Abortion Law: A Matter Of Life And Death

Abortion laws are deadly when they restrict access to safe abortions. In places where abortion is criminalised, restricted, or stigmatised, people are forced to resort to unsafe abortions, which can lead to fatal consequences, including maternal deaths and disabilities. Restrictive abortion laws can also cause distress and stigma, violating human rights, including the right to privacy, non-discrimination, equality, and bodily autonomy. These laws disproportionately impact marginalised communities, who face additional barriers to accessing safe abortions, such as financial constraints and discriminatory social and cultural attitudes.

Unsafe abortions are often performed by unskilled individuals, in environments that do not meet medical standards, or both. The lack of qualified medical providers, stigma, poor health systems, and poverty contribute to the high health risks and social and financial costs associated with unsafe abortions.

The legal status of abortion has a significant impact on its safety. In countries where abortion is broadly legal and accessible, such as those that have liberalised their abortion laws, abortion-related deaths and complications have decreased. On the other hand, restrictive abortion laws do not effectively reduce the number of abortions but instead drive them underground, making them more dangerous.

The social stigma of abortion

Abortion stigma is a set of attitudes and beliefs, conscious or unconscious, that abortion is "bad, shameful, or wrong". It creates discomfort around abortion, which contributes to misinformation and a lack of knowledge about abortion. This misinformation is then weaponized to create and maintain barriers to abortion, such as laws that restrict access, institutions that limit knowledge, and popular media that perpetuates misleading representations.

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. These norms include the expectation of sexual purity, or sexuality reserved for reproduction, and the expectation of motherhood and nurturing. Having an abortion shows that someone had sex and did not become a parent. Abortion marks their rejection of specific gendered norms about sex, gender, and parenting.

Anti-abortion messages contribute to abortion stigma, and it is very common, including among supporters of abortion, to feel uncomfortable or uncertain about when, why, and at what point in pregnancy it is okay to have an abortion. That discomfort is internalized abortion stigma.

Abortion stigma has important implications for quality in abortion care. It can lead to poor treatment of those seeking abortions, such as judgment and insensitivity from providers, which can lead people to resort to clandestine or unsafe abortions. It can also lead to gatekeeping and obstruction of access to abortion services, as well as unnecessary requirements and delays.

Abortion stigma can also manifest as a lack of designated places for abortion services, poor infrastructure and lack of resources, and punishment and threats. This can include fear of criminal liability for those seeking or providing abortions, as well as fear of legal consequences for providers, such as fines or imprisonment.

Abortion stigma is a powerful force that shapes the environment in which abortion is delivered and received. It can have significant impacts on the quality of abortion care and the psychological and emotional health of those seeking abortions.

The criminalisation of abortion

Abortion is a common health intervention, with around 73 million induced abortions taking place worldwide each year. It is a simple, safe procedure when carried out by someone with the necessary skills and using a method recommended by the WHO. However, criminalisation of abortion prevents people from accessing these safe procedures and can lead to fatal consequences.

Abortion remains a criminal offence in most countries, with penalties against those who have abortions, provide abortion services, or assist with accessing or managing abortion. In some countries, such as Equatorial Guinea and Zambia, life imprisonment is issued to those who seek an abortion. Criminalisation of abortion can also extend to those who provide information about abortion. Decriminalisation is a necessary step towards legalisation, but further legal changes may be required to ensure the availability and accessibility of abortion services.

In addition to the health risks, criminalisation of abortion imposes a range of burdens on women, including unnecessary travel and costs, delayed or no access to post-abortion care, distress, and stigma. It can also cause health workers to act cautiously, fearing criminal prosecution. This may result in a lower availability of trained abortion providers and a loss of relevant skills in the health workforce.

The right to abortion is connected to several human rights, including the right to life, health, non-discrimination, and freedom from torture, cruel, inhuman, and degrading treatment. By criminalising abortion, states violate these human rights and put individuals at risk of unsafe procedures.

The consequences of unsafe abortions

Unsafe abortions have severe consequences for women's health and lives, as well as for society as a whole. According to the World Health Organization, about 22 million unsafe abortions are performed annually, with an estimated 47,000 women and girls dying and another 5 million sustaining disabilities. The full extent of the consequences is unknown, as many are unable to seek medical care afterward.

