Every time I sit with a patient struggling with our country’s restrictive reproductive health laws, I think about the power society holds over women’s bodies. That power spans borders. El Salvador jails women for obstetric emergencies. In Poland, pregnancy complications can mean life-threatening delays. And in Saudi Arabia, male guardians decide whether women can access essential healthcare. What I see is control disguised as protection rooted in a deep mistrust of women.
Powerful governments assume women can’t make responsible decisions about their bodies. This power manifests in laws, policies, and norms that enforce punishment or compliance. It damages lives, destabilizes families, and causes widespread harm.
Reproductive oppression is a global struggle. By understanding these patterns, we can fight for change where needed most and push toward a future where every woman can make her own decisions.
El Salvador’s Total Ban on Abortion
El Salvador enforces one of the world’s strictest abortion laws, criminalizing the procedure under all circumstances, including cases of rape, incest, or when the woman’s life is at risk.
This absolute prohibition, established in 1998, has led to severe legal consequences for women experiencing obstetric emergencies. Between 2000 and 2011, the government prosecuted 129 women for abortion-related crimes, with 26 convicted of homicide.
The case of Manuela, a 33-year-old woman who suffered an obstetric emergency, highlights the harsh realities of this policy. After seeking medical help, the government accused Manuela of inducing an abortion and sentenced her to 30 years in prison. Manuela died in custody from untreated Hodgkin’s lymphoma, her case later prompting the Inter-American Court of Human Rights to rule against El Salvador for human rights violations.
Poland’s Near-Total Ban on Abortion
In 2021, Poland implemented one of the strictest abortion laws in Europe, permitting the procedure only in cases of rape, incest, or life-threatening pregnancies.
This change followed a ruling by the Constitutional Tribunal, which declared abortions for fetal abnormalities unconstitutional—a category that accounted for nearly 98% of legal abortions in Poland before the ban. The new restrictions effectively made access to abortion almost impossible.
The consequences of these policies have been severe. In 2022, a 30-year-old woman named Izabela died of sepsis after doctors delayed terminating her pregnancy due to legal fears. Her death sparked nationwide protests. Activists highlighted how the law prioritizes the fetus over the woman’s life, even in emergencies.
Poland’s abortion laws have also driven many women to seek unsafe procedures or travel abroad for care, creating significant financial and emotional burdens. In 2021 alone, organizations like Abortion Without Borders helped nearly 34,000 women in Poland access abortion services.
Saudi Arabia’s Male Guardianship
In Saudi Arabia, women face significant barriers to reproductive healthcare due to the male guardianship system.
Women must get permission from their father, husband, brother, or other male guardian to access many essential services—including reproductive healthcare. While reforms in recent years have reduced some of these restrictions, significant obstacles remain.
Access to contraception and abortion is tightly controlled. Abortion is permitted only in cases where the pregnancy poses a threat to the mother’s health or severe fetal anomalies. Even then, approval from a male guardian is often needed. These restrictions come from deeply ingrained cultural and religious norms that put male authority and family honor over women’s autonomy.
India’s Coercive Sterilization Practices
India’s historical family planning policies are a reminder of what happens when governments put control over care.
During the 1970s Emergency period, India launched female sterilization campaigns that targeted the poor and marginalized, coercing people into procedures without informed consent. These practices mainly affected women from rural and economically disadvantaged communities.
A 2020 report revealed that women in rural areas were still being pressured into sterilization without adequate counseling or alternatives. Healthcare workers, bound by rigid government targets, prioritize numbers over rights, compromising ethical standards in the process.
Despite shifts toward a rights-based policy framework, women still bear the burden of seeking contraception. Female sterilization is more common than male vasectomy, a reflection of entrenched gender norms.
Ireland’s Journey from Restriction to Repeal
Ireland’s story is one of transformation. For decades, its abortion laws were among the most restrictive in the world. The 1983 addition of the Eighth Amendment to the Irish Constitution enshrined the “right to life of the unborn,” effectively banning abortion in nearly all circumstances.
These laws cost lives. In 2012, Savita Halappanavar died after doctors refused to terminate her pregnancy during a miscarriage, citing legal restrictions. Her death became a symbol of what can happen when we deny women reproductive care.
But Ireland didn’t stay silent. Savita’s case led to a powerful wave of public advocacy, culminating in the 2018 referendum to repeal the Eighth Amendment. The result was clear: 66% of voters chose to trust women and grant them the agency they deserve. Later that year, the Health (Regulation of Termination of Pregnancy) Act was enacted, allowing abortion services up to 12 weeks of pregnancy and under specific conditions beyond that point.
Broader Implications
The fight for reproductive rights isn’t just an American issue—it’s a global one.
Around the world, countries are grappling with what it means to trust women. In Ireland, we’ve seen what happens when people demand change: restrictive policies crumble, and women’s lives are valued. But here at home, we find ourselves moving backward, aligning more with countries that criminalize women’s healthcare decisions.
Will we follow a path of control and oppression, or will we stand with the global majority moving toward equity and freedom?
As a doctor and an advocate, I know we can’t wait for change to happen independently. It takes action, it takes voices, and it takes people willing to challenge a system that prioritizes punishment over care.
