Women endangered, says World Population Report.

Denial of reproductive rights, including free choice with regard to pregnancy and childbearing, causes millions of deaths every year and much more illness and disability. Most of those affected are women in developing countries.

Gaps in reproductive health care, along with widespread discrimination and violence against women, amount to a massive violation of internationally recognized human rights, according to The State of World Population 1997, issued by the United Nations Population Fund (UNFPA).

The report, focusing on the theme "The Right to Choose: Reproductive Rights and Reproductive Health", documents global progress and shortcomings in ensuring reproductive rights guaranteed by human rights agreements. It recommends increased funding for reproductive health care, including family planning, along with stepped-up efforts to promote gender equality and protect individual rights.

Human rights treaties and international conference agreements recognize: rights to reproductive and sexual health throughout the life cycle; voluntary choice in marriage and childbearing, including the right to have the information and means to determine when to have children; equality and equity for men and women in all spheres of life; and freedom from sexual violence and coercion.

The State of World Population 1997 documents the effects of denying these reproductive rights:

* 585,000 women (one every minute) die each year from pregnancy-related causes, nearly all in developing countries. Many times this number of women are disabled as the result of childbirth. About 200,000 maternal deaths result from the lack or failure of contraceptive services.

* 120-150 million women who want to limit or space their pregnancies are still without the means to do so effectively. Altogether, 350 million couples lack information about and access to a range of contraceptive services.

* At least 75 million pregnancies each year are unwanted; they result in 20 million unsafe abortions, leading to 70,000 women's deaths. Many unsafe abortions could be avoided if safe and effective contraception were freely available.

* 3.1 million people were infected last year by the human immunodeficiency virus (HIV), and 1.5 million died from HIV/AIDS-related causes; another 1 million died from reproductive tract infections and sexually transmitted diseases (STDs) other than HIV/AIDS. Teenagers account for more than half of the 333 million new cases of those diseases per year, but most teens lack the information and means to protect themselves.

* 120 million women and girls have undergone some form of female genital mutilation; another 2 million are at risk each year.

* Rape and sexual violence are rampant, but often go unreported because of the lack of sympathetic treatment from legal systems. Two million girls between ages 5 and 15 are introduced into the commercial sex market each year.

The report notes a growing number of countries are incorporating reproductive rights into their constitutions, legal codes and institutional procedures. Many are revising national population and development strategies to better meet individuals' reproductive health needs, following the approach recommended by the International Conference on Population and Development, held in Cairo in 1994.

The report also details the heavy and largely avoidable burden of poor health related to reproduction and sexuality suffered by poor women in developing countries, including malnutrition and anaemia, complications of pregnancy, STDs, including HIV/AIDS, unsafe abortion and female genital mutilation. It outlines issues involved in improving the quality and scope of reproductive health services and information, including economic, legal and social obstacles. The need to help adolescents avoid unwanted pregnancy and infection is a major focus.

The report advocates action to ensure choice in marriage and sexual relations, combat violence against women, including those caught in wars and other emergency situations, and end sexual exploitation and trafficking in women and children.