In early May, I changed my Facebook profile picture to the iconic Barbara Kruger image: “Your body is a battleground”. 

The image dates back to 1989. Kruger was already well known for her feminist activist art when she produced this piece of work for the Women’s March on Washington DC. 

It was then 16 years after Roe v Wade. Across America, anti-abortion laws had already started to erode the gains of that landmark Supreme Court ruling. The constitutional right of women to decide for ourselves about our bodies was clearly already under threat.

On Friday, 14 June, half a century of constant right-wing chipping away turned into a violent swing of the axe. The 79 pages of legal argument (with an extra 150 pages of annexes) ends the fundamental rights of people in the US to choose for themselves about what they do with their bodies — starting with everyone who has a womb. 

Justice Samuel Alito’s final opinion on Dobbs v Jackson Women’s Health Organization — little different from the draft that was leaked in early May — states: “Abortion presents a profound moral question.” 

It goes on to assert: “The Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision.” And this is where the true conservative game becomes visible. 

This opinion rows back the basic freedoms agreed in 1973, through Roe v Wade. It removes the rights and freedoms of pregnant Americans to seek the healthcare they choose and to be supported if that choice might include not continuing with the pregnancy. 

As a federal nation, many US states already set their own rules constraining why and when abortion care services can be provided — but until 24 June, the fundamental right to seek medical care remained protected. The Supreme Court ruling has changed all of that.

This “very bad decision”, according to US President Joe Biden, means that everything is now up for grabs. Life and health now sit at the whim of the conservatives — or as the judge’s opinion puts it, at “the authority of the people and their representatives”. 

Thirteen states have already written “trigger” legislation outlawing all abortion — to be enacted within days of what they hoped Alito would say. 

It’s pretty clear what that “authority” means. The best estimate is that only 20 US states — less than 40% of all US states — will use their authority to protect the right to privacy. In the other states, whether the pregnancy starts through rape, incest, joyful fun or coercion, the same rules apply: the pregnancy must continue. 

Who cares what the woman needs or wants? 

There is no longer anything to stop any US state from applying the most extreme bans on abortion, bans that human rights’ defenders have been patiently working to overturn around the world. 

Early estimates suggest that, each year, 60,000 children will now be born to Americans unable to access abortion care — and the impact will fall hardest on the young, poor, black and brown, and those already raising children.

But this is about far more than abortion. What these five conservative justices have done is much more sinister. As Biden said: “The Supreme Court of the United States expressly took away a constitutional right from the American people that it had already recognised.” 

Many have said that this takes America back to 1868 (the date when 14th Amendment to the US Constitution was ratified). Others have said this is progress — but it is progress to an unpleasant destination. 

In his annex to the opinion, conservative Justice Clarence Thomas explains the chilling implication: “In future cases, we should reconsider all of this Court’s substantive due process precedents.” So, if it is not expressly named in the Constitution, it’s up for grabs. 

Thomas goes on to make it pretty clear that he has the rights to contraception and gay marriage in his sights. 

Does his name sound familiar? Yup, it’s the same Clarence Thomas who was accused of sexual harassment by Anita Hill 30 years ago when he was nominated to the Supreme Court. 

The next twist? These Supreme Court justices get a job for life. 

Aged 53 at the time, Brett Kavanaugh, another man accused of sexual harrassment, was nominated by then president Donald Trump and joined the Supreme Court in 2018.  

Amy Coney Barrett was 48 when she was appointed in 2020 to replace the exceptional Justice Ruth Bader Ginsburg (known as RBG), who had died — in her post — at the age of 87. Not only did the world lose a remarkable human, a fierce champion for gender equality, but, with her death, the progressives lost control of the Supreme Court. 

The opinion on 24 June 2022 was the inevitable consequence of the shift in power. When Ginsburg died, it was no longer a question of whether, but when, this would start to unravel.

The US Supreme Court’s judgment is part of a much wider agenda; it’s the start of an all-out battle against progress and human rights. The reach is substantial in the US — and it will embolden other conservative-minded countries. 

It is no surprise that abortion is the starting point. Women’s bodies are easy pickings for the patriarchy, the ideal place for far-right extremists to start reversing the gains of half a century, gains that have slowly put in place steps to protect and respect the dignity of every person. 

