Who Controls Women’s Bodies? Abortion, Birth, and the Fight for Autonomy
Reproductive Autonomy and the Politics of the Body
If you want to understand where women stand in society, look at who controls their bodies. Reproductive autonomy—the ability to decide whether, when, and how to have children—is one of the most fundamental expressions of freedom. Without it, no other right is fully secure.
Control over reproduction is about more than medical care or family planning—it is about sovereignty, citizenship, and power. The ability to decide what happens to one’s body shapes everything from education and employment to civic participation and safety. When that control is undermined or denied, women are rendered politically and economically vulnerable.
Today, women’s bodily autonomy is under sustained and strategic assault. From the denial of abortion care to preventable maternal deaths and forced pregnancies, the battle over reproductive rights reveals the global fault lines of inequality, ideology, and authoritarian control. Reproductive justice—first articulated by Black feminists in the United States—is not just about the right to abortion, but about the right to have children, the right not to have children, and the right to raise children in safe and sustainable communities. That framework is more relevant than ever.
Around the world, the terms of this fight are shifting. In some countries, grassroots movements have forced dramatic gains. In others, governments have stripped rights and criminalized care. What emerges is a fragmented global landscape where geography, class, race, and religion determine whether reproductive freedom is protected—or punished.
🩸 Abortion Access: Expanding and Regressing—at the Same Time
In the past two decades, more than 60 countries have moved to expand access to abortion—a quiet revolution of progress. In Latin America, the feminist “Green Wave” has toppled long-standing bans in Argentina, Mexico, and Colombia. These victories were unthinkable just a decade ago, signaling a shift in both public opinion and legal frameworks.
But at the same time, a few countries have dramatically reversed course:
In Poland, one of Europe’s most restrictive abortion laws bans nearly all terminations, leading to deaths of pregnant women denied care—even in cases of non-viable pregnancies.
In El Salvador, a total abortion ban has sent dozens of women to prison for miscarriages or stillbirths, with sentences of 30 years or more.
In the United States, the 2022 Dobbs v. Jackson ruling overturned Roe v. Wade, ending federal protection of abortion rights and leaving millions without local access to care. As of 2025, more than a dozen states have near-total bans.
This regression is not just about policy—it’s about power. It’s about redefining who has the right to autonomy, whose life is valued, and who gets to decide the terms of reproductive health. And it has life-or-death consequences.
🧬 The Cost of Denial: Unsafe Abortions and Maternal Mortality
When legal abortion is unavailable, abortion doesn’t stop—it just becomes unsafe.
Globally, nearly 7 million women are hospitalized every year due to complications from unsafe abortions. The World Health Organization reports that these procedures remain one of the leading causes of maternal injury and death, particularly in countries with poor access to contraception or healthcare.
Even where abortion remains technically legal, practical access can be hollowed out by clinic closures, targeted harassment, mandatory waiting periods, and narrow legal exceptions. In parts of sub-Saharan Africa and South Asia, legal rights exist—but they are out of reach for rural, poor, and marginalized women.
In the United States, doctors in restrictive states report delaying treatment for miscarriages and ectopic pregnancies—putting lives at risk as legal confusion creates medical paralysis and fear of prosecution. In Texas, recent maternal mortality review data show that the state’s maternal mortality rate remains among the highest in the nation, with preventable deaths linked directly to delays in obstetric care. Black women in Texas face a maternal mortality rate more than twice that of white women, a disparity compounded by limited access to reproductive services in the wake of abortion restrictions.
A 2023 report by the Texas Maternal Mortality and Morbidity Review Committee found that unsafe or delayed care for pregnancy complications—including ectopic pregnancies and miscarriage—was a contributing factor in multiple maternal deaths. Physicians have described a chilling legal atmosphere in which they hesitate to provide timely care for fear of violating restrictive abortion laws. This not only threatens patients’ lives but has also caused staffing shortages in OB-GYN services across rural hospitals.
