–Liberia’s Reproductive Health Crisis Deepens
By Jerromie S. Walters
MONROVIA, Liberia — Liberia has lost at least $2.4 million in family planning and sexual and reproductive health and rights support following funding cuts from the United States and Sweden. According to a new report launched by the Guttmacher Institute titled “More Than Just the Numbers: How Funding Cuts Threaten Sexual and Reproductive Health in Liberia,” the losses leave hundreds of thousands of women and couples without access to contraception and put more women at risk of unintended pregnancy, unsafe abortion and maternal death.
The funding losses stem from the abrupt withdrawal of US health assistance in early 2025, which saw US family planning disbursements to Liberia fall by 34 percent, with support for 2026 likely to fall close to zero. In December 2025, Sweden—Liberia’s second-largest donor after the United States and one of the strongest champions of gender equality and sexual and reproductive health and rights—announced it would wind down its development assistance to the country.
This ends a 2021–2025 cooperation strategy totaling SEK1.85 billion, or about US$197 million, across 39 projects that included sexual and reproductive health and rights, gender equality and youth empowerment. One of the most immediate effects of these cuts is the loss of critical support for contraceptive services.
According to the Guttmacher Institute report, 327,700 women and couples in Liberia will lose access to contraception, leading to 107,600 more unintended pregnancies, 37,800 more unsafe abortions and 323 more maternal deaths annually—almost one maternal death every day. Before the cuts, an estimated 131,500 unintended pregnancies occurred among Liberian women aged 15–49 each year, and about 54,500 ended in abortions, of which only around 15 percent were safe.
About 18,700 women in Liberia needed postabortion care each year at a cost of nearly $976,000, and total abortion-related care cost about $1.02 million. A national study led by the Ministry of Health found that more than 14,500 women sought treatment for abortion complications in 2021, and about one in 10 died or nearly died. After the cuts, the report projects that the expected rise in unintended pregnancies due to loss of access to contraception would result in 37,800 additional unsafe abortions and 6,800 additional safe abortions, raising the annual number of abortions to about 99,100.
Under current law, the number of women needing postabortion care each year would rise to about 34,000—an 82 percent increase—and costs for abortion-related care would rise to $1.85 million, or an additional $833,500 each year. Put simply, every 1,000 additional unsafe abortions create the need for postabortion care for about 400 women and cost the health system about $20,900 to provide this care.
Teenage girls may face the greatest risk. Before the cuts, adolescent girls already faced distinct barriers to accessing contraception compared with older women, including provider bias, cost barriers, and social stigma. In 2024, more than half of adolescent girls in Liberia who wanted to avoid pregnancy were not using modern contraception, and adolescent girls made up 28 percent of total unintended pregnancies in the country.
After the cuts, these barriers are likely to deepen due to the loss of donor financing that provided for youth-friendly service points, community outreach, and free commodity distribution. According to the Guttmacher Institute report, if the US and Swedish 2025 cuts to bilateral aid continue, this could result in approximately 22,400 additional unintended pregnancies and 9,300 additional unsafe abortions among adolescent girls each year—a 62 percent increase in both categories—putting their education, their employment and their critical contributions to Liberia’s future at risk.
The report further shows that prevention offers the greatest savings. Protecting access to contraception and comprehensive sexuality education reduces unintended pregnancies, unsafe abortions, HIV infections and other STIs, generating critical savings for Liberia’s health system. If all abortions were safe, costs for abortion-related care would drop to $0.66 million, saving $1.19 million a year compared with current law.
On the domestic policy front, the Public Health Bill—passed by the House of Representatives in 2022 to modernize the country’s public health law, expand access to safe abortion care up to 18 weeks and promote comprehensive sexuality education—remains stalled in the Senate, and pressure is mounting to strip its provisions related to sexual and reproductive health and rights.
The Guttmacher Institute report warns that the anticipated increases in unintended pregnancies, unsafe abortions, adolescent pregnancy rates, gaps in postabortion care, and limited access to comprehensive sexuality education resulting from these funding losses pose significant threats to Liberia’s national development and its progress toward the Sustainable Development Goals. Research has shown that reproductive agency and access to sexual and reproductive health care are closely associated with access to education, economic empowerment and personal autonomy in decision-making, all of which are essential to a country’s long-term economic development.
Amid the funding crisis, the Amplifying Rights Network (ARN) continues to advocate for access to Comprehensive Sexuality Education (CSE), contraceptives and safe abortion in Liberia, arguing that every individual—especially adolescents, young people, women and girls—deserves access to accurate sexual and reproductive health information, quality healthcare and the ability to make informed decisions about their bodies and reproductive health.
ARN’s advocacy is rooted in the belief that sexual and reproductive health is a human rights, public health, gender equality, and development issue. The network cites three major reasons behind its advocacy. First, to reduce teenage pregnancy: Liberia continues to face challenges with teenage pregnancy, and many adolescent girls become pregnant because of limited access to accurate sexual health information, contraceptives, and youth-friendly reproductive health services.
Second, to promote informed decision-making: ARN believes that people cannot make informed decisions about their sexual and reproductive health without accurate information. Third, to prevent unsafe abortions and maternal deaths: ARN advocates for access to safe abortion because unsafe abortion can cause severe complications, disability, and preventable deaths, and when women and girls cannot access appropriate reproductive healthcare, some may resort to unsafe methods of terminating pregnancies.
The Guttmacher Institute report notes that
the Liberian government must act urgently to protect the health and lives of women and girls. Priorities include integrating sexual and reproductive health care across public, nongovernmental and donor-funded services, equipping community health workers to provide care in line with national guidelines, and prioritizing and protecting access to high-quality, age-appropriate health education.
