Editing Reproductive rights (section)

==Youth rights and access==
{{Further|Sex education}}

===Minors===
{{Further|Parental consent}}
In many jurisdictions minors require parental consent or parental notification in order to access various reproductive services, such as contraception, abortion, gynecological consultations, testing for STIs etc. The requirement that minors have parental consent/notification for testing for [[HIV/AIDS]] is especially controversial as it can cause delayed diagnosis and treatment.<ref>{{cite book|url=https://www.ncbi.nlm.nih.gov/books/NBK217962/|title=HIV and Adolescents: Guidance for HIV Testing and Counselling and Care for Adolescents Living with HIV|series=WHO Guidelines Approved by the Guidelines Review Committee |publisher=[[World Health Organization]]|pmid=25032477|page=3|date=2013|isbn=978-92-4-150616-8 }}</ref><ref>{{cite web|url=http://newsinfo.inquirer.net/696753/doh-backs-bill-allowing-minor-to-get-hiv-aids-tests-without-parental-consent|title=DOH backs bill allowing minor to get HIV, AIDS tests without parental consent|first=Jocelyn R.|last=Uy|website=Newsinfo.inquirer.net|date=7 June 2015}}</ref><ref>{{cite web|url=http://www.unaids.org/en/resources/presscentre/featurestories/2014/july/20140723_youth|title=Challenging parental consent laws to increase young people's access to vital HIV services – UNAIDS|website=Unaids.org}}</ref> Balancing minors' rights versus parental rights is considered an [[ethical]] problem in medicine and law, and there have been many court cases on this issue in the US.<ref>{{cite journal|last1=Maradiegue|first1=Ann|title=Minor's Rights Versus Parental Rights: Review of Legal Issues in Adolescent Health Care|journal=Journal of Midwifery & Women's Health|volume=48|issue=3|year=2003|pages=170–177|doi=10.1016/S1526-9523(03)00070-9|pmid=12764301|url=http://www.medscape.com/viewarticle/456472_6|url-access=subscription}}</ref> An important concept recognized since 1989 by the [[Convention on the Rights of the Child]] is that of the [[evolving capacities|
evolving capacities of a minor]], namely that minors should, in accordance with their maturity and level of understanding, be involved in decisions that affect them.<ref>{{cite web|url=https://www.ippfwhr.org/sites/default/files/srrightsyoungen.pdf|title=Sexual and Reproductive Rights of Young People: Autonomous decision making and confidential services|work=International Planned Parenthood Federation|access-date=1 October 2017}}</ref>

[[Youth]] are often denied equal access to reproductive health services because [[health workers]] view adolescent sexual activity as unacceptable,<ref name=Mugisha>{{cite book |last=Mugisha|first=Frederick |editor-first=Andy|editor-last=Furlong|title=Handbook of Youth and Young Adulthood |publisher=Routledge |year=2009 |pages=344–352 |chapter=Chapter 42: HIV and AIDS, STIs and sexual health among young people |isbn=978-0-415-44541-2}}</ref> or see sex education as the responsibility of parents.  Providers of reproductive health have little accountability to youth clients, a primary factor in denying youth access to reproductive health care.<ref name=Mugisha /> In many countries, regardless of legislation, minors are denied even the most basic reproductive care, if they are not accompanied by parents: in India, for instance, in 2017, a 17-year-old girl who was rejected by her family due to her pregnancy, was also rejected by hospitals and gave birth in the street.<ref>{{cite news|url=https://www.independent.co.uk/news/india-chandil-homeless-street-jharkand-medical-centre-a7918611.html|title=Homeless girl in India forced to give birth on street metres away from health centre: She was shivering and unable to lift and cuddle her infant|date=29 August 2017|first=Andrew|last=Lowry|work=The Independent|access-date=1 October 2017}}</ref> In recent years the lack of reproductive rights for adolescents has been a concern of international organizations, such as [[UNFPA]].<ref>{{cite web|url=http://www.unfpa.org/resources/adolescent-sexual-and-reproductive-health|title=Adolescent sexual and reproductive health – UNFPA – United Nations Population Fund|website=Unfpa.org}}</ref>