Unsafe abortions are a leading cause of maternal mortality, with physical health risks including:

• Incomplete abortion (failure to remove or expel all pregnancy tissue from the uterus)
• Haemorrhage (heavy bleeding)
• Uterine perforation (caused when the uterus is pierced by a sharp object)
• Damage to the genital tract and internal organs due to the insertion of dangerous objects into the vagina or anus

The lack of access to safe, timely, affordable, and respectful abortion care poses risks to women's physical and mental well-being. The stigma associated with abortion can also lead to distress and further violate human rights, including the right to privacy, equality, and non-discrimination.

In addition to the health risks, unsafe abortions can result in financial burdens for women and their families. The treatment of abortion-related complications can be costly, and long-term disabilities can lead to loss of income. Restrictive abortion laws contribute to these financial costs by forcing women to travel to obtain legal care or requiring mandatory counselling or waiting periods.

Unsafe abortions are often the result of barriers to accessing safe and legal abortion services, such as high costs, stigma, and the refusal of health workers to perform abortions based on personal beliefs or religious grounds. These barriers can be particularly detrimental to women from marginalized communities, who may already face challenges in accessing healthcare.

The impact of restrictive abortion laws on women's human rights

Restrictive abortion laws have a detrimental impact on women's human rights. The criminalisation of abortion infringes on the right to bodily autonomy, which is a fundamental aspect of reproductive autonomy. When denied access to safe and legal abortion services, women are forced to resort to unsafe procedures, which can lead to fatal consequences such as maternal deaths and disabilities. This is particularly prevalent in developing countries, where the vast majority of unsafe abortions take place.

The criminalisation of abortion disproportionately affects those from marginalised communities, as they often face additional barriers to accessing healthcare services. This includes people on low incomes, refugees, migrants, LGBTIQA+ individuals, and racialised and Indigenous people. Restrictive abortion laws further compound the difficulties these individuals face in obtaining safe abortions, either by seeking private care or travelling to another country or state.

The inaccessibility of quality abortion care poses risks to women's physical and mental well-being and can result in violations of their human rights. These include the right to life, the right to health, the right to be free from discrimination and cruel, inhuman, and degrading treatment, and the right to privacy. The stigma associated with abortion also acts as a significant barrier, deterring women from seeking safe and legal abortions.

The impact of restrictive abortion laws extends beyond individual women's health and rights. The inability to access safe and legal abortions can have economic consequences for households and health systems. Complications arising from unsafe abortions result in substantial financial costs for households and health systems in developing countries.

Furthermore, restrictive abortion laws can hinder women's participation in society. The denial of reproductive autonomy limits women's opportunities and prevents them from fully engaging as equal members of society. This is contrary to the concept of gender equality, which recognises that women's ability to control their bodies is intrinsically linked to their roles in various spheres, including family, workforce, and government.

International human rights norms have evolved to acknowledge that the denial of abortion care violates women's fundamental human rights. This recognition has influenced national-level abortion laws and increased women's access to safe abortion services. However, despite this progress, restrictive abortion laws continue to exist and pose a threat to women's human rights and well-being.

The role of international human rights bodies in advocating for abortion law reform

International human rights bodies have played a critical role in advocating for abortion law reform. The denial of abortion care in a range of circumstances violates women's and girls' fundamental human rights. International and regional human rights norms have evolved significantly to recognise this, and have influenced national-level abortion laws and policy reform.

International human rights bodies have influenced domestic high court decisions on abortion, and served as a critical resource in advancing law and policy reform. For example, courts in countries such as Argentina, Bolivia, Brazil, Colombia, and Nepal have directly incorporated these standards into groundbreaking cases liberalising abortion laws and increasing women's access to safe abortion services.

International human rights bodies have also influenced national-level abortion law and policy reform in countries such as Spain, Rwanda, Uruguay, and Peru. As international human rights norms continue to evolve and increasingly recognise abortion as a human rights imperative, these standards have the potential to bolster transformative jurisprudence and law and policy reform, advancing women's and girls' full reproductive autonomy.

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