US ramps up its global battle against abortion as women in Africa face health risks

For decades, U.S. anti-abortion groups have lobbied domestically and abroad for restricting access to abortion.

In the U.S., their biggest success was the reversal of Roe v. Wade. Now, the Trump administration is delivering new momentum to the movement exporting “family values” to nations overseas.

As the administration ramped up its global battle against abortion, more and more women in Africa are at heightened risk of medical complications and death.

The expanded restrictions build on the anti-abortion advocacy work carried out by conservative U.S. nonprofits abroad — especially in Africa, where healthcare is highly dependent on foreign aid. The region has the world’s highest estimated proportion of unsafe abortions and highest maternal mortality rates — including the highest number of maternal deaths per 100,000 abortions.

“We’re gonna start blocking every international NGO that performs or promotes abortion abroad from receiving a dollar of U.S. money,” Vice President JD Vance told a crowd of anti-abortion demonstrators in Washington early this year.

At the annual March for Life rally, Vance announced a major expansion of restrictions on American funding for organizations that promote abortion, gender-affirming care and diversity initiatives abroad — building on decades of work by U.S. anti-abortion groups.

These groups have long sought to restrict access to abortion both at home and abroad.

The Trump administration gave fresh momentum to efforts to promote conservative family values overseas through sweeping changes to U.S. foreign aid.

The new rules represent a radical expansion of earlier U.S. policy that cut assistance to overseas groups providing abortion-related services.

Experts said at least $30 billion in U.S. aid could be affected, reshaping health policies worldwide.

It was difficult to track the full scope of the funding U.S. anti-abortion charitable groups send to Africa.

An analysis of tax filings from 17 nonprofits found their spending in Africa rose 50% between 2019 and 2022, to more than $16 million.

And it kept growing—hitting nearly $9.4 million in 2023 and 2024 alone, according to previously unreported data analyzed by the Institute for Journalism and Social Change.

That’s just the tip of the iceberg, said the institute’s Claire Provost.

"We can see quite clearly from the publicly available financial filings of US Christian right groups that they have been making historic investments in Africa,” Provost said.

“The amounts of money are significant, the increases are significant. And this reflects a lot of what we're hearing from sexual and reproductive rights activists on the continent that have been flagging repeatedly the increasing visibility of U.S. groups and U.S. funded groups, U.S. supported groups, in battles against rights that are extremely, extremely serious."

In Kenya, one of Africa’s richest countries, seven women die every day on average from complications of unsafe abortions.

The 2010 Kenyan Constitution permits abortion when a woman's health or life is threatened.

Subsequent court decisions also allowed abortions in cases of rape, incest or serious threat to a woman’s mental health.

But there's a major legal gray area.

Kenya’s penal code, which dates to the colonial era, continues to criminalize abortion providers and women seeking the procedure, who can face up to 14 years in prison.

In Karabok, a village in rural Kenya, two trees mark the spot where Mary Olouch is buried, just meters from where the 25-year-old bled to death after an unsafe abortion.

Olouch already had a young child when she realized she was pregnant.

She did not tell her husband.

One evening, he came home to find her bleeding. He rushed her to the hospital. But it was too late.

Olouch did not qualify for an abortion in a public hospital and couldn’t afford a private clinic on her meager income selling fish. Abortion carries enormous stigma in rural communities, and husbands often don’t allow women to use contraceptives, Loice Ochieng, a community health volunteer in charge of family planning in the village.

After Olouch’s death, women started to talk more openly about abortion in Karabok, where for many even uttering the word had been taboo, Ochieng said.

Now, she said, if women “have a problem, they come to me, they ask. Because they have seen that this thing can cause death.”