Laws Impacting Abortion: Understanding Legal Restrictions

Abortion laws vary widely around the world, with some countries liberalising access and others restricting or banning it outright. In the US, the Supreme Court's overturning of Roe v. Wade in June 2022 gave individual states the power to set abortion policies, with 13 currently banning it. In countries where abortion is illegal, unsafe procedures still take place, leading to maternal deaths and disabilities. The World Health Organisation recommends safe abortion as a simple healthcare intervention, which can be self-managed in the first 12 weeks of pregnancy. Restrictive abortion laws are often based on religious or moral grounds, but they do not reduce the number of abortions and instead lead to unsafe practices. Decriminalisation of abortion removes specific criminal sanctions and treats the procedure as any other form of healthcare.

Criminalisation of abortion

The criminalisation of abortion has been a highly debated topic for decades. It refers to the legal prohibition of abortion, which varies between countries and regions. Some countries, such as the United States, Sierra Leone, Poland, and Morocco, have laws that criminalise abortion entirely, while others allow it only under specific circumstances, such as when the pregnancy is a result of rape or incest, or if the pregnant person's life is at risk. The penalties for seeking or performing abortions range from fines to life imprisonment in certain countries.

The criminalisation of abortion has significant impacts and consequences, especially for those from marginalised communities. It creates barriers to accessing safe abortion services, pushing people towards clandestine and unregulated settings, often with unsafe conditions. This can lead to short-term and long-term health complications, including maternal deaths and disabilities. According to the World Health Organization (WHO), the rate of unsafe abortions is four times higher in countries with restrictive abortion laws compared to countries where abortion is legal. The lack of access to safe and timely abortion care poses critical public health and human rights issues, violating a range of human rights, including the right to life, health, privacy, and non-discrimination.

The criminalisation of abortion also has economic implications. Inaccessible or restricted abortion care can result in financial burdens for individuals and households, as well as health systems. Complications arising from unsafe abortions incur significant costs for treatment, and long-term disabilities can lead to loss of income for those affected. Restrictive abortion laws can also impact women's education, labour market participation, and contributions to GDP growth.

Despite the criminalisation of abortion in some countries, it has been ineffective in preventing abortions from taking place. Data suggests that people facing unwanted pregnancies will still seek access to abortion services, even in highly punitive legal situations. This underscores the need for safe and legal abortion services to protect the health and lives of those seeking abortions.

The debate around the criminalisation of abortion is complex and often influenced by stigma, religious beliefs, and ethical convictions. However, international human rights bodies and experts have emphasised that decriminalising and ensuring access to abortion are necessary to protect fundamental human rights, particularly the rights to life and health.

Restrictive laws

Restrictive abortion laws can cause distress and stigma, and they risk constituting a violation of human rights for women and girls, including the right to privacy, equality, and non-discrimination. Such laws can also impose financial burdens on women and girls, especially those with low resources. Regulations that force women to travel to attain legal care, or require mandatory counselling or waiting periods, lead to loss of income and other financial costs, and can make abortion inaccessible for women with low resources.

In the United States, there are several types of restrictive abortion laws. These include:

• Targeted Regulation of Abortion Providers (TRAP) laws, which single out physicians who provide abortion care and impose burdensome legal requirements that are different from those imposed on physicians who provide comparable types of care.
• Parental involvement laws, which require providers or clinics to notify parents or legal guardians of young people seeking abortion prior to the procedure, or to obtain their consent.
• Criminalization of self-managed abortion (SMA), which prohibits people from ending their pregnancies outside of a healthcare setting.
• Vigilante laws, which ban abortion at an early gestational age and are enforced through private rights of action, allowing members of the public to sue abortion providers and those who help others access abortion care.

In addition to these, other ways to restrict or regulate access to abortion include:

• National constitutions, such as the Eighth Amendment to the Constitution in Ireland.
• Supreme court decisions, such as in the United States (1973, 2016), Canada (1988), Colombia (2006), and Brazil (2012).
• Customary or religious law, such as interpretations of Muslim law that allow or disallow abortion based on specific circumstances.
• Medical ethical codes, which may allow or disallow conscientious objection to providing abortion care.
• Clinical and regulatory standards and guidelines governing the provision of abortion, such as reporting guidelines, disciplinary procedures, parental or spousal consent requirements, and restrictions on who can provide abortions and where.

Social stigma

The criminalization of abortion and restrictive laws also contribute to the social stigma surrounding the procedure. In some countries, such as the United States, Sierra Leone, Poland, and Morocco, abortion is criminalized, and those who seek or provide abortions may face legal consequences. These laws vary, with some countries imposing life imprisonment for abortion, while others have laws in place to penalize those who assist others in seeking an abortion. The criminalization of abortion disproportionately impacts marginalized communities, as they often face additional barriers to accessing health services.

