Introduction

On January 20, 2025, the UN Human Rights Committee published groundbreaking decisions in the cases of Norma v. Ecuador, Lucía v. Nicaragua, and Susana v. Nicaragua (Niñas No Madres cases). ¹These landmark cases address the rights of adolescent girls who became pregnant as a result of sexual violence and were subsequently denied access to abortion services.

All three petitioners were girls when they became pregnant due to sexual violence. In Ecuador, despite legislation permitting therapeutic abortion in certain circumstances, Norma faced significant procedural barriers that made access impossible. In Nicaragua, both Lucía and Susana were completely denied access to abortion services due to the country's absolute criminalisation of abortion, regardless of circumstances. Thus, the communications required the Committee to examine how regulating abortion through criminal law, whether through a total or partial ban, impacted girls’ rights, particularly by highlighting how such criminalisation stigmatised those seeking reproductive health services.

Thus, the case raised significant issues about State obligations regarding: (1) the right to life with dignity for girls; (2) the prohibition of cruel, inhuman, and degrading treatment in relation to forced pregnancy and motherhood; (3) the respect for privacy and autonomy in reproductive decision-making; (4) the right to access information about sexual and reproductive health; and (5) the intersection of multiple forms of discrimination affecting particularly vulnerable girls, including those from rural, indigenous, and impoverished backgrounds.

Outlining access to international human rights mechanisms in abortion cases – procedural issues raised

The case commentary provides answers to three important procedural issues: (1) the implications on the full ban on abortion vis a vis the requirement to exhaust local remedies; (2) whether constitutional injunctions had to be exhausted in cases concerning abortion; and (3) whether access to abortion is protected ratione materia under the International Covenant on Civil and Political Rights (ICCPR).

The first issue concerned the case of Nicaragua, where abortion is completely criminalized. In this case, the Committee recognised that no effective domestic legal remedies existed for Lucía and Susana to challenge the denial of abortion services because of that full prohibition. The Committee deemed this circumstance sufficient to consider that the case was admissible, especially considering that Nicaragua did not participate in the proceedings, and as a consequence, failed to present any response to this argument.

The second issue concerned the case of Ecuador, where abortion is partially criminalized. Unlike the Nicaraguan cases, Ecuador did participate in the proceedings before the Committee and argued that the victim should have exhausted the “acción de protección” (a constitutional remedy) to challenge the barriers to abortion that Norma faced. However, the Committee considered that such action would have been ineffective due to the excessive delays in the resolution of such cases, as argued by the victim’s representation. Obviously, access to abortion must be timely for it to be effective. Ecuador did not challenge that assertion.

Finally, the Committee also addressed Ecuador’s arguments regarding inadmissibility ratione materiae, rejecting claims that reproductive health services, particularly abortion, fell outside the Committee's jurisdiction. It reaffirmed that the denial of reproductive healthcare could implicate multiple civil and political rights within the Covenant's scope, as has been the consistent case law of the Committee.

Major findings: Forced pregnancy and forced motherhood as a breach of the ICCPR

The Committee found violations of several articles of the ICCPR in all three cases. Paradigmatically, the case identified that forcing adolescent girls to continue pregnancies resulting from sexual violence endangered their right to life (article 6) in multiple dimensions. It recognised that adolescent pregnancies carry heightened mortality risks. Moreover, the Committee adopted and applied its developed notions of a broader understanding of the right to life, as envisioned in its General Comment No. 36, encompassing the right to a dignified life. It found that forced motherhood severely disrupted the petitioners' life and livelihood, including their potential to choose the projects they wanted, their education, and their socioeconomic futures.

Likewise, the Committee confirmed that decisions about terminating a pregnancy fall within the right to reproductive autonomy protected by the right to privacy (Article 17). It found that the barriers Norma, Susana and Lucía faced to abortion access constituted arbitrary interference with the right to privacy. Moreover, all three petitioners were denied crucial information about reproductive health options, including potential access to legal abortion. The Committee found this violated their right to seek and receive information (Article 19) necessary for making informed decisions about their health and bodies.

