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Health , Politics & Policy , US , World

Where democracy falters, so do reproductive rights

by Hanna Kozlowska March 16, 2022

This story was co-published with Foreign Policy.


What you need to know
  • Reproductive rights don’t exist in a vacuum: They are inextricably linked to democratic institutions, with threats to one reinforcing threats to the other.
  • As countries like Poland, Brazil, Hungary, and the United States face threats to their democracies, so do the women of those countries face threats to their reproductive rights.
  • While democratic backsliding often leads to the erosion of reproductive rights, the relationship works in the other direction as well: Targeting reproductive rights has proved a useful political tool for illiberal leaders, a bargaining chip that helps them gain power and maintain it.

In a small Polish town in September last year, a 30-year-old woman named Izabela checked into the hospital. She was 22 weeks pregnant with her second child, and her water had just broken prematurely. Her life was in danger, but instead of aborting her pregnancy, the doctors stalled. 

“For now, thanks to the abortion bill, I have to lay here and wait,” Izabela, whose full name has not been made public, texted her family from the hospital. She was referring to an earlier ruling by the country’s constitutional court that strengthened Poland’s already restrictive abortion laws. “They are waiting until it dies or something starts happening, and if not, then I can expect sepsis. Awesome.” 

Early the next morning, after the fetus died, the doctors decided to perform a cesarean section. But it was too late. Izabela died at 7:39 a.m. Her death sparked protests across the country, with people marching under the slogan “Not One More.” 


Related coverage: Poland’s abortion rights protests lead to a louder call for gender equity


Poland is among a group of more than 30 countries that in 2020, led by the Trump administration in the United States, signed the Geneva Consensus Declaration, a commitment to “express the essential priority of protecting the right to life.” While the document isn’t binding, the signing was symbolic of a growing backlash to an otherwise global trend toward broadening reproductive rights.

The declaration’s signatories included countries that already have some of the world’s strictest abortion regulations, such as Egypt and Senegal. It also included governments widely recognized as authoritarian, such as Belarus and Saudi Arabia. 

However, Poland, Brazil, Hungary, and the United States also signed the declaration—all established democracies with generally robust economies, but where in recent years democratic norms have been under threat. As it turns out, reproductive rights don’t exist in a vacuum: They are inextricably linked to democratic institutions, with threats to one reinforcing threats to the other. 

Anu Kumar, the head of Ipas, a global nonprofit that supports abortion access, pointed out that when most people think about how leaders restrict democracy, they think about the freedom of the press or expression or voting. “We don’t necessarily always include reproductive freedom in that package of democracy,” she said. “But we should, because this is a place where authoritarian regimes often go, if not first, then pretty quickly afterward.” 

In the United States, states that have over the last decade introduced restrictions on voting rights are often the same ones that have tried to limit abortion access—and, notably, both efforts disproportionately affect people of color. Last year, Texas Gov. Greg Abbott signed into law a bill that significantly restricts voting the same week that a law that essentially bans abortions in the state at six weeks took effect. Following the election of President Joe Biden, some U.S. anti-abortion groups expanded their work to campaigning for voting restrictions.

Meanwhile, the pernicious practice of partisan gerrymandering has grown more prevalent, empowering anti-abortion activists and politicians. In states like Georgia and Missouri, gerrymandering concentrated power in the hands of conservatives. Harsher abortion laws followed soon after. 

“It’s a slow, iterative process on the ground in building [reproductive rights] up,” said Alicia Ely Yamin, a senior fellow at the Petrie-Flom Center for Health Law Policy at Harvard Law School. “On the other hand, tearing them down seems quite easy.” 

Undermining reproductive rights in one country, especially one as influential as the United States, often has ripple effects. U.S. administrations have for decades swung back and forth on funding family planning around the world, depending on their party line, while American anti-abortion groups look to wield influence far and wide. “Anti-rights organizations are global institutions,” Kumar said. 

President Donald Trump and his administration, under which the United States fell in global democracy standings on several measures, bolstered anti-abortion efforts primarily by making ideologically motivated judicial nominations in both the federal court system and the Supreme Court. Their efforts have culminated in an ongoing Supreme Court case that is the most serious threat to abortion access since it was enshrined in U.S. law by Roe v. Wade in 1973.

In Poland, the ruling Law and Justice party took things further, completely overhauling the country’s constitutional court, effectively putting it under the control of party leadership. As a result, in late 2020, the constitutional court ruled that abortion in cases of fetal abnormality was unconstitutional, a broad designation that bans almost all abortions. Law and Justice has repeatedly, since its 2015 election victory, undermined democratic institutions and civil society—the judiciary, but also the free press and nongovernmental organizations—earning it repeated rebukes from the European Union.

