Liberal Abortion Laws Research Articles

Abortion and Ensoulment = الإجهاض و نفخ الروح

Abortion and Ensoulment = الإجهاض و نفخ الروح

Health system reform and safe abortion: A case study of Mongolia

Unsafe abortion serves as a marker of global inequity as it is concentrated in the developing world where the poorest and most vulnerable women live. While liberalisation of abortion law is essential to the reduction of unsafe abortion, a number of challenges exist beyond this important step. This paper investigates how popular health system reforms consonant with neoliberal agendas can challenge access to safe abortion. We use Mongolia, a country that has liberalised abortion law, yet, limited access to safe abortion, as a case study. Mongolia embraced market reforms in 1990 and subsequently reformed its health system. We document how common reforms in the areas of finance and regulation can compromise the safety of abortions as they foster challenges that include inconsistencies in service delivery that further foment health inequities, adoption of reproductive health programmes that are incompatible with the local sociocultural context, unregulated growth of the private sector and poor enforcement of standards and technical guidelines for safe abortion. We then discuss how this case study suggests the conversations that reproductive health policy-makers must have with those engineering health sector reform to ensure access to safe abortion in a liberalised environment.

Women’s Awareness of Liberalization of Abortion Law and Knowledge of Place for Obtaining Services in Nepal

In Nepal, following the liberalization of the abortion law, expansion and scaling up of services proceeded in parallel with efforts to create awareness of the legalization status of abortion and provide women with information about where services are available. This article assesses the effectiveness of these programmatic interventions in the early years of the country's abortion program. Data from a 2006 national survey are analyzed with 2 outcome measures-awareness of the legal status of abortion and knowledge of places to obtain abortion services among women ages 15 to 44 years. The variations in the outcomes are analyzed by ecological-development subregion, residence, education, household wealth quintile, age, and number of living children. Bivariate and multivariate logistic regression techniques are used. Overall 32.3% (95% confidence interval = 31.4% to 33.2%) of the respondents were aware of the legal status of abortion and 56.5% (95% confidence interval = 55.5% to 57.4%) knew of a place where they could obtain an abortion. Both outcome measures showed considerable variations by the covariates. Women with secondary or higher level of education had the highest odds ratio of being aware of the law and having knowledge of a source for abortion services. Ecological-development subregions showed the second highest levels of odds ratios. Significant disparities among the population subgroups existed in the diffusion of awareness of the legal status of abortion and having knowledge of a place for abortion services in Nepal. The results point to which population subgroups to focus on and also serve as a baseline for assessing future progress in the diffusion process.

Exploring pregnancy termination experiences and needs among Malaysian women: A qualitative study

BackgroundMalaysia has relatively liberal abortion laws in that they permit abortions for both physical and mental health cases. However, abortion remains a taboo subject. The stagnating contraceptive prevalence rate combined with the plunging fertility rate suggests that abortion might be occurring clandestinely. This qualitative study aimed to explore the experiences of women and their needs with regard to abortion.MethodsWomen from diverse backgrounds were purposively selected from an urban family planning clinic in Penang, Malaysia based on inclusion criteria of being aged 21 and above and having experienced an induced abortion. A semi-structured interview guide consisting of open ended questions eliciting women’s experiences and needs with regard to abortion were utilized to facilitate the interviews. Audio recordings were transcribed verbatim and analyzed thematically.ResultsThirty-one women, with ages ranging from 21–43 years (mean 30.16 ±6.41), who had induced surgical/medical abortions were recruited from an urban family planning clinic. Ten women reported only to have had one previous abortion while the remaining had multiple abortions ranging from 2–8 times. The findings revealed that although women had abortions, nevertheless they faced problems in seeking for abortion information and services. They also had fears about the consequences and side effects of abortion and wish to receive more information on abortion. Women with post-abortion feelings ranged from no feelings to not wanting to think about the abortion, relief, feeling of sadness and loss. Abortion decisions were primarily theirs but would seek partner/husband’s agreement. In terms of the women’s needs for abortion, or if they wished for more information on abortion, pre and post abortion counseling and post-abortion follow up.ConclusionsThe existing abortion laws in Malaysia should enable the government to provide abortion services within the law. Unfortunately, the study findings show that this is generally not so, most probably due to social stigma. There is an urgent need for the government to review its responsibility in providing accessible abortion services within the scope of the law and to look into the regulatory requirements for such services in Malaysia. This study also highlighted the need for educational efforts to make women aware of their reproductive rights and also to increase their reproductive knowledge pertaining to abortion. Besides the government, public education on abortion may also be improved by efforts from abortion providers, advocacy groups and related NGOs.

