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Abortion in Cuba vs US shows which country is truly democratic

In Cuba, abortion and all healthcare is free, and enshrined in a constitution democratically voted on by the people. In the US, nine unelected, life-long judges control society based on a 1787 constitution written by slaveowners.

Cuba abortion rally May Day
A May Day 2022 rally in La Habana, Cuba

When I connected to wifi for the first time in five days, a notification appeared on my phone announcing that the US Supreme Court had voted to overturn Roe v. Wade, the landmark 1973 decision that makes access to abortion a legal right.

Like most people when they heard the news, I felt shock waves run down my body. It was a draft opinion, but if the consensus holds, abortion will likely become illegal immediately or very quickly in 13 US states.

This is despite the fact that nearly two-thirds – 64% – of people in the United States oppose overturning Roe v. Wade.

We were hit by this news in Cuba, the first country in Latin America to legalize abortion, and where abortion and contraceptives are free – as with all healthcare services.

Like the United States, Cuba is currently engaged in a nationwide debate over LGBTQ+, women’s, and reproductive rights. But unlike in the US, where these decisions are made by a few unelected Supreme Court theocrats, Cuba’s process is grassroots and democratic.

The US empire would like us to believe that Cuba is an authoritarian dictatorship, because it does not bow down to the laws of neoliberal “democracy.” Yet comparing the debates over reproductive rights in the two countries can help demystify which country is truly democratic.

Socialism enshrines reproductive rights in Cuba

Abortion was first legalized in Cuba in 1936 in cases of rape, risk to the birthgiver’s life, or the possibility of passing on a serious disease to the fetus.

Before the 1959 revolution, Cubans lived through a period of US neocolonialism, and private medical clinics thrived by offering US “health tourists” services like abortion that were not available in the United States.

During this time, Cuba had the second-highest rural infant and maternal death rates in Latin America. Most Cubans had no access to healthcare, especially outside of the capital, La Habana. There was only one rural hospital in the country.

Abortion was effectively only legal for the Cubans who could afford it – a reality we still face in the US. Only with socialism, and the expansion of free healthcare to all, came a full actualization of abortion rights in Cuba.

After the triumph of the revolution in 1959, health outcomes improved immediately. Cuba now has the most doctors per capita in the world. It even has a higher life expectancy and lower maternal mortality rate than the US.

Full access to abortion was institutionalized in 1965 on four basic grounds: “it is the woman who decides, it needs to take place at a hospital, it needs to be carried out by expert staff, and it needs to be totally free.”

The only criminalization of abortion in Cuba is “when it is done for profit, outside of health institutions, by non-medical staff, or against a woman’s will.”

In the struggle to secure Cuba’s strong abortion laws, as well as other protections like paid maternal leave, one should not underestimate the role played by revolutionary mass organizations like the Cuban Federation of Women (FMC), whose membership includes more than 85% of all eligible Cuban women over 14 years of age.

Along with the Communist Party of Cuba (PCC) and the Organs of Popular Power (OPP), mass organizations like the FMC and Cuba Workers Federation (CTC) make up the three main pillars of Cuba’s political system.

In Cuba, I met Dr. Samira Addrey. Born in Ghana, raised in the United States, and recently graduated from the Latin American School of Medicine (ELAM) in Cuba, Addrey is intimately familiar with the radical differences in the Cuban health system.

She now coordinates a scholarship program for students from the US to study at ELAM for free, and subsequently work in underserved communities upon graduation. She explained how reproductive care currently works in Cuba.

“​​Every woman of reproductive age has the right to make the decision that is best for her reproductive health,” Addrey told me. “As soon as a woman reaches the menstrual phase of her life, the family doctor and nurse in her neighborhood classify her within the reproductive age, typically 15 to 49 years approximately.”

“Every factor that could contribute to or take away from good reproductive health for a woman is assessed from the beginning to the end,” she stressed.

