Recently, the UK woke up to distressing headlines: women suspected of using abortion pills were being investigated and prosecuted. Women, some grieving a pregnancy loss, were subjected to police scrutiny—their homes searched, their phones examined. Their private pain was treated as a criminal offence.
Despite being widely accessed, abortion was still criminalised under a 19th-century law. Public outcry followed, and Parliament responded by voting to remove the threat of prosecution for women in England and Wales. But the change, while important, only scratches the surface: abortion remains regulated through the 1967 Abortion Act, which outlines conditions for legality but does not recognise it as a fundamental right.
This moment in the UK is part of a broader global pattern. It is a stark reminder that even in countries where abortion seems easily accessible, abortion rights remain vulnerable when they are regulated as exceptions rather than protected as fundamental rights.
In countries where we thought abortion was secure, we’re now seeing how fragile those protections really are.
Across the world, sexual and reproductive health and rights are under attack. In Poland, once home to one of Europe’s most liberal abortion laws, a 2020 ruling by the Constitutional Tribunal eliminated abortion in most cases, including foetal anomaly, one of the few remaining legal grounds. In Hungary, conservative governments have introduced mandatory waiting periods and counselling requirements.
In the United States, decades of established abortion access and community-level care were erased almost overnight. The rollback has now gone so far that hospitals are no longer required to provide emergency abortion care—even in life-threatening situations.
These examples reveal the chilling truth: where abortion is not explicitly protected as a right, it can be easily taken away.
That’s because in many countries, abortion exists in a legal grey area—permitted, perhaps tolerated, but not protected. The difference is critical. In the United States, Roe v. Wade established abortion access through judicial interpretation, not as a clearly defined constitutional right. This made it vulnerable to reversal, which the Supreme Court ultimately did in 2022. In Poland, abortion was legal under a 1993 law, but never constitutionally guaranteed—paving the way for its near-total ban.
Other countries like Italy, Germany, and Japan allow abortion through statutory laws or regulatory frameworks—but again, without constitutional protection. Access in these contexts depends largely on political will, which can change with every election or court appointment.
When abortion is treated as a policy decision rather than a human right, it is always under threat.
Contrast this with countries that have taken a different path. Slovenia was the first to constitutionally guarantee an individual’s right to reproductive decision-making, a provision carried over from its time as part of Yugoslavia and maintained in its 1991 Constitution. South Africa’s 1996 Constitution explicitly protects the right to make decisions concerning reproduction, and Nepal’s Constitution recognises the right to safe motherhood and, importantly, reproductive health. While barriers to access persist, these constitutional protections make reproductive rights harder to dismantle.
France recently took a bold step, becoming the first country to explicitly name the right to abortion in its constitution. Unlike the broader reproductive protections seen in Slovenia, South Africa, and Nepal, France’s reform marks the first time voluntary termination of pregnancy has been enshrined as a standalone constitutional right. This sets a powerful precedent: when abortion is protected as a right, it becomes significantly harder to roll back.
The stakes could not be higher. Abortion is essential healthcare. Denying it doesn’t eliminate abortions—it pushes them underground.
According to the Guttmacher Institute and the World Health Organization, restrictive abortion laws are linked to higher rates of unsafe procedures, maternal deaths, and serious health complications. These laws disproportionately harm people already facing barriers to care—especially those marginalised by race, income, immigration status, or geography.
One more aspect of the legislation around abortions needs to be brought out of the grey zone: which health professionals are authorised to perform them. Midwives have historically been community-level abortion care providers, but in many countries, were pushed out of this role that was then given exclusively to physicians. However, midwives are still often the first—and sometimes only—healthcare providers that women and gender-diverse people encounter during pregnancy. In many countries, they are delivering reproductive care in legally grey zones or politically hostile environments. Yet, they persist.
In Argentina, midwives are expanding abortion access in rural areas. In the United States, they are pushing back against state-level bans. Their work makes clear: access is not just about legality—it’s about who is equipped, supported, and allowed to provide care.
That’s why movements like the PUSH Campaign matter.
PUSH is a global call to action that centres midwives in the fight for reproductive rights—including the right to safe abortion. It demands that midwives be recognised, invested in, and integrated into policies that affect sexual and reproductive health. Because when midwives are empowered to practise fully, communities have greater access to rights-based, respectful, safe and timely sexual and reproductive healthcare.
Without legal change, even the strongest movements can only go so far.
We must join our voices and push for abortion to be recognised as a right, and an essential service that can, and should, be provided by midwives. Not a loophole. Not an exception. Not a privilege granted by sympathetic governments. Because when abortion is treated as anything less than a right, it is always at risk of being taken away.
In a time when women’s rights are being rolled back, it’s the movements that unite us, across countries, professions, and identities, that hold the power to shift laws and protect our futures. When we come together, we lay the groundwork for real, lasting change.
Now is not the time to be quiet. Now is the time to push.
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Ana Gutierrez F is the Communications Lead at the International Confederation of Midwives
Daniela Drandic is the Head of Advocacy and Communications at the International Confederation of Midwives