Debora Diniz, an anthropologist and leading Brazilian reproductive rights advocate, is worried that Brazilian President Jair Bolsonaro, who is up for reelection in October, will also reshape the country’s highest court.

Bolsonaro has attacked the free press, spread harmful disinformation about the country’s voting system, and repeatedly clashed with the country’s judiciary, even joining a rally that called for the military to intervene in the country’s supreme court. In Brazil, most changes to abortion law must happen on the supreme court level. “One of the main risks in the reelection of Bolsonaro is that he remakes the majority of the supreme court for the next 20 years,” Diniz said.


Related coverage: Analysis: The feminine appeal of macho populism


Reproductive rights have been under attack in Brazil since Bolsonaro’s election in 2018. Abortion was already only permissible if the mother’s life is in danger, or in cases of rape, incest, and anencephaly, a type of fetal abnormality. But whether legal or not, it has been hard to access over the last several years. Lawmakers have introduced at least 30 bills to restrict abortion even further. In one of the most controversial cases during Bolsonaro’s tenure, his minister of women, family, and human rights said a 10-year-old rape victim who legally had an abortion should have instead delivered via C-section. Brazilian reproductive rights advocates and scholars are being threatened and silenced. Diniz herself now lives in exile because of her work.

While democratic backsliding often leads to the erosion of reproductive rights, the relationship works in the other direction as well: Targeting reproductive rights has proved a useful political tool for illiberal leaders, a bargaining chip that helps them gain power and maintain it. 

For both Trump and Bolsonaro, their anti-abortion stances allowed them to forge an alliance with evangelical Christians, which helped them get elected. Bolsonaro was for years a “nobody politician,” Diniz said. “He became nationally known when he started to speak about gender issues, and particularly about sexuality, about abortion, and about this idea of family.”

In Poland, the 2020 decision to broaden the abortion ban was not necessarily part of a long-term plan from Law and Justice. “It’s something that sort of happened because the whole system was allowed to erode,” said Neil Datta, secretary of the European Parliamentary Forum for Sexual and Reproductive Rights. 

Law and Justice’s successful campaign to undermine the judiciary provided an opportunity for the anti-abortion fringe to get a piece of what they wanted—and, in turn, the ruling party calculated the move could mobilize its base and save it from losing its ultra-conservative voters, said Ewa Marciniak, a political science professor at the University of Warsaw. 

Bolsonaro and his supporters in Brazil, Trump and the Republicans, and the Polish right have all positioned themselves in opposition to the same convenient bogeyman, labeled with the umbrella term of “gender ideology” (which is less used in the United States but equally present as an idea). This convoluted concept has for years been promoted by the Catholic Church and encompasses everything from marriage equality to transgender rights to abortion, portraying them as immoral and a threat to traditional values. 

“There’s this framing of ‘gender ideology’ as a foreign ideology that is somehow invading, and that could take different forms in different places. It could be imperialistic or it could be Marxist or it could be Nazi,” Harvard Law’s Yamin said. “Gender ideology” becomes associated with the United Nations or the European Union or international human rights courts—global institutions tasked with maintaining peace and the well-being of all people, and frequent adversaries of leaders who trespass against that mandate. 

In Hungary, the populist, right-wing leader Viktor Orban is centering his reelection campaign on an anti-gender agenda, which observers believe he is pursuing as a distraction from the country’s economic woes and his government’s corruption scandals. Orban’s main crusade is against the LGBTQ community, but his government has also further restricted access to abortion, all wrapped up in “family values” rhetoric. 

“Ultimately, they all would like to not have the restraints of human rights and democracy on the way they want to operate,” said Alejandra Cardenas, the senior director of global legal strategies at the Center for Reproductive Rights, a global legal advocacy group. 

“Gender ideology” rhetoric falls on fertile ground in countries where large swaths of society are deeply patriarchal and religious, but also where economic inequality is significant. This is true in the United States, Poland, Brazil, and Hungary, as well as countries like Nicaragua and El Salvador, which have also expanded their abortion restrictions in the last three decades—and where democracy has broken down.  

Abortion opponents have successfully “tied the destruction of the nuclear family values to ‘this is what is causing your feeling of social and economic insecurity and pain,’” Yamin said. 

In Poland and Hungary, pro-natalist policies like monthly cash incentives for each child and tax breaks help the same people who oppose abortion stay in power. “I think that these days voters are attracted to Law and Justice not because of its worldview, but because of the social support,” Marciniak said.

“They are interested in very particular types of families—they want those families to reproduce,” Kumar, the nonprofit leader, said. Those families don’t include same-sex couples or immigrants. White supremacy, whether in the United States or Hungary, is the through line, she said. 

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