Of all the reproductive healthcare options that exist to manage conception, pregnancy, and childbirth, abortion is the most contentious. The procedure, which can either be surgical or medical, is imbued with significant moral weight by many, especially those who believe that life begins at conception. Arguments such as the personhood of the embryo or fetus are counterbalanced against the bodily autonomy of the person carrying the pregnancy, the material circumstances that unwanted or unplanned babies are born into, and the general lack of support experienced by girls, women, and people who become parents before they are ready.
Given the extremely personal nature of pregnancy, many governments have legislation that guarantees some level of access to abortion, with varying degrees of restriction and regulation. The United States government was one of such: its Supreme Court ruled in Roe v. Wade (1973) and again in Planned Parenthood v. Casey (1992) that access to abortion is a constitutional right guaranteed by the right to privacy. That changed on June 24th 2022, when a new decision in Dobbs v. Jackson’s Women’s Health organization overturned Roe.
This move, which has been widely described among both pro and anti-choice groups as unprecedented, represents a reversal in the constitutional rights of roughly half of the US’ population — with significant implications. More than 20 of the US' 50 states have restrictive anti-abortion laws on their books. In 13 of these states, including Louisiana, Texas and Mississippi, "trigger" laws were immediately put in play, banning abortion from the moment of fertilization. Among other US states criminalizing abortion, the bans are effective between five and thirteen weeks, with few and sometimes no exceptions for rape-related pregnancies, incest, or even health concerns.
However, Americans aren’t the only ones who will have to live with the ripple effects of this decision. As a global superpower, happenings in the US often have an outsized impact on other regions of the world, Africa included. In the near to long term, the decision in Dobbs v. Jackson’s Women’s Health is likely to have an appreciable impact on foreign policy decisions, aid and funding to sexual and reproductive health and rights initiatives, and even the activities of religiously motivated special interest groups operating in Africa, such as CitizenGO.
Across the continent, there are reproductive health clinics and non-profits which rely on US government funding for their programs. Such funding is often provided on the condition that clinics and organizations only carry out activities that are in line with the US’ domestic political landscape. For instance, previous Republican Presidents have, during their tenures, reinstated the 1984 policy colloquially called the "global gag rule." This policy asserts that international organizations receiving US government funding are not allowed to provide abortion services, even in countries where abortion is legal.
The policy also prohibits such organizations from carrying out pro-choice advocacy in countries where abortion is restricted or criminalized, even if this advocacy is carried out with funds from non-US government sources. While this rule is not currently active under Joe Biden’s presidency, it is not far-fetched to expect that the June 24th decision will — in the event of a shift in power from the democratic to the republican party in 2024 — inspire even more stringent restrictions regarding reproductive healthcare in US beneficiary nations. However, the fact that US citizens’ access to abortion has now been restricted has already become a valuable tool for lobbyists home and abroad to advocate against abortion in Africa, as the decision emboldens anti-rights groups.
Prof. Pumla Gqola, a leading feminist scholar at the University of Nelson Mandela, agrees. “We have seen that much of what happens in the US has a ripple effect across the globe. In a world where we are as connected as we are, the religious right everywhere can recognize this win as theirs too," Gqola said. "It's not just the Christian right that will take this and run with it, but other religious fundamentalist blocks too, because regardless of the fake differences they like to foreground, religious fundamentalists are identical.”
According to Prof. Gqola, the impacts of this overturn, which she describes as a “significant triumph” for the Christian right, will be wide-ranging.
“There will be attacks on comprehensive sex education, [as well as] pro-choice, feminist and queer activist and rights work, and within that specifically any spaces where there is unapologetic linking of sexual choice, pleasure, identity and freedom,” Gqola said. “Specifically, we will see greater emphasis on conservative ideas about mothering as destiny rather than choice for women and girls. At a state level, I think the overturn of Roe v Wade is probably the beginning, rather than the end of crude assault on bodily integrity. Where African governments are weak, and civil society work is predominantly external donor-driven, we will see more brazen sponsorship of the anti-abortion, homophobic, 'family values' segments of our society.”
For the present moment, Co-Chief Advocacy Officer Fadekemi Akinfaderin of Fos Feminista, an international organization with partners on the continent, is confident that funding for SRHR services will continue. “I don’t think this decision is going to affect funding at all. The ruling is very different from the 'global gag rule,' so it’s not necessarily going to impose any restrictions for women outside of the United States. The sad thing that we do tend to see is that when republicans come into power, they tend to reinstate the 'global gag rule.,” Akinfaderin said. “The ruling will directly affect Africa in a different way. We have evidence that [anti-rights] organizations are also establishing bases in Africa, and are working to roll back gains in reproductive rights that we’ve seen, including working with legislators to restrict access or ensure that abortion continues to be criminalized.”
As far back as 2003, the African Union adopted the Maputo Protocol, which recognizes abortion as a human right. Still, access to legal and safe abortion varies across the continent.
