After Dobbs: Abortion Rights, Judicial Accountability, and the Global Trajectory of Reproductive Justice

Abstract

The United States Supreme Court’s decision in Dobbs v Jackson Women’s Health Organization (2022)[1]overturned nearly fifty years of constitutional protection for abortion established in Roe v Wade (1973)[2] and reaffirmed in Planned Parenthood v Casey (1992)[3]. By holding that the Constitution does not confer a right to abortion, Dobbs fundamentally reshaped reproductive rights in America, returning regulatory authority to the states. This article critically examines the implications of Dobbs for reproductive justice, judicial accountability, and comparative constitutionalism. Drawing on international human rights law, public health evidence, and comparative case studies, it argues that abortion restrictions imposed after Dobbs undermine women’s equality, health, and autonomy, while diverging from global trends toward liberalisation. It concludes that the Dobbs judgment represents not only a retrenchment of reproductive rights but also a broader challenge to the role of constitutional courts in protecting fundamental rights.

Introduction

Few Supreme Court decisions in modern history have generated the seismic consequences of Dobbs v Jackson Women’s Health Organization (2022). By expressly overruling Roe v Wade (1973) and Planned Parenthood v Casey (1992), the Court held that the U.S. Constitution confers no right to abortion, thereby returning the matter to the “people and their elected representatives”. The decision fractured the legal landscape: while some states moved to entrench abortion protections, others swiftly enacted bans at six weeks, fifteen weeks, or total prohibitions. The consequences for women’s reproductive autonomy, access to healthcare, and equality are profound. This article pursues three central questions: (i) how has Dobbs reshaped abortion rights and judicial accountability in the United States? (ii) how do restrictive abortion laws impact women’s health and socioeconomic status? and (iii) how does the U.S. trajectory compare to global legal trends on reproductive rights?

Constitutional and Legal Framework

The majority opinion in Dobbs rests on a historical-origins approach. Justice Alito reasoned that abortion is not “deeply rooted in this Nation’s history and tradition” and therefore does not qualify as a protected liberty under the Fourteenth Amendment’s Due Process Clause.[4] This method of interpretation originalism stands in contrast to the “living constitutionalism” that had underpinned Roe and Casey. By overruling Roe and Casey, the Court narrowed the judiciary’s role in protecting reproductive autonomy.[5] The dissenting Justices warned that the ruling jeopardises broader rights premised on privacy and autonomy, including contraception and same-sex intimacy. From an international law perspective, restrictive abortion laws conflict with established human rights norms. The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) requires states to eliminate discrimination in healthcare, including family planning.[6] The Human Rights Committee, in General Comment No. 36 on the right to life, has affirmed that restrictions on abortion endangering women’s lives or causing severe suffering to violate the International Covenant on Civil and Political Rights (ICCPR).[7]

Health and Socioeconomic Impacts of Restrictive Abortion Laws

The empirical evidence demonstrates the deleterious effects of abortion bans. A 2025 umbrella review found that restrictive policies are consistently associated with increased maternal mortality, delays in emergency care, and higher rates of unsafe abortion.[8]

The landmark Turnaway Study, a longitudinal project by ANSIRH, found that women denied abortions are more likely to experience poverty, remain in abusive relationships, and suffer adverse physical and mental health outcomes compared to women who received abortions. [9]

Recent data suggest that abortion bans exacerbate maternal mortality in the U.S., which already has one of the highest rates among high-income countries. The Johns Hopkins Bloomberg School of Public Health reported that states with near-total bans saw measurable increases in maternal morbidity within a year of Dobbs.[10]

The economic implications are equally stark. Research in labour economics indicates that abortion access is positively correlated with women’s workforce participation, educational attainment, and earnings. Restrictions disproportionately burden low-income women and women of colour, who face structural barriers to cross-state travel.[11]

Judicial Responsibility and Accountability

Constitutional courts are generally responsible for balancing laws passed by the majority with the protection of individual rights. In Dobbs, however, the U.S. Supreme Court chose to leave the matter fully in the hands of state legislatures, even in situations involving fundamental rights and serious health implications. Critics contend that this retreat from judicial oversight undermines the judiciary’s core duty to protect minority rights from being overridden by the will of political majorities. In South Africa, the Choice on Termination of Pregnancy Act 92 of 1996 has been upheld as consistent with constitutional rights to dignity, equality, and bodily integrity.[12] Similarly, in X v Principal Secretary, Health and Family Welfare Department, Government of NCT of Delhi (2022)[13], the Indian Supreme Court said that the right to make choices about reproduction is an important part of the constitutional right to privacy. Looking at other countries’ court decisions shows that many courts treat abortion as a basic human right, not just something that politicians get to decide on.

Telemedicine and Cross-Border Abortion Access

One of the most notable developments post-Dobbs has been the rise of medication abortion and telehealth services. As of 2023, medication abortion accounts for approximately two-thirds of all abortions in the U.S.[14]

Telemedicine is when doctors help patients using phones or computers instead of meeting in person. It can be used to give people safe medicines (called mifepristone and misoprostol) that end a pregnancy, which is very helpful in places where normal clinics are hard to reach. But there are problems with the law. Some people want to use an old rule from 1873, called the Comstock Act, that says certain things cannot be sent in the mail. This makes it confusing for doctors and patients. In other countries, like Ireland, telemedicine is allowed by law and has been used safely since 2018, showing that when the law supports it, telemedicine can make it much easier for people to get the care they need.[15]

