When a ten-year old rape victim from Ohio, USA, where abortion is banned after six weeks of pregnancy even in cases of rape or incest, and the girl was just a few days over that limit, had to travel to Indiana for a lifesaving abortion, it sparked off a huge uproar. President Joe Biden interjected that ‘this isn’t some imagined horror’, but a ‘cruel consequence’ of the US Supreme Court’s reversal of the Roe v Wade decision. The Indianapolis doctor who performed the abortion is now facing legal action, while deep red Indiana is all set to implement from 15 September a near total ban on abortion’by legislation, the first US State to do so since the June verdict, while 13 others had ‘trigger laws’. As the United States plunges into ‘inter-jurisdictional abortion wars’, it belies the claim by many jurists, scholars and also the Court that once Roe is gone, the abortion laws will become simpler.

Other legal observers rubbished such assertions as ‘woefully naive’, and averred that the ‘legal vacuum, will rather set off a new set of legal challenges, for which there is little precedent’. In an already volatile scenario, anti-abortionists have now opened up a ‘new battlefront’ to stall ‘medication abortions’ and upped the ante for legislative sanctions. Seven States have put in place such bills and 14 states either ban or partially ban drugs like mifepristone and misoprostol, usually used for abortions at home. In July, this year, a 17- year-old Nebraska teenager was criminally charged for allegedly performing a medication abortion at her home in violation of State law. Now, such restrictive State laws are also making it difficult for chronically ill women to have access to critical medicines for cancer, auto-immune diseases, arthritis, and even ulcers, as they could also be used to end a pregnancy.

Moreover, doctors and pharmacists are also making changes to their practices to avoid legal liability. In the face of such pushbacks, many women are choosing for tubal sterilisations considering that the process, though permanent, would allow them for planned pregnancies through in vitro fertilisation (IVF) or surrogacy. Taking cognisance of the trend, the American College of Obstetrics and Gynaecology (ACOG), suggested the ‘option for sterilisation of male partners, which is with fewer risks and greater efficacy’. Nevertheless, as pro-life activists pat the ‘judicial conservatives’ for changing ‘the jurisprudence for unborn life’, Crisis Pregnancy Centres (CPC) are mushrooming in the USA, often religiously affiliated or State-funded, and allegedly, deploying ‘overly aggressive, and even deceptive tactics to talk women out of abortions’.

The ACOG has already warned about these places as ‘incredibly dangerous, as they provide unregulated medical services’. Such unlicensed CPCs now spread their networks in Latin America and Africa. For decades, two US anti-abortion policy initiatives, the ‘global gag rule’ (GGR) and the Helms Amendment, together weaponised US funding to spearhead anti-abortion agenda, especially in the low-and middle-income countries. A 2020 research study (Guttmacher Institute) categorically said that ‘if the Helms amendment is repealed, there could be 19 million fewer unsafe abortions, 17,000 fewer maternal deaths, each year’, and that the ‘GGR lacks any public health value’. The African continent, which has the highest risk of maternal deaths from unsafe abortions, bore the major brunt of Donald Trump’s 2017 expanded GGR.

A 2019 Lancet study in 26 subSaharan Africa countries revealed that ‘it raised the rate of abortion, unintended pregnancies, and maternal mortality substantially, along with a corresponding decline in the use of modern contraception’. However, under the Roe influence, in 2003, more than 49 countries signed the Maputo Protocol, authorising medical abortions. There is a fear that the American U-turn will ‘intensify the power of the anti-choice movement, especially in 12 African nations, which are still outside the Protocol. In Latin America, when a ‘green wave movement to lift abortion bans’ reaches countries like Colombia, Argentina and Mexico, a pan-Latin American NGO working for reproductive rights feels that the ‘US volte face is worrisome, the right-wing political groups and evangelical churches, will now re-double efforts to stop the green wave in Dominican Republic, Honduras, and El Salvador, which have draconian anti-abortion laws’.

In Europe, the Secretary, European Parliamentary Forum for Sexual and Reproductive Rights, opined that ’the legal veto to abortion in the USA, is a wake-up call for Europe’s fragile legal framework’. In 2021, a maiden in-depth policy analysis called, ‘European Abortion Policies Atlas’, disclosed that ‘the laws for safe abortion in Europe are not as progressive as it might seem, and among the 52 countries/ territories evaluated, 38 were marked between medium and exceptionally poor, 19 countries, including several liberal ones, still force women to endure medically unnecessary requirements before accessing abortion care’. Many European experts are also wary that the post-Roe developments ‘will fuel culture wars in Europe and more aggressive posturing by the US Christian Rightists in European law fare’. India took the moral high ground and considered itself ‘as the champion of reproductive rights, when the West curtails such rights’.

But many are of the view that the Indian law is ‘not empowering enough, as it is not available freely or on demand’. In a recent case, the SC allowed an unmarried woman to terminate her 24-week foetus, but the medical board was to take the final call. Nevertheless, as the Kansas voters in a poll, the first electoral test in the US since Roe was overturned, decisively reject a move to remove abortion protections from the State’s constitution, it gives a fillip to the ‘pro-choice’ movement and demonstrates ‘a disconnect between people’s will and the party position’. Thus, all hope is not lost.

A version of this story appears in the print edition of the September 5, 2022, issue.

The writer is former Director-General, Doordarshan and All India Radio and a former Press Secretary to the President of India.