Support Abortion Access on International Safe Abortion Day

The majority of Americans believe people should have a say over whether to continue their own pregnancies. But since the Supreme Court agreed in May 2021 to hear the case Dobbs v. Jackson Women’s Health Organization, people in the U.S. have had to face the prospect, depending on their state of residence, of experiencing state-mandated childbirth and the denial of critical and potentially life-saving medical care.

Indeed, in the wake of the Court’s decision, which ultimately overturned Roe v. Wade in June 2022, at least 14 states have terminated or drastically restricted the right to abortion within their borders. Many pregnant people of means or who have a safety net—friends, relatives, abortion funds, etc.—are still able to get the abortions they want and need, even if they have to travel out of state at great cost and inconvenience. Many, however, are resigned to carry dangerous, nonviable, or unwanted pregnancies to term.

Low-income Americans have had a difficult time affording abortion care since the Hyde Amendment first started lurking in the annual U.S. Appropriations Bill in 1976. Rep. Henry Hyde (R-IL) authored the awful amendment that prohibits federally funded health plans from covering abortion services. This impacts the greatest number of people through Medicaid, but also applies to employees of the federal government and to people who receive their health coverage through Medicare, the Children’s Health Insurance Program, and the Indian Health Service.

Only 17 states use their own state Medicaid dollars to cover abortion for people who don’t meet the federal exceptions to the amendment (rape, incest, threat to pregnant person’s life). Residents in the rest of the states are on their own.

A similar and equally despicable policy applies to U.S. foreign assistance: The Helms Amendment prohibits aid from covering “abortion as a method of family planning.” In practice, however, abortion funding for any reason (including the exceptions applied to patients in the U.S.—rape, incest, and threat to the pregnant person’s life) has been prohibited since the Amendment was introduced in 1973, despite repeated calls for presidents, including the sitting one, to clarify its parameters.

Every September 28, sexual and reproductive health advocates around the world mark International Safe Abortion Day, bringing attention to the plight of people who do not have access to safe abortion services. Estimates from the past decade put the worldwide number of unsafe abortions at about 33 million each year, causing between 4.7 and 13.2% of maternal deaths. Of course, not all people who undergo unsafe abortions end up dying, but about 7 million a year are hospitalized in developing countries alone (where most unsafe abortions occur). This is a preventable tragedy that reflects a flagrant disregard for women’s health, lives, and reproductive rights.

Any elected official who purports to care about maternal health and survival, poverty alleviation, and democracy should support reproductive freedom and affordable access to safe abortion services for everyone, whether they live in the United States or in the countries receiving U.S. foreign aid. There are three important bills that will accomplish this.

1. The Abortion Is Health Care Everywhere Act amends the Foreign Assistance Act to repeal the Helms Amendment and replace it with language explicitly stating that U.S. foreign assistance funds can be used to provide comprehensive reproductive health care, including abortion.
2. The EACH Act requires federal health plans to provide abortion coverage and mandates that federal facilities provide access to abortion services. This bill effectively overturns the Hyde Amendment.
3. The Women’s Health Protection Act (WHPA) goes a step further and prohibits the federal or state governments from banning abortion before fetal viability. It also bars them from restricting medical providers from prescribing abortion-inducing medications, providing abortion care via telemedicine, delaying abortions to patients whose health is at risk, or requiring medical providers to put patients through unnecessary procedures or to give patients inaccurate medical information. Finally, WHPA bans federal and state governments from singling out abortion providers for credentialing that isn’t also required of providers “whose services are medically comparable to abortions.”