 I'd like to please to answer this We've got some South Americans in that's brilliant South Africa stood around I don't suppose we'll have anybody from Australasia now because it's It's about four o'clock in the morning in Australia. Okay last second. I shan't labor the point Anymore all good still some people answering. Okay. Thanks for that Next question is The sort of demographics so what's your main occupation or your main role? and if you are other if you Would like to Put something in the chat box about what other is that would be interesting especially as you seem to have several Okay. Thank you for that. I've still got time Melissa for if you want to do this second one Okay. Thank you for that Finally We're interested in Where you're connecting from Excuse me a minute In the trouble let me clear down the previous answers Looks like most but not everybody's from home and thank you Okay Catherine back to you. It's all yours and while we were polling guess what I found I found the right email so I am going to Proceed with some introductions here. I believe Let's see Although it looks like I see Erica's Aliska's and elect or is so Elena if you want to go ahead and start and introduce yourself and Then Erin can go ahead and introduce herself as well when she takes over you have my hi, my name is My name is Alana Ateva And I am the On the board of editors of human rights in childbirth and Erin Duncan is Another attorney so I'm an attorney. She is another attorney who volunteers with human rights in childbirth and Alyska could also ways joining us from the Czech Republic and she is with one of the oldest NGOs in the Czech Republic a perio which advocates for Improving maternity care in in that country and today we would be talking to you about CEDO which is the CEDO is the international convention the UN convention on eliminating Open all forms of discrimination in human that but So it is a young convention. It is probably the most important UN convention on women's rights It was adopted in 1979 by the UN General Assembly and in 81 it entered into force many enough countries signed on And it includes obligations To states to take all necessary steps to safeguard rights from infringement by third parties Almost every country in the world has signed that convention with exceptions and Then I noticed that a lot of you are from the United States because we are in that time zone And there was somebody from Iran and I'm sorry to say that your country has not Adopted CEDO yet, but these are the few countries that haven't adopted CEDO But but chances are that your country has adopted it because if you see the map Almost everybody else has and even if your country has not Ratified CEDO we will talk about what your options are to advocate using that document So it is not just a tool for rights enforcement, but for rights education as well And it's preamble the convention explicitly acknowledges that extensive discrimination against women continues to exist and Emphasizes that such discrimination violates the principles of equality of rights and respect for human dignity And it also sets the tone regarding Childbirth that the role of women of procreation should not be the basis for discrimination There are a few articles that directly relate And can be used when advocating for human rights in childbirth article one is Brought the definition of discrimination and it's very owing on compassing. So if you are wondering if something You know, you can't find something in the text and if you're wondering if it's included It's probably included with the chances are it's included Articles two and three establish the state responsibility To ensure that women are not discriminated against and it it doesn't just mean adopting legislation But taking all appropriate measures and sometimes those measures could be temporary special measures for substantive equality so measures that Relate to maternity for example These measures could be taken Article five talks about gender stereotypes, which also Play a role when we talk about violations of feminizing childbirth and article 12 is the article that Specifies the right to health with special consideration in pregnancy and childbirth I'm sorry, I laid it Aaron I was hoping to just jump in very quickly. I'm one point if we can go back I just want folks to know that the substantive equality sort of what that means and The differences between formal equality where you're treating everyone the same in some some Instances you need to treat people differently and of course in the constant context of pregnancy You treat women differently where necessary in order to achieve Actual equality, so that's the concept of substantive equality Thank you. Thank you, Aaron, and that's yes And then article 12 also goes to state that not not withstanding the right not to discriminate in article 12 Regarding health in general when we talk about maternity Pregnancy and confinement We have to treat women different differently because of their biological function which which means that they need special considerations There's a general recommendation issued by the CEDO committee and we'll talk about the committee in just a minute But that recommendation it's number 24 on women in health and it goes into More detail about what what that protection means It so it provides elaboration on article 12 it talks about of Deplication of the states to respect protecting fulfill women's rights to health care So the right respect usually means not to infringe to protect It means that it needs to to protect against infringement from others from third parties and this could include for example private hospitals and and the last Requirement to fulfill women's rights to health care means that there's a positive obligation on the state as well The same recommendation read rates the need of availability accessibility acceptability and quality of health services and There's