How is an inquiry conducted by the CEDAW Committee? • An inquiry request may be filed by an individual or group of individuals; it may also be filed on behalf of an individual or group of individuals. • If the Committee receives reliable information indicating grave and systematic violations of CEDAW by a state party, it invites the state party to cooperate in the examination of the information and submit its observations regarding the information received. • An inquiry can be sought without exhaustion of domestic remedies. • The Committee may designate one or more of its members to conduct the inquiry and to report back to the Committee. • If the state party consents, the inquiry may involve a visit to its territory. • All actions carried out by the Committee are confidential. IV. The Impact of Restrictions on Reproductive Health Care on Women’s Survival and Well-Being V. The CEDAW Committee’s Findings of Reproductive Rights Violations EO 003 and EO 030 operate in a country where almost 70% of people rely on local government health facilities for reproductive health commodities and services, including modern contraceptives44 and have had a significant impact on people’s lives. Metro Manila, an area that includes Manila City, has a higher proportion of unintended pregnancies than anywhere else in the Philippines.45 Manila City’s contraceptive bans have disproportionately affected poor women in the Philippines, who, on average, have two more children than they desire.46 As noted in the Center for Reproductive Rights’ report Imposing Misery, poor women are also most likely “to suffer the physical, psychological, economic and social consequences of unintended pregnancies.”47 The latest data on the country’s maternal mortality ratio shows a significant increase within a five-year period (2006–2011), from 162 to 221 deaths per 100,000 live births.48 The increase in maternal deaths is particularly evident in Metro Manila, where 50 maternal deaths were recorded in January 2012 alone.49 [W]hile the lack of access to contraception is generally problematic throughout the State party, the situation in the City of Manila is particularly egregious as a result of an official and deliberate policy which places a certain ideology above the well-being of women and was designed and implemented by the Manila local government to deny access to the full range of modern contraceptive methods, information and services. Bawat pagbubuntis ko, kabado ako. Iniisip ko pag nanganak na ko at mailabas ang bata, doon ako mawala. Hindi ko makayanan ang panganganak kasi manipis na ang matris ko sabi ng doktor. [I get nervous with every pregnancy. I think that the moment I give birth will be the time I will die. That I won’t survive childbirth for the doctor said my uterus is already thin.] —Susan, 32 years old, mother of seven No significant improvements regarding the unmet need for family planning services or contraceptive use have been recorded in recent years at the national level or in Metro Manila.50 Although the rate of teenage pregnancy and childbirth in the country remained unchanged from 2008 to 2013,51 a significant increase was reflected in Metro Manila—from 18% in 2008 to 24% in 2013.52 With regard to abortion, in 2008, an estimated 560,000 abortions were performed in the country despite the criminal ban, and 1,000 women lost their lives to the procedure, while as many as 90,000 were hospitalized for post-abortion complications.53 Since then, the estimated number of abortions has continued to rise—in 2012, it reached 610,000.54 This worsening situation can be seen particularly in Metro Manila, home to five of the nine hospitals where abortion was reportedly one of the top three obstetrics-gynecological cases managed by the DOH in 2012 and 2013.55 —CEDAW inquiry report, para. 48 Taking into account the EO 003 and other restrictive law and policies on reproductive rights, along with the Philippine government’s failure to implement its own legislative guarantees of women’s reproductive health, the CEDAW Committee concluded in its 2015 report that the Philippine government had violated women’s rights to nondiscrimination and health, which require the government to ensure women’s equal access to family planning services.56 The Committee also found several specific violations of CEDAW, which are highlighted below. Obligation to refrain from engaging in any act or practice of discrimination and to modify or abolish discriminatory laws and policies (articles 2[d], 2[f], and 12). The Committee found that the Philippine government violated its obligation to eliminate discrimination against women in access to health services because the national government condoned the acts of the local government of Manila and failed to take action against local government officials despite the harmful effects of the implementation of EO 003, the lack of public funding in the subsequent EO 030, and the strict application of the criminal ban on abortion.57 As noted by the Committee, the Philippine government is responsible for ensuring the rights enshrined in CEDAW for all women in the country, and cannot absolve itself of this responsibility by claiming that these violations are occurring as a result of a local government policy.58 Obligation to guarantee equality in educational information, including specifically information and advice on family planning (articles 10[h] and 12). Substantive equality, as guaranteed under CEDAW, requires that the Philippine government consider “risk factors that predominantly affect women.”59 The Committee found that since pregnancy is a health risk experienced only by women, the lack of access to contraceptives in the City of Manila disproportionately affects women.60 In finding a violation of the rights under article 12, read in conjunction with article 10(h), which protect women’s right to access health services and information, including family planning, without discrimination, the Committee noted that unplanned and unwanted pregnancies, unsafe abortions, unnecessary and preventable deaths, and women’s growing exposure to HIV and other sexually transmitted infections are direct consequences of the government’s failure to provide the full range of sexual and reproductive health services, commodities, and information.61 The Committee also found that the systematic denial of access to modern contraceptive methods particularly harmed disadvantaged groups of women, including poor women, adolescent girls, and women in abusive relationships.62 Obligation to eliminate gender stereotypes and ensure the right to make informed decisions on the number and spacing of children (articles 5, 12, and 16). The Committee expressed the view that gender stereotypes affect women’s capacity to make decisions not only in relation to their health and reproduction but also in relation to their roles in society.63 The Committee found the Philippine government 6 CENTER FOR REPRODUCTIVE RIGHTS ACCOUNTABILITY FOR DISCRIMINATION AGAINST WOMEN IN THE PHILIPPINES 7