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The Supreme Court's 1973 decision in Roe v Wade seemed to make the United States a hemispheric role model. It was the first country in the Americas to guarantee the constitutional right to abortion at a time when abortion remained criminalized throughout most of Latin America and the Caribbean-and much of the world. The limits of the US model soon became apparent with Congress's 1976 passage of the Hyde Amendment, which barred the use of federal funds for abortion. In the ensuing years, federal and state laws and Supreme Court decisions further chipped away at the availability of abortion care. Still, even in the early 2000s, abortion remained legal, if restricted, in all US states, while most Latin American countries, except for Cuba, had restrictive bans.
In the 20 years since, Uruguay, Mexico, Argentina, and Colombia have legalized abortion and made it more accessible. Meanwhile, the Supreme Court's decision in Dobbs v Jackson Women's Health Organization (2022) has transformed the United States into a volatile patchwork of access and legality. As of June 2024, 14 states ban abortion outright, three ban it after six weeks' gestation, and four others ban it after 12 to 18 weeks, even as other states have enshrined abortion rights in their constitutions and enacted measures to expand access.1,2 Recent research indicates that this situation has forced US residents to travel across state lines to access abortion care, to pursue medication abortion via telehealth with an out-of-state provider, or to forgo abortion altogether.2
In this editorial, we review the historical developments that have led to our current predicament. The Appendix (available as a supplement to the online version of this article at https://ajph. org) provides more references for interested readers. We argue that US advocates for legal and accessible abortion should elevate the country's own strong tradition of reproductive justice advocacy coming from communities of color and expand our vision to include successful outcomes from Latin American countries such as Mexico, Argentina, Colombia, and Uruguay. Specifically, we urge activists to center access in any future legalization efforts, to push for legal changes at multiple levels (local, state, federal) and arenas (legislative, judicial, and administrative), and to uplift grassroots organizers who are working on the ground to fund and support those seeking...