special state obligations Written which require all health services to be consistent with the human rights of women including the rights to autonomy privacy confidentiality informed consent and choice So the committee is a committee of women's rights experts 23 women's rights experts And that committee monitors the implementation of the CEDO convention It gathers three times a year in Geneva and it reviews states reports So states need to submit reports every four years that state what steps the state has taken to implement the convention in that particular country the committee also accepts shadow reports Because they don't have offices in different countries They can't travel to different countries to really see what is happening and they only receive the state's reports They also allow civil society to submit alternative reports or shadow reports and those reports usually elaborate more on What violations women's women are facing in that country it thinks that maybe this the state omitted from their report And the CEDO committee also issues Recommendations to the states on what measures they need to take further to improve the implementation of the convention And then in special circumstances it issues those general recommendations that there are two All signatures to the convention such as the general recommendation 24 that I just mentioned that's just a matter if you can see that it's a list of the committee members just to to Give you an overview. They really come from different countries and What what's your nice and I think it's that they're really excellent in women's rights Shadow reports are submitted So usually shadow reports are submitted only when state reports are submitted and states are required to submit every four years But that it doesn't always happen. So you can't rely on on that. You have to kind of monitor the the website of the committee and See they usually have a list for the next year and a half of what states would be reporting And then you know that you can submit a shadow report for that particular state Some for some recommendation states must must submit a two-year interim reports on progress of implementation And we will talk about that later when we talk about the example of Greece So this is really an opportunity for civil society to weigh in and and show the Specific issues that women face in their country and and really get international attention to those issues The committee reviews the state report and the shadow report Engages in what is called constructive dialogue with the state. This is what happens in Geneva And then issues recommendations to the state on what steps need to be taken to implement the convention And this is really this is your opportunity as much wives as a researchers as lecturers Even a student midwives. I mean really There is a place for you to either work with other Organizations or on your own and to bring attention to violations of the rights in childbirth that you know of in your country And I would just like to point a few examples of how shadow reports have been used specifically for some rights in childbirth most recently Ecuador submitted a report in February of 2015 The comments from from civil society included comments on obstetric violence As an invisible form of gender violence predicated on the power dynamic between women and health professional Professionals and also comments on the lack of legislation of outgoing obstetric violence There were also oral comments so NGOs can also Comment orally at the session very briefly really but apparently there were oral comments And the committee's recommendations of the state includes those oral comments They say that they're concerned about barriers faced by indigenous Afro-Equadorian and Montip you women in gaining access to health services that meet their needs and respect their health approaches Including the practice of vertical births followed by indigenous women and their recommendation is to the stages to adopt The bill on intercultural practice for assisted births under in the national health system with DM of recognizing intercultural care during delivery so, you know this this organizations and can go home and Can use the the CEDO recommendation to advocate for their own adopting a bill that was apparently already written But you know, it gives them that strength, you know that an international body should that recommendation And maybe they can get more media attention. It just strengthens their work It's a part of your advocacy strategy Hungary in 2013 The report from civil society included comments on high rates of intervention and the lack of recognition of independent midwives due to restrictive laws and lack of state funding and also comments on the imprisonment of midwife Agnesh Kereb It also included comments on course sterilization of reminding women The recommendation from the CEDO community was to ensure a women's choice to give birth at home or in a hospital by Recognizing trained midwives as independent professionals and by elaborating a legal framework and guidelines on security of home deliveries and providing training of obstetricians I'm not sure who will have time to go through all of this Greece The example of Greece is really interesting. I'm really sorry that electrical drill could not join us today But we were together at the different conference two weeks ago and I can tell you what she told me then so she Contacted an attorney who was already submitting a shadow report But that was barely two weeks before the session itself So really late in the process, but she contacted that attorney and told him well Can you can you talk about the high rates of caesarean sections that that we're facing? And the committee issued the following Recommendation the committee is also concerned at the extremely high rate of caesarean sections performed in public 40% and private up to 65% hospitals without medical justification The