There’s been a lot of talk about reproductive rights lately – and for good reason. Hard-fought freedoms are under fire around the world, from the U.S. to Poland, Niger, and Pakistan. If that fires you up, read this conversation with Nabeeha Kazi Hutchins about how you can join the fight.
Nabeeha, you’re the president and CEO of PAI. What does PAI work on?
PAI was founded 58 years ago with the recognition that women should have the right to family planning and contraceptives and they should have the right to decide if and when to have children. Over the past we’ve evolved to advocate for comprehensive sexual health and rights to the US government and on the global stage. We work with 77 community-based organizations in 31 countries. Together we have an extended reach of 1800 organizations across 60 countries.
What is the current state of family planning and reproductive health globally?
According to the 2023 The State of World Population Report, 44% of women and girls who are part of the countries that reported to this report do not have the right to make their own decision about their bodies when it comes to having sex, using contraceptives and seeking healthcare. Approximately 260 million women around the world have an unmet need for safe and reliable contraception.
These are huge numbers! And the worst thing is that the actual number of girls and women who don’t use modern contraception is growing.
Fundamentally it’s a question of “Do people have access to what they need to achieve their aspirations?” And right now, the answer is no! We know that when an unmet need around contraceptives is met, we see immediate health impact. We see a reduction in maternal morbidity and mortality. We see a reduction in unsafe abortions. We see improvements in health, nutrition and wellness. We see improvements in education outcomes and economic gains.
If there are so many benefits, why is the unmet need still so huge?
First and foremost, there are ebbs and flows in funding for family planning and contraceptives. There is also so much social and cultural pressure and norms that remain. The third piece is I don’t see the level of investment in driving demand and utilization and better informing and addressing some of those societal and social stigmas associated with contraceptive access but also reproductive health.
Can you expand on the last piece?
Look, we can advocate for funding for reproductive health and contraceptives, we can do advocacy to donor countries to make sure they fund supplies and commodities, partners can advocate to their own governments. But if people don’t go out to access contraceptives or if they show up and are denied the access because of societal norms (for example, a young unmarried girl), then there’s a problem. It’s not sufficient to say that we’re spending on contraceptives. We need to see that people are able to access contraceptives, that they are treated with respect when they ask for contraceptives and that they are able to utilize it on their terms.
In which phase of funding are we currently now?
For the past decade, the US investment in reproductive health and rights (US is the biggest reproductive health donor) has remained flat. The amount has remained consistent but we are meeting less need as a result. Right now, the budget for 2024 is being debated by the members of Congress and there is a huge influence by the Republican Party to cut the investment by the US into reproductive health.
Significantly! For example, to not fund the United Nations Population Fund, which is the leading mechanism for communities around the world to access commodities. The fact that we keep having a conversation around “Is funding contraceptives and reproductive health the right investment for the US?” continues to cast doubt on something that we know is fundamental to the rights and achievement of people.
These are the same conversations that have occured in some countries in the world among major donors, right?
Yes! But we also see some bright spots. Canada has made bold commitments to reproductive health and rights (Canada launched a ten-year commitment to advance the health and rights of women around the world (2020-2030) and it wants to raise its global health funding to reach an average of $1.4 billion each year, starting in 2023.) There is no doubt that the US has an outsized influence and role in whether people get reproductive health supplies and contraceptives.
How do you think the budget is going to turn out?
It’s really hard to predict. My hope is for there to be more but given the composition of the Congress right now, I think we’d be fortunate if it were flat.
I’ve been always thinking very hard about how to make people care about women’s rights in other countries. For most of my friends in the Czech Republic, reproductive autonomy is not an issue. They all have access to birth control, they discuss with their partner if they want to have kids and how many, in case they need to, they can have abortion. How do you explain to people that empowering every single woman in the world matters to all of us, women?
We are never going to have gender equality if we don’t care about the well-being and status of women around the world. We’re not going to reach our collective economic potential. We will continue to leave open space for these norms that have been in place from the beginning of time and are based on patriarchal and colonial viewpoints. I believe in the power of sisterhood. We are each other’s keepers.
Rep. Schakowsky summed it up beautifully when she said, “We are such a small world, and what happens anywhere happens everywhere.” You interviewed her in June 2023 at the one-year anniversary of the loss of federal abortion protections in the U.S. Nabeeha, can you explain the consequences of the overturn of Roe v. Wade by the Supreme court on reproductive rights of women globally?