The Relationship between Abortion Liberalization and Sexual Behavior: International Evidence

Economic theory predicts that abortion laws affect sexual behavior since they change the marginal cost of having risky sex. We estimate the impact of abortion laws on sexual behavior by reported gonorrhea incidence. Our data panel includes 41 countries for which consistent gonorrhea data are available for 1980-2000. Compared with laws permitting abortion only to save the pregnant woman's life or her physical health, the switch to more liberal abortion laws is associated with large increases in reported gonorrhea incidence. Our results help explain why birth rates do not decline at the same rate abortions increase when laws are liberalized.

“Yo No Sabía...”—Immigrant Women’s Use of National Health Systems for Reproductive and Abortion Care

Half of pregnancies worldwide are unintended; half of these end in abortion. Immigrant women encounter more obstacles to reproductive healthcare than non-immigrant women, and access to national healthcare is a particularly important factor in abortion access. Spain's government recently liberalized abortion laws, including abortion services in the national health system available to immigrants. Evidence suggests that immigrant women in Spain experience difficulties navigating the health system-the impact of the changed abortion laws on immigrant's women's access to care is not yet clear. Through a literature review and analysis, this paper examines the experiences of immigrant women with national health systems, and their use of such systems for reproductive and abortion care, in order to explore what could be expected in Spain as the national health system expands to include abortion care, and to illuminate immigrant women's experiences with using national health systems for reproductive healthcare more broadly.

By reason alone: Catholicism, constitutions, and sex in the Americas

Catholic backlash against the liberalization of abortion and same-sex marriage laws in the Americas has been gathering momentum through the use of constitutional and human rights arguments. While Bishops’ Conferences as well as individual priests and the Vatican itself continue to frame sexual and reproductive rights in the language of God and faith, lay Catholic lawyers have translated theology into constitutional and human rights arguments to halt and reverse liberal abortion and same-sex marriage laws. Their arguments invoke reason instead of faith, based on the claim that the right use of reason in legal arguments leads to the same conclusions as theological reasoning. This article examines the main arguments recently used by lay Catholic lawyers in the United States, Colombia, Mexico, and Brazil and relates them back to the Vatican’s position on human life, religious freedom, and gender equality. This article examines these parallels, their implicit theological basis, as well as their tensions, both rhetorical and substantive, with mainstream constitutionalism.

Hysterosalpingography Tubal Infertility in an Environment with Non Liberalized Abortion Law

Hysterosalpingography Tubal Infertility in an Environment with Non Liberalized Abortion Law

