–Government failing to fulfil international obligations–
Continued from Issue No. 117 (3089)
In our October 23, 2026 issue, No. 117 (3089), our newspaper published an article titled “Human rights ‘locked’ in maternity hospitals”, which examined violations of the rights of women with disabilities, particularly their right to obstetric care. The article explored relevant cases, the conditions and facilities at maternity hospitals, the lack of accessible equipment and services, and inadequate postpartum care. It also highlighted how their children are effectively excluded from consideration and left out of relevant policies.
Coumba Ndiaye, a Senegalese woman, developed a physical disability as a result of contracting polio during childhood. When she became pregnant, she approached four different hospitals seeking maternity care. However, all of them refused to provide her with care, citing her disability as a complication. She eventually gave birth at a fifth hospital. Initially, the midwife did not even conduct a basic examination but immediately recommended a Caesarean section. However, with the assistance of another staff member, Ndiaye was able to give birth naturally, without complications. Nevertheless, when she was transferred to the postpartum ward, a nurse failed to help her get out of bed. As a result, she fell and suffered severe bleeding. She subsequently lost consciousness and reportedly regained it two days later in the intensive care unit. Despite everything that had happened, the hospital’s senior midwife warned her that she should not have another child, according to an article published in a 2022 World Health Organization (WHO) report.
Following these experiences, Ndiaye decided to advocate for the rights of girls and women with disabilities, particularly mothers, and to make their voices heard. Through her continued activism, she has since become a symbol of this struggle.
Her story continues to be cited as a deeply cruel example of violations of human dignity and human rights. It illustrates how a pregnant woman was denied obstetric care primarily because of her disability, was not examined or assessed appropriately, and was subjected to a hasty decision to perform surgery without her needs being properly evaluated. She was discriminated against, suffered harm to her health because her safety after childbirth was not ensured, and was left traumatised by the experience of giving birth. Her rights were gravely violated, culminating in a hospital staff member effectively telling her that she should never have another child.
In Mongolia, even women without disabilities have long experienced various forms of violence when seeking maternity care. This issue was first brought to public attention by Reem Alsalem, the United Nations Special Rapporteur on violence against women and girls. During her official visit to Mongolia in late 2021, she highlighted the problem and drew public attention to it.
These systemic shortcomings have yet to be fully eliminated. For women with disabilities, however, giving birth has presented even greater challenges, leaving them distressed, anxious and frightened as they continue to face physical barriers in maternity facilities.
This is not an issue that can be dismissed or treated as commonplace with the attitude that “if even women without disabilities experience violence during childbirth, imagine what it must be like for mothers with disabilities”. Such experiences must not be ignored or brushed aside. International organisations have therefore continued to provide Mongolia with recommendations, guidance and advice on the care and services that should be implemented in this area, as well as on addressing the practical challenges women face during childbirth.
NOT ASKING FOR EXTRA COMFORT
Drawing on documents, research and reports from the National Human Rights Commission of Mongolia, as well as comparisons between Mongolia’s maternity care standards and international standards, the article detailed the barriers mothers face and the physical and psychological harm they experience during childbirth.
This time, we aim to examine how mothers with disabilities become victims of inaccessible services at every stage of their maternity care, from entering a hospital and getting onto a delivery bed to receiving postpartum care, using toilets, communicating with doctors and caring for their babies.
Every woman who enters a maternity hospital should be able to give birth safely, receive the necessary care and services, and leave prepared to care for her child. For mothers with disabilities, however, this journey involves much more than simply receiving medical care. Accessibility barriers persist at every step, from ramps and elevators to delivery beds, toilets, communication with medical professionals and postpartum care.
It is misleading to conclude that a maternity hospital has improved its accessibility simply because it has installed a ramp at the entrance or a single handrail in a corridor. Maternity hospitals still lack dedicated units for mothers with disabilities, specialised delivery beds, tactile paving and accessible toilets.
Mothers who use wheelchairs have no equipment to help them get onto delivery beds and cannot use toilets independently after giving birth. Deaf mothers receive no guidance on how to recognise when their babies are crying, while mothers with visual impairments lack the knowledge, practical training and instructions needed to care for their newborns safely. The necessary facilities and support systems remain unavailable.
