Authoritarian Regimes Have More Progressive Abortion Policies Than Some U.S. States
Authoritarian Regimes Have More Progressive Abortion Policies Than Some U.S. States
Americans in states with regressive anti-abortion laws now have fewer human rights protections than those in countries criticized for their records on women’s rights.
As the United States rolls back abortion rights, it places itself next to some of world’s most notorious rights-abusing regimes. Compared to the more than 50 countries that have liberalized their abortion laws since 1994, the United States has become only the fourth country to roll back abortion rights in the same time frame. Americans in states where abortion is outlawed now face similar circumstances as those in El Salvador, Poland, and Nicaragua. And Americans in some states have even fewer rights than those in countries such as Saudi Arabia and Iran, where abortion is limited but some exceptions are still allowed.
This rights rollback doesn’t just matter for the Americans who live in the states with the most regressive laws. It affects democratic stability, economic productivity, and social cohesion in the country. Research continues to show that societies that subjugate women are far more likely to be more fragile, autocratic, and corrupt and to perform worse economically—among other impacts. On the flip side, when women are meaningfully empowered to participate in society on equal footing as men, societal outcomes are much better.
Exploring where else abortion rights are being attacked reveals how the radical right campaign to outlaw abortion has succeeded in dragging American rights down to levels seen among the authoritarian states the United States often criticizes. And looking to where abortion rights have been protected in recent years might offer lessons for how progressives can fight back in the future.
U.S. backsliding compared to global progress
The overwhelming global trend on abortion rights over the past 50 years has been states moving towards greater reproductive freedom and liberalizing abortion laws. While estimates vary—with some finding more than 59 countries that have expanded access—according to the Center for Reproductive Rights, 53 countries enacted laws expanding access to abortion since 1994, including 18 countries that overturned complete bans on abortion. Fifteen other countries reformed their laws to allow abortion upon request since then. Today, some 59 percent of women live in countries that broadly allow abortion.
Americans in states that effectively outlaw abortion, including Alabama, Arkansas, Missouri, Oklahoma, and South Dakota, will have fewer human rights protections than those in Iran or Saudi Arabia.
But progress hasn’t come everywhere. More than 90 million women live in countries that ban abortion in all circumstances, even when a woman’s life or health is at risk, including the Republic of Congo, the Dominican Republic, Egypt, Iraq, the Philippines. In 42 other countries, abortion is only allowed in the most severe cases when a women’s life is at risk, with 22 percent of women falling into this category in countries such as Afghanistan, Nigeria, Venezuela, and Yemen. In many of these countries, abortion restrictions are accompanied by other human rights violations and crackdowns on democratic freedoms. In the United States, by overruling Roe v. Wade, the Supreme Court erased the constitutional requirement that American states include life and health exceptions to abortion bans. Though states retain life and health exceptions in some form in their statutory schemes, access to abortion is so constrained that—in reality—care in even the most dire circumstances can be hard, if not impossible, to access.
This means that Americans in states that effectively outlaw abortion, including Alabama, Arkansas, Missouri, Oklahoma, and South Dakota, will have fewer human rights protections than those in Iran or Saudi Arabia—countries that are often vilified by politicians across the ideological spectrum for their treatment of women. Iran, for example, allows abortion in cases of fetal impairment, and Saudi Arabia allows for abortion when the health of a patient is at risk—including mental health, which can function to allow for abortion in cases of rape or incest—contrary to only the narrow “life” or “medical emergency” exceptions that are now increasingly common in state bans in the United States. These U.S. state bans often specifically require the threat to be physical in nature and explicitly exclude mental health.
Given the material benefits that accrue to countries that empower women to participate on an equal footing in society, few countries have rolled back abortion rights once granted. The United States joins only three other countries—El Salvador, Poland, and Nicaragua—that have regressed on abortion rights in recent years. Each of these countries have seen significant democratic regressions in recent years, according to Freedom House’s “Freedom in the World”report. On a cumulative scale, with 100 being the freest and 0 being least free, El Salvador fell from 77 in 2013 to 59 in 2022; Poland from 93 to 81; and Nicaragua from 51 to 23. The United States has seen its own score fall from 93 to 83.
Where abortion rights are being attacked
The following examples highlight how similar the state-level U.S. laws attacking abortion rights are to laws in other outlier countries around the world. Evidence of ties between groups that fund anti-abortion politicians in the United States and that fund anti-abortion campaigns in foreign countries suggests internationally aligned regressive efforts. Many of these countries are ruled by authoritarian leaders that attack women’s rights and other fundamental freedoms.
Abortions are outlawed and criminalized in El Salvador, a result of a 1998 law that amended the penal code and constitution to remove prior exceptions for the health or life of the woman, rape, and when the pregnancy is near-certain to result in a stillbirth or the baby’s death soon after delivery. As a result, women and girls in El Salvador are routinely prosecuted and imprisoned for suffering miscarriages and stillbirths. The Center for Reproductive Rights reported identifying 181 cases between 2000 and 2019 of women who experienced obstetric emergencies and were criminally prosecuted for abortion and “aggravated homicide,” punishable by up to 50 years in jail. Activists in El Salvador have fought to return to some exceptions for abortion, but lawmakers recently voted to uphold the complete ban.