Induced abortion: incidence and trends worldwide from 1995 to 2008

Data of abortion incidence and trends are needed to monitor progress toward improvement of maternal health and access to family planning. To date, estimates of safe and unsafe abortion worldwide have only been made for 1995 and 2003. We used the standard WHO definition of unsafe abortions. Safe abortion estimates were based largely on official statistics and nationally representative surveys. Unsafe abortion estimates were based primarily on information from published studies, hospital records, and surveys of women. We used additional sources and systematic approaches to make corrections and projections as needed where data were misreported, incomplete, or from earlier years. We assessed trends in abortion incidence using rates developed for 1995, 2003, and 2008 with the same methodology. We used linear regression models to explore the association of the legal status of abortion with the abortion rate across subregions of the world in 2008. The global abortion rate was stable between 2003 and 2008, with rates of 29 and 28 abortions per 1000 women aged 15-44 years, respectively, following a period of decline from 35 abortions per 1000 women in 1995. The average annual percent change in the rate was nearly 2·4% between 1995 and 2003 and 0·3% between 2003 and 2008. Worldwide, 49% of abortions were unsafe in 2008, compared to 44% in 1995. About one in five pregnancies ended in abortion in 2008. The abortion rate was lower in subregions where more women live under liberal abortion laws (p<0·05). The substantial decline in the abortion rate observed earlier has stalled, and the proportion of all abortions that are unsafe has increased. Restrictive abortion laws are not associated with lower abortion rates. Measures to reduce the incidence of unintended pregnancy and unsafe abortion, including investments in family planning services and safe abortion care, are crucial steps toward achieving the Millennium Development Goals. UK Department for International Development, Dutch Ministry of Foreign Affairs, and John D and Catherine T MacArthur Foundation.

Legal Abortion Worldwide in 2008: Levels and Recent Trends

Periodic assessments of abortion incidence are essential for monitoring trends in unintended pregnancy and gaps in contraceptive services and use. Statistics and estimates of legal induced abortions in 2008 were compiled for 64 of the 77 countries in which legal abortion is generally available; the 64 are home to 98% of women aged 15-44 who live in the countries eligible for inclusion. Data sources included reports or completed questionnaires from national statistical offices and nationally representative surveys. The completeness of official figures was assessed by in-country and regional experts. Trends since 1996 and 2003 were examined. Of the 77 countries with liberal abortion laws, 36 are in the developing world. In 2008, abortion rates in the 25 countries with complete records-all of which were developed-ranged from seven (Germany and Switzerland) to 30 (Estonia) per 1,000 women aged 15-44. Abortion rates declined in about half of the 20 countries with consistently reliable information on trends between 1996 and 2008; declines were generally steeper than increases, although the pace of decline slowed after 2003. The highest observed abortion rates were in developing countries with incomplete estimates. For most developing countries that had liberal laws, the reported abortion rates were incomplete and varied widely. High abortion rates in some countries, and small increases in rates in others, indicate a great need for more effective family planning services for these populations. Reliable data collection systems, needed to ensure that trends can be effectively monitored, are lacking in many countries.

‘It hurts, but I don't have a choice, I'm not working and I'm sick’: decisions and experiences regarding abortion of women living with HIV in Cape Town, South Africa

Research was conducted with 36 women living with HIV in Cape Town, South Africa, regarding their decision-making about, and experiences with, abortion of unwanted pregnancies in the public health sector. Abortion intentions and decisions were explored by investigating influencing factors; knowledge of abortion policy and public health sector services; and abortion perceptions and experiences. Findings reveal that many women face censure both for becoming pregnant and terminating a pregnancy, including by family, partners, community members and healthcare providers. Data suggest that abortion may be more stigmatised than HIV despite South Africa's liberal abortion law. Generally, however, study participants were satisfied with the abortion care received. Most would advise women living with HIV to think carefully about abortion, but to make a decision in their own best interests, including only seeking care early in pregnancy from an accredited clinic. Study implications include a need to integrate information and counselling on safe legal abortion within sexual and reproductive health services, especially in efforts to integrate sexual and reproductive health into HIV care, and to forge greater linkages between HIV and abortion services more generally to ensure continuity in follow-up of care for women.

