As the world prepares to mark International Safe Abortion Day on September 28, 2025, the debate over abortion rights is reaching a fever pitch across continents and political divides. The issues at stake are not just legal or medical—they touch on human rights, bodily autonomy, and the very role of government in private health decisions. At the heart of this global conversation are both passionate calls for expanded access to abortion care and determined efforts to limit it, particularly through restrictions on medication abortion and telehealth services.
During a special session of SHE & Rights ahead of the 80th United Nations General Assembly, Dr. Tlaleng Mofokeng, United Nations Special Rapporteur on the Right to Health, made a forceful case for recognizing abortion as a fundamental human rights issue. "Abortion is health care. Access to abortion is a human rights issue. Full stop," Dr. Mofokeng declared, as reported by New Telegraph. She emphasized that safe abortion saves lives and is essential for reproductive autonomy, freedom, and bodily integrity. Dr. Mofokeng's remarks were echoed by a coalition of organizations including the Global Center for Health Diplomacy and Inclusion (CeHDI), International Planned Parenthood Federation (IPPF), and Women’s Global Network for Reproductive Rights (WGNRR), all of whom underscored the urgent need to protect and expand abortion rights worldwide.
Kelcey Armstrong-Walenczak, Senior Advocacy Manager at CeHDI, reminded the session that the right to health is enshrined in international law, obligating states to respect, protect, and fulfill that right. "Respect means removing the legal and practical barriers that prevent people from accessing services, including restrictive abortion laws, unnecessary medical authorizations, or stigmatizing procedures," Armstrong-Walenczak explained. She warned that regressive policies and the politicization of health issues are costing lives, deepening inequalities, and eroding trust in health systems. "Sexual and reproductive health and rights are not optional. Not having legal and safe abortion rights for all is also a form of violence," she stated, arguing that these rights are essential for advancing equity, dignity, and justice, especially for marginalized groups such as women, young people, and the LGBTQIA+ community.
The advocacy for safe abortion rights has deep roots, particularly in Latin America. Dr. Mabel Bianco, founding president of FEIM in Argentina, traced the origins of Safe Abortion Day to 1990, when activists in Argentina and other Latin American countries first observed September 28 as a day of united advocacy. "Not giving safe abortion rights is State’s violation of women’s rights," Dr. Bianco asserted. She recounted the long struggle to decriminalize abortion in Argentina, noting that restrictive laws were linked to high maternal mortality and morbidity rates. It took years of evidence-based advocacy, she said, to demonstrate the dangers of criminalizing abortion and to push for legislative change.
Argentina’s journey was neither swift nor easy. As Dr. Bianco recalled, "When we tried to pass the safe abortion law in 2018, despite all efforts, we could only get it passed in the Chambers of Deputies of Argentina, but the Argentine Senate rejected it (due to the church’s position against abortion). Finally in 2020 we could get a safe abortion law passed in Argentina." The introduction of medical abortion pills, which can be used safely within the first 12 to 14 weeks of pregnancy, was hailed as a significant victory for women’s autonomy. "Medical abortion is something in which we decide as women when, where and how to get a safe abortion. So, we have the pills, we use them, we decide when, where and how," Dr. Bianco explained. She also emphasized the importance of comprehensive sexuality education and access to sexual and reproductive health services as critical tools in reducing maternal deaths.
But while some nations are expanding access, others are moving in the opposite direction—especially in the United States, where medication abortion has become the central battleground in state legislatures. According to the Guttmacher Institute, medication abortion accounted for nearly two-thirds of all clinician-provided abortions in states without total abortion bans in 2023. The process requires two drugs: mifepristone to stop the pregnancy and misoprostol to induce uterine contractions. These medications are also used for other medical purposes, such as managing miscarriage and treating postpartum hemorrhage. Research consistently shows that medication abortion is both effective and safe, with serious complications requiring hospitalization in less than 0.3% of cases.
Despite this safety record, Republican-led states have ramped up efforts to restrict access. In 2024, Louisiana became the first state to reclassify mifepristone and misoprostol as Schedule IV controlled substances—putting them in the same legal category as drugs like Xanax and Valium. As reported by Stateline, this law forced hospitals to store the drugs in locked, passcode-protected containers, complicating access for both abortion and non-abortion medical uses. Physicians in Louisiana reported that these restrictions interfered with patient care. Similar bills were introduced in Kentucky, Missouri, and Texas, though they did not pass. However, more states are expected to follow Louisiana’s lead in the upcoming legislative sessions.
Telehealth has emerged as a critical front in the abortion access fight. By the end of 2024, one in four abortions was provided via telehealth, according to the Society of Family Planning’s #WeCount initiative. About half of these were from providers in shield-law states—eight Democratic-led states including California, New York, and Washington—who mailed abortion pills to patients in states with telehealth restrictions or abortion bans. However, nine states, including Texas, Arizona, and Florida, explicitly ban telehealth-provided medication abortion or the mailing of abortion drugs, according to KFF. Republican lawmakers in at least 14 states have proposed bills to criminalize the purchase, prescription, and distribution of medication abortion, while 15 Republican attorneys general recently urged Congress to ban shield laws, arguing they interfere with states’ rights to enforce their own criminal statutes.
Texas has taken the fight a step further. In 2025, the state legislature passed a bill allowing citizens to sue anyone—physicians, manufacturers, or others—who mails abortion medication into Texas. The bill, which also bans the manufacturing of abortion drugs within the state, is headed to Governor Greg Abbott, who is expected to sign it. Legal experts anticipate a fierce battle over whether one state can enforce its abortion laws beyond its borders. Meanwhile, Louisiana’s “Justice for Victims of Abortion Drug Dealers Act,” passed in June 2025, allows mothers to sue out-of-state doctors or activists for medication abortions and extends the window for such lawsuits from three to five years.
As both sides dig in, the stakes for women, healthcare providers, and society at large could hardly be higher. Advocates like Dr. Bianco insist, "We must fight for bodily autonomy, women’s agency and her right to decide and full range of sexual and reproductive health and rights." The coming months—and the legislative battles ahead—will determine whether safe abortion access expands or contracts, not just in the United States but around the world.
