Reports

The 89-page report, “Whose Abortion Is It? The Harms of State-Mandated Parental Notification for Abortion and Judicial Bypass in the United States,” documents how state-mandated parental notification laws in six US states threaten young people’s health and safety and undermine their human rights. Most young people considering abortion involve a parent in their decision. Those who do not often have no access to a parent or fear that parental involvement will lead to severe consequences, such as physical abuse, loss of housing, family alienation, or forced continuation of a pregnancy against their wishes. The alternative to notifying a parent involves petitioning a judge for a court order in an invasive, stressful, and often traumatizing process called “judicial bypass.”

The 73-page report, “‘It’s Happening Even Without You Noticing’: Increasing Barriers to Accessing Sexual and Reproductive Health Care in Romania,” documents that, although these rights are partially protected under Romanian law, in practice women and girls are regularly and systematically thwarted in their efforts to exercise these rights.

The 85-page report, “‘Forced to Give Up on Their Dreams’: Sexual Violence against Girls in Guatemala,” documents the numerous barriers that girls who are survivors of sexual violence face accessing essential health care, education, social security, and justice. Guatemalan law classifies any sexual activity involving a child under 14 as sexual violence. Guatemala’s National Registry of Persons (RENAP) reported that between 2018 and 2024, 14,696 girls under 14 gave birth and became mothers, in many cases against their will.

The 50-page report, “‘Five Babies in One Incubator’: Violations of Pregnant Women’s Rights Amid Israel’s Assault on Gaza,” finds that Israeli forces’ unlawful blockade of the Gaza Strip, its severe restrictions on humanitarian aid, and attacks on medical facilities and healthcare personnel have directly harmed women and girls during pregnancy, childbirth, and the postpartum period. The Israeli government, as the occupying power in Gaza, has violated the right to the highest attainable standard of health and other rights of pregnant women and girls, including the right to dignified, respectful health care throughout pregnancy, childbirth, and postpartum, as well as the right to newborn care.

The 62-page report, “Witness, Ally, Advocate, Climate Worker: Doula Care for Justice in Maternal Health in Florida,” found that the state provides inadequate financial and programmatic support for doula care, including under state-based Medicaid plans on which almost half of all women who are pregnant or give birth in the state rely. Doulas are non-clinical health workers who provide expert support during birth and provide individualized information about health care options, rights, and resources. Academic and US government research suggests that doula services can help improve the availability, accessibility, and quality of health care services for pregnant people. One multi-country analysis of evidence found continuous labor support by doulas may reduce rates of cesarean delivery and improve Apgar scores (indications of good health in newborns) and women’s ratings of the experience.

The 78-page report, “Reproductive Rights in the US Wildfire Crisis: Insights from Health Workers in Oregon State,” finds that the US government needs to do more to address the growing threat wildfires pose to maternal and newborn health, particularly in marginalized communities. The organizations documented the impacts of recent wildfires on maternal and newborn health in the state of Oregon, drawing on the experiences of community health workers and maternal health providers, among others.

The 44-page report, “Navigating Obstacles: Abortion Access in the State of Mexico,” found that the state’s abortion law does not guarantee access to this essential service, even for legally eligible cases. Barriers to access include healthcare providers denying or delaying services, withholding necessary information, questioning the veracity of sexual violence survivors' statements, subjecting women to mistreatment, and imposing arbitrary requirements for access that contradict existing law and regulations.

The 36-page report, “In Harm’s Way: How Michigan’s Forced Parental Consent for Abortion Law Hurts Young People” examines the impact of a Michigan law that requires people under age 18 seeking an abortion to have a parent or legal guardian’s written consent or get approval from a judge in a process known as “judicial bypass.”

The 39-page report, “Access Denied: How Florida Judges Obstruct Young People’s Ability to Obtain Abortion Care,” documents how in Florida many judges deny young people’s petitions, forcing them to continue a pregnancy against their wishes, travel outside the state, or seek a way to manage abortion outside the health system. Judges have the power to make highly subjective determinations about a young person’s maturity and interests. Vague criteria in state law enable highly arbitrary decision-making, with judges making decisions based on factors such as the young person’s grades and impressions of their demeanor during a nerve-wracking hearing.

The 82-page report, “‘We Need Access’: Ending Preventable Deaths from Cervical Cancer in Rural Georgia” documents how state and federal policies neglect the reproductive healthcare needs of rural Black women. Cervical cancer is highly preventable and treatable. In 2020, 194 countries committed to ending cervical cancer globally, the first such commitment made for a cancer. While cervical cancer mortality rates have declined in Georgia over recent decades, they are still high and racial disparities persist.

The 73-page report, “‘The Only People It Really Affects Are the People It Hurts’: The Human Rights Impacts of Parental Notice of Abortion in Illinois,” is the product of a collaboration between Human Rights Watch and the ACLU of Illinois. The groups found that young people often seek judicial bypass because they fear physical or emotional abuse, being kicked out of the home, alienation from their families or other deterioration of family relationships, or being forced to continue a pregnancy against their will. The groups also documented the hardships faced by young people forced to involve unsupportive family members in their abortion decision or navigate an unfamiliar court system to obtain a judicial bypass, and the additional stress and delays in seeking care this caused.

The 77-page report named “A Case for Legal Abortion: The Human Cost of Barriers to Sexual and Reproductive Rights in Argentina,” describes the consequences of the Senate’s rejection of a 2018 bill that would have fully decriminalized abortion during the first 14 weeks of pregnancy. Human Rights Watch documented cases of women and girls who have, since then, encountered an array of barriers to access legal abortion and post-abortion care. The barriers include arbitrarily imposed gestational limits, lack of access to and availability of abortion methods, fear of criminal prosecution, stigmatization, and mistreatment by health professionals.

The 65-page report, “‘It Wasn’t Really Safety, It Was Shame’: Young People, Sexual Health Education, and HPV in Alabama,” documents the Alabama state government’s failure to provide young people with comprehensive, inclusive, and accurate information on sexual and reproductive health. Human Rights Watch also found that the state is not addressing barriers to the human papillomavirus (HPV) vaccine – an effective tool to prevent several types of cancer – and that vaccination rates throughout Alabama remain low.

This report examines the controversy over the operations inside the medical community and the pressure on parents to opt for surgery. Once called “hermaphrodites”—a term now considered pejorative and outdated, intersex people are not rare, but their needs are widely misunderstood. Based on a medical theory popularized in the 1960s, doctors perform surgery on intersex children—often in infancy—with the stated aim of making it easier for them to grow up “normal.” The results are often catastrophic, the supposed benefits are largely unproven, and there are rarely urgent health considerations requiring immediate, irreversible intervention.

This report documents gaps in the Brazilian authorities’ response that have a harmful impact on women and girls and leave the general population vulnerable to continued outbreaks of serious mosquito-borne illnesses. The outbreak hit as the country faced its worst economic recession in decades, forcing authorities to make difficult decisions about allocating resources. But even in earlier times of economic growth, government investments in water and sanitation infrastructure were inadequate. Years of neglect contributed to the water and wastewater conditions that allowed the proliferation of the Aedes mosquito and the rapid spread of the virus, Human Rights Watch found.