Updated Oct. 21, 6:30 p.m. 2024*
PARIS — It has been more than two years since the United States Supreme Court overturned Roe v. Wade, ruling that safe access to abortion is no longer a Constitutional right for American women.
For women in the rest of the world, the ruling reverberated on the weight of the U.S. judicial and cultural influence, with fears that it could have repercussions in their own courtrooms, parliaments and medical clinics. This November ten U.S. states will have abortion on the ballot in referendums, and the world is watching to see if women voters tip the balance in the presidential election where a growing number have told pollsters that abortion rights is their No. 1 concern.
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In the U.S. and around the world, the status of abortion rights is ever more in flux — in both directions.
In what was perhaps the most momentous decision since Roe’s overturning, the U.S.’s southern neighbor, Mexico saw its own Supreme Court last year unanimously decree that abortion would be decriminalized nationwide, and inflicting any penalty on the medical procedure was “unconstitutional … and a violation of the human rights of women and those capable of being pregnant.”
Mexico is the latest (and most populous) Latin American country to expand reproductive rights, even as their northern neighbor continues to waver on the issue.
Globally, since the June 25, 2022 ruling that overturned Roe v. Wade, abortion rights are progressing in many parts of the world, even as others are in step with the U.S. Supreme Court in restricting access.
Even amid the expansion of abortion rights in Latin America, the shadow of Roe v. Wade still hangs ominously. As Irma Barrientos, director of the Mexican Civil Association for the Rights of the Conceived, puts it: “We’re not going to stop – let’s remember what happened to the United States.”
Latin America: The Green Wave
Still, the news from Mexico stands out as part of what Latin American women’s rights activists are calling a: “green wave”.
Traditionally driven by Catholic Church teachings, Latin America has moved to liberalize the procedure amid widespread public pressure from pro-choice movements and a growing acceptance from the public at large.
"We knew this was not an easy fight, but at some point it had to happen."
The “green” symbolism is traced back to Argentina in 2018, when thousands of women marched on the Senate wearing a pañuelo verde (green handkerchief) ahead of a vote on abortion rights – which did not ultimately result in a win. Wearing green, to symbolize life, was an attempt to reframe the common narrative that abortion opponents are the defenders of life. This would become the symbol for reproductive rights not only in Argentina, but the whole of Latin America.
Even if 2018 did not result in a victory for Argentinian women, that would change in late December of 2020, when a bill to decriminalize abortion was approved. Then in February 2022, in a post-Roe v. Wade climate, Colombia followed Argentina in deciding to decriminalize abortion. Then, barely a month later, Chile passed an article guaranteeing sexual and reproductive rights as fundamental and therefore protected by the state.
Are these laws perfect? No – even in these newly decriminalized countries, women face stigma from the conservative, highly religious societies they live in. Some laws still have restrictions, like in Colombia, where abortion after 24-weeks remains illegal.
Mariana Ardila, an attorney for Women's Link Worldwide, and an advocate for reproductive rights said, "We knew this was not an easy fight, but at some point it had to happen. Of course, while we were hoping for full decriminalization, and we will keep fighting for it, this is an important step forward for us.”
And, still, there are other countries where the green wave is struggling to take effect.
For example, El Salvador still has a total abortion ban, with penalties ranging from two to 50 years in prison. In this Central American country, women have even been imprisoned for stillbirths and miscarriages.
Europe: Looking progressive, feeling conservative
Like in the U.S. pre-2022, many countries in Europe have considered themselves “safe” and “progressive” on the issue, both before and after the overturning of Roe v. Wade. But things are not as simple as they seem.
Close to one-third of women and girls in Europe face challenges in accessing abortion care, according to the European Abortion Politics Atlas. While 21 European countries treat abortion like any other medical service, 16 regulate it through their legal codes, allowing restrictions to be placed on the procedure. Further, in 31 European nations abortion procedures are not covered as part of their national health plan, often making it a financial burden for those who are low income, like undocumented immigrants, Roma people and sex workers.
Many wanting to end pregnancies are forced to travel to find a provider, often resorting to private clinics.
Much of the continent is marked by stark contrasts in access, and slow ebbs of progression and regression. Malta, a majority Catholic country, overturned their total ban on abortions – which had been in the penal code since the 1800s – in November 2022. It happened as a result of an American tourist who sued the country after being denied a life-saving abortion on the island. She had to be airlifted to Spain for the procedure. Still, the change in Malta’ legislation is minute – abortion can only be performed to save the mother’s life, and mothers must be at true risk of dying to be considered.
