'Trump's re-election will be devastating for women’s health, worldwide. But abortion rights movements are up to the fight'
Every four years, in early November, I wake up nervous about election results in the USA. I’m not from there, but I probably don’t need to tell you (or your strung out nervous system) that those election results have an outsized impact no matter where in the world you live.
One concern continuing to send chills down the spines of women worldwide is what a second Trump term will mean for abortion rights. During this campaign, Trump has repeatedly taken credit for 'breaking' Roe v. Wade – a US Supreme Court ruling in the early 1970s, which made abortion a constitutional right.
While some states voted to protect abortion rights at a local level in Tuesday's election, many pundits have predicted that a national ban would come into force if Trump were to win.
It is terrifying. And this is not just about abortion access. The Dobbs judgement – a 2022 Supreme Court case that overturned Roe v. Wade and the constitutional right to abortion in the US – has been calamitous, with mounting evidence highlighting its harmful implications for all aspects of women's health.
That includes maternity, mental health and contraception care, plus medical education and obstetric emergencies, too.
Trump’s restriction on family planning aid resulted in 108,999 maternal and child deaths and 360,000 new HIV infections globally
While another Trump presidency has dire implications for health and rights at the national level, it also affects reproductive health and abortion globally.
We have data to prove this. In 2017, one of the first policy decisions by Trump was to reinstate the “global gag rule”. Officially called the Mexico City Policy it prohibits international non-governmental organisations (NGO) who receive US family planning funding from providing abortion services or referrals and advocating for abortion reform.
This restriction applies even if abortion is legal in that context and extends to other non-US funds that the NGO may receive.
While Democratic presidents have rescinded the gag rule and Republicans have reinstated it, Trump considerably expanded it to cover all US global health assistance.
Research estimates that between 2017 and 2021, this expansion resulted in approximately 108,000 maternal and child deaths and 360,000 new HIV infections globally.
How a Trump administration could further threaten women's health, worldwide
Then there’s Project 2025. This is a dangerous political campaigning effort seeking to promote right-wing policies and reshape the federal government of the US.
Among its other aims – dismantling environmental protections and LGBTQ+ rights - it calls for an immediate reinstation and expansion of the gag rule.
This expansion would apply to all US foreign assistance including humanitarian aid, as well as blocking funding for the United Nations Population Fund (UNFPA) which provides reproductive health services and education in over 150 countries (including in conflict zones and humanitarian emergencies).
In 2017, Trump withdrew funding from UNFPA, causing significant disruption to service delivery. If Project 2025’s policy proposals are adopted, it would be catastrophic , further restricting reproductive health care in contexts where it is already limited.
This will result in more preventable deaths of women and girls, children, and pregnant persons – because they were unable to access care, information, referrals, and/or due to the shock to the health system.
It will disproportionately impact already marginalised communities – racial and ethnic minorities, LGBTQI persons, disabled people, and immigrants, amongst others.
Another key policy proposal in Project 2025 is the expansion of the anti-rights ideology in the United Nations. In 2020, the Trump administration submitted the much-critiqued Geneva Consensus Declaration (GCD) to the UN General Assembly.
Supported by ministers from Brazil, Egypt, Hungary, Indonesia and Uganda, the GCD is an anti-human rights, anti-abortion and anti-LGBTQI+ statement that is nonbinding and was not adopted by the UN.
Human rights organisations, including Amnesty International, have critiqued these efforts for attempting to undermine longstanding, international standards and agreements on reproductive rights.
While Biden (USA), da Silva (Brazil), and Petro (Colombia) all withdrew from the declaration shortly after taking office, the GCD currently has 39 signatories - and efforts to operationalise the GCD continue.
Reproductive rights are under threat in the UK and Europe
In a context of right-wing and anti-gender (a coalition opposed to gender rights, theory and ideology – from LGBTQI+ to reproductive rights) political movements globally – from Poland and Germany to Chile – the risks of these anti-abortion positions and declarations are huge.
Trump’s re-election is likely to supercharge these movements globally – not just through the fortification of such international coalitions, but through increased funding for anti-abortion efforts globally, whilst simultaneously restricting access to global health funding and aid through the aforementioned reinstating of the Global Gag Rule.
This will, as evidence shows, have a catastrophic impact on pregnant peoples’ health – not only abortion seekers, but all reproduction-related healthcare.
