When Violence Meets Exclusion

When Violence Meets Exclusion: Rethinking Care for Women and Mothers with Disability

Each year, as November draws to a close, two commemorations remind us of the unfinished work towards justice and dignity: the International Day for the Elimination of Violence against Women (25 November) and the European Day of Persons with Disabilities (29 November). Though marked separately, their causes are deeply intertwined. In truth, they speak of the same barriers – the lack of recognition, safety, and equality for those whose perspective is too often ignored.

Across continents, women with disabilities continue to navigate health systems that are neither built for nor by them. Violence and exclusion take many forms, intersecting in subtle yet devastating ways – not only through visible acts of physical abuse or coercion, but also through systemic neglect that manifests in inaccessible clinics, homes where care is withheld, discriminatory attitudes within institutions that question their autonomy, and workplaces or communities that ignore their needs. Policies and programmes that fail to account for intersectional realities further reinforce this exclusion.

The global conversation on gender-based violence, therefore, cannot be separated from the need for disability inclusion.

The Hidden Layers of Violence

Violence against women takes many forms. The most evident – physical and sexual assault – are devastating. Yet beyond these acts lie quieter, systemic forms: the neglect of reproductive rights, disbelief in the wishes of women with disabilities’ capacity to mother, denial of appropriate healthcare, or the attitudinal barriers from providers.

Across the European Union, nearly one in three women has experienced physical or sexual violence since the age of 15, according to Eurostat (Eurostat, 2024). Globally, the figures remain equally stark: UN Women estimates that one in three women worldwide experiences such violence in her lifetime (UN Women, 2024).

For women with disabilities, this risk is two to three times higher (UN General Assembly, 2012), amplified by isolation, lack of appropriate support, and limited access to justice or healthcare systems that understand their realities, and they are at significantly greater risk of sexual and intimate-partner violence, yet they remain less likely to access support or legal recourse. Further, they are more likely to experience sexual assault, forced sterilisation, domestic abuse, and institutional violence, but their cases often go unreported or uninvestigated.

Such inequalities cut across borders and income levels. What begins as a lack of access can too easily become a form of structural violence, where systems of care reproduce the very injustices, they are meant to address. Therefore, this is not only a women’s rights issue. It is a matter of public health, human rights, and social justice – one that shapes the well-being of families and communities everywhere.

Motherhood, the Weight of Inaccessibility, and the Right to Care

For mothers with disabilities, the stakes grow even higher. Too often, pregnancy and motherhood are medicalised and monitored not for safety but for suspicion — framed as social “risks” rather than rights. Maternity clinics may lack accessible equipment; healthcare workers may hold unconscious biases, assuming that disability is incompatible with good parenting. Mothers frequently report being infantilised, questioned about their ability to raise children, or even coerced into unwanted medical decisions and sterilisation procedures (Women Enabled International, 2020). The result is an intersecting and multiple form of discrimination – as women and as persons with disabilities – that undermines both bodily autonomy and the joy of motherhood.

Violence, in this context, is not only what happens behind closed doors. It is also what happens in plain sight – when systems exclude, when policies remain silent, when care fails to see the person behind the diagnosis. Women with disabilities are more likely to experience obstetric violence, forced medical interventions, and denial of consent during reproductive healthcare (UN General Assembly (2012), Women Enabled International, 2020), resulting in profound psychological and physical consequences that often go unacknowledged.

These experiences remind us of the fact that inclusion in healthcare is not just a matter of ramps, interpreters, or adaptive devices; it is fundamentally about recognition — about listening, believing, and adapting systems to respect every woman’s right to care, safety, and dignity.

The United Nations Convention on the Rights of Persons with Disabilities (CRPD), ratified by nearly every country in the world, is explicit: women and girls with disabilities have the right to freedom from violence, and to accessible, inclusive healthcare, including reproductive and maternal services (United Nations, 2006). The Convention places a legal and moral obligation on states to ensure that disability is never a barrier to sexual and reproductive health, informed consent, or the right to form a family.

Although implementation remains uneven. In many regions, national health strategies lack targeted measures for women with disabilities, particularly mothers. This gap often leaves community-based initiatives and local organisations to fill the void, creating a patchwork of inclusion that depends on geography, resources, and advocacy strength.