Legal Abortion Worldwide in 2008: Levels and Recent Trends

Periodic assessments of abortion incidence are essential for monitoring trends in unintended pregnancy and gaps in contraceptive services and use. Statistics and estimates of legal induced abortions in 2008 were compiled for 64 of the 77 countries in which legal abortion is generally available; these 64 are home to 98% of women aged 15-44 who live in the countries eligible for inclusion. Data sources included reports or completed questionnaires from national statistical offices and nationally representative surveys. The completeness of official figures was assessed by in-country and regional experts. Trends since 1996 and 2003 were examined. Of the 77 countries with liberal abortion laws, 36 are in the developing world. In 2008, abortion rates in the 25 countries with complete records-all of which were developed-ranged from seven (Germany and Switzerland) to 30 (Estonia) per 1,000 women aged 15-44. Abortion rates declined in most of the 20 countries with consistently reliable information on trends between 1996 and 2008; declines were generally steeper than increases, although the pace of decline slowed after 2003. The highest observed abortion rates were in developing countries with incomplete estimates. For most developing countries that had liberal laws, the reported abortion rates were incomplete and varied widely. High abortion rates in some countries, and small increases in rates in others, indicate a great need for more effective family planning services for these populations. Reliable data collection systems, needed to ensure that trends can be effectively monitored, are lacking in many countries.

Reproductive choices and obstetrical experience in Dutch carriers of haemophilia A and B

Reproductive choices, pregnancy and childbirth are influenced by culture and traditions. This probably also plays a role in carriers of haemophilia. The aim of the study is to evaluate the reproductive choices and obstetrical experiences in the current generation of carriers of haemophilia in our Haemophilia Centre in the north of the Netherlands, a largely secular country with liberal abortion laws and a unique tradition of home births. Retrospective survey among haemophilia carriers. We sent a questionnaire to 74 carriers, 65 were available, 75% responded. Median age was 41 (range 20-83) years. Of the 49 women, 46 had 120 pregnancies: 25 resulted in foetal loss, two in pregnancy termination (one for haemophilia) and 93 in live births. No woman had chosen not to start a family. Mean number of children was 2.0, 2.4 vs. 1.8 in women with and without sons with haemophilia (P = 0.008), respectively. Twenty women (20 of 46) were unaware of their carriership during 1st pregnancy; they were younger at 1st pregnancy than known carriers (25 vs. 29 years, P = 0.03). Twenty-three percentage reported bleeding complications during the first delivery. Overall, 10% vs. 3% of deliveries was complicated by a primary and secondary postpartum haemorrhage (PPH), respectively. In our Haemophilia Centre, carrier state has not influenced reproductive choices in the past, other than older age at first pregnancy. Carriers of haemophilia have an increased risk of primary PPH.

“Braxton Hick’s” or the Birth of a New Era? Tracing the Development of Ireland’s Abortion Laws in Respect of European Court of Human Rights Jurisprudence

In Ireland, Article 40.3.3 degrees of Bunreacht na hEireann (the Irish Constitution) guarantees the right to life of the unborn child and the equal right to life of the mother. Abortion in Ireland is permissible only where there is a real and substantial risk to the mother's own life. Since Ireland became a signatory to the European Convention on Human Rights in 1950,2 there have been concerns that it could result in Ireland being compelled to introduce a right to abortion. This article commences with a review of the extant law on abortion in Ireland, tracing the Constitutional protection afforded to the unborn child. The article will discuss the impact of the European Court of Human Rights' jurisprudence in regard to access to abortion and to information on abortion services in Ireland in an effort to ascertain if it really has resulted in a radical change to Irish abortion laws. As such, it will also be necessary to examine the more recent decisions of the ECtHR such as Tysiac v. Poland, and A, B, and C v. Ireland, to determine both the approach of the ECtHR to access to abortion in general and also to consider if it has resulted in a liberalisation of abortion law in Ireland.

A comparison of women with induced abortion, spontaneous abortion and ectopic pregnancy in Ghana

Background Despite having one of the most liberal abortion laws in sub-Saharan Africa, complications from induced abortion are the second leading cause of maternal mortality in Ghana. Study Design The sample is composed of patients with pregnancy termination complications in Ghana between June and July 2008. The majority of patients report having had a spontaneous abortion (75%; n=439), while 17% ( n=100) and 8% ( n=46) report having had an induced abortion or an ectopic pregnancy, respectively. Factors associated with women in each of the three groups were explored using multinomial logistic regression. Results When compared to women with spontaneous abortions, women with induced abortions were younger, poorer, more likely to report no religious affiliation, less likely to be married, more likely to report making the household decisions and more likely to fail to disclose this pregnancy to their partners. Within the induced abortion subsample, failure to disclose the most recent pregnancy was associated with already having children and autonomous household decision making. Conclusion Identifying the individual and relationship characteristics of induced abortion patients is the first step toward targeted policies and programs aimed at reducing unsafe abortion in Ghana.

