Alyne da Silva Pimentel Teixeira v. Brazil

Alyne, a poor, 28-year-old Afro-Brazilian woman, visited a private health clinic in the state of Rio de Janeiro. Despite presenting symptoms of a high-risk pregnancy, her doctor sent her back home. During the course of the following two days, her symptoms worsened, and she returned to the clinic. By that time, doctors were unable to detect a fetal heartbeat, and her delivery was induced six hours later, producing a stillborn fetus. The surgery to extract her placenta occurred fourteen hours later, though it should have occurred immediately after the delivery was induced. As Alyne’s health was steadily deteriorating, it was necessary to transfer her to a higher tier public health care institution; however, she had to wait more than eight hours to be transferred, as the institution refused to send its only ambulance to transport her. Upon arriving at the other facility, she was forced to wait over twenty hours in a makeshift waiting area without receiving any medical attention, where she eventually died. After four years had passed without a decision from the Brazilian judiciary in domestic claims, the Center for Reproductive Rights and Advocacia Cidada pelos Direitos Humanos submitted an international claim before the CEDAW Committee.

Alyne v. Brazil is the first maternal death case to be decided by a United Nations treaty monitoring body. The decision by the Committee established that governments have a human rights obligation to guarantee that all women in their countries—regardless of income or racial background—have access to timely, non-discriminatory, and appropriate maternal health services. This case further affirmed the principle of vicarious liability for private actors, finding that when governments outsource health services to private institutions, they remain directly responsible for their actions and have a duty to regulate and monitor such institutions.