IN JUNE, THE UNITED STATES Supreme Court overturned its previous Roe v. Wade decision which declared the constitutional right to an abortion. Because of this, abortions are now regarded as illegal in certain US states, where the historic ruling was the only law that guaranteed safe abortion for many. Of course, this decision sent reverberations across the world, even before it was official. Weeks before the decision was final there was a leak of documents which revealed what was to come.
This decision by the US Supreme court places immense strain on pregnant people and their ability to access sexual reproductive healthcare. It exacerbates the gaps that already exist in the reproductive justice space. These are mostly faced by the poor and working-class, who also confront multiple, intersecting forms of oppression in their efforts to access reproductive healthcare. Safe reproductive health intersects with many social issues, such as poverty and economic empowerment. This is especially the case for young women and girls, whose education and overall health can be negatively impacted if they don’t access timely safe abortion services. And as many activists say, criminalising abortion does not stop abortions; it just makes them unsafe. Those who are against safe legal abortion are against the right to health and human rights for all.
But what does that have to do with us, in South Africa?
There is a popular phrase that says, “When the US sneezes, the world catches a cold”. This was the fundamental concern for many of us in feminist and sexual reproductive spaces. When a powerful country such as the US makes such regressive decisions, they not only impact women in the US. They also change and impact the lives of women all over the world. These kinds of decisions deny women their freedom and the right to choose what must happen to their bodies and how. It is a demonstration of how power dynamics play themselves out: a few are given the power to make decisions that impact the majority who, in this instance, are mostly poor, and often Black women and other women of colour.
These concerns are not unwarranted; South Africa has experienced this first hand in the past. In 2017, then-US But what does that have to do with us, in South Africa? There is a popular phrase that says, “When the US sneezes, the world catches a cold”. This was the fundamental concern for many of us in feminist and sexual reproductive spaces. When a powerful country such as the US makes such regressive decisions, they not only impact women in the US. They also change and impact the lives of women all over the world. These kinds of decisions deny women their freedom and the right to choose what must happen to their bodies and how. It is a demonstration of how power dynamics play themselves out: a few are given the power to make decisions that President Donald Trump reintroduced the Global Gag Rule. This is a policy that prohibits US government aid from funding non-US organisations that perform or advocate for abortions. This includes advocating for access to abortion and for its decriminalisation. This policy blocks funds regardless of whether US funding is used for referrals to abortion service providers.
An unprecedented decision of the Trump administration to expand the Global Gag Rule to money allocated for the US President’s Emergency Plan for AIDS Relief (PEPFAR) was devastating across the world. This funding block included South African non- governmental organisations (NGOs) that relied on the funds to offer health services beyond abortion, such as contraception and pregnancy care. PEPFAR is a crucial partner of the South African government and also partners with “more than 100 South African organisations working in more than 1,500 facilities”. In 2021, PEPFAR committed close to R8 billion for activities through these partners. Similar partnerships can be seen across the globe, especially in Global South countries such as ours. And it is through this perspective that activists and NGOs, me included, received the news about the overturning of Roe V. Wade.
South Africa and other countries are still recovering from the impact of Donald Trump’s iteration of the Global Gag Rule. The experiences from the Gag rule raised anxieties about the potential impact of the overturning of Roe V Wade, beyond the legal possibilities. South African legal experts have indicated there will be no direct ramifications for the legal access to abortion. We have the Choice of Termination of Pregnancy Act to thank for that. Our abortion law is considered one of the most progressive in the world. It states that any person above the age of 12 years has the right to an abortion during the first 12 weeks of pregnancy. This can be performed by a midwife, a trained registered nurse, a general practitioner or a gynaecologist.
Will anti-abortionists be emboldened?
But it is the socio-political implications of Roe v Wade that are a cause for concern. It is likely to embolden anti-abortion groups in South Africa and across the continent. In most countries, abortion is criminalised except under circumstances such as pregnancy as a result of incest or risk to the pregnant person’s life.
There is a prevailing anti-abortion sentiment in this country, with many South Africans holding the general view that abortion is wrong. The African Christian Democratic Party has regularly opposed the Act in parliament, even before it was passed into law in 1996. When this failed, they have tried to find ways to limit access to abortion by seeking amendments to the law, which would require any patient getting an abortion to undergo an ultrasound scan. This would limit access to major health facilities. It is a manipulation tactic popularised by US anti-abortion groups.
Additionally, the rise of crisis pregnancy centres in South Africa – yet another US anti-abortion tactic – creates a barrier to abortions. They masquerade as safe spaces for people who have an unintended pregnancy. In fact, they offer counselling based on pseudo-scientific information, with the intention of dissuading the pregnant person from abortion.
Challenges in SA
Despite the progressive nature of our abortion law, access remains a crucial challenge for many South Africans. This results in inconsistent provision of abortion services across the country, especially in rural areas. Additionally, shortages of trained abortion providers, lack of abortion services in all primary healthcare facilities, and limited youth-friendly and stigma-free services are a hindrance.
This is an indication of a lack of political will to uphold and fully implement our abortion laws. Together with the Supreme Court ruling in the US, this will give anti-abortionists in the public health sector more reason to continue the denial of those who seek these services.
Even healthcare professionals are often anti-abortion. They deny patients access to abortion services through excising their right to refuse to perform the procedure on moral or religious grounds. This is called conscientious objection. But studies have shown that this clause is abused. It results in health workers simply refusing to perform abortions without referring patients to where they can get the service. A 2014 study, published in a journal called Reproductive Health, states that “the right to refuse to provide abortion services applies only to the actual abortion procedure”.
In an already hostile environment, overturning Roe v Wade could give antiabortion health workers the courage or confidence to deny abortions to pregnant people.
The Soul City Institute has raised the increasing rates of teenage pregnancy as a structural failure to safeguard girls. This also speaks to issues of access to comprehensive sexuality education, statutory rape, lack of access to contraceptives and ultimately lack of access to abortion. These issues are intertwined and, as an intersectional feminist organisation, we advocate for the provision of safe reproductive services in a stigma free, non-judgmental and youthfriendly environment.
While Roe v Wade does not directly impact South Africa, we must take is as a wakeup call to safeguard our rights. We must fight more than ever for the full implementation of our own regional and international policies, such as the Maputo Protocol, the SADC Protocol on Gender and Development and the Beijing Plus Twenty and Africa Agenda 2063.
As feminists and feminist organisations and activists, we have the responsibility to hold our governments accountable for these policies that they have signed onto, and to see their implementation. More importantly, we must make sure that the Choice of Termination of Pregnancy Act in South Africa stays intact and we see access to abortion even in the most remote of villages and in all health facilities.
Lastly, we stand in solidarity with people, organisations and activists in the US as the devastating blow of Roe v Wade has already started. And we also acknowledge and celebrate that there are moves in the opposite direction in the Global South, for example the decriminalisation of abortion recently in Sierra Leone.
Phinah Kodisang is the CEO of the Soul City Institute, an intersectional feminist organisation.