Mandatory involvement of parents in cases where the minor has sufficient maturity to understand their situation is considered by health organization as a violation of minor's rights and detrimental to their health. The [[World Health Organization]] has criticized parental consent/notification laws:<ref>{{cite web|url=https://www.who.int/mediacentre/news/statements/2017/discrimination-in-health-care/en/|title=Joint United Nations statement on ending discrimination in health care settings — Joint WHO/UN statement|work=World Health Organization|date=27 June 2017|access-date=1 October 2017}}</ref>
<blockquote>
Discrimination in health care settings takes many forms and is often manifested when an individual or group is denied access to health care services that are otherwise available to others. It can also occur through denial of services that are only needed by certain groups, such as women. Examples include specific individuals or groups being subjected to physical and verbal abuse or violence; involuntary treatment; breaches of confidentiality and/or denial of autonomous decision-making, such as the requirement of consent to treatment by parents, spouses or guardians; and lack of free and informed consent. ... Laws and policies must respect the principles of autonomy in health care decision-making; guarantee free and informed consent, privacy and confidentiality; prohibit mandatory HIV testing; prohibit screening procedures that are not of benefit to the individual or the public; and ban involuntary treatment and mandatory third-party authorization and notification requirements.
</blockquote>

According to UNICEF: "When dealing with sexual and reproductive health, the obligation to inform parents and obtain their consent becomes a significant barrier with consequences for adolescents' lives and for public health in general."<ref name="UnicefBAJA">{{cite web|last=Sedletzki|first=Vanessa|year=2016|title=Legal minimum ages and the realization of adolescents' rights|url=https://www.unicef.org/lac/1._DIG._Min_age_of_medical_consent_PDF_BAJA_.pdf|
website=Unicef|url-status=dead|archive-url=https://web.archive.org/web/20171013014033/https://www.unicef.org/lac/1._DIG._Min_age_of_medical_consent_PDF_BAJA_.pdf|archive-date=13 October 2017|access-date=12 October 2017}} [https://www.comprehensivesexualityeducation.org/wp-content/uploads/20160406_UNICEF_Edades_Minima_Eng1_.pdf Alt URL]</ref> One specific issue which is seen as a form of hypocrisy of legislators is that of having a higher age of medical consent for the purpose of reproductive and sexual health than the [[age of sexual consent]] – in such cases the law allows youth to engage in sexual activity, but does not allow them to consent to medical procedures that may arise from being sexually active; UNICEF states that "On sexual and reproductive health matters, the minimum age of medical consent should never be higher than the age of sexual consent."<ref name="UnicefBAJA"/>

===Africa===
{{Further|HIV/AIDS in Africa}}
[[File:Ian Mackenzie High School Classroom.jpg|thumb|left|A classroom in [[South Africa]]]]
[[File:No Sex Signage in Ghana.jpg|thumb|Ad promoting abstinence in [[Ghana]]: ''No Sex Ad'' (Anti-[[HIV/AIDS]] ― [[signage]]). [[Abstinence-only sex education]] is a form of [[sex education]] that teaches [[Sexual abstinence|not having sex]] outside of marriage, most often excluding other types of [[sexual and reproductive health]] education, such as [[birth control]] and [[safe sex]]. [[Comprehensive Sex Education|Comprehensive sex education]], by contrast, covers the use of birth control and sexual abstinence.]]

Many [[unintended pregnancies]] stem from traditional contraceptive methods or no [[contraceptive]] measures.<ref name=Lukale>{{cite journal|last=Lukale|first=Nelly|title=Sexual Reproductive Health and Rights for Young People in Africa|journal=ARROWs for Change|year=2012|volume=18|issue=2|pages=7–8}}</ref>

Youth sexual education in Uganda is relatively low. [[Comprehensive sex education]] is not generally taught in schools; even if it was, the majority of young people do not stay in school after the age of fifteen, so information would be limited regardless.<ref name=Knudson>{{cite book|last=Knudson|first=Lara|title=Reproductive Rights in a Global Context: South Africa, Uganda, Peru, Denmark, United States, Vietnam, Jordan|year=2006|publisher=Vanderbilt University Press|location=Nashville, TN}}{{page needed|date=February 2017}}</ref>