Addrey noted that a woman “is entitled to choose contraceptive methods that are appropriate for her health background and encouraged to involve her sexual partner in each consult visit to make sure they understand what good sexual and reproductive health means for a both partners.”

“A woman is afforded a safe abortion for free, done by a medical doctor at any local policlinic or hospital,” she added. “Reproductive health in Cuba is approached as a multifaceted part of every woman’s life.”

Thanks to the widespread availability of abortion, and public trust in the health system, the issue is much less stigmatized in Cuba than it is in the US, despite the fact that the Caribbean nation is majority Catholic.

Addrey recalled that “numerous times, my OBGYN professors stressed that they prioritized the life of the woman before all else, especially in the case of pregnancies that threatened the life of a mother. For them, it was a no brainer to save a woman’s life if it meant losing a fetus because the woman still had a full life to live even if she may never have a child through her own womb.”

Dailyn Briñas, a Cuban-American who traveled to Cuba with me on the 15th International May Day Brigade, said “very little social consequences” exist in Cuba for people who choose to get abortions, whereas “in the West, women are at times looked down upon or made to feel less if they do.”

The destigmatization of abortion in Cuba is rooted in the revolution’s steadfast commitment to reproductive rights.

Cuba women solidarity trip

People’s democracy and the Cuban families code

Cuba’s constitution, which was revised through a democratic process in 2019, not only guarantees the right to free medical care, but it also enforces gender equality in all aspects of society, including sexual and reproductive rights:

Women and men have equal rights and responsibilities in the economic, political, cultural, occupational, social, and familial domains, as well as in any other domain. The State guarantees that both will be offered the same opportunities and possibilities. The State encourages the holistic development of women and their full social participation. It ensures the exercise of their sexual and reproductive rights, protects them from gender-based violence in all of its forms and in all spaces, and creates the institutional and legal mechanisms to do so.

The US constitution does not mention women at all.

But what might surprise North Americans the most about Cuba’s constitution is the fact that Cubans get to directly participate in the rewriting of the document.

Cuba is currently updating its 1975 Family Code, which codified gender equality into law, into a new Families Code. This process will update the island’s existing regulations on marriage, divorce, adoption, and other family-related regulations, including by legalizing same-sex marriage, expanding the rights of children, allowing assisted pregnancies, fighting gender-based violence, and protecting the elderly.

Minister of Justice Oscar Silvera Martínez described the document as “a transcendental text, which reinforces rights, fulfills and expands rights, and this is inherent to our revolutionary and socialist essence as a society.”

Elaborating on the parts of the bill that pertain to reproductive rights, Dr. Samira Addrey explained, “In Cuba, surrogate mothers who want to help another woman be a mother is also an option. This is consecrated by the new Families Code, and it is important to note that it is entirely prohibited for anyone to charge people for surrogacy.”

In December 2021, the National Assembly of Cuba approved a draft of the Families Code bill to be sent out for popular consultation.

From February to April 2022, more than 6 million Cubans, in more than 79,000 community meetings, participated in debate and discussion of the bill, making around 434,860 proposals, 61.96% of which were favorable.

Even the 1.3 million Cubans living abroad were invited to participate through an online form.

On May 15, Cuba’s National Electoral Council delivered its summary of the national popular consultation to the National Assembly of People’s Power. The drafting commission will now take the 434,860 proposals made by regular Cubans into consideration, delivering a new version of the draft to the National Assembly by June 17.

The version approved by the assembly will then be submitted to a popular referendum for approval by the Cuban people.

This consultative process has long played a key role in Cuban democracy. As political economist Helen Yaffe described in her book “We Are Cuba!“, the “introduction of the new Labour Code in June 2014 followed five months of debate involving 2.8 million workers in nearly 70,000 workplace assemblies and in the CTC, the Ministry of Labour, and the National Assembly. The process led to over 100 amendments to the draft Code.”

