If the Supreme Court overturns the watershed 1973 Roe v. Wade decision and paves the way for dozens of states to restrict or outlaw abortion, the U.S. could become one of the few countries reversing a decadeslong, global trend toward increasing access to abortion.
Across the country, groups advocating on both sides of the issue continue to argue their views are in line with international norms as the high court weighs the legality of a Mississippi law that would ban most abortions after 15 weeks of pregnancy with no exceptions for rape or incest.
But in reality, the issue is convoluted with many countries boasting similar time-period rules but also offering much more lenient exceptions that allow women greater access to such procedures — some not even requesting a reason before a person is allowed to abort a pregnancy.
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More than 70 countries allow abortion upon request, meaning no justification is needed, and the most common time or gestational limit for those countries is about 12 weeks into pregnancy, according to the Center for Reproductive Rights, which advocates for expanding abortion access worldwide.
But many offer broad exceptions after that point for social, economic and physical or mental health reasons.
"If the U.S. were to turn back Roe or were to decrease the gestational limits around abortion, they would really be a global outlier compared to what we've seen worldwide in abortion law trends," said Katy Mayall, director of strategic initiatives at the Center for Reproductive Rights.
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As Supreme Court weighs Roe, more nations legalizing abortion
Abortion was legalized in places like Israel and India around the same time as the Roe decision. Sixty countries, including New Zealand, Thailand and a number of Latin American nations with large Catholic populations, have liberalized abortion laws since the center began tracking in 1994, Mayall said.
Last year, Mexico's Supreme Court unanimously ruled states could no longer criminally prosecute people for having an abortion in the largely Roman-Catholic country where the procedure was once widely restricted.
Colombia, Argentina and Ecuador have also decriminalized abortions under certain circumstances following a protest movement that began in 2015 known as the "green wave." Chile, where such procedures were banned entirely until 2017, could become the first Latin American country to enshrine abortion rights in it's constitution if a new draft is approved later this year, Reuters reported.
Voters in Ireland removed a ban on abortion from the country's constitution in 2018 following years of people being forced to travel to Britain to terminate pregnancies.
A handful of Africa's 54 countries, including Zambia, South Africa and Tunisia have relatively liberal abortion laws. In October, Benin legalized abortion in most circumstances up to 12 weeks.
Australia's laws are the most comparable to the United States, with access varying in each state. But unlike the U.S., all Australian territories in recent years have moved to decriminalize abortion under certain circumstances, Mayall noted, while U.S. states have seemingly moved in opposing directions on the issue.
Just eight countries, including the U.S., allow people to have an abortion without giving a reason after 20 weeks: Canada, China, Iceland, the Netherlands, North Korea, Singapore and Vietnam.
Roughly 40 European countries have 15-week-or-earlier cutoffs, but Mayall said many allow people to end a pregnancy after that limit for a wide range of reasons. None of the time limits in Europe are as early as the recent law in Texas which prohibits the procedure after about six weeks of pregnancy.
A German national, for instance, can get an abortion even after the country's 12-week cut off if there are "present and future circumstances" that show the procedure is needed to avoid harm to mental or physical health.
"The limits are on the books. They are the laws in those countries; certainly enforcement varies depending on the preferences of the citizens of those countries," said Stephen Billy, executive director of the Charlotte Lozier Institute, a research group opposed to abortion. "That is the ideal situation that we should be working toward."
He argued the 15-week ban as part of the Mississippi law that is at the center of the Supreme Court abortion debate would be "mainstream, if not a little more permissive than what the majority of Europe has," even though the law doesn't allow for exceptions like many European nations.
Despite gains, abortion access can be challenging
Even in places where abortion is legal, there can be procedural barriers that make the procedures less accessible. Systemic barriers that make healthcare harder to access in countries with lower levels of economic development also make it more difficult to access abortion, Mayall said.
Germany and the Netherlands have mandatory waiting periods before patients can access such procedures. And in Italy, where abortion is covered for free as a reproductive health service, the process can be a drawn out because many providers can refuse service unless the pregnant person's life is in danger.
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In Japan, where abortion is allowed only for economic and health reasons, patients are required to get their partner's consent except in cases of rape. The country has also not approved the abortion pill.
But many Western countries lack many of the barriers seen in the US. Many have nationalized healthcare systems that mitigate the cost of abortion and patients often don't have to travel long distances due to their size, Mayall said.
"Different countries have different barriers around abortion access, but overwhelmingly where countries have liberalized their abortion laws, at the very least, it has increased access to safe abortion services," said Mayall. "Nearly universally, abortion stigma remains a barrier to access."
US states could become one of the few places to criminalize abortion globally
Two dozen countries including Iran, Malta and several African nations prohibit abortion in all circumstances. Poland, another largely Catholic nation, is the only European country that has tightened abortion laws in recent years, according to the Center for Reproductive Rights.
The country introduced a near-total ban in January 2021 except in cases where the pregnant person's life is at risk, or in cases of rape or incest. Prior to the ban, 98% of legal abortions in the country were performed due to fetal malformations, an exemption ruled unconstitutional by the country's top court.
The Center for Reproductive Rights cites just two other countries that have introduced significant restrictions on abortion recently: Nicaragua and El Salvador. In the latter Central American nation, people who have abortions or even miscarriages can face decades in prison on homicide charges.
Lawmakers in Louisiana approved a bill this week that would allow pregnant people and those who assist in terminating a pregnancy to be charged with homicide.
"A lot of restrictive laws - not all of them - have provisions that criminalize the dissemination of information about abortion or that make it a crime to be an accomplice to abortion as well," said Mayall. "That has an incredibly chilling effect."
Lawmakers in Brazil also introduced at least 30 bills seeking to tighten abortion laws, according to watchdog Women in Congress. China, which has one of the world's highest abortion rates, is also moving to reduce the procedures among teens and those that are not medically necessary.
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Even in African countries where abortion is legal under limited circumstances, it's hard for people to obtain a safe, legal procedure, according to the Guttmacher Institute, a research and policy organization that advocates for advancing sexual and reproductive health and rights. The continent has the highest number of abortion-related deaths, the Institute reported.
"What the evidence shows around abortion laws is that no matter what the legal status of abortion is that people will have abortions either way," Mayall said. "What happens in practice, is that where abortion laws are more restrictive, abortions are just less safe."
Contributing: John Fritze, USA TODAY; The Associated Press
Contact Breaking News Reporter N'dea Yancey-Bragg at [email protected] or follow her on Twitter @NdeaYanceyBragg