Greek rates being the highest in the world way above the 15% rate considered by the World Health Organization is covering medical needs The committee or just the state party to reduce the rate of caesarean sections performed without medical necessity by training or retraining medical personnel on natural birth and introduce strict control of Medical indications for caesarean sections in order to reach the WHO recognized rates And in this case the Greek state is then are required to report in two years on what progress was made on reducing the caesarean section rate increase We have other examples, but I Think that we're not going to have time for them. We'll have the presentation Available on the website of the childbirth. So don't worry. I'll just quickly show you And if it's a more general recommendation Then the Czech Republic will hear from the description only and she was involved in that report and Handing it over to Erin Thanks, Elena. So can everyone hear me? Okay Someone in chat. Maybe let me know great. So I'm joining you from Oregon. I'm a lawyer here and I'll just move forward We have a link here This is also will be linked from our website at human rights and childbirth org if you go to our CDOT page You'll see that link at the end of this session To look up when your country will be reviewed. So you want to go fairly early and see what's going on in the next few years I know they have through I think July 2016 posted right now and this is because the Process for submitting shadow reports really starts a lot earlier than the formal review session. And so I'll I'll just move on to this next page. So The formal review is about a year earlier You want to find out when your actual review session is happening and when your pre-committee Session is happening. So there's several meetings of the committee in Geneva And the goal is to try to submit your shadow report for that pre-committee session That's when the committee is discussing the reports and developing what's called its list of issues and questions Which form the basis for the state review. So when the state submits its own report It might raise issues or it might not raise issues that are important to women in the country And so the goal is to put forth what you believe are are the most critical issues facing Facing women and have the committee actually ask the state about those even if the state didn't raise those issues themselves Like Elena said don't be discouraged if you're late you could with the example of Greece They got that information in at the last minute So there's ways to sort of jump on with other NGO groups and try to get your issue out there The CDOT committee does prefer reports from working coalitions of NGOs. So they don't have a Bunch of disparate reports It's helpful to try to work together with a coalition, but it does it also accept reports from individual groups on particular issues So that's a possibility and and we've been debating whether or not they'll actually accept Reports from individuals if you if you can't find a group to work with I think that is a possibility I would suggest talking to International women's rights action watch which will have a link for them later They do a lot of support work with CDOT and they might be able to connect you and figure out how you could submit a report on your own so the shadow report can't just be a Long list of your issues it really should be tailored to the convention so it's helpful to go back to the language of the convention of CDOT and Identify which articles are actually relevant to the issues you're addressing so I put together just a little example here The language in article 12 says states must provide appropriate services in connection with pregnancy So that's fairly broad, but you can tailor a list of questions and recommendations to that language For instance, does the state have policies in place to ensure that healthcare providers are informed about and utilizing evidence-based care? So in your report you can can raise those questions and then answer those questions by also putting the data in the report And answering those questions So here's answer the questions using supportive data for instance common breaches of evidence-based care in the state Include excessive use of electronic fetal monitoring which can dramatically increase rates of unnecessary c-section and Then of course you want to have some footnotes or some documentation to support that data that you are supplying In preparing your report it's helpful to obtain the current state report if it's already available and From that link that we showed earlier where you find out when the session is actually occurring you can go there and Access the state report You you can also sometimes access a state report from the government itself Earlier than when it's going to be actually posted on the UN site and so you might want to Contact the Ministry of Foreign Affairs see if you can try to get access to the state report as early as possible It's helpful to review previous concluding observations from prior sessions Address the extent or effectiveness of implementation of prior concluding observations and Identify gaps and issues that have not been previously addressed. So maybe you know what we see in some of the examples Elena was pointing out earlier Excuse me There were concluding observations regarding human rights in childbirth And so now for those next sessions if you are from one of those countries You want to look at those recommendations and in your next report Just figure out has your state actually been complying with those prior concluding observations So this is just a little general list be specific prioritize your issues Give contextual economic and political info We saw that list of who the committee members are and they're coming from a lot of different countries So remember that the it's really an international committee and you might need