regard to the right to take autonomous decisions, free of all violence, coercion and discrimination, concerning one’s life project, body, and sexual and reproductive health.311 It also refers to access to both reproductive health services, information and education, and the means to exercise the right to decide freely and responsibly on the number of children desired and the spacing between births.312 193. The Court has indicated that sexual and reproductive health have special implications for women owing to their biological capacity to conceive and give birth.313 Therefore, the obligation to provide medical care without discrimination means that this must take into account that the health needs of women are different from those of men, and provide appropriate services for women.314 194. Additionally, the obligation to provide medical care without discrimination means that under no circumstance can the presumed perpetration of an offense by a patient condition the medical care that the said patient needs. Therefore, States must provide the necessary medical treatment, without discrimination, to women who require this. 315 195. In the instant case, Manuela’s medical record reveals various shortcomings that show that the care provided was neither acceptable nor of good quality. First, according to the hospital records, Manuela was admitted at 3:25 p.m. with placental retention, perineal tear, and signs of severe postpartum preeclampsia.316 In this regard, expert witness Guillermo Ortiz indicated that “in the case of a postpartum woman [with severe preeclampsia], it is urgent to administer medication to avoid complications such as convulsions, […] extract the placenta immediately and suture the tears, to avoid continued loss of blood. 317 According to the file, at 5:30 p.m. on February 27, 2008, after noting down Manuela’s personal information and conducting a physical examination, the treating physician informed her that she was sending regulation of fertility which are not against the law, and the right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.” Programme of Action of the International Conference on Population and Development, Cairo, UN Doc. A/CONF.171/13/Rev.1, 1994, para. 7(2). Cf. Case of Artavia Murillo et al. (“In vitro fertilization”) v. Costa Rica, supra, para. 148. Similarly, the Court has considered, in keeping with the Pan-American Health Organization (PAHO), that sexual and reproductive health “implies that people are able to have a satisfying and safe sex life and have the capability to reproduce as well as the freedom to decide if, when, and how often to do so.” Pan-American Health Organization, Health in the Americas 2007, Volume I - Regional, Washington D.C, 2007, p. 143. Cf. Case of I.V. v. Bolivia, supra, para. 157. See also, UN, Committee on Economic, Social and Cultural Rights, General Comment No. 22, The right to sexual and reproductive health, May 2, 2016, para. 5. 311 Cf. Case of I.V. v. Bolivia, supra, para. 157. See also, Article 16(e) of the Convention for the Elimination of All Forms of Discrimination against Women. 312 313 Case of I.V. v. Bolivia, supra, 157. UN, Committee on Economic, Social and Cultural Rights, General Comment No. 14: The right to the highest attainable standard of health, August 11, 2000, UN Doc. E/C.12/2000/4, para. 12, and UN, Committee on Economic, Social and Cultural Rights, General Comment No. 22, The right to sexual and reproductive health, May 2, 2016, UN Doc. E/C.12/GC/22, para. 25. 314 See, similarly: UN, Committee on Economic, Social and Cultural Rights, General Comment No. 14: The right to the highest attainable standard of health, August 11, 2000, UN Doc. E/C.12/2000/4, para. 12; United Nations Committee against Torture, Conclusions and recommendation with regard to Chile, June 14, 2004, UN Doc. CAT/C/CR/32/5, para. 7(m), and Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Anand Grover, UN Doc. A/66/254, August 3, 2011, para. 30. 315 Cf. Emergency form, February 27, 2008 (evidence file, folio 16); Record of evolution following anesthesia of the San Francisco Gotera National Hospital (evidence file, folio 2); record of admittance and departure (evidence file, folio 17), and Communication issued by the director of the San Francisco Gotera National Hospital of February 29, 2008 (evidence file, folio 58). 316 317 Cf. Expert opinion provided by Guillermo Antonio Ortiz Avendaño during the public hearing held in this case. 56