When I entered parliament in 1976 as the only female member, I took a stand and managed to do what many countries have failed to do, or are threatening to undo: decriminalise abortion.

Recently, President Michelle Bachelet of Chile succeeded in advancing legislation that made abortion legal under certain circumstances. Chile’s new law is only a first step in providing full access to safe abortion care, but it is a momentous change that required the vision of a strong, outspoken, female leader who took a stand on saving women’s lives.

Stories like these are all too rare. Far from campaigning for the rights and health of their constituents, many politicians are bent on taking them away. In countries as diverse as the US, South Africa and Brazil, policymakers are proposing bills that would deny women and girls the right to determine their own future. To resist these efforts requires perseverance, carefully crafted policy and insistent voices. My home country, Barbados – which has a population smaller than most cities – can share some insight on this.

When governments deny women access to safe and legal abortion, it does nothing to decrease the rate at which abortions occur. Instead, it leads to more injuries and deaths. In the absence of care, women resort to all kinds of methods to interrupt unintended pregnancies – unqualified healthcare providers, self-made drug concoctions, coat hangers – each more dangerous than the next.

In Barbados, before we changed the law, women and healthcare providers could be criminally prosecuted for seeking or assisting with abortion services. At the time, I would read the obituary sections of newspapers and highlight the deaths of young women. Their deaths haunted those of us on the frontline, for we suspected many were caused by unsafe abortions.

This was, and in many countries still is, a public health emergency. Unplanned pregnancies are a reality, especially when women don’t have sufficient access to family planning methods or when they are victims of sexual violence. Women around the world die or suffer needlessly when governments restrict their access to critical healthcare.

Barbados’s parliament had considered the issue before, but never found the will to replace the punitive, colonial-era law. When I became the minister of health – the first woman ever to hold a cabinet position – I saw it as an opportunity to change the status quo.

I was vastly outnumbered – an experience that remains all too familiar to many female leaders. But I spoke out and sought to persuade my male colleagues. If they were serious about improving health for women in Barbados, this was an issue they could not ignore. Civil society groups, like the Barbados Family Planning Association, maintained the pressure on my colleagues, noting that the majority of women in our country – young, middle-aged, single, married, mothers and those without children – wanted a full range of options when deciding when and if to start a family or have more children, including whether to continue a pregnancy.

Outside government, I needed broad grassroots support to help the passage of new legislation and ensure its success. Armed with data and women’s stories, I travelled the country and talked to anyone who would listen, including religious leaders, medical providers, social workers and educators. I explained how unsafe abortions were unnecessarily killing women in the prime of their lives, and posed a simple question: “Is preserving our current law worth women’s lives?” The answer, more often than not, was no.

As support grew, it encouraged my government colleagues to recognise safe abortion care as an essential medical service. Finally, in 1983 – seven years after I started my campaign – parliament passed the Medical Termination of Pregnancy Act, allowing women throughout the country to access abortion services legally and safely.

This victory made Barbados a regional pioneer, the first English-speaking Caribbean country to make abortion broadly legal, doing away with laws that criminalised women for seeking health services. The act allows the termination of a pregnancy to protect a woman’s life or physical and mental health, for economic and social reasons, in pregnancies resulting from rape, and in cases where the foetus suffers severe abnormalities. Beyond just passing the law, we worked with providers to ensure these services would be accessible to all.

Over the next 25 years, our maternal mortality ratio plummeted by 53%, turning Barbados into a regional leader on women’s health.

But the progress we’ve seen here has not been echoed elsewhere. Politicians around the world are promoting policies that force women through pregnancies they do not want to continue. Leaders seem not to know, or not to care, about the consequences of these actions. Each year, an estimated 47,000 women die due to complications from unsafe abortion and 7 million women seek treatment for injuries resulting from risky, unsafe procedures. In countries with legal restrictions on abortion care, political leaders are condemning women to suffer injuries or death.

On International Day for Safe Abortion, we are reminded that saving women’s lives requires resistance and persistence.

In Barbados, I spoke out. Many women and more than a few good men came along – and it made all the difference.