The reversal of Roe v Wade is a bigger battle: put simply, Trump and the Christian fundamentalists won. 

His supporters played a long game: packing the US judicial system, including the Supreme Court, with conservatives — knowing that, in time, these judges would have the chance to reverse this cornerstone, and trample across liberal values. 

And they are there for life.

25×25 young leaders, SheDecides Day, 1 March 2019, Kathmandu, Nepal. (Photo: Robin Gorna)

SheDecides: a movement against misogyny

Politically sanctioned misogyny has a long history, and this is not just in the US, even if the policies often start there. 

In January 2017, the day after his inauguration, Trump chose his first policy action. His choice? To reinstate and dramatically expand the “Global Gag Rule”, a policy that restricts US funds from being spent by any NGO overseas that provides information about abortion care or advocates for safe abortion policies. 

At the time, this drew a fierce reaction from progressive politicians, led by Lilianne Ploumen, then the Dutch minister for foreign trade and development, who proclaimed: “He doesn’t decide what happens to her body, she decides.” 

The Dutch rapidly convened a pledging conference. Six weeks after Trump’s announcement, $250-million was on the table for NGOs suffering the effects. Leaders decided that more was needed and the global SheDecides movement was born. 

At the outset, the team supporting the new movement contemplated a strategic legal challenge. The consequence of this new policy was extreme: millions of dollars would no longer reach the services that mattered most in the countries that the US claimed to support; health workers could not offer women and girls the care they judged to be best. But, on balance, we decided not to make it all about the US. Women’s rights were being eroded everywhere. 

Soon the catchphrase “She Decides” caught on across the world. Within months, across Africa, Asia and Latin America, politicians and leaders of UN agencies, NGOs and youth groups joined with these enraged European feminists and formed a progressive global political movement, determined to protect the rights of women and girls to decide for ourselves about what happens to our bodies. 

Together we pledged to pursue the vision of a new manifesto:

When She Decides
The world is better, stronger, safer.
She decides whether, when, and with whom
To have sex, To fall in love, To marry.
To have children.
She has the right
To information, to health care, to choose.
She is free
To feel pleasure,
To use contraception, To access abortion safely,
To decide. 

And this is when I met Mamello Makhele, one of the thousands of people battling at global and local levels to overturn the everyday sexism and misogyny that rules women’s bodies, and gets in the way of our basic human freedoms and rights. 

Midwife Mamello Makhele with the hills of Lesotho in the background. (Photo: Supplied)

Mamello works as a midwife, supporting women in Maseru, Lesotho. Daily she sees the horror of her country’s restriction on abortion. Her job is to provide care to women when they are pregnant — and in Lesotho that also means caring for the 13% of people admitted to hospital who are there with complications of unsafe abortion. 

Mamello is a bold and brave health worker, supporting and speaking out on behalf of her clients who arrive with the damage caused by using local herbs and other traditional ways to try to stop pregnancies from continuing, including the pregnancies that result from rape and incest. 

In Lesotho, the UN said in 2021, that the maternal mortality rate was the highest in the southern Africa region, at 554 per 100,000 live births. 

25×25 young leaders, SheDecides Day, 1 March 2019, Kathmandu, Nepal. (Photo: Robin Gorna)

The push back 

Mamello is one of the SheDecides 25×25 young leaders from 25 different countries who are bringing new energy to amplify the 25th anniversary of the Cairo International Conference on Population and Development (ICPD). 

In 1994, the year Mamello was born, even the most conservative countries got on board with a bold new UN declaration to advance sexual and reproductive rights and health, the idea of bodily autonomy — that each of us decides for ourselves what happens to our bodies. 

Abortion care doesn’t get an explicit name check in the ICPD Declaration, but progress was enshrined in these wise agreements, aligned with the fundamental right to privacy. 

The voices of progressive young people around the world, the 25×25, gave hope that the international battles won in 1994 could and should be sustained and advanced further. 

Or so we thought. 

