The not-so United States of Abortion

Lina AbiRafeh
6 min readMay 3, 2022

I first read The Handmaid’s Tale in 1989, four years after it was published. I was in high school. And I was appalled. The story takes place in a supposedly-fictional patriarchal state, where women known as “handmaids” are forced to bear children.

Margaret Atwood’s “futuristic dystopian” novel was, to me, the stuff of nightmares. Something that could never actually come to pass in my lifetime. Women on their backs — literal and figurative — as they are subjugated and stripped of any agency and individuality. A world where women’s reproductive rights did not exist. No choice, no voice, no opportunity. Essentially: sexual slavery.

Damn! That’s nuts! I thought, when I was 15. That can’t ever happen…

Fast forward more than 30 years.

I’ve worked on violations of women’s rights around the world for decades, often to hear “but this doesn’t happen here” when in the US. Well, maybe now we’re reminded that yes, it’s been happening here all along.

Last night, while America gawked at the gowns in the Met Gala’s “gilded age”, American women were being thrown back to another era: the dark ages.

In an unprecedented breach of proceedings, a leaked document from the US Supreme Court exposed a sinister plan: to overrule Roe v. Wade, the 1973 constitutional ruling granting reproductive protections in the form of legalized abortions.

Put simply, Roe meant that women could choose to have an abortion and not be thrown in jail for it. That women could choose what happens to their own bodies.

This new ruling would mean an end to federal protection of abortion rights, allowing each state to decide whether to ban abortion or not, undoing nearly 50 years of guaranteed reproductive rights. It is likely every state that supports abortion now will continue to and every state that is restricting it will continue to.

Look at the media frenzy. Are we mad about the leak, or about women’s lives?!

What 15-year old me thought could never happen has actually come to pass. Reproductive rights are on their way to being rewritten. Erased. We’ve just experienced the most consequential abortion decision of our lifetime. And a total transformation — destruction — of women’s bodily autonomy in America.

Abortion has always been a particularly divisive issue in the US, and once again, women’s bodies have become a political playground. There are religious and conservative undertones to all this, surely. But this ruling is about power — control over women’s bodies and choices.

Bodily autonomy and reproductive rights are fundamental rights. A fact that slips through the cracks during the flip-flopping of Democrat versus Republican politics. This has been brewing for a while.

On one hand there has been a massive failing from Democrats in power — how on earth did we get an anti-Roe v. Wade majority in the Supreme Court under a Democrat President? In 2008 when Obama was elected, he had a majority in the House and a 60 vote Senate, but did not pass an abortion law, signing an Executive Order instead. They ignored women’s rights because they were cowards — and now we’re paying the price. Relying on Executive Orders to get things done — like Biden is doing now — instead of going through Congress, just means the next president can just reverse them all.

On the other hand Republicans are almost universally opposed to abortion.

Justice Alito, author of the draft, went so far as to state that “Roe was egregiously wrong from the start.” And Donald Trump, no friend to women, was able to appoint three conservative justices to the Supreme Court — the most appointments in a single term in decades.

There’s no doubt of the danger ahead for women. No, we’re not being dramatic. Gradually deteriorating rights is one thing (one very, very bad thing that we should have paid more attention to) but this is a catastrophic setback. Will our access to contraception be next?!

Unfortunately, we saw this coming. And I wrote about this only recently. If Roe v. Wade is overturned, 26 states could ban abortion. That means more than 25 million women of reproductive age losing access to an abortion. Losing access to basic health care. Losing their right to choose.

Let’s be clear — abortions won’t stop. Safe abortions will stop, putting women’s lives at risk.

We’ve all seen the coat-hanger image. I’m not trying to be alarmist. This stuff is real.

Some states that have banned abortion make exceptions for medical emergencies. However, Texas, for example, permits abortions in medical emergencies but physicians are unsure what constitutes an emergency. The language is unclear, and penalties are severe.

Medication abortions — abortion pills — account for over half of all US abortions. These pills are safe, legal, effective, and filling an ever-widening abortion access gap. It doesn’t make them easy to get, though. But it makes them lifesaving.

Regardless of what states allow, we will be faced with a humanitarian crisis where millions of people will be forced to travel hundreds of miles — 279 miles on average — for an abortion. If they can. This becomes less likely for those in poorer communities, black communities, minority communities.

Wondering what a post-Roe world would look like?

Here it is:

  • You’re 17, raped, pregnant, and now forced to carry the child to term. You leave school, and don’t return.
  • You are a 13-year old girl, raped by her uncle. You started your period only last year — your body isn’t ready to bear a child. You don’t have a choice.
  • You are an adult woman, arrested and charged with “murder” for trying to self-induce an abortion.
  • You are a doctor receiving death threats for helping to save women’s lives. Even your support staff is at risk and experiencing violence.

Reality check:

  • Will young women be forced into being mothers before they are ready or willing to do so? Yes.
  • Will illegal and unsafe abortions increase? Yes.
  • Will maternal mortality increase? Yes.
  • Will women’s economic opportunity decrease? Yes. Will women earn even less? Yes.
  • Will girls’ education be compromised? Yes. Will drop-out rates increase? Yes.

Meanwhile, the very country that now wants you to bear children against your will actually will NOT offer universal subsidized child care for those children. In fact, the US has one of the lowest expenditures on childcare for children under 2–0.2% of its GDP, which translates to $200 a year for most families.

Maternity and paternity leave in the US is also considered one of the worst among so-called developed countries. The Family and Medical Leave Act stipulates up to 12 weeks unpaid leave for new parents, but not everyone qualifies and is therefore excluded.

“The highest court in the land has reached its lowest point,” Dr Alvaro Bermejo, Director-General of the International Planned Parenthood Federation stated.

This means that millions will be robbed of liberty, bodily autonomy, freedom — the stuff that America claims to be built upon. And, this isn’t just America. This decision will have a global impact, further fueling conservative misogynist movements already taking hold around the world.

This is a big deal.

Meanwhile, this big-deal bad-news isn’t a done deal — yet. There is time to apply pressure, even if it is unlikely to change minds. I write this blog because this is where I howl — and growl. But now is also the time to collectively channel our rage.

A feminist friend and fellow fighter howls:

How many more marches must we organize? What more can the average American woman do to be listened to? Fine, repeal it, but replace it with a bill that protects women’s reproductive rights once and for all. For all.

Here’s what we must do:

The Women’s Health Protection Act needs to go through to ensure reproductive autonomy and social and economic equality at the federal level. You can email congress to support the Bill.

Crowds have already begun demonstrating — and you can join protests too.

You can donate to the National Network of Abortion Funds.

Consult this incredibly comprehensive database curated by @helmsinki. It contains sample language to promote access to abortion as well as organizations in need of donations.

If you need an abortion, these organizations can help:

Today, abortion is still legal. And it’s still your right to get one. Head to Planned Parenthood for guidance and support. They’ve been fighting for us since 1916 — and are still fighting.

Oh and, when it comes time to vote in November… VOTE! Elect pro-choice officials so we can adopt legislation that codifies Roe — once and for all.

I clench my fists as I write this.

What are we supposed to tell the next generation, the 15-year old girl — just like I was — who was raised to believe that she has agency and opportunities, voice and choice, rights and freedoms? What do we tell that girl?!

We’ll tell her that we almost lost our right to choose, but then we fought like hell.



Lina AbiRafeh

Global women's rights expert, author, speaker, aid worker, feminist activist with 25 years of experience in 20 countries worldwide - and lots of stories!