Photo Credit: Jasmin Merdan
It is likely that the US government’s current stance on abortion will amount to additional fuel for abortion-related stigma, which is known to have a chilling effect on the rate at which people seek out safe abortions. Across Africa, conservatism around matters relating to sex, sexuality, and reproduction contributes to ignorance of the legal protections that are available to those seeking reproductive healthcare. Many Africans believe that abortion is absolutely prohibited in their locales, a belief which is reinforced by the religious or other prejudicial ideologies of their families, communities and medical practitioners who have the training to provide the service. This means that safe abortion access in African countries is sometimes more limited than it legally needs to be.
As far back as 2003, the African Union adopted the Maputo Protocol, which recognizes abortion as a human right. Still, access to legal and safe abortion varies across the continent, with most countries defining choice-based abortion as illegal while making limited exceptions. Countries such as Ethiopia and Mozambique have laws that protect abortion access in a range of instances including sexual violence, serious health concerns for the mother or fetus, and pregnancy in minors. Specifically in Lagos State, Nigeria as well as in Ghana and Liberia, abortion is legally accessible for rape-related pregnancies (RRPs) and pregnancies medically determined to have grave health concerns for either the fetus or the mother.
Meanwhile, a few nations like Sao Tome and Principe, Benin and Cape Verde have full legal protections for the woman’s right to choose. And in South Africa, abortion has been legal for up to twelve weeks since 1997. However, unsafe abortions continue to pose a huge threat to the health and wellbeing of Africans.
Judicaelle Irakoze, an Afro-political feminist working as a coordinator for the MAMA (Mobilizing Activists around Medical Abortion) Network, describes findings from her research on the subject. “In documenting abortion trail activism in different African countries, we saw a pattern of lack of resources in different communities. Marginalized communities get [even less]; I am talking about sex workers, LGBTQ people, people living with disabilities, and so on," Irakoze said. "This ruling will reduce even the [limited] funds that were coming to support the work [and create] a more hostile environment. It is going to be hard for abortion rights advocates on the continent. It was already hard as it's only five countries in the whole continent have legalized abortion and Benin is the most recent one to take that step.”
According to a report by the Guttmacher Institute published in 2020, Sub-Saharan Africa has the highest abortion-related death rate in the world (up to 185 deaths per 100,000 pregnancies). Death is, however, not the only negative outcome of unsafe abortion: debilitating injuries, health complications or disabilities — sometimes life-long — are also common. In the wake of the US Supreme Court’s decision, especially with an honest assessment of the direct and indirect influence the nation has on global rights discourse, it is crucial that African sexual and reproductive health service providers ramp up their advocacy and education efforts. This will reduce the contribution of stigma, ignorance and false beliefs to an increase in unsafe abortions, even in contexts where safe abortions are an option. Such advocacy will also help to combat the almost certain rise in anti-choice activity across the continent.
Women picket during the #TotalShutDown march against gender-based violence on August 01, 2018 in Cape Town, South Africa.
Photo Credit: Brenton Geach/Gallo Images/Getty Images
African governments that are invested in the wellbeing of their citizens must make clear their stance on abortion access and protections, so that citizens are aware of the healthcare options available to them should they choose to explore such. “African governments need to see access to SRHR services as a state issue not a civil society issue only,” Irakoze said. “They need to make national budgets for it, literally, [as] teen pregnancies and unsafe abortions continue to rise. But this requires that the African government see women's rights as important to the well-being of the country's social health.”
There is a common saying among reproductive health workers and advocates: “You can’t ban abortions; you can only ban safe abortions.” Evidence shows that legal abortion combined with comprehensive sex education and access to contraception results in a lower rate of abortions and better socio-economic outcomes for women, girls, and people. African nations are not beholden to the US. Should we so choose, we can follow the example of South American nations such as Argentina, Uruguay, Mexico and Colombia which have recently passed laws that protect reproductive autonomy, or Ireland where abortion has also been decriminalized despite its strong anti-choice history based in Catholicism. For Prof. Gqola, the way forward is clear — as long as the political will exists. “Feminist organizations and campaigns have managed to get so many commitments -- with actual concrete plans, most recently the Total Shutdown movements in both SA and Namibia," Gqola said. "But governments then dilly-dally and the implementation is weak or absent. We need a return of specialist courts, psycho-social services and health units to deal with a whole range of sexuality and sexual-control related issues, and these need to be differentiated.”
At this time, it is vital that African governments demonstrate a commitment to the health and wellbeing of their citizens by rejecting the line being toed by the US. Africans deserve access to reproductive health services that enable them to decide whether and when they want to become parents, without the risk of being criminalized for a bodily function that sometimes lies outside of their control. US internal affairs and foreign policies do not have to retain power, no matter how indirect, over the lives and possibilities of African peoples. In reflecting on the US’ recent decision, Akinfaderin concluded, “African countries are sovereign nations. This overturn doesn’t need to serve as a precedent in Africa.”
Without a doubt, sexual and reproductive healthcare has now become one more arena where African nations can, if they so choose, leave the United States of America behind.
