shoulder the care burden. For example, in Europe employed women are 50 per cent more likely than employed men to be caring regularly for ill, disabled or elderly adult relatives.163 In countries with fewer available social services, the burden on women increases. During previous pandemics, societal expectations about women’s role in caring for the sick put them at risk of infection, and their care-giving responsibilities were associated with high levels of psychological trauma and stress.164 When emergency measures fail to mitigate the disparate impact on women providing additional health care, they are discriminatory. • The classification of certain medical services that are used primarily or exclusively by women as “non-essential” under emergency measures has a discriminatory impact on women. The classification of specific services as “non-essential” in order to divert health resources to address COVID-19 appears to have been gender blind across the OSCE region. Sexual and reproductive health services have been limited (in some cases consultations have been offered through telemedicine arrangements) or suspended. The impact has been restrictions on women’s right to access gender-specific services (e.g., screenings, such as mammograms). In some states, emergency measures have been used to justify curtailing women’s pre-existing rights to reproductive healthcare, with relevant health services classified as “non-urgent” or “deferrable”.165 In fact, pandemics, as well as other crises, require increased protection of women’s right to access sexual and reproductive health care. During emergencies, women’s autonomy over sexual and reproductive health decisions may be constrained (especially in light of the heightened risk for gender-based violence), and disruptions to supply chains (e.g., for contraception, but also menstrual health items) can jeopardize their ability to receive relevant health services.166 • Lockdown measures and travel restrictions impede women’s rights to access health services. For instance, around eight per cent of women in Europe and Central Asia reported that they had experienced difficulties accessing gynaecological and obstetric care services due to lockdowns for COVID-19.167 Many women, however, faced pre-existing difficulties accessing health care, due to multiple and intersecting inequalities and discrimination, for instance, based on their gender, as well as national or ethnic origin, disability, age, sexual orientation or other factors. During emergencies, such obstacles are further compounded. 163 OECD, “Women at the Core of the Fight against COVID-19 Crisis, Version 1st”, op. cit., note 53, pp. 4-5. 164 United Nations Population Fund (UNFPA), “COVID-19: A Gender Lens, Protecting Sexual and Reproductive Health and Rights, and Promoting Gender Equality”, March 2020, p. 6, <https://www.unfpa.org/sites/default/files/resource-pdf/COVID-19_A_Gender_Lens_Guidance_Note.pdf>. 165 See, e.g.: ODIHR’s OSCE Human Dimension Commitments and State Responses to the Covid-19 Pandemic , <https:// www.osce.org/odihr/human-rights-states-of-emergency-covid19>, p.138; American Medical Association (AMA), “AMA Statement on Government Interference in Reproductive Health Care”, 30 March 2020, <https://www.ama-assn. org/press-center/ama-statements/ama-statement-government-interference-reproductive-health-care>; Amnesty International, “Northern Ireland: Urgent Appeal for Home Abortions During COVID-19 Crisis”, 7 April 2020, <https://www.amnesty.org.uk/press-releases/northern-ireland-urgent-appeal-home-abortions-duringcovid-19-crisis>; and Human Rights Watch, “COVID-19: A Human Rights Checklist”, 14 April 2020, <https://www. hrw.org/news/2020/04/14/covid-19-human-rights-checklist>. 166 UNFPA, “COVID-19: A Gender Lens, Protecting Sexual and Reproductive Health and Rights”, op. cit., note 178. 167 The data refer to a rapid gender assessment conducted in ten countries. UN Women, “The Impact of Covid-19 on Women’s and Men’s Lives and Livelihoods in Europe and Central Asia: Preliminary Results from a Rapid Gender Assessment”, op. cit., note 97, p. 31. 48