Abortion access expert talks about the U.S. position in the global abortion landscape



Since the Dobbs decision in June 2022, nearly half of states in the United States — including North Carolina — have curtailed access to abortion by implementing increased restrictions.

The significant rollback in abortion legality throughout much of the country puts the United States in sharp contrast to the global trend of loosening abortion laws and increasing protections for abortion rights.

Anu Kumar, president and CEO of Ipas, has been thinking deeply about abortion access globally for more than 20 years. Ipas is a Chapel Hill-based reproductive justice organization that works on five continents to expand abortion access globally. In 2023, 456,917 people received abortion services in 25 countries at Ipas-supported health facilities. 

NC Health News spoke with Kumar about how U.S. abortion restrictions compare to the global abortion landscape. The conversation has been edited for length and clarity. 

NC Health News: Tell me about Ipas and the work you do. Why focus on abortion access globally?

Kumar: Ipas was started in 1973, so a little over 50 years ago. 1973 was an important year. It was the ruling that brought us Roe v. Wade. It also brought the Helms Amendment [introduced by Sen. Jesse Helms from North Carolina]: a complete ban on the use of federal foreign assistance funds for abortion-related services and information. The United States is the only nation that singles out an essential medical procedure — abortion — in its foreign aid. It’s because of the Helms Amendment that Ipas was formed and our mission was really honed. We now work on five different continents. 

Roughly half of [the world’s annual 73 million abortions] are unsafe. We know that thousands of women [annually] die from unsafe abortion, and millions more are injured and suffer as a result of unsafe abortion. Unsafe abortion is one of the five leading causes of maternal mortality, and it’s the one that can be most easily eliminated. We have known for decades how to prevent these deaths, and that’s one of the things that Ipas has been focused on. 


Two woman stand in a hospital in Kenya

President and CEO of Ipas Anu Kumar (right) talks with Veronica Musiega, a midwife trained by Ipas at the Vihiga County Referral Hospital in Kenya. Credit: Ipas

NCHN: What’s your approach when you’re working in countries to reduce these deaths? 

Kumar: Our approach is to think about the ecosystem that surrounds people who are looking for care and the factors that impact or impede their ability to get that care — things like having trained health providers and health systems. It can include policies, laws and regulations. It can include social norms. Very often abortion is stigmatized, and that stigma will prevent people from actually accessing information as well as care.

When we’re talking about maternal mortality, not just abortion-related mortality, there are three main things that are linked and need to happen. One, people need to have comprehensive sexuality education. The second is that people need to have access to contraception — high-quality modern methods of contraception. And the third is that people need to have access to abortion care because contraception is not infallible. And to me, these three things together — the trifecta, or sometimes I’ve been known to call it ‘the holy trinity of reproductive health care’ — can result in vast improvements in health for many millions of people.







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