Who Holds The Power To Decide Abortion Laws?

Abortion laws vary across the world, and even within countries, depending on the jurisdiction. In the United States, for example, abortion laws differ from state to state. While some states prohibit abortion at all stages of pregnancy, others permit it up to a certain point, and some allow abortion throughout a woman's pregnancy. In the US, the Supreme Court's 2022 decision to overturn Roe v. Wade gave states the power to restrict or ban abortion as they see fit, leading to a patchwork of abortion laws across the nation. Similarly, in countries with restrictive abortion laws, such as Poland, abortion may be criminalized, while in others, like Argentina, abortion has been legalized in recent years due to the efforts of women's rights activists. The legality of abortion is a complex and evolving issue, influenced by cultural, religious, ethical, and legal factors, and it continues to be a subject of debate and activism worldwide.

Criminalisation of abortion

The criminalisation of abortion has a detrimental impact on individuals' ability to exercise reproductive autonomy and enjoy their human rights. It creates barriers that prevent people from seeking safe abortions, leading to unsafe procedures that put their health and lives at risk. The criminalisation of abortion also disproportionately affects marginalised communities, who face additional social, economic, and political barriers to accessing healthcare services.

In some countries, such as the United States, Sierra Leone, Poland, and Morocco, abortion is criminalised, even in cases where the pregnancy is the result of rape or incest, or if it poses a threat to the life or health of the pregnant person. These restrictive laws vary between countries, with some imposing life imprisonment or other harsh penalties for those who seek or assist with abortions.

The criminalisation of abortion does little to protect life before birth, as data suggests that people facing unwanted pregnancies will seek abortion services regardless of the legal consequences. Instead, it pushes abortions underground, leading to clandestine and unsafe procedures. According to the World Health Organization (WHO), the rate of unsafe abortions is four times higher in countries with restrictive abortion laws compared to those where abortion is legal. These unsafe abortions can result in short- or long-term health problems and even death.

The negative consequences of criminalising abortion are evident in Argentina, where abortions are often performed under unsafe conditions. Despite international human rights bodies calling for reform, Argentina continues to forbid abortions except in specific circumstances. However, women and girls in Argentina often face arbitrary and unlawful barriers when seeking abortions, even in cases where their life or health is at risk.

The criminalisation of abortion not only affects access to safe procedures but also discourages people from seeking post-abortion care for complications arising from unsafe abortions or other pregnancy-related issues. It creates a "chilling effect," deterring healthcare providers from offering the best care options and patients from seeking the necessary treatment.

To protect the fundamental human rights of individuals, it is crucial to decriminalise abortion and ensure access to safe and legal abortion services. This will help reduce the number of unsafe abortions and improve overall health outcomes for people worldwide.

Social stigma of abortion

Abortion stigma refers to the set of attitudes and beliefs that abortion is "bad, shameful, or wrong". This stigma is often rooted in gendered norms, such as the expectation of sexual purity and the expectation of motherhood. It can be perpetuated by anti-abortion messaging and advocates, as well as by laws that restrict access to abortion.

Abortion stigma can have a significant impact on both those who have had abortions and those who provide them. It can cause shame, silence, and isolation, making it more difficult for people to access care or support. Additionally, abortion stigma can contribute to gender norms that harm women, people assigned female at birth, and those with feminine gender expressions.

Abortion stigma is a complex and multifaceted issue that varies depending on cultural, religious, and societal norms. It is often influenced by personal beliefs, moral values, and social expectations, particularly around gender roles and sexuality. This stigma can manifest in various ways, from internalized shame and guilt to external judgments and discrimination.

One aspect of abortion stigma is the idea that abortion is a "sin" or morally wrong. This belief is often rooted in religious teachings and can be a powerful deterrent for those considering abortion. It may lead to feelings of guilt, shame, and self-judgment, especially for those with strong religious beliefs.

Another aspect of abortion stigma is the perception that abortion is socially unacceptable. This can result in isolation, secrecy, and judgment from family, friends, and the wider community. People who have had abortions may face social ostracism, discrimination, or even violence. The fear of stigma can lead to silence and self-censorship, making it difficult for people to access support and care.

Abortion stigma also intersects with other forms of oppression, such as racism, classism, and heteronormativity. It can disproportionately affect marginalized communities, including people of color, low-income individuals, and members of the LGBTQ+ community. Structural inequalities and power dynamics often contribute to abortion stigma and create barriers to accessing safe and legal abortion services.

Additionally, abortion stigma can have a significant impact on healthcare providers. They may face social and professional repercussions, including harassment, violence, and legal consequences. This can create a chilling effect, deterring providers from offering abortion services or even discussing it as an option, further limiting access for those seeking abortions.

Finally, abortion stigma has real-world implications for policy and law. It can influence legislation and shape public opinion, impacting the availability and accessibility of abortion services. Stigma-based arguments are often used to justify restrictive abortion laws and policies, further compounding the stigma and creating a cycle that perpetuates itself.