The ripple effects of these policies are being felt throughout the healthcare system—deepening racial inequities, endangering patients, and eroding trust in the institutions meant to preserve life.
⚠️ Unmet Need for Contraception: The Silent Emergency
Globally, 218 million women who want to avoid pregnancy still lack access to modern contraceptive methods. This gap contributes to high rates of unintended pregnancy, unsafe abortion, and maternal death—especially in regions with fragile health systems.
In low- and middle-income countries, lack of access to contraception accounts for a significant share of maternal mortality.
Experts estimate that one-third of maternal deaths could be prevented if women who wished to avoid pregnancy had the tools to do so.
Education and access matter. Where women have both, fertility rates drop, maternal health outcomes improve, and women gain greater control over their economic, social, and political lives.
🏥 The U.S. Maternal Mortality Crisis: Systemic Failures and Racial Disparities
The United States stands alone among high-income countries for its consistently high—and in recent years, rising—maternal mortality rate. While most nations have seen steady improvements in maternal health outcomes, the U.S. saw its maternal mortality rate more than double between 2018 and 2021, peaking at 32.9 deaths per 100,000 live births in 2021.
Although provisional 2022 data showed a slight decline (22.3 per 100,000), the long-term trend remains deeply troubling. The causes of these deaths are overwhelmingly preventable: CDC review panels estimate that over 80% of pregnancy-related deaths in the U.S. could have been avoided.
These deaths are not distributed equally. Black women are nearly three times more likely to die from pregnancy-related causes than white women, regardless of income, education, or geographic location. In 2021, the maternal mortality rate for Black women reached 69.9 deaths per 100,000 live births, compared to 26.6 for white women. Indigenous women also face unacceptably high and rising maternal mortality rates.
The primary causes of maternal death in the U.S. include:
• Cardiovascular complications
• Hemorrhage
• Infection and sepsis
• Thrombotic embolism
• Mental health conditions, including substance use disorder and suicide
These health conditions are compounded by social and systemic barriers—lack of postpartum care, insurance gaps, transportation difficulties, provider bias, and hospital closures, particularly in rural and underserved communities.
Preliminary reports since 2022 suggest that abortion bans and legal uncertainty are worsening maternal care. In states like Texas, Idaho, and Mississippi, doctors have reported delaying or denying life-saving care due to confusion over abortion laws. Hospitals in restrictive states face growing OB-GYN staffing shortages, leaving vast areas without basic obstetric services. These delays and systemic barriers may not yet be fully captured in national mortality statistics, but their consequences are already visible on the ground.
📉 Preliminary Observations: Post-Dobbs Trends in 2024–2025
While national maternal mortality data for 2024 and 2025 have yet to be released by the CDC, a growing body of preliminary evidence suggests that abortion restrictions are having a measurable impact on maternal health—particularly in states with the most severe bans.
• In Texas, Idaho, and Mississippi, OB-GYNs have reported delays in treating miscarriages and ectopic pregnancies due to fear of violating abortion bans. These delays have led to near-miss maternal emergencies, with patients only receiving care after their lives were in critical danger.
• A 2024 Health Affairs study documented a chilling effect on emergency obstetric care, especially in rural hospitals, where legal ambiguity around abortion has deterred timely interventions.
• Staffing shortages in obstetric units are worsening, as physicians relocate from states with strict bans to avoid potential legal liability or ethical conflicts. This has exacerbated maternity care deserts, particularly in the South and Midwest.
• According to the Guttmacher Institute, more than a dozen states have now reported clinics turning away patients in urgent need of pregnancy care, citing legal risks or lack of capacity.
These outcomes, while not yet reflected in finalized national data, suggest that the post-Dobbs landscape is not only reshaping access to abortion—but also undermining the basic safety and continuity of pregnancy care. The full public health toll may not be understood for years, but early indicators point to a growing maternal health crisis driven as much by legal chaos as by clinical risk.