to provide some context for your particular issue and Again, also for that reason use easily understood language for non-native speakers You can put your report together in different languages. I am trying to remember I think CEDA has it has to be one of certain languages, but then it gets translated Into a number of the the UN languages so that Everyone can have access so we have sort of asking the question based on the article Supplying the data to support your answer and then you want to also try to include concrete recommendations for state improvement So using my previous example You could say the state should formulate training curricula and promote changes in the behavior and attitudes of health care professionals To ensure that now routine practices, which do not actually have an evidence-based Indications that the expected benefits will outweigh the potential harms are eliminated from routine care of low-risk pregnant women So something like the electronic fetal monitoring, which doesn't have evidence-based indications You're making that recommendation that the you're essentially recommending that the committee recommend this your recommendation to the state and and Find support for that Again, you want to be specific with your recommendations and think about who should be involved what data is required In order to make those changes what resources that are required. What's an appropriate timeline? You want to try to show the committee that The state should be able to accomplish these recommendations even if you have a state with limited resources Be specific about what what you think the state is capable of doing doing to improve the situation You do want to organize your report around the committee guidelines for state reports so again the the language of shadow reporting you're you're trying to organize your own report to in some ways respond to the state report that I won't get into this too much again the international women's rights action watch group has Some great resources on actually developing your shadow report and so we can link you to them But part of this is that there's now requirements about something called a common core document that the state has to put together That's there's sort of two separate documents for the state report So you want to address both of those documents in your shadow report That's getting a little bit too much into the details right now, but again We'll link you to some resources that can help you with preparation So you want to submit your report several weeks before the pre-session meeting of the committee Again, you should be able to figure out when your pre-session meetings are from that original links that we have for when the formal review sessions are there also is information about the pre-session meetings and Like Elena said you can also send representatives to those meetings So if possible, you know plan far ahead if you're going to be part of a coalition putting together a report See if you can get some funding and send a few folks to Geneva to Try to brief the committee on Some of these these issues So when you're in Geneva, you won't have a lot of time. Unfortunately. I haven't been there So I don't know exactly how it works But my understanding is that you you get a few minutes to speak before the committee try to connect with other NGOs Be concise about the issues and putting forward really the key points Learn what you can about the committee members beforehand try to catch them by name during breaks if I invite them out to lunch You're really just trying to get their ear During this time when they're developing that list of issues and questions It's just a picture from the one of the sessions there and remember that that this doesn't stop with your Just submitting the report you want to use those concluding observations Use those outcomes at the internet from the international level and relate them back to your domestic campaigns. So you're Want to find out are your domestic decision-makers aware of these concluding observations and can you use those Observations not let them go unnoticed Talk to your government use them to focus your own field work And then of course use them in future advocacy for CEDA again I think that was the end of our slides there Okay, well, so I'm going to turn it over to We had one more slide, but it's only got cut off with If and sorry, maybe sharing some personal experiences with advocacy for women's rights in childbirth Catherine actually So if Alishka is there if you can if you want to she's going to share some of her work in the Czech Republic and Actually working on recommendations to CEDA from personal experience Going to turn off the recording and we're going to have another part of the pressure great. I can hear me I Can hear you Alishka, okay, great. Thank you for confirming it Can you please go back to the slides on CEDA in the Czech Republic so that I can follow them? Otherwise let's introduce myself I am a psychologist by profession and I read the part of the CEDA shadow report for the Czech Republic I work at a barrier which as Alina said is an organization that supports parents to make their own decisions around parenting including and most importantly childbirth and We worked on that CEDA shadow report for 2010 submission as part of the Czech women's lobby Which is a local group of the European women's lobby It's well, it's a group of organizations that support women's rights in general in all areas So you are put together quite a strong case for for the situation about women's rights in different areas and We were proud to Prepare the part on health and which for us meant mainly maternity care pregnancy care and Also part of the report was on health was forced the realizations of Roma women in the Czech Republic which was not a very nice part of the Czech history in the 90s and and Back to the back to pregnancy in childbirth related issues. You can