But while we were celebrating 25 years of progress since the ICPD declaration, the fundamentalist plot against women’s rights — a plot on which Christian and Islamic fundamentalist share a common purpose of hate — was progressing with even more energy, under the radar. 

Countries that, in the aftermath of two brutal World Wars, committed to the vision expressed in the UN Universal Declaration on Human Rights, were happy to reel it back when it came to women, when it came to sexual rights.

That direction was starting to show itself in 2017, when SheDecides was formed. We knew that we needed to keep the political pressure strong — a movement of progressive politicians with young people at its heart was essential.

Within the first two years of SheDecides, we were proud that African leaders and activists, including Mamello, took the vision to where it matters most, including advocating hard for the Southern African Development Community (SADC) to create a new framework and scorecard to measure progress on sexual rights and reproductive justice across the region. 

As the world shakes in horror at this unbridled, explicit attack on progressive agendas, now may be the time to turn our eyes beyond the US. 

I don’t pretend to know all the twists and turns of how the US does its political business, but I do know that the right to a private life is a founding principle of the Universal Declaration on Human Rights, and so I asked Mamello for her advice to US activists. “Stand together in solidarity; support each other, and use social media constantly,” she said, “And don’t let them hide behind Christianity when a young woman dies. They need to see what these laws do to real lives.” 

Mamello has some hope. 

The laws against abortion are still on the books in Lesotho, but with allies, such as the brilliant pro bono lawyers supporting the Center for Reproductive Rights Africa Program, they are chipping away at the attitudes that sustain them, working from the grassroots up. 

Mamello works on a project that aims to educate communities and schools about reproductive justice, explaining the consequences of unsafe abortion. There is a swift change in attitudes among those on the receiving end of this outreach. 

This is the slow, patient work of making change happen — the same slow patient work that conservatives have been undertaking for decades in the US. 

Reorganising for human rights

Within hours of the legal opinion, Biden used his speech to reject the judgment, commiting to protect rights and announcing some smart policy fixes, such as protecting the right to travel across states and making sure mifepristone (abortion pills) are available — anything under his control. 

Good for now, but what can those of us who are not presidents — and not Americans — do? 

Biden pressed the point that we must avoid violence. 

Tough. Our bodies are, once again, clearly the battleground. We watch people suffer, knowing that some will die and thousands more will have their lives wrecked, their dreams shattered. 

Our rage is just, yet violence is just what the conservatives want. It plays into the story line: “Abortion protectors are baby killers.” 

Maybe one tactic is to spotlight the painful reality in countries, such as Lesotho, where abortion is currently illegal, where the rates of death and suffering among young women are extreme.

It’s time to talk about current realities rather than only referencing the dystopian stories of Margaret Atwood’s The Handmaid’s Tale.

And it’s time to focus on the slow, patient work needed to make long-term change happen. 

As we take the higher ground, reaffirming the fundamental dignity of every woman’s life, of every pregnant person, we need also to learn from their tactics. That means playing the long game. 

If it’s true that “Trump won”, then let’s steal those tactics for the counter-battle. For decades, they have been squeezing the wrong people into the right places, stacking the court, so that these ugly decisions can be taken.

As human rights defenders, our most radical actions must be to protect our democracies, to vote, to watch closely; to burst with courage, and call on our allies to stand up, speak out; to get the right people in the right places to change the rules and make sure that our rights will be protected. 

One of the simplest smartest things we must do is vote — and encourage the best and the brightest of us to stand for election.

Kruger’s slogan half a century ago — Your body is a battleground — was a call to arms, a sharp reminder that progress is hard won and demands constant vigilance. 

As we move forward let’s recommit to a bold vision:

Together, we create the world that
is better, stronger, safer.
But only if. And only when.
She Decides. DM/MC

Robin Gorna is an Aids activist and feminist. She is the vice-chair of the Global Fund’s Technical Review Panel to Fight Aids, TB and Malaria. She is working on a memoir about her work with Aids and Covid-19. She has led global and local campaigns and organisations, including SheDecides, the Partnership for Maternal, Newborn and Child Health, the International Aids Society, and set up the UK Department for International Development’s global Aids team in 2003. She spent four years in South Africa leading the UK’s regional and national HIV and health programmes.