The global reproductive rights landscape is constantly changing. The US Supreme Court ruling that overturned Roe v Wade – the landmark 1973 decision that protected a woman’s right to an abortion – marks a significant setback for abortion access. But this is not the only case. While countries like the United States, Poland and Russia are slipping back, gains are being made in places like Ireland, Colombia and Argentina.
Abortion restrictions range from laws where abortion is only permitted to protect the life or health of the pregnant person, to the complete decriminalization of abortion. Often restrictions are structured around gestational time limits, such as allowing abortion only in the first trimester.
Some laws allow abortion for socio-economic reasons, for example in Finland. And the UK Abortion Act of 1967 is an example of a broad interpretation of health that includes well-being. Physicians may consider the actual or reasonably foreseeable life circumstances of the pregnant woman when making a decision about the impact of continuing a pregnancy.
Where health is interpreted more restrictively, such as in Zimbabwe, Morocco or Peru, abortion may only be available if a pregnant person’s physical health is at risk. In other regions, such as Ghana or Bolivia, language referring to mental health is explicitly included in legislation, which can expand access to abortion.
In some regimes, abortion may be performed later in the pregnancy depending on the health status of the fetus, especially if there is a serious abnormality. This is the case in Croatia. Despite this, anti-choice sentiment in the country recently led to a woman being denied an abortion after her fetus was diagnosed with a serious brain tumour. After four Croatian hospital refusals, the woman was advised by doctors to travel to neighboring Slovenia. But following media and public outcry, she was finally allowed to have an abortion in Croatia.
The most liberal abortion laws are those where abortion has been removed entirely from the criminal law. Decriminalization allows abortion without penalty and prioritizes the safety of pregnant women in healthcare decision-making.
Northern Ireland decriminalized abortion in 2019 following an international human rights inquiry into its abortion laws and subsequent intervention by Westminster. The Abortion (Northern Ireland) Regulations 2020 came into force in March 2020. These regulations allow abortion up to 12 weeks on request, and thereafter on specific grounds of severe fetal impairment and abnormalities fatal fetuses.
Although Northern Ireland’s abortion laws have been liberalized, this does not necessarily mean that abortion is easily accessible.
The government has failed to fully commission services, meaning abortion is provided on an ad hoc basis by health trusts in Northern Ireland. Some women seeking abortions have continued to travel to England, illustrating how political stalemate can limit access to abortion.
In some countries, abortion is completely prohibited or only to save the life of the pregnant person. Malta is the only country in the EU where abortion is prohibited in all circumstances. Malta has recently seen the emergence of a pro-choice movement.
Draconian restrictions on abortion also affect general reproductive and maternal care, such as miscarriages and ectopic pregnancies. They can delay decision-making with urgent medical care when the rights of the fetus are considered equal to the rights of the pregnant woman. In El Salvador, women have been prosecuted and imprisoned for miscarrying or attempting abortions. Accused of aggravated homicide, a sentence can go up to 50 years.
In the Republic of Ireland, before liberalization in 2018, abortion laws affected all aspects of maternal health care. The fetus was considered to have equal rights to the pregnant woman, allowing medical professionals to override its claims. In 2014, a brain-dead pregnant woman was kept on life support for four weeks against her family’s wishes, on the grounds that the fetus’s right to life might have been violated.
Militant movements to liberalize abortion laws have made significant progress in recent years as seen on the island of Ireland, but also in Colombia where the Constitutional Court decriminalized abortion up to 24 weeks in 2022. In Argentina, abortion is legal on request in the first 14 weeks of pregnancy since 2020.
outside the law
Advances in abortion rights have been cyclical and non-linear. As we see in the United States, anti-abortion movements continue to push back against any gains made. The regression of reproductive rights is often correlated with broader negative reactions to women’s rights and the rise of far-right and populist political regimes.
Laws are only part of access to abortion. Conscientious objection from health professionals, regulations targeting abortion providers, stigma and protests in clinics make obtaining an abortion more difficult and riskier.
Even in countries with less restrictive laws, there are movements outside of legal frameworks to help people access abortion and health care, by facilitating travel or financial support.
While these activist networks and organizations are often seen as band-aids that will no longer be needed when restrictions are eased, the reality is that barriers to abortion continue to exist after the laws change. The England-based organization Abortion Support Network continues to help around 60 Irish women a year, four years after abortion laws were liberalized. These efforts are as much a part of reproductive rights as they are of the legal framework – and their work isn’t done when the laws change.