On 24 June 2022, the United States Supreme Court issued its decision in Dobbs v. Jackson, removing the right to abortion and sending shockwaves around the world. What happens now?

We can say with some certainty that the ruling will not achieve its presumed aim: to end the practice of abortion.

Research has illustrated time and again that reducing abortion rates is more successfully achieved through sexual education, comprehensive reproductive healthcare and social support for families. Even then, there will be cases where abortion is the best option, due to a whole host of circumstances too personal to be regulated by the broad dictates of the state.  

In countries where abortion is illegal or heavily restricted, the most commonly observed impact, instead, is an increase in reproductive inequality. Those who can afford to pay for elite private clinics or to cross borders to access services continue to have safe, medically supervised abortions. Those who cannot may turn to untrained practitioners, increasing the risk of complications.

Even accessing safer methods of self-managed abortion – like the medical abortion pill – puts one at risk of criminal prosecution.

As we might expect, the burden of this inequality falls most heavily on those who already face marginalisation and/or state surveillance, including people of colour, LGBTQ communities, people with disabilities and people with low income.

Abortion is thus not only a question of reproductive rights, but also of women’s rights, human rights, public health and social justice.

In glossing over this reality, the Dobbs decision sets a dangerous precedent on an international scale. That the United States is a major donor to sexual and reproductive health services internationally makes this development all the more troubling.  

Still, we should not overestimate the ability of the United States to influence what happens elsewhere. In recent years, donors from other countries have explicitly committed themselves to supporting abortion internationally. Domestic activist movements have also propelled an overall trend towards liberalisation of abortion laws in the last 50 years, most recently in Ireland, Thailand, Colombia and Argentina.

Just a week after the Dobbs decision, Sierra Leone’s president announced at the 10th Africa Conference on Sexual Health and Rights that his government had unanimously backed a bill to decriminalise abortion in the country, stressing the importance of the reform “at a time when sexual and reproductive health rights for women are either being overturned or threatened”.  

One can only hope that the Dobbs decision will fuel a broader discussion around abortion, one that moves beyond philosophical debates to address the complex realities of sex, reproduction and inequality. In the meantime, people will suffer.

This article was published in Globe #30, the Institute Review.