Costa Rica’s National Ombud’s Office reiterated the state’s obligation to provide full prenatal and maternal health services to all women irrespective of their migratory status in the country or their ability to pay for basic coverage.

The office’s statement was in response to their recent investigation which found, among other things, that the state public health care provider (CCSS, its initials in Spanish) was denying services to pregnant women who were behind on paying their basic monthly insurance fees – a requirement for all  foreign residents in Costa Rica.

In addition, the office found that mandated maternity leave was not being granted to female migrant workers because of their irregular migrant status, which violates Costa Rican laws.

The country’s Ombud, Montserrat Solano Carboni, in a statement on International Women’s Day (March 8), pointed to the structural inequalities that are leaving Costa Rican women disproportionately excluded from the workforce, and leaves them defenseless when facing gender-based discrimination such as being fired when pregnant, being denied maternity pay, and not being able to access time legislated for breastfeeding during the workday.

“The labor rights of women are not enshrined in day-to-day practices or reflected in the structure of the system, and this results in serious failings that violate their rights and is the result of a lack of a state policy that promotes the structural changes required to eradicate discrimination against women in the workplace,” said Solano.

Solano continued to say that the country’s labor laws, international conventions, and other regulations are not sufficient to eliminate labor discrimination. In Costa Rica, women continue to be discriminated against in the public and private sectors, she emphasized.

Complaints are received on an ongoing basis by the Office of the Ombudsman from women for delays in the payment of maternity leave, unjustified dismissal of pregnant women, denial of breastfeeding time, non-payment of maternity leave to migrant workers, among other issues, revealing the harmful and discriminatory ways in which women’s labor rights are in many cases ignored.

The Ombuds’ office said pregnant women’s human rights take precedence over their ability to continue paying voluntary or self-employment insurance fees, as this puts the mother’s and her fetus’ health at risk.

Migrant workers said they were required to present passports when seeking health services and/or residency cards or current visas, to which the Ombuds’ office responded that if a person is affiliated with the health system as a worker, there is no need for them to present their migratory documents at clinics or hospitals to receive health care.

Other tactics that women have described in complaints include being billed for prenatal care after being seen for appointments when their insurance payments have lapsed, which has caused some to stop seeking care for fear of acquiring debt, and which the Ombudsman said can endanger their life and health as well as that of their unborn child, and which could eventually have a negative impact on Costa Rica’s low maternal and child mortality rates.

The office said the principle of services operating in best interest of a minor should apply and these are part of the country’s Child and Adolescent Welfare Code.

Likewise, the Office of the Ombudsman has recently received complaints related to the suspension of family benefits for relatives of prisoners.

The Office of the Ombudsman is aware that the CCSS and the Ministry of Justice signed a Convention in 1993 to ensure that relatives of people deprived of liberty also have access to health care.

In response to this situation, the Office of the Ombudsman asked the CCSS and the Ministry of Justice to ensure compliance with the clause established in the current agreement between CCSS-Ministry of Justice related to the insurance for relatives, spouses and companions of prisoners.

Regarding women’s participation in the labor force, the Office of the Ombudsman said reforms to labor legislation must be considered in order to address the labor discrimination suffered by pregnant women, women during maternity leave, and to facilitate paternity leave to promote new forms of co-responsibility in childcare.

In addition, the office said childcare options should be increased and enhances so that family responsibilities do not constitute an obstacle to access and permanence in paid employment.

Another form of discrimination suffered by women at work, because of their gender status, is sexual harassment, said Solano. This form of discrimination and violence occurs regardless of women’s positions, and affects women in both the private and public employment. In the case of the public sector, the Office of the Ombudsman has expressed its concern about the serious weaknesses demonstrated by some institutions to address this problem, since they lack internal policies for prevention and attention to the matter.