Liberalization of abortion and reduction of abortion related morbidity and mortality in Nigeria

This study aimed at determining the knowledge and perception of physicians in Nigeria on abortion related deaths, and also to find out if they will support the liberalization of abortion as a means of reducing deaths from unsafe abortion. Physicians' willingness to offer abortion services was also explored. A self-administered questionnaire was distributed to a convenience sample of physicians in Delta state of Nigeria. Physicians were equally divided on whether legal liberalization of abortion would significantly reduce maternal mortality in Nigeria. Only 13.4% of the doctors were willing to offer abortion services if legally liberalized. The majority of the doctors considered promoting abstinence from pre-marital sex and contraceptive use as best effective strategies for reducing abortion-related deaths. However, liberalization of abortion law in Nigeria was not considered a very effective strategy.

The Effect of Abortion Liberalization on Sexual Behavior: International Evidence

Most industrialized countries have increased access to abortion over the past 30 years. Economic theory predicts that abortion laws affect sexual behavior since they change the marginal cost of having risky sex. We use gonorrhea incidence as a metric of risky sexual behavior. Using a panel of 41 North American, European and Central Asian countries over the period 1980-2000, we estimate the impact of abortion law reform on risky sex. Compared to the most restrictive legislation that permits abortion only to save the pregnant woman’s life or her physical health, more liberal abortion laws are associated with at least thirty additional gonorrhea cases per 100,000 individuals. The marginal effect of laws which make abortion available on request is larger than the effect of laws which allow abortion on socioeconomic and mental health grounds. Our results are robust against a set of alternative sample constructions and model specifications.

Still Waiting for Mister Right? Asymmetric Information, Abortion Laws and the Timing of Marriage

Previous studies have suggested that more liberal abortion laws should lead to a decrease in marriage rates among young women as 'shotgun weddings' are no longer necessary. Empirical evidence from the United States lends support to that hypothesis. This paper presents an alternative theory of abortion access and marriage based on asymmetric information, which suggests that more liberal abortion laws may actually promote young marriage. An empirical examination of marriage data from Eastern Europe shows that countries that liberalized their abortion laws saw an increase in marriage rates among non-teenage women.

Abortions--statistics and reality

West Germany has the lowest birthrate in the world. The rate of abortions per 1000 women between the ages of 15 and 45 in 1978 was 5.6. Many women in Germany, however, go to the Netherlands to take advantage of the more liberal abortion laws. When the abortions performed on Germans in the Netherlands are considered, German states bordering on the Netherlands, which show the lowest growth in abortion rates (Saarland, Rheinland-Pfalz) in Germany actually show the highest growth in abortion rates, and the overall abortion rate for Germany was found to be 9.0/1000 women between 15 and 45 in 1978. The German city-states of Berlin, Hamburg, and Bremen show the highest abortion rates overall. Most of the abortions performed in Germany are performed between the 10th and 11 week of pregnancy, in the Netherlands between the 6th and 8th week of pregnancy.

Opinions of decision-makers on the liberalization of abortion laws in Mexico

In the last decade, important advances were made in the struggle for reproductive rights in Mexico. The goal of this study was to discover the opinions of decision-makers about the grounds for legal abortion as well as to explore their perceptions about further liberalization of abortion laws countrywide. In-depth interviews were conducted with eight prominent decision-makers working in governmental health, law and social institutions as well as representatives of political parties. Six decision-makers favored a further liberalization of abortion laws. They proposed several strategies to move forward with liberalization. Two decision-makers were against abortion under all circumstances. Three factors seem to play a key role in the liberalization of abortion: a liberal party governing at the state level, a favorable public opinion and the pressure of NGOs promoting reproductive rights. A state-by-state approach seems more effective for generating changes in abortion laws.