How the US scrapping of Roe v Wade threatens the global medical abortion revolution

Medical abortions are a global success story, and not one that will be easily derailed by the legislative backsliding in the US. Time, now, to close the access gaps, report Sally Howard and Geetanjali Krishna

BMJ 2022; 379
doi: (Published 19 October 2022)

Sally Howard, Geetanjali Krishna

In 2021, a 20 year old woman in Hyderabad, India, discovered she was pregnant.
A well educated, city girl, she was nevertheless afraid of the stigma attached
to unmarried pregnancy and did not know if she could legally terminate the
pregnancy. Around the same time, another young couple living together in
Bengaluru were in a similar predicament.

“Both women were not ready for a child but completely clueless about the
options they had, and the gestation period up to which abortion is legally
allowed in India,” says Anusha Pilli, a doctor who practises privately in
Hyderabad. Pilli helped both women to get medical abortions before their first
trimesters ended.


Thailand – Safe abortion is a must

4 OCT 2022

The recent move to permit abortions for women who are 12–20 weeks pregnant puts the pendulum swinging in the right direction for rights groups in Thailand. Yet, the policy is far from providing sufficient safe and legal abortion services to those who need them.

The amendment to Section 305(5) of the Criminal Code that regulated the elective termination of pregnancy will come into effect at the end of this month after changes were codified and gazetted on Sept 26. The country now allows women 12–20 weeks pregnant to seek medical consultation at state hospitals before being allowed to receive legal abortion services.


Global implications of overturning Roe v Wade

US decision must not derail international trend towards liberalisation of abortion law

BMJ 2022; 378 doi: (Published 18 August 2022)

Susheela Singh, Gilda Sedgh

Given the United States’ extensive global influence—including on sexual and
reproductive health programmes—how might the recent US Supreme Court decision
overturning the federal right to abortion1 affect the global trend towards expanding
access to safe and legal abortion? This important question is considered from
different perspectives and for different geographies by three linked articles
(doi:10.1136/bmj.o1844, doi:10.1136/bmj.o1908, doi:10.1136/bmj.o1945).234
Although the reverberations of the Supreme Court decision are just beginning to
play out, it is crucial to raise awareness of the potential for negative
consequences outside the US—and to explore ways of averting such effects.


Roe v Wade: How its scrapping will affect women worldwide

The US Supreme Court’s decision to overturn the longstanding abortion ruling will have a chilling effect on reproductive healthcare provision in low income and middle income countries.

BMJ 2022; 378
doi: (Published 11 August 2022)
Sally Howard, freelance journalist1,  Geetanjali Krishna, freelance journalist

In 2018 a reproductive health organisation in Kenya found that anti-abortion advocates had put the address of its reproductive rights helpline on social media. “It was a veiled threat,” its programme manager, Mina Mwangi, tells The BMJ. “They wanted us to know that they knew how to get us.”

On 24 June 2022 the US Supreme Court overturned Roe v Wade, the landmark 1973 decision that protected women’s liberty to choose to have an abortion without excessive government restriction.1 Sexual and reproductive health rights organisations across the world, including Mwangi’s, feared the effects of the overturning in terms of funding and potential attacks. “We are heightening our security because of how emboldened the opposition are,” Mwangi says, adding that she dreads a potential withdrawal of funds from US non-governmental organisations: her organisation receives over 50% of its funding from US donors.


Not enough: Editorial on India’s Maternal Mortality Rate

The findings published in PLOS Global Public Health journal suggest that about 70 per cent of the country’s districts had failed to meet the global target between 2017 and 2020

The Editorial Board  
Published 29.07.22

Over the past few years, India has been making efforts to improve maternal health. A decline in maternal mortality has also been documented. But is this decline uniform? A recent study by the International Institute for Population Sciences, which analysed maternal deaths at the district level, has found serious imbalances. Maternal Mortality Rate — deaths on account of childbirth per one lakh live births — is a measure of women’s reproductive health. Under the United Nations Sustainable Development Goals, all countries are expected to lower their MMR to below 70 by 2030. At present, India’s MMR is 103. Dishearteningly, this figure is not representative of ground realities.


Why restricting access to abortion damages women’s health

The PLOS Medicine Editors
Published: July 26, 2022

In late June, the landmark Roe v. Wade ruling was overturned by the United States Supreme Court, a decision, decried by human rights experts at the United Nations [1], that leaves many women and girls without the right to obtain abortion care that was established nearly 50 years ago. The consequences of limited or nonextant access to safe abortion services in the US remain to be seen; however, information gleaned from abortion-related policies worldwide provides insight into the likely health effects of this abrupt reversal in abortion policy. The US Supreme Court’s decision should serve to amplify the global call for strategies to mitigate the inevitable repercussions for women’s health.


Indonesia – Making abortion legal

Editorial Board (The Jakarta Post)
Wed, June 29, 2022

The United States Supreme Court recently overturned the constitutional right to abortion, reversing a nearly 50-year-old precedent that had been a milestone in the struggle for women’s rights in the country.

In the 1973 Roe vs. Wade ruling, the court found that the petitioner, who was known for the purposes of the proceedings as Jane Roe, had a right to end her pregnancy in Texas and established guidelines for legal abortion throughout the country. But the precedent continued to be challenged thereafter.

The US Supreme Court abortion verdict is a tragedy. This is how research organizations can help

NATURE editorial
28 June 2022

In response to the demise of Roe v. Wade, universities and research organizations can support those affected, ensure education and research on abortion continue and advocate for evidence-based policy.

The consequences of the US Supreme Court’s 24 June decision to overturn Roe v. Wade, the court’s own landmark 1973 decision that enshrined the constitutional right to abortion for nearly 50 years, are already being felt. By striking down Roe, the court has put abortion rights in the hands of US state legislators. They have already responded.

Why Roe v. Wade must be defended

The Lancet
May 14, 2022

“Abortion presents a profound moral issue on which Americans hold sharply conflicting views.” So begins a draft opinion by Associate Justice Samuel Alito, leaked from the US Supreme Court on May 2, 2022. If confirmed, this judgement would overrule the Court's past decisions to establish the right to access abortion. In Alito's words, “the authority to regulate abortion must be returned to the people and their elected representatives”. The Court's opinion rests on a strictly historical interpretation of the US Constitution: “The Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision.” His extraordinary text repeatedly equates abortion with murder.


The US Supreme Court is wrong to disregard evidence on the harm of banning abortion

Fifty years of research shows that abortion access is crucial for health care and important for equality.

Nature, Editorial
05 May 2022

Abortion could soon cease to be legal across
the United States, according to a leaked draft of a US Supreme Court opinion,
published by news outlet Politico on 2 May. The court’s chief justice, John
Roberts, confirmed that the 98-page document is authentic, but not necessarily
final. If the draft does represent the court’s final position, it will fly in
the face of an overwhelming body of evidence from economists and reproductive-
and public-health researchers who point to the dire, immediate and unequal
impact this ruling will have on hundreds of thousands of people.