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On the occasion of World Health Day, the Platform for International Cooperation on Undocumented Migrants (PICUM) urges governments to change legislation and practices to ensure access to sexual and reproductive health services for all, regardless of residence status.

The right to sexual and reproductive health is well established in international human rights instruments that bind all EU Member States. Undocumented migrants are nonetheless frequently denied their sexual and reproductive health rights (SRHR). They are disproportionately affected by high rates of maternal and infant mortality, limited access to contraception and pregnancy termination, and heightened levels of discrimination and gender-based violence, including at the border, in transit and in detention.

The severity of the current situation in Europe, which has experienced large movements of migrants and refugees within the past year, has thrown the deficiencies of policy and practice on SRHR into even greater relief.

“The desperate trip across borders brings an untold number of new dangers for vulnerable women and girls – violence, rape, sexually transmitted infections, unintended pregnancies, unsafe abortion. Access to essential sexual and reproductive health services can be the difference between life and death. Yet it is still shamefully neglected in response strategies. If we value women’s lives, it must move from afterthought to priority,” said Caroline Hickson, Regional Director, International Planned Parenthood Federation (IPPF) Europe.

PICUM’s new report ‘The Sexual and Reproductive Health Rights of Undocumented Migrants: Narrowing the Gap Between Their Rights and The Reality in the EU‘ calls attention to the gulf between restrictive national laws and policies limiting access to services for undocumented migrants on the one hand, and governments’ clear obligations and commitments to provide those services, on the other.

An undocumented woman from the Philippines shared her experience: “Throughout the course of my pregnancy in Denmark, I did not visit a doctor. I was afraid, because I was in the country without permission. So I continued my work as a cleaner. I went to the hospital only when the pain was unbearable. The labour was already advanced. There was so much blood. I had a caesarean section, but the baby did not survive. She died in an incubator. But I did see my daughter, I have a photograph of her. I named her Claire. She is buried in Copenhagen.” A few weeks after giving birth, the woman was deported from Denmark after she was reported by hospital staff to immigration officials.

The majority of EU member states’ laws and policies impose significant barriers on undocumented migrants’ ability to access sexual and reproductive health services. Often, these restrictions are justified in the name of deterring irregular migration or cost savings, but in reality they serve mainly to generate costs. When undocumented migrants are unable to access such services, financial costs are incurred by health systems because of delayed care and burdensome administration. There is also the devastating cost to individuals denied adequate or timely care. A study by the European Fundamental Rights Agency (FRA) suggests that providing access to regular preventive health care for migrants in an irregular situation would be cost-saving for health care systems.

PICUM’s report calls for reforming legislation and policies that deny or limit access to sexual and reproductive health services on the basis of residence status, to ensure that services are provided based on need. It also urges governments to establish a ‘firewall’ to delink the provision of basic services, including sexual and reproductive health services, from immigration control. In practice, this requires limiting the sharing of personal data between health care providers and immigration enforcement authorities to ensure that patients can access care without fear of being denounced or deported.

The European Commission’s communication on effective, accessible and resilient health systems recognises that health systems are built on four common values: universality, access to good quality care, equity and solidarity. These values must not be compromised by policies and practices that are designed to leave out certain segments – often among the most vulnerable – of the population.

World Health Day provides an occasion to recall the values underlying our health systems, and to ensure that, in the European Union, an individual’s ability to access sexual and reproductive services is determined by her need, and not by her immigration status.

Read the full report here.

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