Brazil: landmark CEDAW decision re maternal death

Many thanks to Beatriz Galli, a graduate of our International Reproductive and Sexual Health Law Programme, for preparing this legal comment for the REPROHEALTHLAW listserve.  Beatriz currently works for Ipas Brazil as a Policy Associate for the Latin America and Caribbean regions. 
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Comment on Alyne da Silva Pimentel Teixeira Case: landmark decision for womens human rights related to maternal mortality in Brazil

Committee on the Elimination of Discrimination against Women (CEDAW) Communication No. 17/2008

by Beatriz Galli

On August 10 2001, the Committee on the Elimination of Discrimination against Women (CEDAW) issued its landmark decision on the Communication No. 17/2008. The case was filed by the organization Advocaci – Advocacia Cidada pelos Direitos Humanos and the Center for Reproductive Rights against the state of Brazil on November 30th 2007. This is the first decision establishing states’  international responsibility on preventable maternal death case within the UN Human Rights System.

Alyne da Silva Pimentel Teixeira was twenty years old, was married and had a five-year-old daughter when she died in the state of Rio de Janeiro, on November 16 2002. She was six months’ pregnant when she felt severe nausea and abdominal pain. She was examined in a health center and scheduled two days later for medical tests. Her health situation worsened and she went back and was told that her fetus was dead. 14 hours after she delivered a still birth in a private health facility,  she underwent curettage surgery and became disoriented. With no transportation available, she had to wait 8 hours  to be transferred to a public health hospital, where no beds were available.  She had been left unattended in the hallway of the hospital for 21 hours when she died, due to the lack of appropriate medical treatment and timely emergency obstetric care.

Regarding the merits, the Committee�s decided that her death was a maternal death.  It established: the state�s neglect of its due diligence obligation to ensure appropriate services in connection with pregnancy; the state�s neglect of its duty to regulate and monitor private health care institutions; the state’s failure to address  the multiple forms of discrimination against a woman of African descent and poor socio economic background; and the state’s failure to ensure effective judicial protection for the family. The Committee considered that the state party violated its obligations under article 12 (access to health), article 2 (c) (access to justice), article 2 (e) (states parties’ due diligence obligation to regulate the activities of private health service providers), in conjunction with article 1 (discrimination against women), of the Convention, read together with general recommendations No. 24 and 28 It made several recommendations to Brazil to comply with its international human rights obligations including appropriate compensation to her family, and more generally ensuring women�s rights to safe motherhood and affordable access to emergency obstetric care.
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Scan of this new CEDAW decision: Alyne da Silva Pimentel Teixeira (deceased) v Brazil, CEDAW, UN Doc CEDAW/C/49/D/17/2008 (2011)  Online here

Amicus Curiae Brief by CLADEM:  English version    Portuguese version

Press release from the Centre for Reproductive Rights: online here

Further background from Center for Reproductive Rights: online here

“Invoking Human Rights to Reduce Maternal Deaths,” by Rebecca J. Cook & Maria Beatriz Galli Bevilacqua (January 3, 2004). The Lancet 2004; 363(9402): 73 . Abstract online here.