A/HRC/32/44 and ill treatment during childbirth in health facilities in many countries provide a deeply distressing picture of the extent of women’s exposure to degrading treatment, lack of privacy, and even verbal and physical violence. Pregnant women are sometimes refused pain relief during labour or anaesthesia during a termination of pregnancy by curettage. The use in some countries of custodial or punitive rather than educative measures to prevent injury to the fetus as result of drug or alcohol consumption by addicted pregnant women is another manifestation of gender discrimination. 40. Women have a longer life expectancy and are particularly exposed to neglect and abuse in older age, including in health-care settings, and higher risks of diseases such as Alzheimer’s disease and other forms of dementia. A gender- and age-sensitive approach needs to take into account the specific needs for care and protection of older women, including those widowed, living alone or displaced, those with dementia or other disability, those in need of palliative and geriatric care and those in emergency situations; these women are most at risk of multiple forms of discrimination, violence and poverty. 41. In addition, problems associated with ageing affect women disproportionally as a result of the cumulative effect of discriminatory practices women face over the course of their lives, as the Working Group described in its report on discrimination against women in economic and social life (A/HRC/26/39). Women are more likely to take care of men and to be left without spousal support. At the same time, they are more likely to suffer economic disadvantages, exacerbated by discriminatory pension systems that fail to produce equal outcomes for women, and to be excluded from social security and health insurance schemes. They are thus at greater risk of living in poverty. The mere recognition of equal rights for all, without distinction, is thus insufficient to ensure in practice the enjoyment by older women of all human rights, including the right to health. 2. Women facing multiple and intersecting forms of discrimination 42. Recognizing and addressing the nature and consequences of multiple and intersectional discrimination against women in national laws and practices is essential for protecting women’s health and safety. Factors such as socioeconomic, minority and ethnic status, religion, race, sexual orientation, gender identity and expression, disability and bodily diversity exacerbate the discrimination that women face and infringe upon their ability to protect their health and safety. Women and poverty 43. The Working Group is particularly concerned about the discrimination experienced by women because of their economic status. It has witnessed first-hand during its country visits that women living in poverty are disparately affected in their access to health services, particularly reproductive and sexual health and preventive health care. 44. There is growing concern about the feminization of poverty and the disparate impact of global economic crises, austerity measures and climate change on women’s health and safety. Gender inequality persists in all regions, and women and girls continue to be overrepresented among the world’s population living in poverty. Women and girls, particularly those living in the global South, are disproportionately burdened by the costs of these rapid changes, to the detriment of their personal health and well-being. Women with disabilities 45. Women with disabilities face particular barriers in accessing health care for reasons of cost, distance, discriminatory attitudes, and lack of physical access or information. This seriously limits their access to immunization, reproductive health care and cancer screening. In some settings women with disabilities, particularly intellectual disabilities, are 9