Abortion Laws: What's Changed And What's Next?

Abortion laws vary significantly worldwide, with some countries and states prohibiting it altogether, and others permitting it under certain circumstances. In the US, the Supreme Court's 2022 decision to overturn Roe v. Wade removed nationwide protection for abortion rights, allowing individual states to impose their own regulations. This has resulted in a patchwork of abortion laws across the country, with some states criminalizing the procedure while others have strengthened protections. The situation is further complicated by the Supreme Court's recent refusal to intervene in a Texas case regarding emergency abortions, creating confusion about the applicability of federal law. Globally, there is a trend towards liberalization of abortion laws, with more than 60 countries and territories relaxing restrictions over the past 30 years. However, the regression of abortion rights in the US stands in stark contrast to this global trend.

Criminalisation of abortion

The criminalisation of abortion is a complex and multifaceted issue that varies across different countries and jurisdictions. In some places, such as the United States, Sierra Leone, Poland, and Morocco, abortion is criminalised, while in other countries, it is only allowed under specific circumstances. For instance, some countries permit abortion when the pregnancy is a result of rape or incest, or if there is a severe and fatal injury to the foetus. The criminalisation of abortion creates barriers for individuals seeking abortions and has a detrimental impact on those who are already marginalised.

In the United States, the legality of abortion varies from state to state, with some states prohibiting abortion entirely, while others permit it with certain restrictions. After the Supreme Court overturned Roe v. Wade in 2022, states gained the authority to impose any regulation on abortion as long as it does not conflict with federal law. As a result, several states have enacted stricter abortion laws, and some have resumed enforcement of pre-1973 laws. Alabama, for example, has made performing an abortion a Class A felony punishable by up to 99 years in prison. On the other hand, states like Alaska, California, and Colorado allow abortion at all stages of pregnancy with varying restrictions.

The criminalisation of abortion not only affects those seeking abortions but also impacts health-care providers. Providers may face legal consequences for performing abortions, even in cases where the pregnant person's life is at risk. This creates a "chilling effect," deterring providers from offering the best care options for their patients and overapplying restrictions out of fear of criminal liability.

Additionally, the criminalisation of abortion disproportionately affects marginalised communities. Health services are generally less accessible to low-income individuals, refugees, migrants, LGBTIQA+ people, and racialised and Indigenous people. This makes it more challenging for these communities to seek safe abortion services or access private care.

The World Health Organization (WHO) has emphasised the importance of ensuring access to safe abortion services to prevent harmful consequences such as maternal deaths and injuries. According to the WHO, the rate of unsafe abortions is four times higher in countries with restrictive abortion laws compared to countries where abortion is legal.

Despite the varying legal landscapes surrounding abortion, there is a growing movement towards recognising abortion as a human right. International human rights bodies have interpreted international law to support the decriminalisation of abortion and ensure access to it as necessary for protecting fundamental human rights, including the right to life and health.

Social stigma of abortion

Abortion stigma is the set of attitudes and beliefs, conscious or unconscious, that abortion is bad, shameful, or wrong. Researchers define abortion stigma as “a shared understanding that abortion is morally wrong and/or socially unacceptable”. Abortion stigma is about “the transgression of a gendered norm”, which refers to the social expectations imposed on women, people assigned female at birth, and people with feminine gender expressions.

Abortion stigma is associated with the following:

• Abortion as a sin and other religious views
• Regulation of abortion
• Judgement, labelling and marking
• Shame, denial, and secrecy
• Poor treatment and the repercussions
• Gatekeeping and obstruction of access
• Avoiding disclosure
• Arduous and unnecessary requirements
• Poor infrastructure and lack of resources
• Punishment and threats
• Lack of a designated place for abortion services

Abortion stigma can be experienced or anticipated by both providers and abortion seekers. Abortion stigma can serve as a barrier to safety and quality in abortion care. Abortion stigma is also associated with the psychological and emotional health of abortion seekers.

State-by-state abortion laws

In June 2022, the U.S. Supreme Court overturned Roe v. Wade, which for nearly 50 years had protected the federal constitutional right to abortion. The Court's ruling in Dobbs v. Jackson means that individual states now have broad discretion to prohibit or regulate abortion. As a result, abortion laws vary significantly across the United States.

States where abortion is illegal

Abortion is illegal in 14 states, with few exceptions: Alabama, American Samoa, Arkansas, Florida, Georgia, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, and West Virginia.