see on the slide the main issues that we commented on we focused mainly on how women Can choose where how and with whom they will give birth Because in the Czech Republic we have quite a good network of maternity hospitals, but it is difficult to find a midwife to support you when you decide to have a home birth and When you find this midwife and she is willing to to accompany your birth then you might then you may face other obstacles such as registration of the child in the state registry or Finding a pediatrician who will take care of your child Of course, we also commented on How informed consent is not always Given by women for all sorts of interventions. So it was also an important thing I would like to stress here how important it was for us to work here with the midwives and midwifery organizations because we as a as an organization we present mainly parents mothers and fathers who told us about their experience of childbirth, but for us midwives were kind of They are those who gave us information on What is going on in hospitals on a daily basis? they midwives See what is going on in hospitals in other kinds of settings Every day, so they can report what is happening. What issues are the most are most important They can give you a they could give us a more colored a more varied picture of the situation in the Czech Republic than just statistics or Stories of birth stories we heard from parents even though they are very important for us and That's why we that's why we collaborated with them on preparing the three-dough Shadow report and I think that this is what made such an impact At the committee. Can I please ask you to show another slide Alena? Not sure how to move it Yes, thank you Here you can see the recommendations that we that the Czech Republic received from the three-dough committee and You are really glad that many of the of the issues that we included in the report were actually confirmed as important in the By the committee and what we did Was that we sent as a whole group as the Czech women's lobby a representative to the Geneva just as Erin mentioned it was really I had to say that Alena's and Erin's description of the whole procedure was really exhausting and We are going to prepare the shadow report for next year because this is the year when we will Have to then the Czech Republic will defend it again it I'm sure that we are going to use it again and as a As a groundwork for what we are going to do. So that's it for me. If you have any questions, I'm here Thank you post it in the chat box the link To the document that we have prepared with more information On how you can prepare a shadow report and some information that we mentioned here We will also upload this presentation there as well and the recording will be available But I just wanted you to to draw your attention to that link as well And I just wanted to know this is Erin again our last slide that didn't make it up said human rights are not just aspirational and to use the existing framework to affect real systemic change So I think a lot of times we think of human rights as being this thing this sort of overarching idea But actually there are real existing legal frameworks to take some action and on the other hand when you have states that Haven't ratified the treaty it's it's a great tool for education and Using this statement of rights in the context of childbirth It's really a powerful tool to know that those rights are supported by international law that when you have a bad gut feeling about How you're being treated by a provider or something that might actually be what could be considered a human rights violation Now we'll open it up for questions We have requested the first slide with the pseudo definitions. Is this it? The articles it's fairly easy to find that the full text of CEDA in several languages You can just Google it and and look through the articles with the definitions of discrimination We also have it linked from that human rights and childbirth Sight that Elena has put in the chat Also, I just need to make sure you have the correct link. So this is the link to the CEDAW committee There is an old website that used to host the CEDAW committee and the convention It's a UN website and then there was some structural changes and the committee just moved So they have a new website. So this is the correct website. It's the office of the high consumers And if you if you go to the website you can check Like we had before on the upper right corner under session If you click on that you can see which countries that are scheduled to be reviewed in the next maybe year and a half to two years So you can see if your country is on that list Okay, well that was certainly a very interesting perspective and certainly a framework that Those of us down in the trenches are not often aware of so We really sincerely thank you for all the information that you've brought to us Thank you for hosting us and thank you to the organizers I think this is an amazing gathering and and very accessible to I think this is my third year and they're all participating and I really appreciate that I don't have to you know be away from my family I Can actually do things around the house usually I'm listening and and I think this is amazing It's very very accessible. I also like to thank yet the arrow close on Who's my friend and a midwife from Denmark and who encouraged me to submit? An abstract she said that this is something that midwives should be aware of and and I said well, why not? I think it's great. So I really hope that you Take that presentation and and think about the option that you have to to advocate on an international level for information child violence, okay? Carla did Are you going to continue typing Carleen? Oh, okay, so you just typed in a comment great Okay, so we're going to wrap up and continue with the goodbye slides and the request for feedback. Thanks again everybody