On the other hand, San Marino, a Catholic micronation, saw its residents vote an overwhelming 77% in favor of overturning its full ban on abortions in September of 2021. One year later, in September of 2022, the bill to make abortion legal in the first 12 weeks was approved, with the cost covered by San Marino’s public health system.
Currently 26 European countries allow healthcare workers to deny abortions based on their personal beliefs, which is a particular issue in Spain: The country liberalized its abortion laws in 2010, allowing abortions up to 14 weeks in any public hospital. But an abundance of so-called "conscientious objectors" means that many wanting to end pregnancies are forced to travel to find a provider, often resorting to private clinics. Despite legislative attempts to curb these conscientious objectors, doctors refusing to perform abortions are also on the rise in countries like Italy and Argentina.
Still, the country is pushing for progress: in February, Parliament approved a legislation which would allow girls aged 16 and 17 to have abortions without parental consent, and a mandatory three day “reflection period” for all abortions was done away with.
Italy is currently under the right wing presidency of Giorgia Meloni, who was elected last September. This raised many concerns for Italian citizens, but Meloni, who is personally anti-abortion, will not seek to change the law. The political climate within the country has maintained its Catholic conservatism, but on the world stage, it seems that Meloni would prefer to present herself as moderate.
Meanwhile, French president Emmanuel Macron has spoken of his support of reproductive rights, particularly in light of Roe v. Wade. Almost as a direct response to the U.S Supreme Court overturning of Roe.V. Wade. On March 4, France became the first country to enshrine abortion rights in its Constitution, following a decisive vote by lawmakers.
The move is a major victory for women's rights in France, and pro-choice movements around the world. This came despite opposition from some conservative groups, including the Catholic Church, the measure passed with overwhelming support. But this attitude is not universal throughout Europe especially in eastern European countries like Poland.
Poland - a league of their own
There is some hope for increased abortion rights in Poland after last year's national elections saw the victory of a moderate coalition led by Prime Minister Donald Tusk, which ousted from power the unapologetically pro-Catholic PiS, which had been in power for eight years, and had introduced some of the most rigid abortion bans in the world. Still, a year since the election, the Tusk government has not fulfilled its promises of reversing some of the abortion restrictions.
Poland instituted a near total abortion ban in 2022 except in cases where the woman's health was at risk – and even in these cases, abortions are not being performed. This is part of a shift toward more conservative legislature that has also targeted LGTBTQ rights in the name of "pro-family" resolutions. Polish doctors who conduct abortions could be given up to a three-year prison sentence. Countries with more progressive abortion stances have stepped up in response, most notably Belgium, which is funding cross-border abortions for Polish women.
The one caveat, saving the mother’s life, is itself a difficult one for women to navigate. Take the case of Joanna (no last name specified), who legally took an abortion pill, before being detained by Polish police. The authorities claimed that Joanna had been pressured into conducting the abortion, and four officers awaited her at the hospital, making her “undress, squat, and cough” as part of their investigation.
In June, the European Court of Human Rights rejected a complaint by eight Polish women who argued that they were forced to carry their pregnancies to term despite severe fetal abnormalities. In the same month, protests were sparked after the death of Dorota Lalik, a 33-year-old woman who could have been saved if the Polish hospital hadn’t refused to conduct an abortion.
China - women's bodies as economic instruments
China has long been known for its family planning through its One-Child Policy to limit population growth, which formally ended in 2016. Now, birth rates are dwindling, and as of last September there have been new efforts to reduce abortions. The State Council, China's cabinet, announced its intention to curb "medically unnecessary" abortions, but with few details on how this would be achieved. The plan also included increased access to birth control, and higher quality of sexual education in schools.
"China's government still treats women's bodies as tools"
While the government issued a similar proposal in 2011, some are more concerned now given increased government intervention in promoting childbirth amidst an aging population. The country's population growth has slowed for close to 30 years now, with the over 60 population increasing from 13.3% in 2010 to 18.7% by 2010.