The Committee also, in a first for reproductive rights cases, recognised the intersectional discrimination faced by the petitioners based on gender, age, and socioeconomic status, prohibited under Article 3 of the ICCPR. It found that the denial of abortion services and reproductive healthcare represented a form of gender-based discrimination that particularly impacted vulnerable girls. The decision identified how the intersection of these vulnerabilities created a compounded impact that made barriers against abortion even more difficult to overcome. Moreover, it contributed to further ostracising the girls in their efforts to access reproductive healthcare and access to justice in these types of cases.

Commentary

These decisions establish important precedents on abortion rights and reproductive autonomy in international human rights law. Through its analysis of three distinct cases, the Committee addressed both absolute prohibitions on abortion and the failure to implement partial exceptions, while providing significant insights into the relationship between reproductive rights and the rights enshrined in the ICCPR. The decision confirms that the Human Rights Committee serves as an effective forum to achieve the protection and advancement of reproductive health and rights, including abortion, similar to how the Camila v. Peru case did before in the Committee on the Rights of the Child.

Camila’s case is significantly similar to the cases of Norma, Susana and Lucía. Camila’s case also involved the rape perpetrated by her father that led to her forced pregnancy and the denial of access to abortion. However, the case has one major difference which was not discussed in the cases of Norma, Susana and Lucía, that she had a spontaneous abortion, and was thus criminalised afterwards for the crime of “self-abortion”. In the latter cases, they were forced to continue and finish their pregnancies, and enter into an impactful forced motherhood. Finally, in Camila the CRC requested Peru to “decriminalize abortion in all cases involving child pregnancy”; and “ensure access to safe abortion services and post-abortion care for pregnant girls, particularly in cases where there is a risk to the life or health of the mother and cases involving rape or incest”, among others.

A. Just one step away from abortion rights protection

The Committee’s findings in the Nicaragua cases unequivocally establish that absolute criminalization of abortion is incompatible with international human rights law. By holding Nicaragua responsible for violations that derive from its full ban on abortion, the Committee reinforced an established standard that total prohibition of abortion constitutes a breach of multiple human rights obligations. The Committee stated that:

• The Committee recalls that the right to life cannot be properly understood if it is interpreted restrictively; the protection of this right requires States to adopt positive measures. In this regard, the Committee notes that ‘violations by omission include the failure to take the necessary measures to achieve the full realization of the right of everyone to sexual and reproductive health, as well as the failure to enact and enforce relevant laws’. In addition, the Committee notes that access to health care, including access to sexual and reproductive health is extremely limited for rural women, where maternal mortality and morbidity are disproportionately high. Where abortion is illegal, the health impact is even greater. The Committee recalls that States parties ‘must provide safe, legal and effective access to abortion when the life and health of the pregnant woman or girl is at risk, or when carrying the pregnancy to term would cause substantial pain or suffering to the pregnant woman or girl, especially if the pregnancy is the result of rape or incest’, and that they must ‘remove existing barriers to women's and girls’ effective access to safe and legal abortion (para. 8.4, case of Lucía V Nicaragua).

However, the Committee missed an opportunity to adopt an even more progressive standard that would have aligned with current public health expertise. The World Health Organization's 2022 Guidelines on Abortion Care recommend full decriminalisation of abortion as essential for eliminating stigma and ensuring access to safe services. By focusing specifically on access for victims of sexual violence rather than addressing the broader implications of criminalisation, the Committee adopted a more restrictive approach than the current scientific consensus.

Significantly, the Norma case from Ecuador demonstrates how even partial exceptions to abortion bans can prove ineffective in practice. Despite Ecuador's legal framework theoretically permitting abortion in cases such as hers, Norma faced many procedural barriers as well as social stigma. The case illustrates how criminal frameworks surrounding abortion, even those with exceptions, create an environment of fear, judgment, and obstruction that prevents access to healthcare services. If abortion had been removed from criminal law regulations, many of these barriers might have been prevented, because healthcare providers would not have operated under the shadow of potential criminal liability.

Thus, despite clearly establishing that total criminalisation of abortion violates human rights, the Human Rights Committee stopped short of directly addressing how even partial criminalization creates substantial barriers to access. This leaves room for future cases to explore more fully how even limited criminalisation contributes to the denial of reproductive healthcare.