In the United States, several hundred women were prosecuted for their pregnancy outcomes even before Roe was overturned. Alabama already has laws that vaguely define “fetal personhood” such that a person could be prosecuted for behavior that endangered a fetus, including waiting to call authorities after losing a pregnancy.
Poland’s constitutional court imposed a near-total ban on abortions in 2021 after it ruled a 1993 law allowing exceptions in severe cases of fetal abnormalities unconstitutional. Previously, 98 percent of abortions were granted under the exception. The ruling prompted huge protests, and the government was forced to issue a clarification after a 30-year old pregnant woman died of sepsis because doctors feared they could not treat her. This year, the conservative government has been accused of plans to create a “pregnancy register” to better surveil and potentially prosecute women whose pregnancies end—even in miscarriage. In practice, activists expect any register to disproportionately affect poor women who rely on the government medical system, while more affluent women can seek private care or travel abroad.
Some U.S. states have enacted legislation that would allow anyone to sue those who “aid and abet” abortions, and some states, such as in Missouri and Texas, have considered legislation that would penalize helping someone cross state lines to obtain care. That means that those most likely to be impacted by abortion restrictions will be those who can’t afford to travel to other states, meaning disproportionate impacts on people of color, young people, and LGBTQ people. At the same time, however, it is important to note that the states with supportive policies on abortion care cannot absorb the influx of patients expected from states with bans in place—so while some of the most affluent women may be able to travel to Canada or even farther abroad to seek care, the wave of bans being put in place across the country are creating a truly national crisis.
Where abortion access is expanded
In countries where abortion access has been expanded recently, it has been the result of tireless campaigns by activists who mobilized broad coalitions that generated public support for abortion rights. These recent changes suggest ways that the United States could reverse course and protect abortion rights in the future.
Argentina, Mexico, and Colombia
Until recently, 97 percent of women in Latin America lived in countries where abortion access was outlawed or severely restricted. But in just five years, three large countries—Argentina, Mexico, and Colombia—have taken great strides by decriminalizing abortion, meaning that women cannot be punished for seeking an abortion. Another large country, Chile, has included the right to an abortion in a draft of their new constitution. If passed, it would legalize and expand access in a country where abortions are currently outlawed except to save a woman’s life. Activists across Latin America worked for decades to build momentum toward these changes—building on years of campaigns against authoritarian leaders and demanding that women’s rights be part of a broader fight for democracy that was intersectional and inclusive. As a reflection of these intersectional efforts, abortion rights were enshrined with policies that made them accessible and safe for all. For example, Argentina legalized abortion and made it free of charge with legislation in 2020, with protections for the rights to contraception and sex education as well as for the rights of LGBTQ people to access reproductive care. And, in a judicial example, Colombia’s constitutional court decriminalized abortion this year by focusing on the inequitable impacts of criminalizing abortion whereby the most marginalized women are also those most likely to be prosecuted for abortion and to suffer the effects of unsafe procedures. Mexico’s supreme court decriminalized abortion in 2021 and abortion is now legal in nine Mexican states.
Voters in Ireland repealed a constitutionally enshrined ban against abortions in a decisive referendum in 2018, with 66 percent voting to repeal the provision. The previous ban came from a constitutional amendment from 1983 that prohibited abortion under almost all circumstances by granting equal rights to the mother and the fetus. Under the abortion ban, many Irish women who sought abortions traveled to the United Kingdom, where abortions were, and still are, available. Abortions are now regulated by the Health (Regulation of Termination of Pregnancy) Act of 2018 that allows for legal abortions up to 12 weeks—and later in cases of serious risks to the life or health of pregnant women or if the pregnancy is likely to result in a stillbirth or the baby’s death soon after delivery. While Ireland’s abortion rights are still limited compared to standards in the United States pre-Roe—and compared to more progressive states in the U.S. and laws in some other countries—they still exceed the bans now being imposed in some U.S. states. Most Americans oppose these restrictions; in a recent survey by Pew Research Center, 61 percent of American adults said abortion should be legal in all or most cases—strikingly similar to the results in Ireland’s referendum.
Before South Korea’s constitutional court decriminalized abortion in 2021, people who sought the procedure and health care workers who provided them risked prison sentences and fines. In practice, the laws that made abortion illegal since 1953 were rarely enforced, but they contributed to stigma and fear that prevented providers and patients from effectively providing care. The court’s decision was the result of “a years-long effort by a broad coalition that included feminists, healthcare providers, disability rights advocates, lawyers, youth activists, and religious groups” and was influenced by amicus briefs in support of abortion rights from rights groups and government officials. This broad coalition continues to press for reforms to ensure that laws and policies enable access for all, including demanding clarity from the legislature on abortion rights in practice after decriminalization.
With abortion rights regressing in the United States, it will be important for progressives to look toward allies in countries that have recently won their campaigns for abortion rights and successfully fought to change abortion bans through legislative and judicial measures. Working in solidarity with brave activists in El Salvador, Poland, and Nicaragua who are fighting their own battles for abortion rights can also foster collaboration and allow for lesson sharing.
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Former Senior Policy Analyst
Former Associate Director, Women\'s Health and Rights
Former Legal Fellow
Maggie Jo Buchanan
Senior Director and Senior Legal Fellow, Women’s Initiative
The Women’s Initiative develops robust, progressive policies and solutions to ensure all women can participate in the economy and live healthy, productive lives.