NAIROBI, Kenya (AP) — Nowhere in the world has a higher rate of unsafe abortions or unintended pregnancies than sub-Saharan Africa, where women often face scorn for becoming pregnant before marriage.

Efforts to legalize and make abortions safer in Africa were shaken when the U.S. Supreme Court ended the national right to an abortion a year ago. Within days, Sierra Leone President Julius Maada Bio declared that his government would decriminalize abortion “at a time when sexual and reproductive health rights for women are being either overturned or threatened.”

But some U.S.-based organizations active in Africa were emboldened, especially in largely Christian countries. One is Family Watch International, a nonprofit Christian conservative organization whose anti-LGBTQ+ stance, anti-abortion activities and “intense focus on Africa” led to its designation as a hate group by the Southern Poverty Law Center.