PATTAYA, Thailand — For years, the biennial International Conference on Family Planning has mostly shied away from focusing on abortion.

But the U.S. Supreme Court’s decision in June to overturn a woman’s right to an abortion has galvanized the issue internationally, leading the more than 125 countries represented at an annual event last month billed as the “world’s largest gathering of family planning and reproductive health professionals” to wonder how the seismic change in U.S. policy will impact nations that receive U.S. global aid or look to the country for leadership. 

“When the U.S. sneezes, the rest of the countries catch a cold,” said Jedidah Maina, executive director at Trust for Indigenous Culture and Health, a Kenyan nonprofit. “This is what we are anticipating, that the changes that are happening in the U.S. will reverberate across the globe. Because most of the time, the U.S. is seen as progressive and is seen as the leader.”

Katherine Mayall, director of strategic initiatives for legal strategies, innovation and research at the Center for Reproductive Rights, which focuses on international reproductive rights, said the Dobbs v. Jackson Women’s Health Organization decision June 24  galvanized some nations to fortify abortion rights in their countries.  

“Since the Dobbs decision, we have seen a number of countries across the globe enact laws and policies to further protect abortion,” Mayall said. “Both Finland and San Marino finished liberalizing their abortion laws since that time, and at least four European countries are actually currently talking about enshrining abortion rights in their constitutions to ensure there’s a much stronger legal framework around them.”

In July, Sierra Leone President Julius Maada Bio addressed the Supreme Court’s decision at the 10th Africa Conference on Sexual Health and Rights. His country is moving to decriminalize abortion.

“At a time in the world when sexual and reproductive health rights for women are either being overturned or threatened, we are proud that Sierra Leone can once again lead with progressive reforms,” he said.

Latin America

Abortion rights advocates hope countries will follow in the footsteps of Latin American countries’ moves as part of the “green wave” of grassroots feminist-led protests. 

The movement began with protests resulting in the legalization of abortion in Argentina in 2020 and continued most recently with the decriminalization of abortion in Colombia in February.

“Latin America is still the region in the world where we have the most countries that completely criminalize abortion,” said María Antonieta Alcalde, director of Ipas Latin America and the Caribbean, pointing to countries like El Salvador, Honduras, Nicaragua and the Dominican Republic. 

But Marta Royo, executive director of Profamilia, Colombia’s biggest abortion provider, said the overturning of Roe v. Wade can be viewed as an opening for conservative leaders in countries that are reliant on the United States.

“Our region is very dependent on the relationship with the United States, and they saw it as they’re sending us the green light to strengthen our restrictions,” she said.

While the Supreme Court ruling doesn’t have a direct legal impact on Latin America, Royo said countries like Nicaragua, a dictatorship, take it as a sign that they can also change long-standing policies. By contrast, Mexico has seen short-term changes aimed at decriminalizing abortion.

Last year, Mexico’s Supreme Court unanimously voted to decriminalize abortion nationwide, with states now passing and implementing new policies on a local level. So far, 10 of 32 states have legalization laws.

“Mexico is moving in the direction that the world is moving, that is to recognize bodily autonomy and to recognize women’s reproductive rights,” Alcalde said.

Mexico and the United States are two of the only countries that allow abortion policies to vary by state.

After the leak of the Dobbs decision in May, Oliva López Arellano, secretary of health for Mexico City, said the city would provide the service to Americans who needed it.

“The service is for everyone who asks for it, since women have the right to make decisions over their body, and we have an obligation to protect their health,” she said in a statement translated from Spanish. 

Pregnant American women have been accessing abortion by purchasing medication abortion drugs in Mexico, where misoprostol is available over the counter. Others have traveled to the Mexican states where abortion has been legalized.

Alcalde said many Mexican women have been hosting Americans to self-manage their abortions as a support system. But while Mexico is happy to help women from the U.S. and Central America, it puts a lot of pressure on Mexico to provide these services, she said.

Africa

Across Africa, the biggest worry for advocates relates to outside influence and funding.

They worry that anti-abortion groups both in the United States and abroad may ramp up efforts to restrict abortion abroad. They also worry about further restrictions to U.S. global aid.

The downstream effects could limit efforts to reduce maternal mortality and sex-based violence or advance other gender-based policies. Maina, of Kenya, said she worries about future influence from groups like CitizenGO, a far-right advocacy group based in Spain that promotes abortion restrictions worldwide.

“Its influence across the continent is very strong,” she said. “One of the things that we’re also trying to challenge is that they are not a Kenyan organization, and they are making a lot of influence right now even sitting in technical working groups of the Ministry of Health.”

Ipas President Anu Kumar said she is watching both East and West Africa in the near term.

“East Africa is the home and site of a great deal of global opposition activities. Kenya [and] Uganda have long been in the sights of the religious right from the United States, with a lot of activism taking place,” she said. “West Africa is somewhat vulnerable as well, because while there is a growing momentum for abortion care and rights in West Africa, it’s quite nascent.”

Angela Akol, director of the Ipas Africa Alliance, said the U.S. court decision has given anti-abortion advocates “another weapon in their arsenal of weapons, another weapon, that they can use against safe abortion.” 

“The reversal of Roe v. Wade in the United States is interpreted in Kenya and in other African countries as foreign policy,” she said. “Anything that impacts the health care environment within the United States is interpreted to impact the health care environment in countries that are recipients of U.S. foreign aid.”

She pointed to increased pushback against providing access to contraception to young people in Kenya, delays in implementation of court rulings related to abortion rights, increased pushback against East African sexual health bills and opposition in Malawi during a recent African Bar Association conference.

“In countries where we work, we have seen that liberalizing abortion laws provides more women with access to services and saves more lives,” said Namakando Simamuna, policy and advocacy officer for reproductive rights organization Marie Stopes Zambia. “We have seen the Zambian government trying as much as possible to use telemedicine to enhance [abortion] access and other digital platforms.

“The overturning of Roe v. Wade reminds us how vital our work is and how we should never be complacent about rights to reproductive choice.” 

Other regions

Some experts eye Europe as a sleeper on the issue, pointing to shifting governments.

Last month, France’s National Assembly passed a bill that would enshrine the right to abortion, inspired by changes in the United States and elsewhere. But the French Senate is controlled by more right-wing political groups, providing a more difficult path forward.

“No one can predict the future,” said Mathilde Panot, who represents the France Insoumise in the National Assembly, in a tweet translated from French.

Advocates have pointed to the recent rise of right-wing governments in countries like Italy, Sweden and Hungary, as well as concerns about Poland, which rolled back abortion access in 2020. Poland has one of the strictest abortion laws in Europe.

Abortion rights supporters worry that more European countries could take the lead of the U.S. and Poland and move toward more abortion restrictions in Europe and elsewhere and chip away at other gender-based rights.

Sweden’s new government, for instance, stopped its feminist foreign policy, which prioritized gender equality in its dealings with other nations, in October.

“I think we need to be concerned about Europe as a site also of opposition organizations. They have offices in Europe and London, and they’re moving in that direction,” said Ipas’ Kumar. “I think we need to connect all of these to much bigger processes. It’s not just about abortion. It’s never just been about abortion.”