“It's very much part of this movement to undermine democracy”: a qualitative study of European Union level opposition strategies against reproductive health and rights

Despite increasing contestations of agreed global commitments on sexual and reproductive health and rights (SRHR), our understanding of strategies of opposition in global health policymaking remains limited. This article explores the opposition to SRHR at the European level focusing on the decision-making institutions of the European Union (EU). The central research questions ask i) how SRHR opposition actors seek to influence EU institutions and ii) what challenges their actions pose for health policymaking at the EU level. Our empirical focus is based on mixed methods with data collected from multiple sources, including documentary data on European Parliamentary debates, Council conclusions of the European Union, reports of nongovernmental organisations, and key informant interviews. Our study confirms observations on globally coordinated efforts to restrict access to SRH services. This is a challenge for specific forums and countries, but as well for European Union's wider internal and external policies. We present a toolbox of strategies and actors operational at the European Union level. We show that opposition to SRHR is also a political tool that is part of a broader anti-democratic movement. Understanding strategies of anti-SRHR opposition is important for health policymakers as it shapes debates and the achievement of universal health coverage (UHC).