As an Ethiopian American, I am disturbed that the United States is rolling back the reproductive rights of American women and girls, one state at a time. Unlike most Americans today, I grew up in a country where abortion bans once restricted reproductive autonomy and claimed many lives.
Now I believe that the same country – Ethiopia – can provide a valuable lesson for activists and providers looking to resurrect rights that were guaranteed through Roe v Wade until it was overturned by the US Supreme Court earlier this year.
Before Ethiopia relaxed its abortion laws in 2005, unsafe abortions contributed to a third of all maternal deaths in the country. The law was very strict – abortions were only lawful if the woman’s life was in danger – but, as in many other places with restrictions, the risks did not deter women from seeking to end unwanted pregnancies. Abortion rates remained high. Women were forced to resort to dangerous and illegal techniques, resulting in infections, injuries with lifelong consequences and, in some cases, death.
The desperate methods women used at the time ranged from traditional remedies like consuming tree roots and herbs to inserting implements such as catheters and metallic tools, causing uterine perforation and organ injury. At that time, it was normal to see half of the delivery and gynaecology wards filled with women who needed immediate medical assistance as a result of unsafe abortions.
Growing up in Addis Ababa, my siblings and I all knew someone who had had an unsafe abortion. My sister had a friend who died by suicide because of unintended pregnancy. I remember girls who dropped out of school after they drank bleach or attempted to terminate a pregnancy through other dangerous means. I often think about where these girls are now and how these tragic stories were all avoidable.
These stories also remind me of how far Ethiopia has come in the last 17 years and how the progress achieved should never be reversed. Instead, it should be emulated.
Ethiopia – like other countries in which MSI Reproductive Choices works such as South Africa, Cambodia, Mexico and Nepal – shows what happens when safe abortion is made more accessible. Since 2005, the law allows abortions in the case of rape, incest, foetal impairment, if the woman is a minor, or if she has physical or mental disabilities. Today, deaths from unsafe abortion only account for 1 percent of all maternal deaths (pdf) in Ethiopia.
Even in relatively conservative societies, change is possible. In Ethiopia, legislators with support from the health sector were able to articulate the grim reality of the restrictive law to their voters, with women of all ages dying or experiencing life-altering damage to their physical and mental health. It was clear expanding safe abortion access was key to lowering maternal mortality rates, an argument that even anti-choice groups could not ignore.
In Kansas recently, pro-abortion rights campaigners framed abortion on similar terms with voters crossing traditional party lines to vote on an issue rapidly becoming one of the top priorities for Americans ahead of the mid-terms in November.
Ethiopia’s example makes it even more egregious for legislators in the US – where maternal deaths could increase by up to 30 percent among women of colour – to seek to overturn decades of progress. But the evidence from Ethiopia should also offer hope: If deeply religious Ethiopia can move the dial forward on reproductive health and rights, and save lives in the process, so can the US.
After all, only three other countries have rolled back abortion rights in the past 30 years: Poland, El Salvador and Nicaragua. In that period, 59 countries have expanded access, following evidence that restricting access to abortion does not decrease the number of women seeking abortion care and simply makes abortions unsafe.
Of course, just as Ethiopia’s example can serve as an inspiration to the US and others, I fear the reversal of Roe v Wade will also embolden the anti-choice movement far beyond America’s borders. In 2020, openDemocracy estimated that right-wing Christian organisations in the US spend roughly $280m a year on attacking abortion and LGBTQ rights globally. This funding supports anti-choice proxies across Africa and provides resources and support to politicians seeking to overturn or further restrict abortion rights.
Left unchallenged these groups will go further, trying to undermine the progress that has been made in expanding abortion access in many parts of Africa as essential healthcare.
Over the past few decades, many in the US might have forgotten the positive change Roe v Wade brought to American women. And, similarly, the younger generation in Ethiopia has not had to witness the effect of unsafe abortion on the same scale as before 2005. Despite this, many Ethiopian women continue to access unsafe care outside of regulated providers due to a lack of access to safe facilities, particularly in rural areas.
We must continue to talk about the past and celebrate how far we have come, as a reminder to those in power and to ourselves of what is at stake.
Ethiopia is an outlier compared with other countries across sub-Saharan Africa, which has the highest rate of maternal deaths from unsafe abortions in the world. This fact alone should give pause to anyone seeking to restrict abortion rights.
As we mark International Safe Abortion Day today, the voices of African abortion campaigners and providers must be heard. We will not be spoken for by US anti-choice activists who seek to restrict women’s rights across the globe. We know the dangers of following America’s lead and we know the progress that can be achieved by following the example of countries like Ethiopia, Benin, Mozambique and South Africa.
Women and girls deserve a world of opportunity, where they can finish school, pursue a career, plan for their future and exercise their full economic, political and social potential and power. The way forward is clear. We will not go back.
The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.