At a global level, the U.S. now has the highest maternal mortality rate among peer nations, despite spending more per capita on healthcare than any other country. This is not just a public health failure—it is a reflection of deep structural inequities and policy choices that devalue women’s health, especially for Black and Brown communities.
Reproductive autonomy is not an isolated issue—it is foundational to all others. In the next section, we explore how maternal health, healthcare infrastructure, and social inequality further shape who survives pregnancy, who is supported in parenting, and who is left behind.
💥 The Fallout of Forced Birth: Unwanted Pregnancies and Their Impact on Families
Much of the conversation around abortion bans focuses on legality—but what happens after someone is forced to carry an unwanted pregnancy? The social, psychological, and economic costs of forced birth are immense, and they reverberate not just through individual lives, but through entire communities and public systems.
Unwanted pregnancies disproportionately affect those who already face structural disadvantage: young people, low-income women, Black and Brown communities, people in rural areas, and survivors of violence. The consequences extend well beyond the delivery room.
🔹 Pregnancies Resulting from Rape and Assault
One of the starkest outcomes of post-Dobbs policies is the denial of care to survivors of sexual violence. According to CDC data, 1 in 9 women of reproductive age in the U.S. has experienced rape that resulted in pregnancy. Yet in many states with near-total abortion bans—including Texas, Missouri, and Arkansas—there are no exceptions for rape or incest.
This means survivors may be legally required to carry pregnancies conceived through violence, often while navigating trauma, stigma, and lack of support. It is a profound form of state-imposed control over the bodies of people who have already been violated.
🔹 A Foster System Already at Capacity
Opponents of abortion often suggest adoption as an alternative—but the U.S. child welfare system paints a different picture. As of 2022, more than 390,000 children were in foster care, many of them entering the system due to neglect, poverty, or parental incarceration.
• States with strict abortion bans—such as Mississippi and Texas—also have some of the highest rates of child poverty and the lowest investment in foster care services.
• In practice, only a small fraction of women with unwanted pregnancies choose adoption. Most are raising children under constrained and unsupported conditions.
By forcing birth without investing in the infrastructure to support children and families, these policies do not value life—they merely control reproduction.
🔹 The Economic Toll of Denying Abortion
The Turnaway Study, a landmark longitudinal research project, found that women who were denied an abortion were significantly more likely to live in poverty, experience unemployment, stay in abusive relationships, and struggle with food and housing insecurity compared to those who received care.
• The lifetime cost of raising a child in the U.S. exceeds $300,000—not including healthcare, housing, and educational costs.
• Yet most states with abortion bans do not guarantee paid leave, universal childcare, or basic income supports for new parents.
• Women denied abortions are also less likely to complete college, less likely to pursue desired career paths, and more likely to suffer long-term financial instability.
For those already on the economic margins, forced birth deepens inequality and traps families in cycles of precarity.
🔹 Intergenerational Impact
The effects of unwanted pregnancy ripple across generations. Children born as a result of denied abortions are more likely to live in poverty, face unstable housing, and have lower educational outcomes. Their mothers are more likely to experience chronic stress, postpartum depression, and long-term financial hardship.
In essence, the fallout of forced birth is not just about reproductive injustice—it’s about economic disempowerment, public health degradation, and state-sponsored harm that affects entire families and communities.
💀 The Global Maternal Health Divide
The state of maternal health worldwide reflects how societies value women’s lives—not just rhetorically, but in concrete investment, infrastructure, and political will.
• Globally, 287,000 women die every year from complications of pregnancy and childbirth. Nearly 95% of these deaths occur in low- and middle-income countries, and almost all are preventable with timely access to skilled care and emergency services.
• In sub-Saharan Africa, maternal mortality remains staggeringly high, accounting for roughly two-thirds of global maternal deaths. Conflict zones such as Sudan, South Sudan, and the Democratic Republic of Congo face compounded challenges: collapsed infrastructure, displacement, and targeted attacks on healthcare facilities.