Cubans have many ways to engage in democracy, from participating in grassroots consultation, to joining mass organizations, to running for municipal assemblies, provincial assemblies, or the National Assembly as delegates themselves.

“It would be a mistake to think that because the opportunities for participation are on people’s doorsteps, that the issues they become involved in are only of local significance,” emphasized Ph.D. researcher Lauren Collins.

What happens at the hyper-local level in translates directly to the national level, showing just how advanced Cuban democracy is.

Cuba candidates election

Cubans reading printed biographies of candidates in front of a polling station

Roe v. Wade and the illusion of democracy

Danaka Katovich, an organizer with the peace group CODEPINK, visited Cuba as part of the International People’s Assembly youth delegation. She later wrote, “I was eating dinner with our Cuban hosts when we got word that Roe could soon be overturned. The table went silent. The Americans were scared and the Cubans were afraid on our behalf.”

Hearing the news about Roe v. Wade while in revolutionary Cuba put the reactionary decision in a different context.

“It made me wonder what my rights really look like, and if I really have any rights,” said B. “Goddess” Dillard Saunders, an internationalist organizer and May Day brigadista from Minnesota who has had multiple abortions in the US.

“If you can just take something away from me with your pen, did I ever have it to begin with?” she asked.

The precariousness of reproductive rights – and all rights – in the United States bears a sharp contrast to life in Cuba, where it would be unimaginable for the government to strip away healthcare from millions of people with a single vote, let alone a vote between nine unelected justices.

The fact that these nine unelected justices can make a major decision that is so clearly opposed by 64% of the population, and only supported by 33%, exposes how hollow US “democracy” is.

Moreover, it would be unimaginable to North Americans for us to participate in community debate and national referendums on our constitution, which has barely changed since it was written by a handful of slaveowners 235 years ago.

But most North Americans are still convinced that we live in a functional democracy, while Cubans live in a totalitarian dictatorship.

Dailyn Briñas, who has lived in both countries, explained that in the US, “There exists no democracy, and the elite are the main executioners of laws or regulations,” whereas the “Cuban system is quite the opposite, and it is this attention toward collective action and thought that provides the foundation for their system.”

Take voting access. If the United States is the democracy and Cuba is the dictatorship, why does Cuba regularly have 90% voter turnout rates, while the US has rarely passed 60% in recent presidential election years?

Why does Cuba automatically register all citizens and permanent residents to vote at age 16, while endless voter suppression exists in the US? The list goes on.

The illusion of democracy in the US is multifaceted. Studies show that public opinion in the US has zero influence on policymaking.

The United States is the definition of an oligarchy. Laws are determined by the capitalist elite, who buy elections, influence legislation through the corporate lobby, or sit themselves in Congress, where more than half of the members are millionaires.

On average, a US Senate seat costs $10.5 million, and a House seat $1.7 million.

But even if democracy couldn’t be bought in the US, our so-called “democratic institutions” were designed to be fundamentally undemocratic.

The Supreme Court is a prime example. Justices are appointed by the president, who can win the electoral college without a majority of votes.

Supreme Court Justices are approved by the Senate, the world’s “greatest deliberative body,” where 40 people can outvote 60, and mostly white, rural states get disproportionate representation. The Nation reported that, “by 2040, it is projected that 70 percent of the country will be represented by just 30 senators, while the other 70 senators will give voice to the 30 percent.”

Once confirmed, Supreme Court justices serve limitless terms, with power over the lives of 330 million people in their hands.

Another deceitful aspect of US “democracy” is the illusion of choice between the Democratic and Republican parties, which are really two sides of the same imperialist coin.

Democrats have used the Roe v. Wade decision as a rallying cry – and email fundraising subject line – for the 2022 midterm elections, arguing that voting in November is the only way to save abortion rights.

What they fail to mention in their fundraising emails is that they could save Roe right now, by codifying abortion rights into federal law with the current Democratic control of the House of Representatives, Senate, and White House.