[[Africa]] experiences high rates of unintended pregnancy, along with high rates of [[HIV/AIDS]].  Young women aged 15–24 are eight times more likely to have HIV/AIDS than young men. [[Sub-Saharan Africa]] is the world region most affected by HIV/AIDS, with approximately 25 million people living with HIV in 2015. Sub-Saharan Africa accounts for two-thirds of the global total of new HIV infections.<ref>{{cite web|url=http://www.afro.who.int/health-topics/hivaids|title=HIV/AIDS Factsheet|work=World Health Organization|access-date=1 October 2017}}</ref>

Attempted [[abortions]] and [[unsafe abortions]] are a risk for youth in Africa.  On average, there are 2.4 million unsafe abortions in East Africa, 1.8 million in Western Africa, over 900,000 in Middle Africa, and over 100,000 in Southern Africa each year.<ref name=Lukale /> The [[Guttmacher Institute]] estimates that, over the time range of 2015 to 2019, 77% of abortions in Sub-Saharan Africa are unsafe, with a fatality rate of 185 deaths per 100,000 abortions, making it the unsafest region for abortions.<ref name="Bankole et al">{{Cite journal |last1=Bankole |first1=Akinrinola |last2=Remez |first2=Lisa |last3=Owolabi |first3=Onikepe |last4=Philbin |first4=Jesse |last5=Williams |first5=Patrice |date=December 2020 |title=From Unsafe to Safe Abortion in Sub-Saharan Africa: Slow but Steady Progress |url=https://www.guttmacher.org/report/from-unsafe-to-safe-abortion-in-subsaharan-africa |access-date=24 December 2022 |website=Guttmacher Institute|doi=10.1363/2020.32446 |s2cid=234402025 |doi-access=free }}</ref>

In [[Uganda]], abortion is illegal except to save the mother's life.  However, 78% of teenagers report knowing someone who has had an abortion and the police do not always prosecute everyone who has an abortion.  An estimated 22% of all [[maternal deaths]] in the area stem from illegal, unsafe abortions.<ref name=Knudson />

As of 2022, the only countries in Africa in which abortion is broadly legal are [[Abortion in Benin|Benin]], [[Abortion in Cape Verde|Cape Verde]], [[Abortion-rights movements#Africa|Mozambique]], [[Abortion in South Africa|South Africa]], and [[Abortion-rights movements#Africa|Tunisia]].<ref>{{Cite news |last=Peltier |first=Elian |date=13 Nov 2022 |title=While Abortion Rights Shrink in U.S., This Small Country Expanded Access |work=The New York Times |url=https://www.nytimes.com/2022/11/13/world/africa/benin-abortions.html |access-date=24 December 2022}}</ref> [[Abortion in Zambia|Zambia]] allows abortion for health or socioeconomic reasons, though there are limitations to access.<ref name="Bankole et al" /> Discussion about legalizing abortion is ongoing in [[Abortion in Liberia|Liberia]] and [[Abortion in Sierra Leone|Sierra Leone]].<ref>{{Cite web |date=10 Nov 2022 |title=UN Report on Sexual and Reproductive Justice Highlights Global Progress (and Lost Ground) |url=https://www.publichealth.columbia.edu/public-health-now/news/un-report-sexual-and-reproductive-justice-highlights-global-progress-and-lost-ground |access-date=24 December 2022 |website=Columbia Public Health}}</ref>

The Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa, also known as the [[Maputo Protocol]], states in Article 14(2)c that governments must "protect the reproductive rights of women by authorising medical abortion in cases of sexual assault, rape, incest, and where the continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus."<ref name="Bankole et al" /> It is the only human rights charter that details conditions for abortion. Since the protocol was written in 2003, 39 countries have ratified it. It has played a significant part in the easing of abortion laws in several African countries.

