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We Need a Post-Roe Strategy for the Long Haul

VOICES

REPRODUCTIVE RIGHTS - After the initial shock over the Supreme Court's action against abortion rights, we're all grappling with an inevitable, fundamental question: what now?

We now face a future rewritten by this attack on abortion access, a right-wing power grab over our bodies that threatens our safety, rights, and freedom and that was facilitated by a decades-long coordinated anti-choice effort. US reproductive justice activists will need just as much stamina and determination in our defense of our bodily autonomy and freedom.

But we have allies and teachers in this fight—including in feminist movements worldwide.

As we build a long-term strategy for reproductive justice, we must look towards feminist allies around the world who are fighting for reproductive justice and abortion care for all who seek it, despite legal and political obstacles. From movements to decriminalize abortion in Colombia and Mexico, to frontline workers providing abortion care despite criminalization: their work illuminates a path towards safe and accessible abortion care that we can build here at home.

El Salvador is one of the 24 nations in the world where abortion is illegal in all circumstances. Federal prosectors visit hospitals and encourage doctors to report any woman suspected of self-inducing abortion. These women face jail sentences of up to 40 years, even when they are simply treating a miscarriage, which requires the same medication used for abortion. Frontline feminist organizations like Agrupación Ciudadana por la Despenalización del Aborto El Salvador and Red Salvadoreña de defensoras de derechos humanos are working against criminalization.

Despite the legal risk, about 5,000 abortion procedures are performed on El Salvador's black market every year. One doctor providing abortion care reports "I've seen fathers bringing their teenage daughters, taken by force, raped by gang leaders and left pregnant… If those of us who are technically trained don't help, women will have to go elsewhere. They will go to people who have no experience or training."

For pregnant people in their first trimester, abortion care doesn't always depend on surgery: it can also depend on access to the medication mifepristone and misoprostal, aka "the abortion pill."

A Canada-based service, Women on Web, ships the abortion pill to people living in countries where abortion is illegal. Until the abortion ban was repealed in May 2021, people living in Ireland either received abortion pills in the mail from services like Women on Web or traveled to England to get abortions, often using a fake English address. People in the US may face similar options: travel to other states, or even to other countries like Mexico or Canada, where the procedure is not banned, or find services that will ship the abortion pill to you, despite the legal risks. In Mexico, a coalition of feminist organizations are working together to create "a cross-border network of support for safe abortion for Texan women" with plans to expand the network to other states.

Doctors, activists, and patients take on the legal risks of abortion because the alternative is desperation and death. In Brazil, where abortion is illegal, it's estimated that every year 250,000 womenare hospitalized, and 200 die, from complications from abortion. When abortion was criminalized in Nicaragua, a prominent gynecologist called it "a government death penalty imposed on women." He was right: maternal mortality increased as people died in childbirth, from pregnancy complications, and from pre-existing conditions exacerbated by pregnancy. And they died from desperation: among the pregnant women who died from causes 'unrelated' to pregnancy, 63% died of suicide.

It's simple: abortion care saves lives.

It saves the lives of people who want to be pregnant but have miscarriages or complications. It saves the lives of parents who cannot take care of one more child. It saves the lives of people who desperately do not want to be pregnant. It saves the lives of people like Rosaura, who died at 16 in the Dominican Republic because she was denied chemotherapy, life-saving treatment, because she was pregnant. Her mother, Rosa Hernandez, cried "they let my daughter die."

Medical providers, networks distributing abortion pills, and legal support networks are the frontline defense of our bodily autonomy, but they are not alone: feminist political groups are organizing political pressure to end punitive abortion laws. And, these feminist movements are winning: over the last 25 years,nearly 50 countries have liberalized their abortion laws.

In Latin America, new and transformative abortion laws were secured by "the green tide": an international feminist movement for bodily autonomy and abortion access that crossed state borders, identified by the green scarves activists wear at demonstrations. The imagery has historic roots in feminist and economic justice movements, including movements against domestic violence, international feminist strikes, and popular resistance to military rule led by the Mothers of the Plaza de Mayo. During COVID-19, millions of women wearing green scarves joined protests demanding abortion care across Latin Americaunder the banner: "Ni Una Menos. Vivas y libres nos queremos" ("Not One Woman Less. We want to be alive and free"). This feminist framing of abortion as a human rights issue drove home the message that abortion is not a discrete issue, but part of the spectrum of rights that guarantees the safety and wellbeing of people across the region.

It worked. New abortion laws in Mexico and Colombia have been transformative. In 2020, MADRE joined a case at the Colombian Constitutional Court, brought by Causa Justa, to legalize abortion access. We won. In February 2022, abortion was legalized in Colombia through the 24th week of pregnancy, making it one of the most liberal laws in the world. In Mexico, since the 2021 Supreme Court ruling that abortion is not a crime, hospitals are no longer required to report abortions as a criminal activity, saving the futures of poor women in particular who depend on public hospitals for abortion treatment and care.

Bodily autonomy is fundamental: it determines our ability to care for ourselves, to care for others, to exercise economic independence, to build a life of pleasure, and to transform political systems. Authoritarians attack bodily autonomy because the social, economic, and political independence of historically marginalized communities is a building block of change. And that independence rests on the ability to control, and care for, our bodies.

In the US, the criminalization of abortion care won't just dictate the health outcomes of pregnant people: this attack will reverberate throughout the LGBTQ community as an attack on theright to privacy, the right to marriage, and the right to non-discrimination, with consequences as far-ranging asundermining our digital privacy to limiting access to condoms and birth control.

The Supreme Court has taken away a constitutional right and a human right. But the court cannot take away the care we show for one another. The court cannot stop us from providing abortion care if we guarantee it for one another. MADRE remains committed to supporting abortion funds and reproductive justice organizations working to guarantee bodily autonomy and accessible abortion care for all pregnant persons, especially Black, Indigenous, people of color, LGBTQ, and disabled communities who face systemic and historic barriers to non-discriminatory healthcare.

The court cannot stop us from standing shoulder-to-shoulder with feminists around the world and working towards that promised future where we see ourselves, alive, and free.

(Yifat Susskind is the Executive Director of MADRE, an international women's human rights organization. She has worked with women’s human rights activists from Latin America, the Middle East, Asia and Africa to create programs in their communities to address women's health, violence against women, economic and environmental justice and peacebuilding. She has also written extensively on US foreign policy and women’s human rights and her critical analysis has appeared in The New York Times, The Washington Post, Foreign Policy in Focus and elsewhere. This article was published in Common Dreams.)

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