The social stigma of abortion can have severe consequences for those who are unable to obtain safe and legal abortions. It can drive people to resort to unsafe abortion methods, putting their health and lives at risk. According to the World Health Organization, approximately 23,000 women die each year from unsafe abortions, and many more experience significant health complications. The stigma surrounding abortion also leads to underreporting and misclassification of abortion-related deaths and complications, making it difficult to accurately assess the impact of unsafe abortions.

The negative health implications of restricting abortion access are well-documented. Restrictive laws do not reduce the number of abortions but instead compel women to seek unsafe alternatives. This can lead to physical and mental health complications and impose financial burdens on individuals and health systems. The stigmatization of abortion also affects the mental well-being of those seeking abortions, as they may experience distress due to the social disapproval and restrictive laws surrounding the procedure.

To address the social stigma of abortion and improve access to safe and legal abortions, it is essential to implement measures at the legal, health system, and community levels. This includes destigmatizing the procedure through societal initiatives, ensuring a supportive legal framework, improving access to accurate information, and providing a well-functioning and universally accessible health system. By addressing the social stigma and legal barriers surrounding abortion, we can create a future where abortion rights are respected and protected as human rights.

Human rights

Abortion laws vary across the world, with some countries liberalising their abortion laws and others making abortion illegal or highly restricted. However, the topic of abortion is closely tied to human rights, and human rights bodies have played an increasingly active role in calling for progressive abortion law reform.

Abortion restrictions can violate a range of human rights, including the right to life, the right to health, and the right to be free from violence, discrimination, and cruel, inhuman, and degrading treatment. According to Amnesty International, everyone has the right to bodily autonomy, and this is another reason why anyone who can become pregnant should be able to get an abortion. Restrictive abortion laws disproportionately impact marginalised communities, as health services are often less accessible to people with low incomes, refugees, migrants, LGBTIQA+ people, and racialised and Indigenous people.

The criminalisation of abortion can also be seen as a form of gender discrimination against women and girls, and anyone else who can become pregnant. By restricting access to abortion, states are failing to address social, economic, and political inequalities that prevent people from marginalised communities from exercising their sexual and reproductive rights.

The right to safe and legal abortion is protected by numerous international and regional human rights treaties and national-level constitutions around the world. Access to safe abortion is included in a constellation of rights, such as the rights to life, liberty, privacy, equality, and non-discrimination. Human rights bodies have repeatedly condemned restrictive abortion laws as incompatible with human rights norms.

The decriminalisation of abortion refers to removing specific criminal sanctions and changing laws, policies, and regulations to ensure that safe abortion is treated like any other form of healthcare. This includes not punishing anyone for providing or receiving a safe abortion and not involving the police or courts in deciding whether to allow an abortion.

Global Perspectives

In Latin America, a combination of legal reforms, court rulings, and public health guidelines have improved access to safe abortion for women. Countries such as Mexico, Argentina, and Uruguay allow abortion on request in the first trimester of pregnancy. In Africa, the Maputo Protocol, a legally binding document ratified by 49 states, calls for safe abortion to be authorised in cases of sexual assault, rape, incest, or when the continued pregnancy endangers the mental and physical health of the mother or foetus.

In contrast, some countries have introduced more restrictive abortion laws in recent years. For example, El Salvador, Nicaragua, and Poland have made abortion more restricted or entirely illegal. In the United States, the Supreme Court's overturning of Roe v. Wade in June 2022 gave individual states the power to ban abortion outright, and currently, abortion is illegal in 13 states.

Public health

Abortion laws have a significant impact on public health, and this impact differs depending on the nature and extent of the restrictions imposed. Restrictive abortion laws can have detrimental effects on the physical and mental well-being of women, as well as impose financial burdens on individuals and health systems.

Health Implications of Restrictive Abortion Laws

When individuals with unintended pregnancies encounter barriers to safe and legal abortion care, they often resort to unsafe abortion methods. According to the World Health Organization, unsafe abortions lead to the deaths of 23,000 women each year, with tens of thousands more experiencing significant health complications globally. Restrictive laws do not reduce the number of abortions but instead drive women to risk their lives and health by seeking unsafe alternatives.

Financial Burdens and Health System Costs

Unsafe abortions impose financial burdens on women and girls, as well as result in substantial costs for health systems. In 2006, the complications of unsafe abortions cost health systems in developing countries US$553 million in post-abortion treatments. Additionally, households experienced a loss of US$922 million in income due to long-term disabilities associated with unsafe abortions.

Impact on Human Rights

Restrictive abortion laws can violate a range of human rights, including the right to life, the right to physical and mental health, the right to privacy, and the right to non-discrimination. These laws can also impose financial burdens, especially on women with limited resources, by forcing them to travel to access legal care or comply with mandatory counselling or waiting periods.

Global Trends in Abortion Law Reform

While some countries have been loosening restrictions on abortion rights, such as Mexico, Argentina, New Zealand, Thailand, and Ireland, others have moved towards more restrictive laws or total illegality, including El Salvador, Nicaragua, and Poland. In the United States, the Supreme Court's overturning of Roe v. Wade in June 2022 has resulted in abortion becoming illegal in 13 states, with millions of people forced to travel for legal abortion care.

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