===European Union===
Over 85% of European women (all ages) have used some form of [[birth control]] in their lives.<ref name=Irala />  Europeans as an aggregate report using [[Oral contraceptive pill|the pill]] and [[condoms]] as the most commonly used contraceptives.<ref name=Irala>{{cite journal |doi=10.1016/j.contraception.2011.04.004 |pmid=22078183 |title=Choice of birth control methods among European women and the role of partners and providers |journal=Contraception |volume=84 |issue=6 |pages=558–64 |year=2011 |last1=De Irala |first1=Jokin |last2=Osorio |first2=Alfonso |last3=Carlos |first3=Silvia |last4=Lopez-Del Burgo |first4=Cristina |hdl=10171/19110 |url=http://dadun.unav.edu/bitstream/10171/19110/3/Choice%20of%20birth%20control%20methods%20among%20European%20women%20and%20the%20role%20of%20partners%20and%20providers.pdf |hdl-access=free }}</ref>

Sweden has the highest percentage of lifetime contraceptive use, with 96% of its inhabitants claiming to have used birth control at some point in their life.<ref name=Irala /> Sweden also has a high self-reported rate of [[Emergency contraception|postcoital pill use]].<ref name=Irala />  A 2007 anonymous survey of Swedish 18-year-olds showed that three out of four youth were sexually active, with 5% reporting having had an [[abortion]] and 4% reporting the contraction of an [[Sexually transmitted disease|STI]].<ref name=Larsson>{{cite journal |doi=10.1080/13625180701217026 |pmid=17559009 |title=Contraceptive use and associated factors among Swedish high school students |journal=The European Journal of Contraception & Reproductive Health Care |volume=12 |issue=2 |pages=119–24 |year=2009 |last1=Larsson |first1=Margareta |last2=Tydén |first2=Tanja |last3=Hanson |first3=Ulf |last4=Häggström-Nordin |first4=Elisabet |s2cid=36601350 }}</ref>

In the [[European Union]], reproductive rights are protected through the [[European Convention on Human Rights]] and its jurisprudence, as well as the [[Convention on preventing and combating violence against women and domestic violence]] (the Istanbul Convention).<ref name="Europarl">{{cite book |title=Sexual and reproductive health rights and the implication of conscientious objection : study. |isbn=978-92-846-2976-3 |url=https://www.europarl.europa.eu/RegData/etudes/STUD/2018/604969/IPOL_STU(2018)604969_EN.pdf|last1=Anedda |first1=Ludovica |year=2018 |publisher=European Parliament }}</ref>
However, these rights are denied or restricted by the laws, policies and practices of member states.<ref name="Council of Eu">{{cite web |title=Women's sexual and reproductive rights in Europe |url=https://www.coe.int/en/web/commissioner/women-s-sexual-and-reproductive-rights-in-europe |website=Commissioner for Human Rights}}</ref>
In fact, some countries criminalize medical staff, have stricter regulations than the international norm or exclude legal abortion and contraception from public health insurance.<ref name="Europarl"/>
A study conducted by Policy Departments, at the request of the [[European Parliament Committee on Women's Rights and Gender Equality]], recommends the EU to strengthen the legal framework on equal access to sexual and reproductive health goods and services.<ref name="Europarl"/>

===Latin America===
{{Main|Reproductive rights in Latin America}}
[[Latin America]] has come to international attention due to its harsh anti-abortion laws. Latin America is home to some of the few countries of the world with a complete ban on abortion, without an exception for saving [[maternal mortality|maternal life]].<ref name="ChileCourt">{{cite news|url=https://www.bbc.com/news/world-latin-america-41005517|title=Chile abortion: Court approves easing total ban|date=21 August 2017|work=BBC|access-date=1 October 2017}}</ref> In some of these countries, particularity in [[Central America]], the enforcement of such laws is very aggressive: [[Abortion in El Salvador|El Salvador]] and [[Abortion in Nicaragua|Nicaragua]] have drawn international attention for strong enforcement of their complete bans on abortion. In 2017, [[Abortion in Chile|Chile]] relaxed its total ban, allowing abortion to be performed when the woman's life is in danger, when a fetus is unviable, or in cases of rape.<ref>{{cite news|url=https://www.independent.co.uk/news/world/politics/chile-the-long-road-to-abortion-reform-a7917791.html|title=Chile: the long road to abortion reform — After a fierce debate, one of the most restrictive reproductive laws in the world has been eased|date=29 August 2017|first=Cordelia|last=Freeman |work=The Independent|access-date=1 October 2017}}</ref>

