Brazil must urgently improve the health services available to women during and after pregnancy, Amnesty International said today after a UN body determined the country failed to prevent the death of a pregnant Afro-Brazilian woman.
Alyne da Silva Pimentel Teixera, a 28-year-old Brazilian woman of African descent, was six months pregnant with her second child in late 2002 when she died following inadequate treatment at a local health centre in one of Rio de Janeiro’s poorest districts.
Following a complaint filed by da Silva’s mother, the UN Committee on the Elimination of All Forms of Discrimination against Women recently concluded that Brazil had failed to provide da Silva with appropriate maternal health care and had discriminated against her based on her sex, ethnicity and socio-economic background.
It is the first time an international human rights body has intervened on an individual case and determined that governments have a duty to prevent maternal mortality and protect the rights of pregnant women and girls.
“The government’s failure to prevent death or injury during pregnancy is a form of discrimination against women and girls that affects their rights to life, health, and equality,” said Widney Brown, Amnesty International’s Senior Director of Law and Policy.
“Not only was Alyne da Silva given inadequate care leading to her death, which was completely avoidable, but discrimination against poor Afro-Brazilian women played a role in the quality of treatment she received. It is positive that the Committee expressly recognized that women can suffer from multiple forms of discrimination – and in this case it was lethal.”
Da Silva, who was married and had a four-year-old daughter at the time, was near the end of her second trimester of pregnancy when she went to her local health centre on 11 November 2002, complaining of severe stomach pains and nausea.
According to the UN decision, staff at the local health centre misdiagnosed her symptoms and delayed emergency medical care. Two days later, doctors induced delivery of her foetus after they could no longer detect its heartbeat.
Da Silva became disoriented after the stillbirth and on 14 November 2002 she underwent surgery to remove portions of the placenta. Although her condition continued to worsen after the operation, staff at the health centre assured her family members she was well.
On the night of 15 November 2002, Da Silva was transferred to a hospital after entering into a coma earlier in the day. Despite her critical condition, she had been forced to wait for hours at the health centre while requests for a hospital bed or an ambulance to transfer her were denied.
Da Silva died in hospital the following evening of a haemorrhage, which doctors determined had resulted from the stillbirth of the foetus. Before her death, hospital staff and da Silva’s family members were repeatedly denied access to her medical records at her local health clinic.
“Alyne died as a result of negligence and discrimination. The Brazilian authorities must provide reparations to her family, who lost a mother, wife and daughter,” said Widney Brown.
“Brazil must ensure its public health system meets the needs of women and girls as part of their obligation to respect the right to health. Women must have access to adequate health care during and after pregnancy, regardless of their income or racial background. No more women should be made to suffer like this.”
Brazil has a high maternal mortality rate considering the economic strides the country has made in recent years. Indigenous, low-income, and Afro-descendant women in Brazil run a much greater risk of dying during pregnancy and childbirth.
The case was brought by da Silva’s mother who was represented by the Center for Reproductive Rights and the Brazilian NGO Advocacia Cidadã pelos Direitos Humanos. Amnesty International and others provided amicus curiae briefs to the UN Committee.