A/HRC/32/44 women aged 20-59 years, resulting in 1 million deaths, the majority in low- and middleincome countries where screening, prevention and treatment are almost non-existent. Young women bear the brunt of new HIV infections. One in three women under 50 has experienced physical and/or sexual violence by an intimate partner or family member. At least 200 million women and girls have been subjected to female genital mutilation. 1. Discrimination throughout a woman’s life cycle 33. The Working Group notes with concern that issues relating to women’s health are not addressed in a holistic manner on political and health agendas at the national and international levels. Policies regarding women’s health services are often limited to questions of “maternal health”. Despite the importance of prioritizing this issue, such a restrictive focus fails to recognize the full spectrum of women’s rights to sexual and reproductive health at all stages of their life cycle and contributes to the instrumentalization of women’s bodies, viewing them mainly as a means of reproduction. 34. Many girls are exposed to a wide variety of practices which are harmful to their health and well-being, such as female genital mutilation, discrimination in food allocation resulting in malnutrition and discrimination in access to professional health care. Furthermore, early marriage and adolescent pregnancy have a long-lasting impact on girls’ physical integrity and mental health. Pregnancy and childbirth are together the second leading cause of death among 15- to 19-year-old girls globally, putting them at the highest risk of dying or suffering serious lifelong injuries as a result of pregnancy. For example, up to 65 per cent of women with obstetric fistula, which is a severely disabling condition and often results in social exclusion, develop this condition as adolescents. 35. Adolescent girls are particularly exposed to gender-based violence in the family and on their way to or at school, with extremely harmful impacts on their physical and mental health. In its resolution 70/137 the General Assembly called upon all States to improve the safety of girls on the way to and from school, taking steps to ensure that all schools are accessible, safe, secure and free from violence and providing separate and adequate sanitation facilities that provide privacy and dignity. 36. In some countries, adolescent girls are deterred from accessing information and services for family planning and termination of pregnancy that are needed to protect their health and safety and prevent unwanted high-risk pregnancies, including the requirement of third party authorization. 37. During pregnancy, many women are vulnerable to malnutrition owing to discrimination in the allocation of food. This can result in a serious and irreversible deterioration of women’s general health and increase the risk of premature delivery, low birth weight and birth defects. After childbirth, such discrimination can continue to affect women’s health, including in connection with breastfeeding. Furthermore, as stated by the Special Rapporteur on the right to food, structural violence is an underexamined barrier to women’s right to adequate food and nutrition. Gender-based violence, which is a primary form of discrimination, can impede women from accessing adequate food and nutrition. 38. Delays in seeking appropriate medical care, in reaching an appropriate health facility and in receiving appropriate care once at a facility, along with the lack of accessible maternal health care, are the main reasons behind high rates of maternal mortality and morbidity. A human rights-based approach that provides a functioning health system with adequate supplies, equipment and infrastructure as well as an efficient system of communication, referral and transport are therefore essential to eliminate these preventable deaths and to ensure women’s rights to health and life. 39. Women’s mental health during pregnancy, childbirth and the post-partum period requires both stability in their environment and emotional support. Reports of disrespect 8

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