In [[Ecuador]], education and class play a large role in the definition of which young women become pregnant and which do not – 50% of young women who are illiterate get pregnant, compared to 11% of girls with secondary education.  The same is true for poorer individuals – 28% become impregnated while only 11% of young women in wealthier households do.  Furthermore, access to reproductive rights, including contraceptives, are limited, due to age and the perception of female morality.  Health care providers often discuss contraception theoretically, not as a device to be used on a regular basis.  Decisions concerning sexual activity often involve secrecy and taboos, as well as a lack of access to accurate information.  Even more telling, young women have much easier access to maternal healthcare than they do to contraceptive help, which helps explain high pregnancy rates in the region.<ref name=Goicolea>{{cite journal|last=Goicolea|first=Isabel|title=Adolescent Pregnancies in the Amazon Basin of Ecuador: A Rights and Gender Approach to Adolescents' Sexual and Reproductive Health|journal=Global Health Action|year=2010|volume=3|pages=1–11|doi=10.3402/gha.v3i0.5280|pmid=20596248|pmc=2893010}}</ref>

Rates of [[adolescent pregnancy]] in Latin America number over a million each year.<ref name=Goicolea />

===United States===
{{See also|Birth control in the United States}}
Among sexually experienced teenagers, 78% of teenage females and 85% of teenage males used contraception the first time they had sex; 86% and 93% of these same females and males, respectively, reported using contraception the last time they had sex.<ref name="Fact Sheet Guttmacher">{{cite web|title=Fact Sheet: Contraceptive Use in the United States|url=http://www.guttmacher.org/pubs/fb_contr_use.html|publisher=Guttmacher Institute|access-date=24 April 2013|date=4 August 2004|archive-date=4 October 2013|archive-url=https://web.archive.org/web/20131004232616/http://www.guttmacher.org/pubs/fb_contr_use.html|url-status=dead}}</ref>  The male [[condom]] is the most commonly used method during first sex, although 54% of young women in the United States rely upon the [[Combined oral contraceptive pill|pill]].<ref name="Fact Sheet Guttmacher" />

Young people in the U.S. are no more sexually active than individuals in other developed countries, but they are significantly less knowledgeable about contraception and safe sex practices.<ref name=Knudson /> As of 2006, only twenty states required [[sex education]] in schools – of these, only ten required information about contraception.<ref name=Knudson />  On the whole, less than 10% of American students receive sex education that includes topical coverage of [[abortion]], [[homosexuality]], [[Intimate relationships|relationships]], [[pregnancy]], and STI prevention.<ref name=Knudson /> [[Abstinence-only education]] was used throughout much of the United States in the 1990s and early 2000s.<ref name=Knudson />  Based upon the moral principle that sex outside of marriage is unacceptable, the programs often misled students about their rights to have sex, the consequences, and prevention of pregnancy and STIs.<ref name=Knudson />

[[Abortion in the United States]] was a [[constitutional right]] since the [[United States Supreme Court]] decision ''[[Roe v. Wade]]'' which decriminalised abortion nationwide in 1973, and established a minimal period during which abortion is legal (with more or fewer restrictions throughout the pregnancy) until this decision was overturned in June 2022 by the decision ''[[Dobbs v. Jackson Women's Health Organization]]''. Abortion rights are now decided at the state level with only [[Abortion in California|California]], [[Abortion in Michigan|Michigan]], [[Abortion in Ohio|Ohio]], and [[Abortion in Vermont|Vermont]] conferring explicit rights to abortions. The state constitutions of [[Abortion in Alabama|Alabama]], [[Abortion in Louisiana|Louisiana]], [[Abortion in Tennessee|Tennessee]], and [[Abortion in West Virginia|West Virginia]] explicitly contain no right to an abortion.