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Choice In Contention: Abortion Rights Globally

The U.S. Supreme Court's decision overturning Roe v. Wade, which secured the constitutional right to abortion for nearly fifty years, how does abortion regulation in the United States contrast with that in other nations?

Over the past fifty years, there has been a global trend toward the liberalization of abortion laws, particularly in industrialized nations. Each year, an estimated seventy-three million abortions occur worldwide, with an average rate of around thirty-nine abortions per one thousand women since 1990, according to the World Health Organization (WHO). Notably, abortion rates have diverged between countries with fewer restrictions and those with more stringent regulations. Between 1990-94 and 2015-19, countries with generally legal abortion saw a 43 percent decline in the average abortion rate, whereas countries with severe restrictions experienced around a 12 percent increase.

As nations have expanded access to reproductive health services, the quality and safety of abortion care have improved, leading to better maternal survival rates. However, safety standards for abortion procedures vary widely between countries with liberal abortion laws and those with high restrictions. Approximately 90 percent of abortions in countries where abortion is legal are considered safe, whereas only 25 percent of abortions in countries where it is banned meet safety standards. Unsafe abortions contribute significantly to maternal mortality worldwide, accounting for 5-13 percent of maternal deaths, with the majority occurring in developing countries.

Despite progress, there remains strong opposition to abortion among certain constituencies, and in recent years, some countries, particularly autocracies, have resisted the expansion of women's and reproductive rights. The 2022 U.S. Supreme Court decision in Dobbs v. Jackson Women's Health Organization, which overturned Roe v. Wade, marked a significant shift in abortion law in the United States. Since then, twenty-one states have moved to restrict abortion access.

Globally, the legal status of abortion varies considerably by region, with a large majority of countries permitting abortion under at least some circumstances. Twenty-two countries ban abortion entirely, while most industrialized nations allow the procedure without restriction. Around one hundred countries have some restrictions, typically permitting abortion in limited situations such as socioeconomic reasons, risks to a woman's health, or fetal anomalies. However, legal language concerning exemptions for fetal impairment is often ambiguous, leading to uncertainty for medical professionals regarding the legality of certain abortions.

Access to safe abortion has been recognized as a human right by numerous international frameworks and courts, including the UN Human Rights Committee and regional human rights courts. Efforts to prevent unsafe abortions have been endorsed by various international agreements, such as the 1994 International Conference on Population and Development and the United Nations' 2030 Agenda for Sustainable Development.

Recent global trends show a movement toward liberalization of abortion laws, with over sixty countries expanding the legal grounds for accessing abortion services since 1990. However, some countries, including Honduras and the United States, have enacted policies to tighten restrictions in recent years.

In 2020, Poland's Constitutional Tribunal made a ruling that declared abortions in cases of fetal impairment unconstitutional, resulting in one of the strictest abortion laws in Europe. This decision effectively initiated a near-total ban on abortion, as many abortions previously performed in Poland were due to fetal abnormalities. The ruling sparked widespread protests, with hundreds of thousands of people taking to the streets to express their opposition. Despite the outcry, the ban remains in effect. Under Polish law, abortions are still permitted in cases of rape, incest, and life-threatening pregnancies. However, doctors have reportedly been hesitant to perform legal abortions following the ruling.

There are strict penalties in place for doctors found to have performed abortions hastily or without sufficient justification, with potential consequences including up to three years in prison. This legal landscape has generated significant controversy and debate within Poland and internationally, highlighting the ongoing struggle over reproductive rights in the country.

In 2024, France achieved a historic milestone by becoming the first country to embed abortion rights within its constitution. This move marked a significant evolution from the initial decriminalization of abortion in 1975, a decision that allowed the procedure up to the tenth week of pregnancy. Over the years, France progressively extended the gestational limit to twelve weeks in 2001 and further to fourteen weeks in 2022. Considering the overturning of Roe v. Wade in the United States that same year, France took proactive measures to solidify this right by amending its constitution.

After passing through both the National Assembly and Senate, the amended Article 34 now explicitly guarantees a woman's freedom to access abortion. Public support for this amendment was overwhelmingly positive, with more than 80 percent of respondents endorsing it in polls. France's decisive action not only reaffirms its commitment to women's reproductive rights but also sets a precedent for other nations to prioritize and protect these fundamental freedoms.

In India, the Medical Termination of Pregnancy (MTP) Act, enacted in 1971 and amended in 2002, serves as the primary legislation governing abortion procedures. This act provides a framework for the termination of pregnancy under specific circumstances and with certain conditions. According to the MTP Act, abortions can be conducted by registered medical practitioners in authorized facilities, catering to various reasons such as safeguarding the woman's life, preserving her physical or mental health, addressing fetal abnormalities, or in cases of contraceptive failure, marital relationships, or instances of rape or incest.

The MTP Act allows abortions up to 20 weeks of pregnancy, subject to compliance with specified conditions. These conditions include obtaining the opinion of one registered medical practitioner for pregnancies within the first 12 weeks and the opinion of two registered medical practitioners for pregnancies between 12 and 20 weeks.

However, abortions beyond 20 weeks are permissible only if they are deemed necessary to save the woman's life or if there's a substantial risk of severe physical or mental abnormalities to the fetus. Additionally, ongoing discussions about potential amendments to the MTP Act aim to further expand access to safe and legal abortion services across the country.

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