Whether through being forced to end a pregnancy or carry one to term, some Chinese women feel like they have little control over their bodies. As Yaqiu Wang, a China researcher at Human Rights Watch, told the Sydney Morning Herald, "Today, many across the country still painfully feel the trauma of forced abortion. And now, without government acknowledgment or accountability, Beijing is doing a potentially abusive about-face. What hasn't changed is that China's government still treats women's bodies as tools for its economic development goals."
North Africa and Middle East: de facto bans
Close to 80% of women in the Middle East and North Africa region face restricted access to abortion. Sites like Women on Web help facilitate sending abortion pills to areas where they are difficult or impossible to acquire, but these platforms have been banned in Saudi Arabia, where abortions are authorized only in rare circumstances.
Tunisia and Turkey are the only two MENA countries that allow elective abortions; most governments in the region only permit them when they are medically necessary. Even in circumstances where abortion is legal, many seeking to end pregnancies deal with strong social stigma in these majority Muslim nations.
Turkish women have described the situation as a "de facto" abortion ban under President Recep Tayyip Erdogan and many are forced to turn to illegal clinics with questionable health practices. In Tunisia, abortion has been legal since 1973, but women must overcome societal outcasting as well as economic and structural hurdles in terminating pregnancies.
While the Arab Spring focused specifically on achieving equal rights for women, the reality is many still face inequitable treatment, including for reproductive health care. Unwed mothers who keep their babies are often seen as social outcasts, creating a terrible Catch-22 for many.
Sub-Saharan Africa: feeling ripples from the U.S.
Nations located in the Sub Saharan area have long struggled to make access to abortions safe and legal, but in the recent year efforts have been complicated by the intervention of religious conservatives.
Anti-abortion organizations operating in Africa have been emboldened by the overturning of Roe v. Wade, with players such as the US-based Family Watch International playing a role in influencing health policies. The organization has organized a meeting centering on “family value and sovereignty” in Uganda, which hosted law-making participants from more than 20 African countries. Additionally, Family Watch International is pushing for the revocation of a 2005 Ethiopian law which widened access to abortion in a push to reduce maternal mortality rates.
Annually, more than 77% of abortions in Africa are unsafe, but this year has seen the collaboration of many activists throughout sub-Saharan Africa to change this. For instance, the recently established CATALYSTS consortium, set-up by a number of organizations, is moving forward with their plan to share health knowledge throughout the continent.
The Unites States - one year later
Back in the U.S., it has been a tumultuous time since the overturning of Roe v. Wade, which put an end to the constitutional right to safe abortions, but leaves each state to decide how to handle the issue. Already, more than a dozen states have taken up the opportunity to do so.
Tarah Demant, National Director of Programs at Amnesty International USA, has stated that “one in three women and girls of reproductive age now live in states where abortion access is either totally or near-totally inaccessible.” Bans on abortion vary in terms of how many weeks after the pregnancy the procedure is being pursued: Texas bans abortions after six weeks, with no exceptions for rape or incest, while Florida bans abortions after 15 weeks of pregnancy, also without exception for cases or rape or incest. Both have allowances to save the life of the mother. Mississippi bans abortions with exceptions in the case of rape – but not in the case of incest.
Advocates on the left are concerned that other constitutional rights may be overturned.
There are a number of states where abortions bans have been proposed, but blocked by the courts. For instance, Montana’s Supreme Court blocked an abortion ban after 15 weeks by declaring that its constitution protects abortion rights. Similarly, judges have blocked motions to reduce the time allowed for abortions in the states of Wyoming, Iowa, Indiana, Ohio and South Carolina.
Still, there are states where abortion does remain legal, and access has been facilitated. Many clinics have moves across state lines, hired more staff, and lengthened working hours. For instance, the clinic CHOICES, which used to operate in Tennessee, has moved three hours away to Illinois, and the CEO has stated that: “I would say 80% or more of our patients continue to come from the communities that CHOICES has always taken care of.”
Abortion remains a pressing and highly politicized issue in America, and this will only continue into the 2024 presidential elections. Meanwhile, advocates on the left are concerned that other constitutional rights may be overturned, including anxieties over LGBTQ rights nationwide. Evan Wolfson, the founder of Freedom to Marry, which campaigned to legalise gay marriage, told NBC news: “We don’t need to speculate about how many more bad things will come. What they have done is already betrayal enough.”
*This article, originally published on Sept.8 , 2023, was updated Oct. 21, 2024 with enriched media and information about the U.S. election and France's constitutional amendment enshrining abortion.