Bridging the Divide: Towards Inclusive Healthcare

The European Union has taken meaningful steps through frameworks such as the EU Strategy for the Rights of Persons with Disabilities 2021-2030 European Commission, 2021) and initiatives such as EU Gender Equality Strategy 2020-2025 (European Commission, 2020), tackling gender-based violence and health inequality.

Yet, for change to reach daily life, inclusion must be woven into the very fabric of health services – from medical education to policy design, from community midwifery to hospital management. People with disabilities often experience poorer health outcomes due to inaccessible services, inadequate provider training, and discriminatory attitudes, despite their right to equal healthcare.

But the lessons are universal. The same need for inclusive training, cross-sector collaboration, and survivor-centred approaches exists everywhere. The World Health Organization and UN Women jointly recognise that the elimination of violence against women is inseparable from disability justice, and that accessible, inclusive healthcare is both a form of prevention and empowerment (UN Women, CEDAW & CRPD, 2021).

Grassroots women’s movements and international disability organisations echo this message: addressing gender-based violence requires not only protective laws but also accessible, respectful health systems that recognise women with disabilities as experts in their own lives.

From Awareness to Action: A Shared Responsibility

As Europe turns its attention to these two observances, we are called not only to reflect but to act. Reflection without action risks becoming complacent.

Action begins with concrete commitments:

• To ensure that every healthcare space – from maternity wards to family clinics -becomes a place of respect, safety, and accessibility,
• To train healthcare providers in disability awareness, communication and supportive methods,
• To recognise that violence can be prevented when inclusion is achieved – when no one is left unseen in policy, in care, or in compassion.

Accessible healthcare for women and mothers with disabilities is not a privilege — it is the practical expression of human rights.

Eliminating violence and achieving inclusion are not parallel paths – they are the same moral and public-health imperative. A world free of violence against women must also be a world where disability inclusion is realised in every clinic, every policy, and every act of care.

Health systems that are inclusive are not only fairer – but they are also stronger, more resilient, and more capable of protecting the rights, dignity and well-being of all people. Building such systems is both a global responsibility and a measure of our shared humanity.

References:

European Commission (2020) Union of Equality: Gender Equality Strategy 2020–2025. Brussels: European Commission. Available at: https://ec.europa.eu/newsroom/just/items/682425/en

European Commission (2021) Union of Equality: Strategy for the Rights of Persons with Disabilities 2021–2030. Brussels: European Commission. Available at: https://ec.europa.eu/social/main.jsp?catId=1484&langId=en

Eurostat (2024) Every third woman in the EU experienced gender-based violence. Available at: https://ec.europa.eu/eurostat/web/products-eurostat-news/w/ddn-20241125-3

UN General Assembly (2012) Report of the Special Rapporteur on violence against women, its causes and consequences (A/67/227)

UN Women (2024) Facts and Figures: Ending Violence Against Women. Available at: https://www.unwomen.org/en/articles/facts-and-figures/facts-and-figures-ending-violence-against-women

UN Women, Committee on the Elimination of Discrimination against Women (CEDAW) and Committee on the Rights of Persons with Disabilities (CRPD) (2021) Joint statement: Ending sexual harassment against women and girls with disabilities, 22 January 2021. Available at: https://turkiye.un.org/en/109020-ending-sexual-harassment-against-women-and-girls-disabilities

United Nations (2006) Convention on the Rights of Persons with Disabilities (CRPD). New York: United Nations. Available at: https://www.un.org/disabilities/documents/convention/convoptprot-e.pdf

UN Women & World Health Organization (2021) Joint UN Statement: Ending Violence against Women – Preventing and Responding to Violence through Health Systems. Available at: https://www.unwomen.org/en/news-stories/press-release/2021/11/press-release-joint-un-statement-on-ending-violence-against-women

Women Enabled International (2020) accountABILITY Toolkit: The Human Rights of Women and Girls with Disabilities with regards to Sexual and Reproductive Health and Rights. Available at: https://womenenabled.org/reports/wei-atk-un-standards-srhr-women-and-girls-with-disabilities/