CEDAW/C/GC/34
services capable of performing caesarean sections, and indirectly from early
pregnancy and malnutrition.
38. Maternal mortality and morbidity are disproportionately high in many rural
areas. Child marriage exposes rural girls to early pregnancy and significantly
contributes to maternal mortality, in particular in developing countries. Globally, the
presence of skilled birth attendants and medical personnel is lower in rural than
urban areas and leads to poor prenatal, perinatal and postnatal care. There is a
greater unmet need for family planning services and contraception owing to poverty,
the lack of information and the limited availability and accessibility of services.
Rural women are more likely to resort to unsafe abortion than their urban
counterparts, a situation that puts their lives at risk and compromises their health.
Even in countries in which abortion is legal, restrictive c onditions, including
unreasonable waiting periods, often impede access for rural women. When abortion
is illegal, the health impact is even greater.
39. States parties should safeguard the right of rural women and girls to
adequate health care, and ensure:
(a) That high-quality health-care services and facilities are physically
accessible to and affordable for rural women, including older women, heads of
household and women with disabilities (provided free of charge when
necessary), culturally acceptable to them and staffed with trained medical
personnel. Services should provide: primary health care, including family
planning; access to contraception, including emergency contraception, and to
safe abortion and high-quality post-abortion care, regardless of whether
abortion is legal; prenatal, perinatal, postnatal and obstetric services; HIV
prevention and treatment services, including emergency intervention following
rape; mental health services; counselling on nutrition, the feeding of infants
and young children; mammography and other gynaecological examinations
services; the prevention and treatment of non-communicable diseases, such as
cancer; access to essential medicines, including pain relief; and palliative care;
(b) The adequate financing of health-care systems in rural areas, in
particular with regard to sexual and reproductive health and rights;
(c) That laws and regulations that place obstacles to rural women’s
access to health care, including to sexual and reproductive health services, are
repealed, in particular laws that criminalize or require waiting periods or
third-party consent for abortion;
(d) The systematic and regular monitoring of the health and nutritional
status of pregnant women and new mothers, especially adolescent mothers, and
their infants. In case of malnutrition or lack of access to clean water, extra food
rations and drinking water should be provided systematically throughout
pregnancy and lactation;
(e) That rural health-care facilities have adequate water and sanitation
services;
(f) That health-care information is widely disseminated in local
languages and dialects through various media, including in writing, through
illustrations and orally, and that it includes information on, inter alia: hygiene;
preventing communicable, non-communicable and sexually transmitted
16-03601
11/25