Applying global lessons to protect abortion access in the United States

Since the US Supreme Court overturned Roe v Wade in 2022, eliminating the federal constitutional right to an abortion, the introduction of state laws and policies has made the legal and healthcare landscape more challenging. Twenty states have banned or severely restricted abortion care,1 and recent legislation is restricting access to abortion medication as well as abortion services, with Wyoming becoming the first state explicitly to ban the use of abortion medication.2

In response, US abortion rights advocates have pushed to extend federal protections and the federal government has taken important steps to expand and protect access to medication abortion. These efforts have focused on strengthening executive branch rules and guidance because the lack of a pro-abortion majority in Congress prevents legislation being passed to protect abortion. In January 2023, the US Food and Drug Administration eliminated a requirement that mifepristone, the most common form of medication abortion, be dispensed in person.3 In December 2022, the Department of Justice ruled that it was legal to post mifepristone or misoprostol, another drug often used in medication abortion, to anyone seeking an abortion.4 While these efforts are critical, federal level mitigation strategies alone are insufficient to preserve and expand abortion access and are vulnerable to legal challenges, especially if an anti-abortion administration is elected in 2024.

In contrast to the regression of abortion rights in the US, the global trend is towards liberalisation of abortion laws.5 Globally, strategic litigation, the use of referendums, and new models of advocacy that merge law, public health, and activism have often been successful in legalising, restoring, and protecting abortion rights.678 …