Abortion Law: A Woman's Right To Choose

Abortion laws vary across the world, with some countries criminalising the procedure, and others allowing it on varying grounds. In the United States, the Supreme Court's overturning of Roe v. Wade in June 2022 has given individual states the power to restrict or ban abortions. This has resulted in a complex and rapidly changing legal landscape, with some states banning abortion outright, while others continue to allow it. While abortion pills have become more accessible, with the FDA removing an in-person dispensing requirement, state restrictions still make accessing abortions difficult. Globally, efforts to decriminalise and improve access to abortions are ongoing, with human rights bodies and activists playing a crucial role.

Abortion pills

Mifepristone blocks the hormone progesterone, which is needed for a pregnancy to grow normally. Without it, the lining of the uterus breaks down and the pregnancy cannot continue. Misoprostol is then taken to cause the womb to contract, resulting in cramping and bleeding to empty the uterus. This process is similar to having a heavy, crampy period or an early miscarriage.

The abortion pill is very effective, especially when both medicines are used together. Up to 8 weeks into a pregnancy, it has a success rate of 94-98%. The effectiveness decreases slightly as the pregnancy progresses, and at 10-11 weeks, it works about 87% of the time with both medicines.

In the United States, the abortion pill has been approved by the Food and Drug Administration for use through 10 weeks of gestation. However, state restrictions and varying laws across the country make accessing abortion pills challenging. While medication abortion is legal in 22 states and Washington, D.C., 18 states ban it, and 10 states place limitations on it.

State-by-state abortion laws

In June 2022, the US Supreme Court overturned Roe v. Wade, which for nearly 50 years protected the federal constitutional right to abortion. The Supreme Court's decision has given states total leeway to restrict abortion or prohibit it altogether.

States Where Abortion Is Illegal

Since the overturning of Roe v. Wade, 14 states have made abortion illegal. These include Florida, Georgia, Iowa, and South Carolina, which ban abortion after six weeks of pregnancy, and 10 other states with near-total abortion bans.

States Where Abortion Is Hostile

In states categorised as "hostile", abortion may continue to be accessible, but it is not protected by state law. These states have expressed a desire to prohibit abortion entirely and are extremely vulnerable to the revival of old abortion bans or the enactment of new ones.

States Where Abortion Is Not Protected

Abortion may continue to be accessible in these states, but it is not protected by state law. It is unclear whether the legislatures in these states will enact a ban.

States Where Abortion Is Protected

The right to abortion is protected by state law in 21 states and the District of Columbia. However, there are limitations on access to care.

States With Expanded Access

The right to abortion is protected by state statutes or state constitutions, and other laws and policies have created additional access to abortion care.

Abortion restrictions

• Gestational bans: Prohibiting abortions before the foetus is viable outside the uterus (between 24 and 26 weeks).
• Specific method bans: Prohibiting certain abortion procedures, such as dilation and extraction (D&X) and dilation and evacuation (D&E).
• Reason bans: Prohibiting abortions sought for reasons such as the sex or race of the foetus.
• Criminalisation of self-managed abortion (SMA): Outlawing abortions performed outside of a healthcare setting.
• Targeted Regulation of Abortion Providers (TRAP): Imposing burdensome legal requirements on physicians providing abortion care.
• Parental involvement laws: Mandating that parents or legal guardians be notified or give consent for a minor's abortion.
• Ultrasound requirements: Requiring pregnant individuals to receive an ultrasound and/or biased counselling before an abortion.
• Restrictions on public funding: Prohibiting federal funding for abortions through the Hyde Amendment.
• Physician-only laws: Restricting the provision of abortions to physicians, rather than other qualified medical professionals.

Outside of the US, abortion laws and restrictions vary widely by country and region. Historically, abortion restrictions were introduced for reasons of public health, morality, and the protection of fetal life. Today, efforts to reform and decriminalise abortion are ongoing worldwide, with a focus on ensuring safe and accessible abortion care as an essential component of reproductive rights and health care.

Self-managed abortions

• Usually have regular periods and are fairly sure of the first day of their last period.
• Are less than 10 weeks from the first day of their last period.
• Have access to good information about how to take the pills, what to expect, and warning signs for possible complications.
• Don't have medical reasons why they shouldn't use the pills (such as hereditary bleeding disorders, heart or kidney disease, if they still have an IUD inserted, and/or think they may have an ectopic pregnancy).
• Could get to urgent care if needed.

It's important to note that there may be legal risks to buying and using abortion pills outside of the health care system. As of 2020, 61 people in the US have been criminally investigated or arrested between 2000 and 2020 for allegedly self-managing their abortion or helping someone else do so. However, the risk of prosecution for people seeking a medication abortion in states where they are banned or restricted is low.

There are a number of hotlines that provide support for people considering a self-managed abortion:

• The Miscarriage + Abortion Hotline is a private and secure phone and text hotline, staffed by medical professionals.
• Aya Contigo offers free and confidential live chat with educators to get emotional support and information.
• The Reprocare Hotline offers logistical or emotional support.
• The All Options hotline offers counseling and emotional support, and can also refer people to other professionals depending on their need.
• The Exhale text message hotline offers emotional support.
• The Repro Legal Helpline offers free and confidential legal information and support.

Abortion bans

Abortion laws vary widely around the world, with some countries having highly restrictive laws and others having more liberal ones. In general, abortion laws can be categorized into three types of legal systems: common law, civil law, and Islamic law. Common law is followed by former British colonies such as the US, Canada, and Australia, while civil law is prevalent in most of Europe and Latin America. Islamic law influences the laws in many countries with Muslim populations, such as Indonesia and Pakistan.

In the US, the Supreme Court's decision to overturn Roe v. Wade in June 2022 has given individual states the power to restrict or ban abortion. As of October 2024, 41 states have implemented abortion bans with limited exceptions, and 9 states along with the District of Columbia do not restrict abortion based on gestational duration. The remaining states fall into the "Not Protected" or "Hostile" categories, indicating that abortion may still be accessible but is not protected by state law. These varying state laws have created a complex and uneven landscape for abortion access in the US.

The specific restrictions and requirements for abortion vary from state to state. Some common requirements include mandatory ultrasounds, multiple in-person visits to a provider, and the involvement of a physician or certified physician. In some states, abortion pills have become a popular method for accessing abortion, but even in states where medication abortion is legal, state restrictions can make it difficult to access. For example, Florida, Georgia, Iowa, and South Carolina ban abortion after six weeks, often before a woman realizes she is pregnant.

The debate around abortion laws is ongoing and highly contentious, with advocates for abortion rights pushing for greater access and abortion opponents seeking to impose further restrictions. The upcoming presidential election is expected to reshape the complexities of the issue, and ballot measures in several states will give voters a direct say in deciding the future of abortion rights.

Frequently asked questions