Addressing abortion stigma requires a multi-faceted approach, including education, advocacy, and the promotion of reproductive rights and justice. It is essential to challenge harmful stereotypes, provide accurate information, and create safe spaces for open dialogue and support.

Intersectional discrimination and marginalisation

The term "intersectionality" was coined by Kimberlé Crenshaw in 1989 to describe how multiple kinds of discrimination overlap and impact people in marginalised groups. Intersectionality acknowledges that individuals have unique combinations of social and political identities, which result in distinct privileges and disadvantages. These identities include gender, race, class, sexuality, religion, disability, and age, among others.

In the context of abortion laws, intersectionality recognises that people of all races, genders, incomes, sexual orientations, abilities, and immigration statuses need abortions. Therefore, it is essential to understand how intersecting oppressions create barriers to abortion access for marginalised groups. For example, health services are generally less accessible to people with low incomes, refugees, migrants, LGBTI+ individuals, and racialised and Indigenous people. This makes it more challenging for these individuals to seek safe abortion services or access private care.

Additionally, social stigma and criminalisation of abortion further hinder people's ability to seek abortions. Even in places where abortion is legal, factors such as cost, distance to services, and socially or religiously reinforced conservative attitudes can create obstacles. For instance, medical staff may refuse to provide abortions based on their personal beliefs or religious grounds.

The criminalisation of abortion disproportionately impacts those who are already marginalised. In some countries, such as the United States, Sierra Leone, Poland, and Morocco, abortion is criminalised, and those who seek or assist in obtaining an abortion can face severe penalties. This further compounds the challenges faced by marginalised individuals, as they may be unable to afford to travel to another country or state to access legal abortion services.

To achieve true abortion justice, it is essential to address intersectional discrimination and marginalisation. This includes recognising the unique needs of LGBTI+ individuals, who may face intersectional forms of discrimination and stigma when seeking abortions. It also involves addressing the deeply rooted social, cultural, and economic barriers that make it difficult for people to exercise their reproductive rights, even in places where abortion is legal.

Restricting insurance coverage

In the United States, abortion laws are determined by individual states, with no uniform federal law in place. This means that the legal status of abortion varies significantly across the country. While some states prohibit abortion at all stages of pregnancy, others permit it up to a certain point, and some allow abortion throughout pregnancy.

One way in which states restrict abortion access is by limiting insurance coverage for abortion care. Most Americans with employer-based health insurance currently have coverage for abortion care. However, politicians have been actively working to remove this coverage. As a result of federal healthcare reform, states are establishing new insurance exchanges, and in several states, lawmakers are prohibiting insurance companies from including abortion coverage in their policies.

As of 2023, only 17 states, including California, Illinois, and New York, offer or require insurance coverage for abortion care. This means that in many states, individuals seeking an abortion must pay out of pocket, creating a financial barrier to accessing abortion services.

In addition to restricting insurance coverage, states employ various other strategies to limit abortion access. These include parental consent or notification laws, requirements for ultrasounds and mandatory waiting periods, and counselling requirements. Furthermore, some states have enacted trigger laws, which automatically ban abortion if Roe v. Wade is overturned.

The landscape of abortion laws in the United States is constantly evolving, with states enacting new restrictions or protections in response to changing federal legislation and court rulings.

Mandatory ultrasounds, waiting periods and biased counselling

In the United States, abortion laws are determined by individual states, with no uniform federal law in place. In states where abortion is legal, several restrictions may exist, including mandatory ultrasounds, waiting periods, and counselling requirements.

In 2013, a law was passed in Wisconsin requiring abortion providers to display and describe ultrasound images to patients before offering an abortion. This law goes beyond simply offering women the opportunity to view their ultrasound images; it mandates that the image be placed in the patient's line of sight. While this law does not explicitly require women to view the ultrasound, they are unable to proceed with their appointment until this step is completed.

The impact of mandatory ultrasounds on a woman's decision to continue her pregnancy is a topic of ongoing research and debate. Some studies suggest that ultrasound viewing does not dissuade women from abortion and that the majority of women who viewed their ultrasound image still proceeded with the procedure. However, other studies indicate a slight increase in the likelihood of continuing pregnancy after mandatory ultrasound viewing. It is important to note that decision certainty and other factors, such as financial considerations, also play a significant role in a woman's decision-making process.

The mandatory ultrasound law in Wisconsin has been criticised for potentially violating the ethical principle of respect for patient autonomy, as it interferes with the shared decision-making model typical in the patient-physician relationship. Additionally, it may cause harm by forcing patients to undergo unwanted procedures, particularly invasive ones, which goes against the principle of nonmaleficence.

Waiting periods are another restriction that may be imposed in states where abortion is legal. These mandatory waiting periods require patients to wait a specified amount of time between counselling and/or ultrasound and the abortion procedure. Such waiting periods serve no medical purpose but instead aim to dissuade pregnant individuals from exercising their bodily autonomy.

Biased counselling is a further concern in the context of abortion laws. Counselling requirements may mandate that patients receive biased and inaccurate information before obtaining an abortion. This type of counselling is not medically justified and can create unnecessary barriers for individuals seeking abortion care.

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