Everything, women around the world would say,  because they know how closely linked reproductive health is to issues ranging from poverty and food security to climate change and beyond. This message was precisely what female leaders brought to the Rio+20 conference on sustainable development, but not many were listening, least of all the Vatican.

“The only way to respond to increasing human numbers and dwindling resources is through the empowerment of women,” said Dr. Gro Harlem Brundtland, former prime minister of Norway and former director-general of the World Health Organization.

“It is through giving women access to education, knowledge, to paid income, independence and of course access to reproductive health services, reproductive rights, access to family planning,” she elaborated, adding that no other way existed to change the current “pattern of human consumption”.

Female leaders have long been trying to tell the world that sustainable development is not just about deforestation, climate change and carbon emissions. Equally as important to sustainable development are gender equality and human rights, which include sexual and reproductive rights.

But the reality is that globally, 215 million women who want to avoid pregnancy are not using effective methods of contraception. More than two and five pregnancies are unplanned, and approximately 287,000 girls and women die each year from pregnancy-related causes. The world has a ways to go to ensure that women have access to full reproductive rights and health.

Yet twenty years ago, the Rio earth summit saw unanimous agreement that sustainable development cannot be realized without gender equality.

So the current state of negotiations – to be fighting over something that was recognized 20 years ago – are frustrating for people like Rebecca Lefton, a policy analyst focusing on international climate change and women at the Washington, DC-based think tank Centre for American Progress, who has been following the negotiations for several months.

She watched the draft of the summit’s outcome text start off at 19 pages, balloon to hundreds, and then be cropped down to 49 pages. To her dismay, she found that references to women’s reproductive rights and gender equality were being scrapped.

“Women’s rights and gender equality were affirmed but not as strongly as they could be,” Lefton told TerraViva. “To some extent (they) saw a reasonable backsliding; I don’t think the text would be reopened to be revised or tweaked.”

Dr. Babatunde Osotimehin, executive director of the U.N. Population Fund (UNFPA), tried to sound optimistic, telling journalists, “In the first draft there was no mention to health at all, and now the entire Cairo agenda is there, which implicitly addresses reproductive rights. There are many elements we can work with.”

Even Brundtland said, “It looked quite bad some weeks ago, in the preparing process for this meeting. Not only reproductive rights, but in most paragraphs it was hard to get in women’s rights and their place in the economy to stimulate economies, and to protect (the) environment.”

“In the last week or two, this has improved,” she said. “The declaration has many weaknesses, but there are key passages on women as central partners in decision-making….All of that is better than what we had in Rio twenty years ago.”

The United States, Norway and several women’s rights organizations have fought to keep the text’s language strong, but the Holy See (the Vatican) led the opposition to remove references that ensured women’s reproductive rights.

“The result is that the final text has no reference to reproductive rights and commits to promotion rather than ensuring equal access of women to health care, education, basic services and economic opportunities,” said Lefton, adding that the Vatican equates reproductive rights and health with abortion – an inaccurate comparison, at best.

Yet female heads of state and government gathered at the Rio+20 women leader’s summit remained undaunted and pledged that the document they signed would not be lost in the “forest of declarations on gender issues”. They urged governments, civil society and the private sector to priorities gender equality and women’s empowerment in their sustainable development efforts.

“We know from research that advancing gender equality is not just good for women, it is good for all of us. When women enjoy equal rights and opportunities, poverty, hunger and poor health decline and economic growth rises,” said Michelle Bachelet, executive director of U.N. Women.

Cate Owren, executive director of Women’s Environment and Development Organization (WEDO), criticized the removal of references to reproductive rights from the Rio outcome document. “Political compromises for the sake of an agreement should not have cost us our rights – nor our planet,” she said.