Global Trends in Opposition to Women’s Reproductive Autonomy
Sexual and reproductive health and rights are increasingly under threat. The Trump Administration in the United States has restricted dialogue about and access to contraception and safe abortion causing a global ripple effect. A troubling trend is emerging: other governments and international organisations are following suit by limiting funding and avoiding the language of reproductive rights.
Defunding SRHR – Global Impact and Consequences
The Trump Administration has overseen the dismantling of the US Agency for International Development (USAID), withdrawn 500 million USD in global health funding, and terminated all US contributions to the United Nations Population Fund (UNFPA), the UN agency for sexual and reproductive health. The result is the destabilisation of global sexual and reproductive health and rights (SRHR) initiatives, undermining progress toward gender equality, jeopardising the 2030 Agenda for achieving the United Nations Sustainable Development Goals (SDGs).
The suspension of contraception, comprehensive abortion care and reproductive health programmes has left an estimated 130,390 women without access to contraceptive services every day, translating to 47.6 million women annually. This gap is projected to result in 17.1 million unintended pregnancies and 34,000 preventable maternal deaths. The impact will be felt most harshly by women in humanitarian environments, where the need for contraception is often overlooked and more than 60% of all maternal deaths occur.
Further compounding the crisis, the termination of USAID contracts and the Global Health Supply Chain Program—which served more than 40 countries—has resulted in $9.7 million worth of contraceptives, including intrauterine devices (IUDs), implants, and pills, being stockpiled in Belgium. In July 2025, a decision was made to destroy these supplies at a cost of 167,000 USD. This, even though the life-saving commodities were already paid for by American taxpayers and multiple attempts had been made by international humanitarian organisations, governments and global health actors to purchase and redistribute the supplies (at the time of writing, it was unknown whether the incineration of the stockpile had been commenced). These actions make clear the current American President’s determination to break from established international human rights norms, replacing them with an agenda openly hostile to sexual and reproductive health and rights.
Cutting costs or controlling the rhetoric?
Evidence shows that contraceptive services yield cost savings by reducing unintended pregnancies. Modelling carried out in 2020 revealed that for every additional 1 USD spent on family planning services in low- and middle-income countries, 3 USD could have been saved on the cost of maternal, newborn and comprehensive abortion care. UNFPA has described the global agenda of strengthening health systems and preventing unintended pregnancies, unsafe abortion and maternal deaths by meeting women’s needs for access to modern contraceptives as “work that is a ‘best-buy’ in development, a cost-effective investment that generates positive returns over generations”.
Although the United States has been the largest bilateral donor to global health funding, this cost represents less than 1% of the country’s budget. The cuts have been described as a ‘negligible saving for the United States, yet a devastating loss for the world’. Economic policies shape reproductive autonomy. The recent cuts to global health funding disproportionately impact women’s access to reproductive services. These measures are being justified as fiscal responsibility, but in fact reflect deeper political choices about whose needs matter, foreshadowing an imminent future where reproductive health and rights, especially those of women, will matter less and less.
The spread of regressive policies
The current American Government has been reinstating and strengthening regressive, conservative policies that further an agenda which has a global impact. One example is the reinstating of the ‘Global gag rule’ in January 2025. The rule prohibits organisations that receive U.S. foreign assistance from providing, referring for, or advocating abortion services using any funding, including money from non-U.S. sources, even in countries where abortion is a standard part of healthcare. This creates confusion and reduces access to essential contraception and abortion care services, interferes in the patient-health professional relationship, and silences of SRHR advocates.
In January 2024 the American Government, led by President Trump, invoked another piece of policy – the Kemp-Kasten Amendment which restricts funding to organisations or programs that support or participate in the management of a program of coercive abortion or involuntary sterilisation. Originally developed in the 1980s in response to concerns over China’s coercive population policies, the Kemp-Kasten Amendment has been used in 19 of the past 40 fiscal years, consistently by Republican governments, to withhold UNFPA funding. UNFPA maintains that allegations of promoting abortion or involuntary sterilisation are unfounded and have been repeatedly disproved, including by the American Government itself.
The Trump Government’s precedent has prompted several other donor countries to cut, or plan cuts to international family planning, further endangering global SRHR. This reflects a shift in norms around women’s reproductive autonomy, a tacit acceptance of the anti-rights-based rhetoric, and a weakening of international cooperation. ICM’s member associations describe both the impact of restrictions imposed on women as care recipients and as providers and that of funding cuts on services provided by midwives and working to reduce maternal morbidity and mortality, especially in humanitarian and fragile settings.
Patriarchal Control and Gender Norms
Women’s reproductive autonomy is about power, who holds it, who controls bodies, and whose voices shape laws and norms. At the heart of the global backlash against women’s rights, particularly SRHR, is patriarchal control over women’s bodies. Societies have long prioritised women’s reproductive functions and their role as mother and caregiver over their autonomy with cultural conservatism driving much of the opposition to reproductive rights. Selected doctrines across many different faiths are used to promote heterosexual marriage, distinct gender roles, male dominance, and female modesty, clashing with SRHR principles like gender equality and sexual autonomy. Sexual education is perceived as encouraging promiscuity, and contraception or abortion viewed as morally unacceptable and regarded as a threat to moral values or national identity.
Advocates of restricting reproductive freedom often frame their position as protecting life or family values, yet forced pregnancies, denial of contraception, and criminalising abortion are forms of reproductive coercion. Whether imposed by partners, families, or communities, these practices aim to control rather than empower women and should be recognised as gender-based violence.
Intersectional Inequities
Restrictions to reproductive autonomy are not experienced equally and tensions between approaches to gender and sexuality also significantly impact the rights and freedoms of LGBTQ+ individuals, women of colour, women with disabilities and those experiencing poverty, all of whom face compounded barriers to accessing SRHR services.
Reproductive justice is key to addressing the gendered dynamics that control people’s reproductive lives. It is based on an intersectional analysis of how factors such as race, age, class, economic status, gender, and sexual orientation combine to affect people’s experiences and opportunities. Protecting those most affected by restrictive reproductive norms is essential for achieving justice and freedom for all.
Gender equality and sustainable development
Shifts in global norms around SRHR, combined with funding cuts, programme closures, and the loss of vital medical supplies, are a major setback for women’s SRHR and reproductive autonomy. These policies are not neutral; they reflect political ideologies and world views that seek to limit women’s agency and reinforce traditional hierarchies.
The long-term consequences will harm women’s health, gender equality, and sustainable development.
Governments must move beyond male-centred, patriarchal norms and create conditions for women to fully exercise reproductive autonomy. This means challenging gender stereotypes about women’s sexuality and their position in family and society and removing legal and practical barriers to reproductive health services. This can be achieved in a way that is respectful of diverse cultural and religious beliefs provided these do not infringe upon individuals’ SRHR, and respecting cultural and religious beliefs as long as they do not infringe on individuals’ SRHR.
The International Confederation of Midwives (ICM) asserts that governments, implementing partners, and donors must have the courage to resist restrictive sexual and reproductive health and rights (SRHR) policies and continue funding global health initiatives, ensuring that women everywhere can access comprehensive sexual and reproductive health services.
The ICM strongly advocates for continued efforts by midwives, midwives’ associations, regional and national decisionmakers and the global health community to eliminate all forms of gender-based violence, including reproductive coercion, to empower women through the provision of information and education, ensuring their unlimited access to contraception and comprehensive abortion care services based on free and informed consent, the protection of the right to privacy, confidentiality and the provision of adequate support and services to ensure positive reproductive outcomes.