Mothers with disabilities are not asking for extra comfort. Like everyone else, they simply want to exercise their right to healthcare without discrimination, intimidation or fear, and without unnecessary barriers. It is deeply regrettable that maternity hospitals in Mongolia have yet to provide even for these basic needs or establish an environment that enables them to do so.
In 2025, the American College of Obstetricians and Gynecologists (ACOG) issued recommendations on providing obstetric and gynaecological care to people with disabilities. These recommendations address several aspects of healthcare accessibility, including service arrangements that accommodate physical and sensory needs, access to information, accessible toilets, height-adjustable examination tables, assistance with transfers and positioning, and staff training. They also emphasise improving communication with and attitudes towards people with hearing and visual impairments.
Deaf mothers may be unable to understand medical instructions, while mothers with visual impairments may struggle to navigate room layouts, locate doors or identify ward names and signs. Mothers with speech impairments may find it difficult to communicate their pain, physical discomfort or even their babies’ most basic needs to medical staff. ACOG therefore recommends using appropriate methods and tools to address these communication barriers.
The recommendations also propose practical solutions, including introducing Braille, providing sign language interpreters and using other accessible communication methods.
Similarly, a 2024 guide published by the World Health Organization’s Regional Committee for the Western Pacific on making healthcare accessible to people with disabilities emphasised the importance of removing not only physical barriers, such as inaccessible entrances, exits and toilets, but also barriers to information and communication. The guide also recommends involving people with disabilities in the planning, implementation and evaluation of healthcare services.
MATERNITY CARE ACCESSIBILITY STRONGLY CRITICISED
The United Nations Population Fund (UNFPA), in collaboration with Mongolian civil society organisations and associations of people with disabilities, assessed the actual conditions in maternity hospitals and reached several conclusions.
In particular, the assessment highlighted the lack of specialised examination beds designed to accommodate mothers who use wheelchairs, whether for sitting or lying down. This not only results in obstetric care that fails to meet established standards but also creates significant difficulties for mothers.
Report by the Committee on the Rights of Persons with Disabilities, also revealed widespread inappropriate conduct by medical professionals and hospital staff. Women with disabilities are often discriminated against as though they are “incapable of” or “not entitled to” having children. When they arrive at maternity hospitals, they frequently face verbal abuse, intimidation and even physical assault.
During discussions of the report at a session of the UN Committee in Geneva, international experts strongly criticised the lack of accessible maternity services for mothers with disabilities. In response, the Mongolian Government pledged to ensure that every maternity hospital would have at least one specially designed delivery bed.
UN Special Rapporteur Reem Alsalem also drew attention to the double discrimination experienced by mothers with disabilities, drawing on cases and experiences she encountered during her visit to Mongolia and raising the issue at the committee’s session. She highlighted how the inaccessible and unwelcoming nature of hospital environments, infrastructure and maternity care, which fail to accommodate the needs of women with disabilities, causes them considerable physical and psychological harm during childbirth.
Furthermore, the UN Committee on the Elimination of Discrimination against Women (CEDAW), in its recommendations to the Mongolian Government, called for regular specialised training for doctors, midwives and nurses at maternity hospitals. The training should teach healthcare professionals how to treat pregnant women with disabilities humanely and ethically and how to provide maternity care tailored to their physical needs without discrimination. Unfortunately, the Mongolian Government has done little over the years to fulfil its commitments and pledges to organisations such as the WHO and the United Nations.
As mentioned above, none of the maternity hospitals has specialised delivery beds. Although some hospital toilets have only recently been fitted with bidets, no maternity hospital has toilets specifically designed for mothers with disabilities. These shortcomings provide grounds to conclude that the authorities have failed to fulfil the country’s international obligations.
Mongolia is a member of these international organisations and has acceded to relevant international human rights instruments, treaties and conventions. Yet its failure to recognise and fulfil its obligations and responsibilities is shameful.
At first glance, the issue may appear to concern only improvements to tactile paving, ramps, specialised delivery beds and toilets in maternity hospitals. However, at a systemic level, it is about ensuring that the needs of mothers with disabilities are taken into account when obstetric care is planned and that maternity services are delivered to mothers and newborns without unnecessary barriers or difficulties.
