As many look to an imminent threat to abortion rights in the U.S., there are changes afoot around the world, from strict new bans and more subtle means for limiting access to surprising progress elsewhere for women's right to choose.
PARIS — While Roe v. Wade cemented abortion access in the United States almost 50 years ago, the pro-life fight to overturn the landmark legislation has long kept the United States in the global spotlight in the debate over reproductive healthcare.
A recent Texas law banning the procedure once cardiac activity is detected (about six weeks into pregnancy) has resulted in an 80% reduction in abortions in the country's second-largest state. Now, as the Supreme Court prepares to hear arguments on November 1 to determine whether the federal government has the right to sue over the law, it's an opportune moment to also look at the status of legal abortions around the world.
As the COVID-19 pandemic has upended healthcare systems globally, abortion regulations have also taken radical and sometimes surprising shifts. Some countries, including several in Latin America traditionally driven by Catholic Church teachings, have moved to liberalize the procedure amidst widespread public pressure from pro-choice movements; others are doing little to meet the demand for these services or even stepping backward, like in Poland, in an attempt to curtail abortions amidst broader socially conservative legislative shifts. It is a decidedly mixed landscape across the globe.
Europe: surprises in Spain, Malta, Poland
Close to one-third of women and girls in Europe face challenges in accessing abortion care, according to the European Abortion Politics Atlas. While 21 European countries treat abortion like any other medical service, 16 regulate it through their legal codes, allowing restrictions to be placed on the procedure. Further, in 31 European nations abortion procedures are not covered as part of their national health plan, often making it a financial burden for those who are low income, like undocumented immigrants, Roma people and sex workers.
Much of the continent is marked by stark contrasts in access: Residents of the microstate of San Marino voted overwhelmingly last month to legalize abortion. But Malta, which is also majority Catholic abortion has been criminalized since the 1800s, and remains the last European Union country with a total ban. A proposed bill to decriminalize the procedure was blocked earlier this year.
Currently 26 European countries allow healthcare workers to deny abortions based on their personal beliefs, which is a particular issue in Spain: The country liberalized its abortion laws in 2010, allowing abortions up to 14 weeks in any public hospital. But an abundance of so-called "conscientious objectors" means that many wanting to end pregnancies are forced to travel to find a provider, often resorting to private clinics. El Pais reports that only 6.2% of abortions are done in public hospitals. Despite legislative attempts to curb these conscientious objectors, doctors refusing to perform abortions are also on the rise in countries like Italy and Argentina.
Polish doctors who conduct abortions face up to a three-year prison sentence.
In June, the European Parliament called on member countries to ensure "high quality, comprehensive and accessible sexual and reproductive health and rights." Some Western European countries have aimed to broaden access, like France now providing free contraception to women up to age 25. But the EU ruling also raises questions around rule of law for some member states.
For example, Poland instituted a near total abortion ban earlier this year except in cases of endangerment to the woman's health. This is part of a shift toward more conservative legislature that has also targeted LGTBTQ rights in the name of "pro-family" resolutions. Now, Polish doctors who conduct abortions could be given up to a three-year prison sentence. Countries with more progressive abortion stances have stepped up in response, most notably Belgium, which is funding cross-border abortions for Polish women.
China - women's bodies as economic instruments
While China has long been known for its family planning through its One-Child Policy to limit population growth, recent efforts to reduce abortions are raising concerns. In September, the State Council, China's cabinet, announced its intention to curb "medically unnecessary" abortions, but with few details on how this would be achieved. The plan also included increased access to birth control.
While the government issued a similar proposal in 2011, some are more concerned now given increased government intervention in promoting childbirth amidst an aging population. The country's population growth has slowed for close to 30 years now, with the over 60 population increasing from 13.3% in 2010 to 18.7% by 2010.
Whether through being forced to end a pregnancy or carry one to term, some Chinese women feel like they have little control over their bodies. As Yaqiu Wang, a China researcher at Human Rights Watch, told the Sydney Morning Herald, "Today, many across the country still painfully feel the trauma of forced abortion. And now, without government acknowledgment or accountability, Beijing is doing a potentially abusive about-face. What hasn't changed is that China's government still treats women's bodies as tools for its economic development goals."
Abortion rights protest in Washington D.C. earlier this month
U.S. - front line in Texas
Texas's new abortion law effectively bars the procedure after six weeks of pregnancy and is being challenged by the Biden administration, which urged the Supreme Court to temporarily block the ban, known as SB 8. The Supreme Court announced last Friday that it will hear arguments in the case sooner than expected, which could have an impact on Roe v. Wade, the landmark ruling that ensured women abortion rights.
The Court already declined to block the Texas legislation from going into effect, citing procedural reasons; the justices did not weigh in on the law's constitutionality. Meanwhile, some 561 abortion restrictions in 47 states have been introduced since January 2021. More than 100 of those have been enacted, making 2021 the worst year for abortion access since 1973 (the year Roe v. Wade was decided), according to the Guttmacher Institute.
Latin America: Choice on the rise
Latin America has some of the world's strictest abortion laws, partially because of the influence of the Catholic Church. But this might be changing, with large-scale protests by feminist groups influencing the policies of legislatures across the region. This year, thousands marched as part of the September 28 International Safe Abortion Day, which began in 1990 as an event promoting the decriminalization of abortion in Latin America and the Caribbean.
Some of the most pressing actions took place in El Salvador, which still has a total abortion ban, with penalties ranging from two to 50 years in prison. In this Central American country, women have even been imprisoned for stillbirths and miscarriages. But some who have been prosecuted are fighting back, even bringing in the Inter-American Court of Human Rights to challenge the ban. In this case, the woman, Manuela, was sentenced to 30 years in prison after falling and having a stillbirth in 2008.
Ripple effects from Mexico
In contrast, abortion access has increased in Argentina, which in 2020 legalized abortions for up to 14 weeks; previously, abortions came with up to 15-year prison sentences except in cases of rape and medical necessity. Chile has also taken the first steps to decriminalize the procedure, with a proposed bill to legalize abortions for up to 14 weeks. Protestors recently gathered in Santiago, where Congress is holding debates on the law.
But perhaps most notably, Mexico's Supreme Court delivered a landmark decision in September when the majority of judges voted to decriminalize abortions. Women around Mexico held up green bandanas — an abortion rights symbol that began in Argentina — to honor a shift that clearly is having ripple effects in their country and beyond.
Protest in Mexico City, Mexico.
Malvestida Magazine via Unsplash
North Africa and Middle East: de facto bans
Close to 80% of women in the Middle East, North Africa region have restricted access to abortion. Sites like Women on Web help facilitate sending abortion pills to areas where they are difficult or impossible to acquire, but these platforms have been banned in Saudi Arabia, where abortions are authorized only in rare circumstances.
Tunisia and Turkey are the only two MENA countries that allow elective abortions; most governments in the region only permit them when they are medically necessary. Even in circumstances where abortion is legal, many seeking to end pregnancies deal with strong social stigma in these majority Muslim nations.
Turkish women have described the situation as a "de facto" abortion ban under President Recep Tayyip Erdogan and many are forced to turn to illegal clinics with questionable health practices. In Tunisia, abortion has been legal since 1973, but women must overcome societal outcasting as well as economic and structural hurdles in terminating pregnancies.
While the Arab Spring focused specifically on achieving equal rights for women, the reality is many still face inequitable treatment, including for reproductive health care. Unwed mothers who keep their babies are often seen as social outcasts, creating a terrible Catch-22 for many.