Defending Reproductive Choice

48 years after Roe v. Wade

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On January 22, 1973, the U.S. Supreme Court ruled in Roe v. Wade that the Constitution protects the freedom to have an abortion without excessive government restriction. It was a breakthrough in the long fight for reproductive choice and a landmark decision that positioned the United States as a leader in women’s reproductive rights. Paradoxically, it also reignited the anti-choice crusade that continues today.

While women across the country were celebrating a new era in sexual and reproductive rights, opponents of choice were already at work, looking for ways to reverse Roe v. Wade and restrict access to safe abortion both domestically and internationally.

On this anniversary of the Supreme Court’s decision, we take a moment to celebrate the achievements of all those in the U.S. and around the world who have been fighting for choice for almost half a century. We want to thank the bold women and men who continue the fight to make choice possible and remove barriers to safe abortion access.

The following successes are just a few examples of the progress made in 2020 through advocacy led by MSI and many champions for reproductive choice and rights:

  • The European Union’s General Court confirmed the Commission’s decision to continue providing funding for safe abortion.
  • In Thailand, the Constitutional Court found that laws making abortion illegal except in cases where the woman’s health was at risk or the pregnancy was due to rape or incest were unconstitutional because they breach the principle of equality.
  • Ireland became the first country to allow telemedicine for first trimester medical abortion provision.
  • Countries around the world, including Nepal, Kenya, Democratic Republic of Congo, Burkina Faso, India, Mali, Tanzania and Uganda established systems to ensure continuity of safe abortion services and provision of contraceptives during the Covid-19 pandemic.
  • In June, the World Health Organization defined safe abortion as essential health care in a guide to maintaining services during Covid-19.
  • The U.S. Supreme Court struck down a Louisiana law requiring doctors in abortion clinics to have admitting privileges in nearby hospitals.
  • Jadelle implants were authorized on the Essential Drugs List in Afghanistan. Misoprostol and mifepristone, medications used for abortion, were registered on the Essential Drugs List in Nigeria.
  • The Constitutional Court of Uganda was the first in Africa to declare maternal health a constitutional right.
  • Argentina passed landmark law, making abortion legal up to 14 weeks, becoming the largest Latin American country to legalize abortion.
MSI US staff members protest outside the Supreme Court.

MSI United States staff outside the Supreme Court.

More than 75% of Americans support access to legal abortion and celebrate these significant successes, but opponents of choice are working relentlessly to undermine reproductive rights. In the United States, states have considered hundreds of laws that would restrict or even eliminate abortion care. Common tactics include:

  • establishing unnecessary waiting periods that sometimes push a woman past the legal deadline for abortion,
  • requiring the pregnant woman to attend biased or inaccurate counseling,
  • burdening clinics with expensive regulations,
  • requiring doctors to have admitting privileges at nearby hospitals.

Well-organized and well-funded, abortion opponents in the U.S. are behind policies that threaten reproductive health and rights worldwide, especially for women in the poorest parts of the world. Policies like the Global Gag Rule (GGR), which prohibits U.S. government funding to international organizations that even talk about abortion services, make it even harder for women to access abortion care, putting women’s lives at risk.

Without access to legal, safe abortion services, women resort to dangerous unsafe abortions with tragic results. For example, in Zimbabwe, there are 60,000 unsafe abortions each year, half of them in adolescents. 16% of maternal deaths there are due to unsafe abortion. In the Central African Republic, one-third of maternal mortality is caused by unsafe abortion. In Mozambique, where abortion is legal, barriers to access remain and unsafe abortion causes 11-18% of hospital maternal deaths. And death isn’t the only risk: when women are denied wanted abortions, they have lower quality of life, reduced income and worse outcomes for their children.

The United States took a giant leap forward in women’s reproductive health and rights with Roe v. Wade and pro-choice advocates have admirably defended that decision for the last 48 years. But the work continues, and we must meet the opposition’s dogged persistence with our own relentless defense of a woman’s right to choose.

Today, we pause to celebrate our achievements and tomorrow we get back to the fight!

Our Global Impact Last Year


women using a MSI
method of contraception


unintended pregnancies


unsafe abortions prevented


pregnancy-related deaths prevented