A Senate vote this May to try to codify Roe nationwide was blocked, as Democrat Joe Manchin joined all 50 Republican senators in opposing the bill. But Democrats in the Senate, without any Republican votes, could end the filibuster, the undemocratic rule that requires 60 votes, instead of a simple majority, to pass most pieces of legislation.

Like Obama, who promised to codify abortion rights into federal law on the first day of his presidency, then decided they were no longer a legislative priority, Biden and his Democratic Party serve as controlled opposition. They claim to fight for abortion rights while failing to pass an abortion bill every time they have had the ability to do so.

Democrats and Republicans are not fundamentally opposed to each other; they simply have different strategies for how to best maintain US global capitalist hegemony.

Cuba may only have one party (which I should note is not an electoral party and it is barred from involvement in the entire electoral process), but within the Communist Party of Cuba – as well as the Organs of Popular Power and mass organizations it has helped build for women, workers, and youth – there is much more room for democratic debate and direct input from the masses than any viable party in the US.

Cuba’s democratic structures also cannot be assessed outside of their surrounding conditions: the onslaught of yankee imperialism and global neoliberalism.

Cuban socialism has not been able to develop for a single day not under siege by the US government – through the illegal economic blockade, direct and indirect terrorist interventions, and the continued illegal occupation of Guantánamo Bay.

The Cuban Revolution has survived for over 60 years, in the harshest possible conditions, as countless other revolutions were crushed by US intervention, for a reason.

Cuba abortion solidarity trip

Only socialism can bring about democratic and reproductive freedom

When I asked Dr. Samira Addrey if she thinks socialism is necessary for the full actualization of reproductive rights for all people, she gave a wholehearted yes.

“The rights of a woman to determine the best course for her reproductive health can never be a commodity nor a question laid in the hands of men,” she said. “Socialism upholds the humanity of women by ensuring that their roles in society be fully respected and protected.”

“Health is a human right and socialism delivers a system where that unalienable right can never be trampled upon by greedy exploitative capitalist machines,” she added.

Having seen the drastic advancements women made through the Cuban Revolution, Dailyn Briñas views socialism as “a transitional point for the eventual goal of universal women’s liberation.”

She maintained, “Reproductive rights are one of the many things that would come with bringing about the collective transformation and destruction of a capitalist global structure.”

With the destruction of capitalism also comes a full realization of democracy. Socialism – the common ownership of production, distribution, and exchange under the political rule of the working class masses – is the most democratic form of society that can now be constructed.

Before the revolution, Cuba was ruled by a series of US-backed dictators – and before that, direct US military rule and Spanish colonialism.

Today, Cuba has a people-powered, consultative, socialist democracy that is centuries ahead of the US in terms of grassroots participation and social achievements.

For many in the United States, it is easier to believe that Cuba is lying about their democratic achievements than to come to terms with the fact that our own government is choosing to deny us those same rights.

How could a country just 90 miles away provide all of its citizens with healthcare, housing, education, and reproductive freedom, free of cost, when we have been told our entire lives that we do not deserve those same achievements, and that they are physically impossible?

It is not a pretty reality to accept, that the US willingly perpetuates violence upon us and the rest of the world every day, but it is better than living in the delusion of imperialist benevolence.

When we all wake up – and we will – we’ll realize how much we have to learn from Cuba.



  1. Diana Block

    2022-05-23 at 15:00

    Great exposition of how reproductive justice reflects the goals of liberation for women and LGBTQ people in Cuban society!

  2. James Simpson

    2022-05-25 at 01:53

    In the USA, the campaign to secure abortion rights in the 1960s/70s and to the present was conducted largely by well-off, bourgeois elite activist who preferred to use the also-elite Supreme Court to impose a decision on the country. They did not even try to build a working-class movement so they cannot complain now when the successors to those elite judges impose a decision they do not like.

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