Abort Laws: Do They Fuel Abortion Rates?

Abortion is a contentious issue worldwide, with laws governing the procedure varying from country to country. In some countries, such as the United States, abortion is a highly politicized topic, with states divided between those that protect access to abortion and those that ban it entirely. The impact of these laws on abortion rates is a subject of ongoing debate, with proponents of legal abortion arguing that its incidence is not affected by its legal status, while opponents argue that legal abortion results in more abortions. This paragraph will explore the evidence and arguments surrounding the impact of abortion laws on abortion rates.

Criminalisation of abortion increases unsafe abortions

Criminalisation of abortion has been shown to increase the number of unsafe abortions. In places where abortion is criminalised, stigmatised, or restricted, people are forced to resort to unsafe abortions. It is estimated that 25 million unsafe abortions take place every year, the vast majority of them in developing countries, and they can lead to fatal consequences such as maternal deaths and disabilities.

The World Health Organization (WHO) deems unsafe abortion one of the easiest preventable causes of maternal mortality. It is defined as "a procedure for terminating an unintended pregnancy carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both". Almost every death and injury from unsafe abortion is preventable.

Data indicates a correlation between unsafe abortion and restrictive abortion laws. The median rate of unsafe abortions in countries with restrictive abortion laws is up to 23 per 1000 women, compared to 2 per 1000 in nations where abortion is legal. Abortion-related deaths are also more frequent in countries with more restrictive abortion laws.

Liberalising abortion laws to allow services to be provided openly by skilled practitioners can reduce the rate of abortion-related morbidity and mortality. However, this requires better education and access to healthcare, as less restrictive abortion laws do not guarantee safe abortions. In nations where abortion is legal, providing women with better access to health centres that perform abortions is imperative.

Restrictive laws and social stigma prevent people from seeking abortions

Restrictive laws and social stigma are significant barriers that prevent people from seeking abortions. Restrictive abortion laws, often punitive in nature, stigmatize those who seek and provide abortion services. This stigma creates feelings of shame and psychological stress about abortion and imposes the government's disapproval of abortion at every point in the delivery of services. Abortion-related stigma is created by cultural norms and is reinforced by policies that harm those who provide and receive abortions. This stigma has been defined as "a negative attribute ascribed to women who seek to terminate a pregnancy that marks them, internally or externally, as inferior to ideals of womanhood". Social norms label those who seek abortions as "deviants" who are "promiscuous, sinful, selfish, dirty, irresponsible, heartless or murderous". Abortion is often seen as violating traditional standards of womanhood, motherhood, and sexual purity.

Restrictive laws and policies further exacerbate, reinforce, and perpetuate this stigmatization at an institutional level. For example, abortion-related laws build on the misconceptions that those who seek abortions are irresponsible or selfish and on the inaccurate stereotype that abortion is dangerous or unsafe. As a result, those who are stigmatized suffer negative social and health outcomes, including experiences of prejudice and discrimination, which create daily stress and psychosocial distress that can interfere with physical and mental well-being.

Abortion stigma discourages individuals from seeking reproductive health services due to fear of interpersonal and societal-level persecution and judgment. It also discourages healthcare providers from offering abortion services due to fear of criminal liability and negative consequences for their professional careers. This results in a lack of designated places for abortion services, as the procedure is marginalized and not provided with the same resources as other reproductive health procedures.

In addition to restrictive laws, social stigma also prevents people from seeking abortions. Even in countries where abortion is legal, it may be difficult to access due to factors such as cost, distance to services, and social stigma or religiously reinforced conservative attitudes. For example, medical staff may refuse to provide abortions on grounds of conscience or religion. The social stigma associated with abortion often leads individuals to seek unsafe abortions, which can have fatal consequences such as maternal deaths and disabilities.

Abortion laws vary between countries

Abortion laws vary widely among countries and territories, ranging from abortion being freely available on request to outright prohibition in all circumstances. Many countries that allow abortion have gestational limits for the procedure depending on the reason for the abortion. As of 2022, countries that legally allow abortion on request or for socioeconomic reasons comprise about 60% of the world's population.

France

In 2024, France became the first country to explicitly protect abortion rights in its constitution. Abortion is broadly legal in France, and the country has added new protections since Dobbs.

United States

In the United States, abortion laws vary by state. In June 2022, the U.S. Supreme Court overturned Roe v. Wade, which had established abortion as a fundamental right. This decision opened the door for states to ban abortion outright, and 14 states have since made abortion illegal. However, abortion remains legal in several states, with courts blocking bans and restrictions. Some states have also added legal protections for abortion access.

Mexico

In 2021, the Supreme Court of Mexico found the absolute criminalization of abortion to be unconstitutional and recognized the right to abortion early in pregnancy. About 40% of Mexican states now comply with this ruling.

Ireland

Ireland has also liberalized its abortion laws, recognizing abortion rights as fundamental human rights.

Latin America

In Latin America, abortion laws vary by country. Abortion on request is only legal in Cuba, Uruguay, Argentina, Colombia, and parts of Mexico. It is completely banned in the Dominican Republic, El Salvador, Honduras, and Nicaragua, and only allowed in restricted circumstances in most other Latin American nations due to the influence of the Catholic Church.

United Kingdom

The Abortion Act of 1967 legalized abortions up to 28 weeks (later reduced to 24 weeks) in the United Kingdom. However, a Care Quality Commission report in 2012 found that several NHS clinics were circumventing the law by using forms pre-signed by one doctor, allowing abortions to patients who had only met with one doctor.