• In South Asia, countries like Afghanistan and Pakistan struggle with low rates of skilled birth attendance, especially in rural areas. Traditional practices, gender-based restrictions, and lack of health literacy further endanger maternal survival.
• Even in high-income countries, disparities persist. The United States has the highest maternal mortality rate among peer nations, with severe racial disparities: Black women are nearly three times more likely to die from pregnancy-related causes than white women.
In Afghanistan, maternal health has entered a humanitarian freefall. Since the Taliban’s return to power in 2021, the collapse of the health system has left millions without access to even basic reproductive care. Female doctors and midwives have been expelled from hospitals, clinics have shuttered, and aid organizations face severe restrictions. Women are now forced to give birth at home, often without medical assistance—reviving conditions that global public health had spent decades trying to overcome.
Meanwhile, climate disasters, war, and political instability are compounding maternal health risks worldwide. Women in regions affected by droughts, floods, and displacement are often last to receive food, medical aid, or transport—yet are first to bear caregiving burdens, including during childbirth.
Ultimately, maternal mortality is not just a health indicator—it is a moral and political one. It reflects whether women’s pain is believed, whether their lives are prioritized, and whether their autonomy is treated as essential to human flourishing.
✂️ FGM, Forced Birth, and Bodily Control
Reproductive oppression goes beyond the right to abortion—it includes a wide spectrum of practices that seek to control female bodies, often beginning in childhood and continuing across a woman’s lifespan.
In more than 30 countries, female genital mutilation (FGM) remains widespread, despite decades of international pressure, public health warnings, and national bans. An estimated 200 million women and girls alive today have undergone FGM, often before the age of 15. These procedures are frequently performed without anesthesia, by non-medical personnel, and in unsanitary conditions. The consequences—chronic pain, infections, complications in childbirth, and psychological trauma—can last a lifetime.
While FGM is often framed as a cultural issue, it is fundamentally about control—ensuring a girl’s “purity,” policing her sexuality, and reinforcing male ownership of female bodies.
In other communities, childbirth is not a choice—it is a social mandate. Child marriage, still legal in some form in over 90 countries, forces girls into early motherhood at great risk to their health and autonomy. In South Asia, West Africa, and parts of the Middle East, millions of girls are married before the age of 18. Many are pulled from school, isolated from support systems, and denied any say in when—or whether—they become mothers.
Even outside the context of FGM and child marriage, bodily control is often institutionalized. From mandatory virginity tests, to forced sterilizations, to coerced contraception targeting poor women, disabled women, and women of color, governments and medical systems have historically exercised authority over female reproduction in ways rarely applied to men.
What’s changing now is the boldness and coordination of these efforts. Around the world, gender control is no longer hidden behind paternalistic rhetoric—it is being openly embraced by political movements that cast reproductive autonomy as a threat to tradition, nationhood, and religious identity.
This is not just about policy—it is about ideology. The battle over the body is a battle over power.
🧭 Where We Go from Here
The right to control one’s body is the foundation of all other rights. Without bodily autonomy, the promise of democracy, citizenship, and equality is hollow.
But women are pushing back—forcefully, strategically, and across borders. In Argentina, Mexico, and Colombia, feminist movements have forced courts and legislatures to decriminalize abortion. In the United States, voters in Kansas, Ohio, and Michigan have mobilized to protect reproductive rights at the ballot box. In Afghanistan, women defy Taliban restrictions by organizing underground schools, medical support networks, and acts of public protest—at immense personal risk.
These struggles are not isolated—they are interconnected. They remind us that reproductive rights are not static gains; they are constantly contested, and must be vigilantly defended.
In the next section, we turn to the global economy—and examine how women’s labor is often exploited, underpaid, and devalued. Because while legal and health rights are essential, economic power is what enables women to leave abusive relationships, support their families, and imagine different futures.