Induced Abortion: A Worldwide Perspective

Abstract

Laws and Policies Today, 76 percent of the world's people live in countries where induced abortion is legal, at least for health reasons; and 39 percent reside in nations where abortion is available upon request. The procedure is legal in nearly every developed country, and although a majority of developing countries prohibit abortion, 67 percent of the residents of the developing world live in countries where it is permitted at least for health reasons. The other 33 percent-more than one billion people, most of them living in Sub-Saharan Africa, Latin America and the more strongly fundamentalist Islamic nations-have little or no access to legal induced abortion. Although many women around the world are unable to obtain legal abortions when they need them, the current world situation differs considerably from conditions prevailing 50 years ago, when nearly every nationoutlawed abortion. The first definitive steps toward the legalization of abortion were taken in Northern Europe during the 1930s and gained momentum in the years following World War II, when the socialist nations of Eastern and Central Europe (with the exception of Albania) adopted laws permitting firsttrimester abortions either at the woman's request or on the basis of broadly interpreted social indications. Many other developed countries, including the United States, followed suit in the 1960s and 1970s. By the beginning of 1986, induced abortions could be legally obtained for health reasons in North America and in every European country except Belgium, Ireland and Malta. Although in many of these nations certain restrictions apply to the provision of abortion, especially in the second trimester, almost any woman who wants one can get a legal first-trimester abortion. Thus, the legalization of abortion in the United States can be viewed as part of a trend toward liberalization of abortion laws throughout the industrialized world. This trend, which is occurring in developing as well as developed countries, has continued up to the present, as abortion laws have been relaxed in five more countries within the past four years-Greece, Portugal, Spain, Taiwan and Turkey. During the same period, women's access to legal abortion has been significantly reduced only in Romania (in 1984). That nation's population policy also restricts the availability of modern contraceptive methods and authorizes the investigation of all women who experience miscarriages. In addition, the Irish constitution was amended in 1985 to prevent any future liberalization of its highly restrictive abortion law. Motivations for changes in abortion laws have varied widely, from considerations of public health, social justice and women's rights to concern about rapid rates of population growth. This last factor was an explicit reason for the adoption of liberal abortion laws in Japan and Tunisia. Of the few countries that have made their abortion policies stricter, most appear to have been motivated by a desire to increase fertility. For example, Romania changed its policy in 1984 for that reason; abortion is permitted only for women who have four or more children, who are over 45, who are the victims of rape or incest or who have medical reasons for seeking an abortion. (Although these restrictions were in effect prior to 1984, they were not strictly enforced.) The prospect of a dwindling work force encouraged the governments of Bulgaria, Czechoslovakia and Hungary to restrict abortion between 1961 and 1974, although Czechoslovakia has recently liberalized its law. On the other hand, abortion laws were relaxed in some Western European nations where there is much concern over low fertility, such as France and West Germany. The only instance since 1945 in which a liberal abortion law was completely reversed occurred for religious reasons in Iran, when the country's revolutionary Islamic government replaced a newly liberalized abortion law with one that is extremely restrictive. However, other branches of Islam are generally less opposed to abortion, and abortion laws have been relaxed in several of the more modern Islamic countries, notably Tunisia and Turkey. Although most developing countries prohibit abortion, the two largest, China and India, liberalized their laws in 1957 and 1971, respectively. In Sub-Saharan Africa, such nations as Burundi, Ghana, Rwanda, Zambia and Zimbabwe have eased some of the restrictions that they inherited from the colonial period. Only a few Latin American countries have changed the restrictive laws that were enacted in the 19th century. However, even in countries where abortion is prohibited without exception, implicit provisions of statutes or general principles of criminal law in most, if not all, cases permit abortion to save the life of a pregnant woman. Actual abortion practice sometimes deviates from the provisions of statutory law. In Belgium, for example, a network of nonprofit clinics openly performs abortions, despite the fact that the procedure is illegal. Similarly, clinics and physicians in some areas of Latin America and elsewhere who provide large numbers of abortions are tolerated by the government.