Here's what happens in countries that restrict abortion

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The Supreme Court overturned Roe v. Wade: Here’s what happens in countries that restrict abortion

The significance of the Supreme Court’s historic move to strike down Roe v. Wade on Friday may be best understood by looking beyond U.S. borders.

The decision in the Dobbs v. Jackson Women’s Health Organization case is a rare example in the past few decades of a country backsliding on abortion rights. In fact, the global trend has been in the opposite direction. Ireland long stood out in Europe for its strict abortion controls. But the death of a woman named Savita Halappanavar, whose life may have been saved by an abortion, galvanized a movement that overturned that country’s abortion ban in 2018. In September, Mexico’s Supreme Court decriminalized abortion, a decision celebrated by crowds of feminist activists wearing green bandanas — a symbol borrowed from Argentina’s own recent successful push to expand abortion access.

“The reversal of abortion rights in the United States runs counter not only to the trend in other democracies but against the trend throughout the world,” Susheela Singh, vice president for global science and policy integration at the Guttmacher Institute, told Grid.

In countries that have enacted restrictive laws against abortion, healthcare data offers a stark warning to the U.S. Compared with nations with limited restrictions, these countries have a higher rate of unsafe abortions, which can have severe consequences for the patient’s health. And these consequences tend to fall unevenly across socioeconomic lines.

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Grid reviewed data reflecting where the world stands on abortion rights, the trends in certain countries toward greater access to abortion and what the impact of restrictions has been on global maternal health. Those stories are covered in the following three charts.

The U.S. turns against the tide

As the map shows, abortion is now fully banned in only a small subset of countries, but a wide range of restrictions exist worldwide. Across high-income nations, the norm is restriction-free abortion, according to the Council on Foreign Relations. While some 100 countries still place restrictions on abortion, 38 countries have moved to expand access to abortion in recent years. Prior to the Dobbs decision, the U.S. was actually an outlier on the global stage for its relative lack of restrictions to abortion; now it is headed in the other direction.

“The overall global trend is toward expanding the reasons under which abortion is legally permitted,” said Remez, adding that only three countries — and now a fourth, the U.S. — have added restrictions or removed protections since 2008.

Worldwide abortion restrictions impact maternal health

A global study published in the Lancet in 2020 showed that in countries with highly restrictive abortion laws, the abortion rate is actually higher than in countries that broadly allow abortion. From a public health perspective that is a concern because these abortions are more likely to put pregnant people at risk.

In countries that allow abortion, a separate Lancet study found that 90 percent of abortions were safe, versus only 25 percent in nations with bans in place. And a striking percentage of maternal deaths globally are due to unsafe abortions: 5 to 13 percent, according to the World Health Organization and the Council on Foreign Relations.

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“Legal restrictions impose a physical, emotional and financial toll on the well-being of people seeking abortion care, and disproportionately harm people with the fewest resources,” said Singh.

Unsafe abortions aren’t the only issue; the inability to end a pregnancy can have other repercussions. For instance, when children are born close together, mothers may stop breastfeeding, which negatively affects the health of the first born, Ndola Prata, a professor of maternal and child health at University of California, Berkeley, told Grid. Mortality is also higher for people who are unable to space out their children, she said, adding that experts recommend a minimum of two years between births. These issues are particularly prominent in low-income countries, where the map below shows maternal mortality is highest.

In recent years, maternal mortality has also been on the rise in the United States. Amanda Klasing, associate director of the Women’s Division at Human Rights Watch, said that the experience of countries with limited abortion options should be a warning for the United States: “Those experiences have taught us that the U.S. — which shockingly already has the highest maternal mortality rate among at least 10 other wealthy countries — should brace for maternal mortality and morbidity to rise, particularly among Black people and people living in poverty.”

Correction

An earlier version of this article misattributed a quote from Susheela Singh. This version has been corrected.

Thanks to Lillian Barkley for copy editing this article.