A year on, the global impact of overturning Roe v. Wade abortion ruling

Emboldened anti-abortion advocates, stalled policies on safe abortions, and resistance against reproductive health efforts. That has been the “chilling” impact worldwide, from India to Nigeria, from last year’s U.S. Supreme Court ruling that effectively revoked the constitutional right to abortion. The decision last June to overturn the longstanding Roe v. Wade directive, which gave women a constitutional right to an abortion, put the U.S. alongside Poland, El Salvador, and Nicaragua as the only nations in decades to restrict abortion access. Its impacts “reverberate on a global scale,” said Nabeeha Kazi Hutchins, chief executive of PAI, which works to increase access to sexual and reproductive health and rights. “Over the past year, inspired by U.S. actions and U.S. rhetoric, the anti-rights movement across the globe has jumped into immediate action to try to derail and dismantle progress for sexual and reproductive health,” Kazi Hutchins said at a recent event in Washington, D.C. The decision has had a “chilling effect,” civil society leaders told PAI, and policies exported from the U.S. opposing sexual and reproductive health and rights have damaged health systems and health workers’ ability to do their jobs, she said. Groups that oppose abortion have been “emboldened” by the Dobbs v. Jackson Women’s Health Organization decision, and for already “anti-rights” governments it has “added fuel to their fire,” Anu Kumar, the head of Ipas, an NGO that works to increase access to safe abortions and contraception, told Devex. Anti-rights or anti-abortion groups “have just supercharged their efforts in the last year and some of them are pointing directly to the repeal of Roe as their inspiration,” said Kumar, sharing exchanges from Ipas teams worldwide. Rights advocates argue that limiting access to abortion jeopardizes the health and lives of millions of people in addition to restricting their ability to make decisions about their bodies. And numerous studies have shown that criminalizing the procedure doesn’t mean that it won’t be performed, it just increases the risks that it won’t be done safely. The U.S. is the world’s biggest global health funder, so its policies have an outsized impact. Millions of women have been affected by the overturn, including in countries that were beginning to make hard-fought gains to improve abortion policies, and powerful lobbies are pushing behind the scenes to export a U.S. model for fighting those changes. Kenya In Kenya, the constitution restricts abortion to cases where the mother’s health is at risk. But just prior to the U.S. Supreme Court decision, the High Court of Malindi in Kenya outlawed the arrest and prosecution of patients and health care workers involved in abortions, opening the door for increased abortion rights. That decision is now under appeal, in part because it drew on various international laws about abortion, including Roe v. Wade. Anti-abortion advocates successfully won an appeal saying that the high court, by citing Roe, was using a “bad law,” Fadekemi Akinfaderin, the chief global advocacy officer of Fòs Feminista, said at a recent online briefing. “We have been having a very strong anti-rights narrative with people speaking against abortion rights because of our culture and our traditions,” said Brenda Otieno from Kisumu Medical and Education Trust, or KMET, an NGO that promotes quality health and education services in Kenya. But the Dobbs decision is an opportunity to raise the issue of abortion and push for current laws and policies about sexual and reproductive health and rights to be improved, she added. India Shortly after the Dobbs decision, anti-abortion activists in August held their first March for Life demonstration in Delhi, India, and called on the government to overturn its medical termination of pregnancy act, a 1971 bill that legalized abortion. Dobbs created an opportunity and a “cause for hope because it demonstrates to countries like India that such unjust laws can be overturned,” Right to Life UK spokesperson Catherine Robinson said at the time. While opposition to abortion existed, it was more geographically limited and wasn’t “aggressive” or “very obvious,” said Alka Barua from CommonHealth, a coalition focused on increasing access to sexual and reproductive health and rights. “What this particular ruling in the United States has done is it has brought it into the public domain and post this judgment the movement has gained momentum,” she said at a recent online briefing. It is a “very dangerous sort of landscape full of landmines where we are heading right now.” A top government lawyer also cited the Dobbs decision in his argument against same-sex marriage during an Indian Supreme Court hearing, saying the decision should be left to parliament. But the court’s chief justice Dhananjaya Yeshwant Chandrachud had a different perspective. He said, “don't cite Dobbs. Because we have gone far beyond the Dobbs here. And, fortunately so. We can give credit to ourselves that we are far ahead of Western countries.” Nigeria In Nigeria, 23 pro-life organizations held a press conference to celebrate the Dobbs decision and send a message to the government saying that if the U.S. has rejected abortion access, Nigeria should too, Ipas’ Kumar said. Abortion is restricted in Nigeria though different states have different policies. In Lagos State, abortion is illegal except to save the life or protect the health of the pregnant woman. But the absence of clear guidelines has meant that despite abortions being permitted under those circumstances, they were still inaccessible or unavailable. Less than a month after the Dobbs decision, the Lagos State government issued a policy document on the safe and legal termination of pregnancy to help health care professionals. But just nine days later, the government suspended the guidelines due to pressure from anti-abortion advocates. Those advocates said that given the U.S. Supreme Court decision, why would Nigeria want to move the abortion agenda forward, Fòs Feminista’s Akinfaderin said. What’s next Dobbs will likely continue to be cited by global advocates urging their countries to follow the U.S. example and restrict access to abortion. Some will be U.S.-based organizations expanding and partnering with local organizations to spread their ideas and deploy similar strategies to those used in the U.S. Family Watch International, a U.S.-based group, is very active in Ethiopia and Malawi, for example. In Malawi, rights advocates have tried to grant abortion access for years, but there has been more pushback recently, including from Family Watch International, which has lobbied senior government officials, Kumar said. “The agenda and the way that they are framing these issues is very similar, if not the same as what we’re seeing here in the U.S.,” she said. The push also goes well beyond limiting access to abortion. The anti-rights lobby, for example, has also sought to prevent comprehensive sexuality education and limit LGBTQI+ rights, Kumar said, pointing to the recent bill criminalizing homosexuality in Uganda as an example. But some countries have continued to grant greater abortion rights in recent years, including Colombia, where it was decriminalized in 2022. The focus is now on improving access by increasing awareness, combating social stigma, and educating the public and medical professionals, said Daniel Arango Arango, a research associate at Fundación Oriéntame in Colombia. “Despite the important victories achieved, it is important to continue working on strengthening these victories to avoid setbacks in access to [sexual reproductive health and rights],” he said. But abortion rights advocates have numerous concerns, including a lack of clarity from President Joe Biden’s administration about how the Dobbs decision impacts U.S. programs and the allocation of resources globally. They also worry that funding will be diverted to tackling abortion rights efforts in the U.S. That said, while the U.S. plays a key role in the global narrative generally, and certainly on abortion, countries and civil society leaders have not looked to the U.S. for leadership on the issue for years, Kumar said. “In a sense, the Dobbs decision was sort of the nail in the coffin for U.S. credibility on abortion rights. It just doesn’t have any.” Update, June 29, 2023: This article has been updated to clarify that Anu Kumar is the CEO of Ipas.