Canada

Canada legalized abortion in 1969, and it is currently allowed on request.

In summary, abortion laws differ significantly worldwide, with some countries freely providing abortions upon request and others imposing various regulations or outright prohibitions. These laws have changed over time, with a global trend towards liberalization in recent decades.

Incremental pro-life laws reduce abortion rates

The impact of pro-life laws on abortion rates has been a contentious issue, with supporters of legal abortion arguing that its incidence is not affected by its legal status. However, research indicates that various legal protections for unborn children do indeed reduce the incidence of abortion, with even incremental pro-life laws preventing some abortions.

The Impact of Broad Legal Protections for the Unborn

The Lancet and Guttmacher Institute have published studies presenting abortion rate data from numerous countries, finding that global abortion rates have declined since the early 1990s, with faster reductions in developed regions. However, these studies have been criticized for not adequately controlling for other factors that might affect abortion rates, such as poverty rates and economic growth.

A more robust study by economists Levine and Staiger examined the impact of changes in abortion policy in Eastern European countries after the fall of communism. They found that countries with more restrictive abortion laws had significantly lower abortion rates, even after controlling for economic growth, inflation, and the age composition of women of childbearing age. Specifically, countries where abortion is only legal to save the mother's life or for specific medical reasons have abortion rates that are about 5% of those in countries where abortion is legal on request.

The United States Experience

The experience of the United States also provides insights into the impact of legal status on abortion rates. After the Supreme Court's Roe v. Wade decision in 1973, which effectively legalized abortion on demand nationwide, abortion rates in the US increased significantly in both the short and long term. This suggests that the legalization of abortion can lead to higher abortion rates.

Incremental Pro-Life Laws in the United States

Since Roe v. Wade, various incremental pro-life laws have been enacted at the state level in the US, including public funding limits, parental involvement laws, and informed consent laws.

Public Funding Restrictions

Research has shown that restricting Medicaid funding for abortions leads to a decrease in abortion rates. A Guttmacher Institute literature review identified 18 peer-reviewed studies that analyzed the impact of state Medicaid funding restrictions, with 15 finding statistically significant evidence of a reduction in abortion rates after funding was reduced.

Parental Involvement Laws

Parental involvement laws, which require minor girls to notify or receive permission from their parents before obtaining an abortion, have also been found to reduce abortion rates among minors. A literature review by the Guttmacher Institute identified 19 studies that analyzed the impact of such laws, all of which found a statistically significant decline in the in-state abortion rate for minors.

Informed Consent Laws

While there is less research on the effect of informed consent laws, which provide women seeking abortions with information about fetal development and potential health risks, some studies have found that properly designed informed consent laws can reduce abortion rates. For example, a study of Mississippi's informed consent law, which required women to make two separate trips to the abortion clinic, found a statistically significant abortion rate reduction.

In conclusion, while the legalization of abortion may increase abortion rates, incremental pro-life laws have been shown to reduce abortion rates. These laws include public funding restrictions, parental involvement laws, and informed consent laws. However, it is important to note that the impact of these laws may vary depending on the specific context and other factors affecting abortion rates.

Abortion laws affect public health outcomes

Abortion laws do affect public health outcomes. Restrictive abortion laws can have a detrimental impact on the health and well-being of individuals, particularly women, and can also affect the economy.

Impact on Health and Well-being

Abortion restrictions can lead to unsafe abortions, which are a significant preventable cause of maternal deaths and morbidities. According to the World Health Organization (WHO), around 45% of abortions worldwide are unsafe, often performed under dangerous conditions by untrained persons. This can result in physical complications such as incomplete abortion, haemorrhage, uterine perforation, and damage to the genital tract and internal organs. Additionally, the stigma associated with abortion and the barriers to accessing safe and timely abortion care can negatively impact women's physical and mental health throughout their lives.

Research has shown that women who are denied wanted abortions experience higher levels of household poverty, debt, and economic instability. They also face increased physical violence from the men involved in the pregnancy and endure more serious health problems. Restrictive abortion laws have been linked to higher rates of abortion-related maternal deaths and low-weight births.

Economic Impact

Abortion restrictions can have economic implications for both individuals and the wider economy. The costs associated with treating complications from unsafe abortions can be substantial, with health systems in developing countries incurring significant expenses. Additionally, households may experience loss of income due to long-term disabilities related to unsafe abortions. Ensuring access to safe abortion services can lower medical costs for health systems.

Abortion restrictions can also impact women's earning potential and labour force participation. For example, data from Mississippi suggests that removing abortion restrictions could lead to an increase in the labour force participation of Black, Hispanic, and Asian-Pacific Islander women, resulting in significant economic gains for these groups.

The Role of Public Health Agencies

Public health agencies have a crucial role to play in abortion-related issues. Historically, these agencies have focused on abortion-related data collection, clinical quality improvement, and research synthesis. However, in recent years, they have been tasked with defending, implementing, and enforcing abortion-related laws that may not align with public health frameworks or be evidence-based. This has led to concerns about the impact of these laws on women's health and well-being.

A proposed alternative is to adopt a 21st-century public health approach to abortion, based on accepted public health frameworks such as the Centers for Disease Control and Prevention's 10 Essential Public Health Services. This approach suggests that health departments should facilitate women's access to abortion, research barriers to abortion care, and promote the use of scientific evidence in abortion-related laws and policies.

Frequently asked questions