When Roe was overturned after 50 years of constitutional protection in the US, we saw a lot of chaos, confusion and outrage. PAI and many of our partners were concerned about global ramifications. The signal that the United States sent was “We in the United States are not going to respect the agency and autonomy of people in this country as a constitutional right to make a decision on abortion”. Now it would be up to states to decide what would be the right policies for their residents. The piece that I found very reassuring was that more than 70% of Americans support the right to choose. The decision was made by courts but it was not a decision made by people.
What impact did this decision have globally?
We saw anti-rights organizations going to countries in the East and West Africa to have their own mobilization. We saw policy commitments to expand abortion care and access start to either fall off the table or to retract those commitments. Governments are now saying “If the United States, which is a great liberal democracy, has decided to do it for its people, then why should we take some of these issues ourselves on?” We see a huge amount of funding going into countries by anti-rights to place political leaders, to influence laws, to activate and engage local communities with false information. These are fear tactics, manipulations. It extends beyond abortion. We’re seeing now threats to contraceptives, comprehensive sexuality education. We’re also seeing threats to the LGBT community.
One thing that strikes me is that the anti-abortion activists want to limit other reproductive rights as well, including the use of contraception. Isn’t that absurd? What will come after contraception? Women won’t be able to go to work?
It’s baffling to me that an anti-rights minority cares so much about our bodies and what we get to do with our brain, voice and autonomy. From a US perspective so much of this is grounded in religious ideology and wanting to control others. These people want to hold others back and their rights back because it doesn’t match with their values. These are all systems of patriarchy that we’re trying to break down. It’s completely incompatible with progress and justice and equity. The majority of people in the US don’t stand for it.
People should protest against this!
When we recognize and appreciate the power of women, the ability of women to make excellent choices for themselves and their communities, people across the board are better off – from an economic, health, education perspective. Empowering women is not just good for themselves and their families, but it’s good for the world. The irony is this notion of if we put down laws and prevent people from achieving their rights, we are going to have a better society. It’s actually quite the opposite. It’s a losing game for those who feel the anti-rights movement is going to win because it’s not.
Do you have any advice to the people who want to promote sexual and reproductive health and rights in these turbulent times where we see so much conservatism?
Don’t be afraid to use your voice and ask questions. Pay attention deeply to the political and donor landscape and have conversations about why family planning and reproductive rights are important. It can’t be just thirty of us talking, but everyday people raising this issue. If we don’t speak up, we’re letting a minority shape and dictate what our future should be. This movement is certainly about health, rights, making sure that people can do what they want to do. But this movement is about recognition that we love each other. And when you love each other you want to make sure that every single person has the best they can for their lives and their families. And so we all need to lead with love.
But what if the anti-rights activists believe that what they are doing is proving love? They think that if you ban abortion, then you are not killing innocent babies and that’s actually just love.
That is a manipulation tactics used by the opposition but I also think that the anti-rights movement does not ground its arguments in science and research. For example, access to safe abortion significantly reduces maternal deaths and morbidities. Unsafe abortions are one of the leading contributors to maternal deaths. The numbers are the numbers. I think that if we’re going to live in a world where we want to put forward policies and laws that underestimate the intelligence, the abilities of people to make the decisions for themselves and their lives, then we’re not walking in a world of kindness. We’re thinking that some are superior and therefore should be making the decisions for the rest. And that is precisely the history of colonialism where a small group of people decided what was better for others and we have the world that we have today.
True! And the sad thing is the opposition doesn’t realize that if you provide women contraceptives, you will prevent abortions. How are they going to prevent abortions if people have unprotected sex? They also forget about the fact that even if they ban abortion, women will still go to have abortions.
It’s forcing people to become pregnant even if they don’t want to. With all these restrictions on abortion, on access to contraceptives and sex education, you’re not getting the knowledge from a young age, you’re not getting the supplies to prevent you from getting pregnant and if you get pregnant, then you’re forced to carry that pregnancy to term. You’ve had an unwanted pregnancy. I don’t see how that is good for society.
And how that is love, right?
If you’re interested in more interviews like this one, check out my interviews with solutionaries from all over the world here on my blog.