The risk and threat to abortion and reproductive rights is also prescient for us. In England and Wales, despite its availability as a legal procedure, abortion remains a criminal offence.
Investigations and convictions have seen a sharp rise since 2022, with some being accused of ‘illegal abortion’ when experiencing a stillbirth or miscarriage. One woman was kept in police cell for 36 hours after a stillbirth.
In Poland, abortion is illegal unless the pregnant person’s health or life is at risk or if the pregnancy results from a crime. In practice, providers rarely provide abortion care either due to conscientious obstruction or due to the chilling effect of the law.
Almost all abortions in Poland are provided by feminist collectives and groups. In Italy, where abortions are available at no cost and the law is liberal, 71% of gynaecologists conscientiously obstruct – meaning, they are exempted from offering abortion care.
While abortion laws might seem more ‘liberal’ in the UK and in Europe, access to terminations require managing multiple barriers, delays, and contending with stigma.
Racial and ethnic minorities, LGBTQI+ persons, immigrants, and other marginalised groups encounter even more barriers and delays, including higher costs, drastically restricting their options.
Why reproductive justice matters – now more than ever
‘There is no such thing as a single-issue struggle because we do not live single-issue lives,’ wrote Audre Lorde, a Black lesbian feminist activist and poet.
While Republican critics have framed abortion as a “single-issue”, it is not just patently untrue, it is disconnected from the realities of peoples’ lives.
The fight for abortion rights contains multitudes: it’s reflective of ambitions, hopes. The ability to care for and raise the children one already has, or hopes to have.
The ability to complete one’s education. The ability to work. The ability to care for ailing parents or siblings. Sometimes, simply, the ability to survive.
Rather than a singular act, it is tied to previous sexual and reproductive experiences, one’s healthcare, labour, debt, employment – the conditions of one’s life.
Abortion, then, is more than just about individual choices and autonomies but about the very meanings of citizenship and relationships with the state. As Latin American feminists have put it, abortion is a 'debt of democracy'.
Understanding abortion as part of a bigger project – the right to have children, the right not to have children, and the right to raise them in thriving; sustainable communities is the project of reproductive justice.
Coined by Black feminist activists in the early 1990s, reproductive justice understands that abortion – and reproduction – cannot be divorced from conditions of climate catastrophe, war, patriarchy, racism, ableism, and other entrenched systemic inequities.
It is this understanding and approach that has galvanised transnational feminist abortion and reproductive rights activism in more liberal and restrictive contexts over the years.
From the feminist abortion accompaniment networks of Latin America, the reclaiming of abortion as joy, the creation of hotlines and self-managed abortion networks (before telemedicine during the pandemic), and even opening an abortion clinic in Poland, despite the law.
When Roe was overturned in 2022, it was this transnational feminist solidarity that stepped up to share lessons and strategies – and as abortion and reproductive rights continue to be at risk, it is these solidarities that offer hope.
Irrespective of Trump, these movements and collectives will find ways to enable care and access for abortion seekers.
The flourishing of rights and claiming of them occurs otherwise – this is important because the visions of what abortion care looks like refuses to be limited by the current laws or systems, in the US and globally. (For more on this, read Naomi Braine’s Abortion Beyond the Law.)
Feeling scared, angry, upset? Channel that – here’s how
Yesterday, like that fateful November day in 2016, my first reactions were anger and upset. I then did exactly what I did in 2016: I checked in on friends and family living in – and hailing from - the USA, and I reached out to abortion and reproductive justice activists globally.
What is needed now is for people to channel that outrage – work with your local community organisations and support reproductive rights groups nearby and further afield.
Some doing great work include Abortion Dream Team (Polish abortion activists), Alliance for Choice (campaigning in Northern Ireland) Adi’yah Collective (offering miscarriage and abortion support for Muslims), Reproductive Justice Initiative (working in the UK), Supporting Abortions for Everyone (who fund and support grassroots abortion providers in Europe), and Women Help Women (supporting self-managed abortion through medication abortion, hotlines, and information).
If you can support with time and skills, offer that. If you can donate money, please set up single or recurring donations. Hope is an act.
Dr Rishita Nandagiri is a feminist researcher focusing on abortion and reproductive (in)justices in the Global Souths.
She is a Lecturer in the Department of Global Health and Social Medicine, King’s College London. Find out more about her work and follow her on X.
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