Comparative Global Trends

Globally, the trend is very different from the U.S. reversal. Since 1994, over sixty countries have eased their abortion laws, allowing broader access. Argentina approved abortion in 2020, Ireland did so in 2018, and Mexico’s Supreme Court removed criminal penalties in 2023.[16]  Only a handful of countries including Poland, El Salvador, and now the United States have moved towards restriction. Scholars argue this places the U.S. as an outlier in the global constitutional order, where reproductive rights are increasingly framed as integral to gender equality and public health.[17]

The Way Forward

The impact of Dobbs shows why it is important for courts to be held accountable. Judges cannot stay passive when rights that affect life and death are involved. There are three possible ways forward:

1. Constitutional Interpretation: In the future, courts may overturn Dobbs and adopt a broader view of liberty that matches international standards.
2. Legislative Safeguards: Congress could pass national laws protecting abortion rights, though deep political divisions make this difficult for now.
3. Transnational Advocacy: Activists and international organizations can put pressure on governments by treating reproductive rights as human rights, helping to bring U.S. law closer to global practices.[18]

Conclusion

The Dobbs decision marks a major step back from protecting reproductive rights under the Constitution, with serious effects on women’s health, equality, and freedom. It goes against international human rights principles and the global move toward more liberal abortion laws. Although the Court in Dobbs claimed it was leaving the issue to democratic choice, the hardest impact falls on vulnerable women, while constitutional protection is taken away. Court decisions in South Africa, India, and other countries show that reproductive choice can and should be upheld as a constitutional right. Around the world, the trend is towards greater progress in reproductive justice, making Dobbs an exception—one that future generations may see as a warning about the risks when courts fail to protect basic rights.

Reference(S):

1. Dobbs v Jackson Women’s Health Organization 597 US (2022).
2. Roe v Wade 410 US 113 (1973).
3. Planned Parenthood v Casey 505 US 833 (1992).
4. ibid, Alito J (majority opinion).
5. ibid, Breyer, Sotomayor and Kagan JJ (dissenting opinion).
6. UN General Assembly, ‘Convention on the Elimination of All Forms of Discrimination Against Women’ (adopted 18 December 1979, entered into force 3 September 1981) 1249 UNTS 13.
7. UN Human Rights Committee, ‘General Comment No. 36 on Article 6: Right to Life’ (2019) UN Doc CCPR/C/GC/36.
8. A Gemmill, ‘Abortion Policy and Maternal Mortality: An Umbrella Review’ (2025) The Lancet Global Health.
9. D Foster and others, The Turnaway Study: Ten Years, a Thousand Women, and the Consequences of Having – or Being Denied – an Abortion (Scribner 2020).
10. J Johns Hopkins Bloomberg School of Public Health, ‘Maternal Health Outcomes under Abortion Bans’ (Report, 2025).
11. M Bailey, O Malkova and Z McLaren, ‘Access to Contraception and Women’s Economic Outcomes’ (2019) 109 Quarterly Journal of Economics 113.
12. Christian Lawyers Association v Minister of Health 1998 (4) SA 1113 (T).
13. X v Principal Secretary, Health and Family Welfare Department, Government of NCT of Delhi (2022) Supreme Court of India.
14. Guttmacher Institute, ‘Medication Abortion Now Accounts for the Majority of U.S. Abortions’ (2023).
15. Alliance for Hippocratic Medicine v FDA 78 F 4th 210 (5th Cir 2023).
16. M Sidebottom, ‘Telemedicine Abortion in Ireland: Lessons for Post-Dobbs America’ (2023) 41 Health and Human Rights Journal 55.
17. Center for Reproductive Rights, World’s Abortion Laws 2023 (CRR 2023).
18. R Cook, J Erdman and B Dickens, Abortion Law in Transnational Perspective (University of Pennsylvania Press 2014).

[1] Dobbs v Jackson Women’s Health Organization 597 US (2022).

[2] Roe v Wade 410 US 113 (1973).

[3] Planned Parenthood v Casey 505 US 833 (1992).

[4] ibid, Alito J (majority opinion).

[5] Ibid, Breyer, Sotomayor and Kagan JJ (dissenting opinion)

[6] UN General Assembly, ‘Convention on the Elimination of All Forms of Discrimination Against Women’ (adopted 18 December 1979, entered into force 3 September 1981) 1249 UNTS 13.

[7] UN Human Rights Committee, ‘General Comment No. 36 on Article 6: Right to Life’ (2019) UN Doc CCPR/C/GC/36

[8] A Gemmill, ‘Abortion Policy and Maternal Mortality: An Umbrella Review’ (2025) The Lancet Global Health

[9] D Foster and others, The Turnaway Study: Ten Years, a Thousand Women, and the Consequences of Having – or Being Denied – an Abortion (Scribner 2020).

[10] J Johns Hopkins Bloomberg School of Public Health, ‘Maternal Health Outcomes under Abortion Bans’ (Report, 2025).

[11] M Bailey, O Malkova and Z McLaren, ‘Access to Contraception and Women’s Economic Outcomes’ (2019) 109 Quarterly Journal of Economics 113.

[12] Christian Lawyers Association v Minister of Health 1998 (4) SA 1113 (T).

[13] X v Principal Secretary, Health and Family Welfare Department, Government of NCT of Delhi (2022) Supreme Court of India.

[14] Guttmacher Institute, ‘Medication Abortion Now Accounts for the Majority of U.S. Abortions’ (2023).

[15] Alliance for Hippocratic Medicine v FDA 78 F 4th 210 (5th Cir 2023).

[16] M Sidebottom, ‘Telemedicine Abortion in Ireland: Lessons for Post-Dobbs America’ (2023) 41 Health and Human Rights Journal 55.

[17] Center for Reproductive Rights, World’s Abortion Laws 2023 (CRR 2023).

[18]  R Cook, J Erdman and B Dickens, Abortion Law in Transnational Perspective (University of Pennsylvania Press 2014).