGE6J3RyYW1pdGUnLCB1dWlkOic4YTgyMzU1MC0wMGU2LTQwZjQtOWUyMC1lMWNjMmM3M2U4YzIucGRmJ30= (accessed July 26, 2024).
[75] Constitutional Lawsuit 93-22IN, Admission Chamber of the Constitutional Court of Ecuador, December 16, 2022, http://esacc.corteconstitucional.gob.ec/storage/api/v1/10_DWL_FL/e2NhcnBldGE6J3RyYW1pdGUnLCB1dWlkOic4YTgyMzU1MC0wMGU2LTQwZjQtOWUyMC1lMWNjMmM3M2U4YzIucGRmJ30= (accessed July 15, 2024)
[76] Ibid., paras. 36 – 37(6).
[77] See, Action of unconstitutionality of Article 149 of the Criminal Code, Justa Libertad, March 19, 2024.
[78] UN Committee on the Elimination of Discrimination against Women, Concluding observations on the tenth periodic report of Ecuador, 2021, par. 33(a), https://documents.un.org/doc/undoc/gen/n21/353/95/pdf/n2135395.pdf (accessed July 30, 2024).
[79] UN Human Rights Committee, General Comment No. 36, The Right to Life, UN Doc. CCPR/C/GC/36 (2018), para. 8
[80] American Convention on Human Rights (ACHR), art. 5.1; ICCPR Art 7; Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, arts. 2 and 16.
[81] UN Committee against Torture, Concluding observations on the 6th periodic report of the United Kingdom of Great Britain and Northern Ireland, 2019, par. 46, https://digitallibrary.un.org/record/3859788?v=pdf (accessed August 15, 2024).
[82] CEDAW Committee, General Recommendation 35 on gender-based violence against women (2017), para. 18.
[83] CESCR, General Comment 22, para. 10.
[84] Whelan v. Ireland, CCPR/C/119/D/2425/2014 (2017); Mellet v. Ireland, CCPR/C/116/D/2324/2013 (2016); K.L. v. Peru, CCPR/C/85/D/1153/2003 (2005); and L.M.R. v. Argentina, CCPR/C/101/D/1608/2007 (2011).
[85] United Nations Human Rights Committee, 2014, KL v. Peru, Communication No. 1153/2003, para. 6.3, Views adopted by the Committee at its 110th session, https://reproductiverights.org/wp-content/uploads/2020/12/KL-HRC-final-decision.pdf (accessed August 14, 2024).
[86] Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, UN Doc. A/HRC/31/57 (2016), para. 43.
[87] Ibid., para. 44.
[88] Follow-up Mechanism to the Convention of Belém Do Pará Committee of Experts, “Declaration on Violence against Women, Girls and Adolescents and their Sexual and Reproductive Rights,”, OEA/Ser.L/II.7.10, September 19, 2014, http://www.oas.org/es/mesecvi/docs/CEVI11-Declaration-EN.pdf, p. 3-4.
[89] See, “The Turnaway Study,” Advancing New Standards In Reproductive Health (ANSIRH), University of California San Francisco, https://www.ansirh.org/research/ongoing/turnaway-study (accessed July 17, 2024).
[90] See, Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”.
[91] Ibid., p. 55.
[92] See, for example, ICCPR, art. 2; ICESCR, art. 2; American Convention on Human Rights (ACHR), arts. 1(1) and 24.
[93] CEDAW Committee, “Statement of the Committee on the Elimination of Discrimination against Women on sexual and reproductive health and rights: Beyond 2014 ICPD review” February 2014, http://www.astra.org.pl/pdf/onz/CEDAW_SRHR_26Feb2014.pdf (accessed June 17, 2024).
[94] Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), Article 12, https://www.ohchr.org/sites/default/files/Documents/ProfessionalInterest/cedaw_SP.pdf (accessed March 19, 2024).
[95] CEDAW, Article 12.2, (“Notwithstanding the provisions of paragraph I of this article, States Parties shall ensure to women appropriate services in connection with pregnancy, confinement and the post-natal period, granting free services where necessary, as well as adequate nutrition during pregnancy and lactation,” ) https://www.ohchr.org/sites/default/files/Documents/ProfessionalInterest/cedaw.pdf (accessed June 12, 2024).
[96] CEDAW Committee, “Statement of the Committee on the Elimination of Discrimination against Women on sexual and reproductive health and rights: Beyond 2014 ICPD review” February 2014, http://www.astra.org.pl/pdf/onz/CEDAW_SRHR_26Feb2014.pdf (accessed June 17, 2021).
[97] CEDAW Committee, General Recommendation 24, para. 14.
[98] CESCR General Comment No. 22, para. 34.
[99] Ibid.
[100] See, for example, CESCR concluding observations on El Salvador, UN Doc. E/C.12/SLV/CO/3-5 (2014); and Nepal, UN Doc. E/C.12/NPL/CO/3 (2014).
[101] Inter-American Commission on Human Rights, “Access to Maternal Health Services from a Human Rights Perspective”, OEA/Ser.L/V/II. Doc. 69, 2010, http://cidh.org/women/SaludMaterna10Eng/MaternalHealthTOCeng.htm (access June 17, 2021), para. 53.
[102] See International Covenant on Civil and Political Rights (ICCPR), Articles 17 and 26; Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), Articles 1, 2, 12, and 16(e); and United Nations Human Rights Committee, General Comment No. 28 on the Equality of Rights between Men and Women, 2000, paras. 4 and 20, https://www.refworld.org/legal/general/hrc/2000/en/38892 (accessed August 14, 2024).
[103] See, Human Rights Watch, “Why Do They Want to Make Me Suffer Again?”.
[104] Human Rights Watch Amicus Curiae in the case of Guzmán Albarracín y otros vs. Ecuador, 2020, pp. 2-3, https://www.hrw.org/sites/default/files/media_2020/07/Human%20Rights%20Watch%20Amicus%20Curiae%20in%20the%20case%20of%20Guzma%CC%81n%20Albarraci%CC%81n%20y%20otros%20Vs.%20Ecuador%20-%20February%2012%202020.pdf (accessed July 30, 2024).
[105] Planned Parenthood Global, “Stolen Lives: a multicounty study on the health effects of forced motherhood on girls 9-14 years old,” 2015, https://www.plannedparenthoodaction.org/uploads/filer_public/db/6d/db6d56cb-e854-44bb-9ab7- 15bb7fc147c5/ppfa-stolen-lives-english.pdf (accessed July 12, 2024), p. 26.
[106] Human Rights Watch, “Why Do They Want to Make me Suffer Again? “The impact of abortion prosecution in Ecuador, 2021, “For example, Morona Santiago province, with a substantial indigenous population, reported a disproportionately high number of cases despite its small overall population.”
[107] Human Rights Watch, “Why Do They Want to Make me Suffer Again?”, p. 4.
[108] Ibid, p. 49-50.