B. The right to information and comprehensive sex education

A novel aspect of the Committee's decisions concerns the right to access information. In all three cases, the Committee found violations of Article 19, as the girls were denied information necessary to make informed decisions about their reproductive health. This finding opens important possibilities for advancing the right to comprehensive sexual education.

Although the Committee did not elaborate extensively on this aspect, its recognition that access to information about reproductive health options is a protected right, seems to echo the doctrine of active transparency acknowledged by the Inter-American Court of Human Rights in I.V. v. Bolivia, where the Court emphasised states' affirmative obligation to provide complete healthcare information without waiting for it to be requested, particularly when the persons involved have to make decisions concerning such health situations.

Moreover, the Committee's findings align with the Inter-American Court's decision in Guzmán Albarracín v. Ecuador, which recognised comprehensive sexual education not only as a right in itself but as a crucial tool for empowering adolescents to exercise their autonomy (including reproductive autonomy) and prevent sexual violence. By finding violations of the right to information in these three cases, the Committee implicitly acknowledges that states have positive obligations to provide age-appropriate information about sexual and reproductive health so that they can exercise these rights. Active transparency concerning reproductive healthcare should not, thus, be limited to the healthcare contexts, but should extend to all individuals who have the possibility to provide tools towards ensuring that girls and adolescents can exercise their autonomy fully, most importantly school contexts, both as a policy to prevent violations to girls sexual and reproductive rights, but also to promote the full capacity to exercise those rights.

This creates a foundation for future cases to explore more deeply how comprehensive sexual education can be understood as a component of the right to access information under Article 19. The Committee's findings suggest that providing such education is not optional but a necessary element of states' human rights obligations, particularly for protecting vulnerable adolescents from sexual violence and its consequences.

C. The implementation potential of the decisions

Finally, the remedial aspects of these decisions warrant particular attention for their transformative potential. The Committee ordered both Ecuador and Nicaragua to make "necessary normative adjustments to ensure that all women victims of sexual violence, including all girls who are victims of sexual violence such as incest or rape, have effective access to pregnancy termination services" and to "undertake actions to combat sexual violence in all sectors, including through education and public awareness, as well as in the field of justice administration."

This broadly framed approach to structural remedies creates significant opportunities during implementation. The orders encompass two mandates: (1) adopting measures to ensure effective access to abortion for victims of sexual violence, and (2) eliminating barriers that may exist in accessing abortion services. While the Committee identifies minimum structural failings to be corrected, such as Nicaragua's absolute criminalisation and Ecuador's implementation failures, the language used by the Committee permits more comprehensive reforms that address the root causes of reproductive rights violations.

This approach allows civil society organizations, activists, girls movements, healthcare professionals, and stakeholders to advocate for measures that go beyond minimum compliance. During implementation, these actors can argue for comprehensive reforms including protocols ensuring non-discriminatory treatment of abortion seekers; training programs for healthcare providers and judicial personnel; information campaigns about sexual and reproductive rights; and, among others, monitoring mechanisms to identify and address implementation failures.

The flexibility of these remedies also creates space to address intersectional discrimination factors identified in the decisions. Implementation strategies can specifically target the needs of rural, indigenous, and impoverished communities, where access barriers are often most severe. All this will contribute to ensuring that reforms produce meaningful change for those most vulnerable to rights violations.

Conclusion

The Committee's decisions in these three cases provide significant steps forward in reproductive rights protection for the Latin American region and for the world. By establishing that forced pregnancy and forced motherhood constitutes a violation of multiple covenant rights, including the rights to life, privacy, the right to be free from torture and cruel, inhuman, or degrading treatment, and non-discrimination, the Committee strengthens an already existing robust framework for challenging laws that criminalise abortion.

In a context where backlashes against reproductive rights seem to be increasing, the reiteration of acknowledging that abortion access is a human rights issue creates an important precedent for both international and domestic human rights law, offering powerful tools to advance reproductive justice.

The cases discussed here are part of the Niñas No Madres strategy and were litigated by the Center for Reproductive Rights, Planned Parenthood Global, Surkuna (Ecuador), Mujeres Transformando el Mundo (Guatemala), and Promsex (Peru).