States where abortion is legal with restrictions

Some states permit abortion with certain restrictions, such as gestational limits, parental consent or notification laws, mandatory waiting periods, and counselling requirements. These include Arizona, Colorado, Connecticut, Delaware, Iowa, Kansas, Maryland, Massachusetts, Michigan, New Hampshire, North Dakota, Ohio, Pennsylvania, South Dakota, Utah, Virginia, Wisconsin, and Wyoming.

States where abortion is legal without restrictions

Several states allow abortion at all stages of pregnancy without major restrictions: Alaska, California, District of Columbia, Hawaii, Illinois, Maine, Minnesota, Montana, Nevada, New Jersey, New Mexico, New York, Oregon, Puerto Rico, Rhode Island, Vermont, Washington, and the U.S. Virgin Islands.

States with conflicting laws or ongoing legal challenges

In some states, the legal status of abortion is unclear due to conflicting laws or ongoing legal challenges. These include Guam and Nebraska.

Abortion laws in other countries

Abortion laws vary significantly across the world. While almost 90% of nations allow abortions in some capacity, only 662 million (34%) of women of reproductive age live in 77 countries that allow abortion on request, with varying gestational limits.

In the US, abortion laws vary by state. Some states prohibit abortion at all stages of pregnancy, while others permit it up to a certain point, and some allow abortion throughout a woman's pregnancy. Since the Supreme Court overturned Roe v. Wade in 2022, 14 states have made abortion illegal. However, some states have expanded access to abortion by adding legal protections.

Outside of the US, abortion laws also vary by country. In Latin America, the Green Wave movement has brought about significant changes, with countries like Argentina, Cuba, Uruguay, and French Guiana legalizing abortion. In Europe, abortion is prohibited in Andorra and Malta, while it is legal in others like France, where abortion is covered by most health insurance plans. In Asia, abortion is banned in the Philippines and Laos, while it is legal in countries like Thailand and South Korea.

On a global scale, abortion laws have been trending towards liberalization, with over 60 countries liberalizing their laws in the past 30 years. This shift is particularly notable in industrialized countries, with almost all allowing abortion without restriction. However, about 100 countries still have some restrictions in place, allowing abortion only under certain circumstances, such as socioeconomic reasons, risks to the physical or mental health of the woman, or fetal anomalies.

Access to safe abortions has been established as a human right by several international frameworks, including the UN Human Rights Committee and regional human rights courts. Despite this, criminalization, social stigma, and intersectional discrimination continue to create barriers for people seeking abortions worldwide.

The impact of abortion laws

Abortion laws have a significant impact on people's ability to seek abortions and their access to safe abortion services. While some countries have liberal abortion laws that allow abortions in most circumstances, others have restrictive laws or completely ban abortions. The legality of abortion varies depending on the jurisdiction and the laws of each state or territory. The impact of these laws is felt differently by individuals and communities, with marginalised communities often facing greater barriers to accessing abortion services.

Restrictive abortion laws and criminalisation of abortion create barriers to accessing safe and legal abortion services. In some countries, such as the United States, Sierra Leone, Poland, and Morocco, abortion is criminalised, and those who seek or provide abortions can face legal consequences, including imprisonment and fines. Even in countries where abortion is legal, social stigma, religious influences, and conservative attitudes can make it difficult for people to access abortion services. Additionally, factors such as cost and distance to service providers can hinder people's ability to obtain abortions.

The criminalisation of abortion disproportionately affects marginalised communities, including people on low incomes, refugees, migrants, LGBTIQA+ individuals, and racialised and Indigenous people. These communities often face challenges in accessing health services in general, and the criminalisation of abortion further compounds these difficulties. Restrictive abortion laws do not reduce the number of abortions but instead push people towards unsafe abortion methods, putting their lives and health at risk.

Unsafe abortions are a significant public health issue, with approximately 25 million unsafe abortions occurring each year, mainly in developing countries. According to the World Health Organization, unsafe abortions are the third leading cause of preventable maternal deaths worldwide and result in approximately five million preventable disabilities. Restrictive abortion laws contribute to the high number of deaths and disabilities associated with unsafe abortions, as they limit access to safe and legal abortion services.

On the other hand, progressive reforms to abortion laws can lead to improved access to safe abortion services and better health outcomes for women. Liberalising abortion laws can reduce the stigma associated with abortion and decrease the number of deaths and disabilities caused by unsafe abortions. Additionally, reforms that improve access to comprehensive reproductive health care, such as contraception, can help reduce the number of unwanted pregnancies and, consequently, the demand for abortions over time.

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