Overturning Roe v. Wade: Concerns for Accessing Sexual and Reproductive Health Services, Including Safe Abortion

PMNCH special report

One-third of respondents to a survey of PMNCH partners believe there is less access to sexual and reproductive health services including abortion and post-abortion care, and family planning in their countries following the June 2022 U.S. Supreme Court decision.

A new survey from PMNCH, the world’s largest alliance for women’s, children’s and adolescents’ health, finds that more than one third (35%) of respondents primarily active in Africa, South Asia and the Americas believe there may be reduced access to sexual and reproductive health and rights (SRHR) after the overturn of Roe v. Wade, the landmark ruling that legalized abortion in the United States in 1973.

A PMNCH Special Report “Overturning Roe v. Wade: Concerns for Accessing Sexual and Reproductive Health Services, Including Safe Abortion ” has been produced by PMNCH in collaboration with Fòs Feminista, AMREF and Aga Khan University to assess if and how the US decision is being felt around the world. It also aims to help partners strengthen advocacy and accountability for SRHR in this global context.

Key findings

• One-third of respondent organizations (52 in total) believe there is less access to SRH services including abortion and post-abortion care, and family planning in their countries following the June 2022 U.S. Supreme Court decision.
• One-quarter of respondents perceive negative changes in domestic funding and international funding for SRH services including family planning, abortion care and post-abortion care
• More than half of respondents think that overturning Roe v. Wade has emboldened anti-abortion movements in their countries.
• More than one-third of respondents believe the overturning of Roe v. Wade is limiting opportunities among key stakeholders and decision makers to discuss and support abortion, post-abortion care, and SRHR policies, including family planning laws and policy frameworks.
• Advocates are countering these effects by supporting increased public education on the benefits of SRH services, as well as on the harmful effects of the U.S. Supreme Court ruling.

Broader implications

The US Supreme Court’s decision on 24 June 2022 in Dobbs v. Jackson Women’s Health Organization (Dobbs) ended the federal constitutional right to abortion in the United States, previously established by the Supreme Court in 1973’s landmark ruling, Roe v. Wade. As of September 2023, abortion has been banned or heavily restricted in 22 U.S. states, with more expected to ban or restrict access to the service.

Beyond its direct impact on abortion services, respondents believe the overturning of Roe v. Wade has cast a shadow over access to a broader range of SRH services including family planning, affecting policies, service delivery, and financing.

Survey results revealed deep concern about perceived local effects of the U.S. decision in some countries.

“ Most likely, abortion advocacy in the country will be impacted, especially for us at the forefront,” reported one Ugandan NGO.   “We also anticipate that women will go into hiding and procure unsafe abortions rather than having the courage to go to (health) facilities.”

“Funding for abortion advocacy has been a challenge for the most part, but with the Roe v. Wade repeal, it has doubled the constraints and challenges around access to funding,” reported another organization from Sierra Leone focused on adolescents and youth.”

“India has for the first time seen an anti-choice/abortion protest across the country, along with judicial appeals to ban abortion and restrict access within the Indian courts system by faith-based opposition groups,” a donor foundation based in India reported. “This has never been an issue for India but is emerging/growing into one post Roe.”

In other countries, however, the Roe v. Wade decision served as a significant wake-up call for the feminist movement, underlining the imperative of sustained abortion advocacy efforts and showing that progress is possible even within more challenging global contexts. Exemplar countries showcased in the report – including Colombia – can provide insights globally, fostering changes in SRHR policy dynamics and funding flows.

For PMNCH, the survey results confirm widely held fears of potential impact. The need for intensified advocacy is clear, especially at a time when SRH services and rights have been assaulted by the impact of COVID-19, as well as other factors, such as the expanding number of humanitarian conflicts in the world today, where women are often highly affected.  The findings highlight the realities faced by some PMNCH members – in particular, the need for practical tools and mitigation strategies that partners can use to strengthen accountability for SRHR within their respective domains.

“The effects of the overturn of Roe v. Wade extend far beyond US borders,” s aid Rt. Hon. Helen Clark, PMNCH Board Chair and former Prime Minister of New Zealand. “As is often said, ‘When America sneezes, the world catches cold’. The PMNCH survey results show that what we most feared: that there could be a potential reduction in access to sexual and reproductive health services for women, following the overturn of Roe v. Wade. This may pose serious risk to the health and well-being of millions of women worldwide, who rely upon access to family planning and abortion services.

“The ruling also lends spurious legitimacy to those who seek to restrict the rights of women and may also encourage some countries to move towards their own regressive and restrictive abortion laws. This cannot be accepted. Now more than ever, we must invest in protecting sexual and reproductive health services, increasing public education on the value of these services, and upholding human rights.

Ahead of the UN General Assembly in New York this month, this report supports countries in making the case for SRH and rights to be prioritized and recognized with urgency within global agreements. Advocates and partners supporting health service provision must re-double their efforts to scale up access to comprehensive and accessible reproductive healthcare services to safeguard the well-being of individuals seeking the full range of SRH services, including safe abortion.

Survey methodology and contributors

The questions were developed by PMNCH, and responses were solicited through PMNCH networks in early 2023 via PMNCH’s newsletter, social media channels (Twitter, LinkedIn), the PMNCH membership engagement platform (Digital Advocacy Hubs), and through direct outreach to PMNCH’s constituencies. These efforts gathered 52 voluntary responses between March and July 2023 among local, regional and global organizations involved in women’s, children’s and adolescent’s health advocacy. Respondents’ primary country or territory of work was described as “global” (13.4%), with the highest number of survey responses received from India (15.4%) followed by Malawi, Nigeria and the United States of America (11.5% each). In terms of the primary focus of work, the survey revealed that 84.6% of respondents were primarily engaged in advocacy, 38.5% in programming, and 25% in policymaking.

The report herein is complemented by interview findings from a report by Fòs Feminista, a New York-based coalition of more than 170 organizations working to advance sexual and reproductive health, rights, and justice for women, girls, and gender-diverse people. In their report, Fòs Feminista conducted 66 key informant interviews about the impact of overturning Roe v. Wade, collaborating with women’s groups in Colombia, India, Kenya, and Nigeria.

The findings of this report should be interpreted within the context of this methodology, recognizing its limitations and the need for further, more comprehensive research to understand the real-world impact of overturning Roe v. Wade in a variety of settings.

For media inquiries and further information, please contact:

Cathy Moroney Bartley, PMNCH Media Relations  

M/WhatsApp: +44 7958561671

E:  moroneyc@who.int

Mijail Santos Lujan, PMNCH Team Lead, Digital Communications

E:  msantos@who.int

About Fòs Feminista

Fòs Feminista is a coalition of over 170 organizations championing sexual and reproductive health, rights, and justice for women, girls, and gender-diverse individuals worldwide.

About Amref Health Africa

Amref Health Africa is Africa’s leading health NGO, partnering with communities in 35 countries to identify their unique health challenges and co-design solutions to close the gap between them and the healthcare they need.

About Aga Khan University

Aga Khan University is an international institution providing education, research, and health care for communities across the globe.

About Population Council Inc. 

The Population Council is an international, nonprofit, non-governmental organization. The Council conducts research in biomedicine, social science, and public health and helps build research capacities in developing countries.

Report first published on https://pmnch.who.int/news-and-events/news/item/15-09-2023-overturning-roe-v-wade-concerns-for-accessing-sexual-and-reproductive-health-services-including-safe-abortion