Hard-won reproductive health rights could be threatened by US Supreme Court ruling on abortion
Religious campaigns and political interference could threaten hard-won reproductive health rights in the Global South following the US Supreme Court’s ruling on abortion, health advocates fear.
Solidarity and coordination across borders will be needed to tackle growing global threat to reproductive rights, health and policy experts say SciDev.Net.
Unsafe abortion is one of the leading causes of maternal death worldwide. About ten percent of abortion-related maternal deaths occur in Latin America and sub-Saharan Africa, where access to abortion is most restricted. Yet evidence shows that legal restrictions do not reduce abortions – they most often occur where abortions are legally restricted.
Health advocates fear that the U.S. Supreme Court’s decision to strike down the federal norm that protected the right to abortion, enshrined in Roe v. Wade, has a chilling effect on funding and political support for sexual and reproductive health services in the Global South.
But abortion shouldn’t be treated as a foreign funding policy issue, says Rasha Khoury, assistant professor of obstetrics and gynecology at Boston University. “[Abortion] is a medical benefit and everyone should be entitled to it,” says Khoury.
For nearly 40 years, the United States’ controversial “Global Gag Rule” has been used by Republican presidents to block federal funding for non-U.S. organizations that provide abortion counseling, referrals, and related services. , or those who advocate for greater legal abortion rights.
As President Joe Biden overturned the Trump administration’s gag rule in January 2021, members of Congress are making steady efforts to permanently introduce the policy, according to Rebecca Dennis, associate director of US policy and advocacy at PAI. (formerly Population Action International). Some opponents are pushing to have it removed permanently, she says.
The expanded reach of the global gag rule under the Trump administration meant that public health services were largely affected, leading to some clinics closing if they refused to be gagged, Dennis says. “This policy really had the effect of weakening many health systems around the world just before we entered a massive global health crisis,” Dennis says.
Abortion opponents take their message to the world – and focus their eyes on the Global South. Marleen Temmerman, professor of obstetrics and gynecology and former Belgian senator, says nationalist and religious groups are mobilizing, leading some European governments to reverse reproductive health rights.
The struggle for the legalization or decriminalization of abortion continues in many countries. What we are currently seeing here, at least in Kenya and in African countries, is that evangelical churches are becoming more and more powerful.”
Marleen Temmerman, Director of the Center of Excellence in Women’s and Children’s Health, Aga Khan University
Religious opponents in the United States are encouraging European groups to take their fight to Africa, says Martin Onyango, associate director of legal strategies for Africa at the Center for Reproductive Rights. “The opposition groups that operate across the continent – and particularly in sub-Saharan Africa – are led by religious groups, they are transnational, crossing from the United States to Europe, from Europe to Africa,” Onyango said.
“The same tactics you see deployed in the United States and Europe are the same tactics deployed in sub-Saharan Africa, they work with the same groups – largely evangelical church groups. They have gone from just a group of religious discussion, [there are] also professional groups within these religious groups who then use tactics such as litigation to further restrict access to reproductive health care.
South Africa’s Choice in Termination Act states that counseling pregnant women should be “non-directive”. When the government proposed amendments to the law in 2004, the US-based Catholic anti-abortion organization Human Life International (HLI) campaigned to have the provision overturned.
HLI says it has branches in more than 100 countries, funds pregnancy care centers in 25 countries, and conducts anti-abortion activities worldwide, including increased efforts to “keep Latin America pro-life.” Abortion advocacy group Equity Forward reported that HLI has spent millions of dollars in developing countries to counter legal abortion campaigns, including in Rwanda, the Philippines, Mexico and El Salvador.
In sub-Saharan Africa, anti-contraception messages are now delivered to adolescents, Onyango says, to disrupt their access to information and services.
Onyango points out that abortion bans have a colonial legacy. In North Africa and the Middle East, abortion is heavily restricted in more than 55% of countries, says Khoury, a board member of Médecins Sans Frontières USA who has carried out surgical missions in Iraq, Lebanon and in Afghanistan.
“These are laws that are based on the penal code that was often established by colonial entities,” Khoury explains. “You cannot divorce the history of coloniality from the current restrictions on access to abortion and contraception in these spaces. It is not an indigenous problem to try to restrict women’s access to this much-needed health service, it’s really a vestige of coloniality.”
Systemic vulnerabilities in global reproductive health services developed 100 years ago, says Sarah Hawkes, director of the Center for Gender and Global Health at University College London.
Trump’s expansion of the scope of the global gag rule has led to an estimated US$8 billion to US$12 billion being withheld from health services worldwide, up from US$600 million under previous administrations, says Dennis . The UK, meanwhile, has reduced its support for family planning services by drastically reducing foreign aid.
“It’s a situation that we got ourselves into because we relied on an incredibly old model that was developed in the 1920s of how population control programs were funded,” Hawkes said. . “What we haven’t done is share responsibility, especially in the countries where people live, operate, work.”
Hawkes says it’s time for states to take control of funding and support reproductive rights in their communities. “The whole fabric of who we are — as individuals, as families, as communities, as societies — is at stake,” says Hawkes, who is also co-director of the nonprofit. Global Health 50/50.
Temmerman agrees: “We have to think about how best to organize ourselves so that we are not so dependent on the United States. With the necessary efforts, we can have this debate at the level of the [Inter-Parliamentary Union], what we have done for HIV. We could consider working with parliament and revitalizing this structure for family planning and reproductive health. »
Advocates say a coordinated global response and alliance between rights movements could protect hard-won abortion rights.
Catalina de la Mar Calderón, an activist for Latin America and the Caribbean, said that while there are political and social nuances between countries and regions, the US Supreme Court’s decision underscored the need for greater interaction between regional movements.
“We are under threat…the Dobbs decision is the best example of going backwards instead of forwards,” says Calderón, a member of the Women’s Equality Center, referring to the Supreme Court case known as Dobbs v. Jackson Women’s Health Organization. “We must stick together: no matter the latitude, country or community in which this happens, it will affect the whole world.
“We are here to share everything we have learned, but we also need to learn a lot from other countries. We have won legal changes, but access – we are far from it. And in countries where regulation is still needed , we had a fight [in Latin America] for 20, 30 years, so we can also share what worked and what didn’t, so you don’t have to go through that.”