How abortion laws in the US compare to those in other countries

In the last three decades, countries around the world have made it easier to legally get an abortion. In parts of the United States, it’s gotten harder.

Recently, Mexico’s supreme court ruled to decriminalize the practice. Argentina’s Senate legalized abortion in December. New Zealand, Thailand and Ireland all took steps to ease abortion restrictions in recent years.

The United States Supreme Court made abortion legal in 1973. But over the last few decades, access to the procedure has increasingly declined in more than a dozen states around the county that have passed laws making it harder for pregnant women to get an abortion.

The most restrictive law to date is in Texas, a state with nearly 30 million people. The new law that came into effect in September outlaws most abortions once a fetal heartbeat can be detected, which is usually around six weeks into a pregnancy. There are exceptions for medical emergencies, though those are not clearly defined in the law, and no exceptions for pregnancies resulting from rape or incest.

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[What to know about the Texas abortion law]

The U.S. Supreme Court has ruled to keep the new Texas law in place while legal challenges continue. Antiabortion activists hailed the decision as a major victory toward their efforts to overturn Roe v. Wade and outlaw abortion in other parts of the country. Last Wednesday, similar legislation to ban most abortions was proposed in Florida.

A Washington Post analysis looked at how the U.S. abortion law, as well as the new Texas legislation, compare to other parts of the world.

Protesters stand outside the gate of the Texas Capitol in Austin earlier this year. (Sergio Flores/Getty Images)Understanding legality versus access

Legality is one thing. Access on the ground can look very different. Many European countries limit on-request abortions to the first trimester, which is more restrictive than much of the United States.

Antiabortion groups say U.S. laws are too liberal when compared with the rest of the world.

“Currently, the U.S. is an extreme outlier in abortion law and policy,” said Denise Harle, senior counsel for the Alliance Defending Freedom, which supports antiabortion policies. She added that the U.S. is one of the few countries that allows the abortion of a child “who can hear her mother’s heartbeat.” The United States is one of less-than 10 countries whose federal law allows elective abortions after 20 weeks of pregnancy.

“I think very few Americans realize just how radical and out-of-step America’s abortion laws are in comparison to the rest of the world,” said Angelina B. Nguyen, an associate scholar at the Charlotte Lozier Institute.

But in Europe many countries offer broad exceptions after the first three months for socioeconomic reasons like unemployment, medical issues like fetal impairment, or social issues like the age of the mother during her pregnancy.

Mark Levels, a professor of health at Maastricht University who studied the development of abortion laws over four decades, said that in places like the Netherlands where abortion on request is available until the fetus is viable, most abortions still take place in the first trimester.

He attributed this fact to the combination of widespread availability of effective modern contraceptives, such as birth control pills, and a culture that openly talks about sex and provides sex education. “If you really want to ban abortion, the one thing that you can do is provide contraceptives freely and openly, and be open about it,” Levels said in an interview with The Post.

Yet liberal abortion laws do not necessarily mean abortions are easily accessible. There are countries with procedural barriers including doctor approval, parental consent and mandatory waiting periods. In Germany, women must receive counseling and wait three days to get an abortion. In the Netherlands, the waiting period is five days so that, according to a governmental website, “you can think carefully about your decision.”

Signs for both sides of the abortion debate outside a cemetery in Ireland. (James Forde for The Washington Post)

“The enabling legal environment is really just the first step toward enabling people to actually exercise reproductive autonomy and to access safe abortion care,” said Katherine Mayall, the director of strategic initiatives at the Center for Reproductive Rights, which advocates for expanded abortion access worldwide. “Making access to abortion a reality for people across the globe requires so much more,” she added. This includes policies that cover the cost of abortion services and integrate it into the health care system and societal measures that destigmatize abortion.

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In countries where abortion is legal, or decriminalized, women still face obstacles to access. A March 2020 study found that in Italy, where abortion is legal, access can still be limited because 71 percent of gynecologists are registered as conscientious objectors. This allows them to refuse abortions due to moral or religious beliefs. And while abortion was decriminalized in South Korea in January, it is not clear if the procedure is widely available.

Expanding abortion rights worldwide

Still overall, when it comes to the legality of abortion, countries around the globe that have changed their legislation on this issue have largely pushed to increase access in the last three decades.

Even as fewer restrictions are being put in place around the world, data shows that “a lot of countries with the most liberal abortion laws have lower abortion rates,” Mayall said, because those countries often also have wider access to contraceptive services and sexual education. “Restrictive abortion laws don’t lead to fewer abortions, they only lead to more unsafe abortions,” she said.

As Argentina was debating last year whether to pass a law legalizing the practice, then-health minister Ginés González García said that more than 3,000 women had died in Argentina since the early 1980s as a result of underground abortions.

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A regional anomaly in abortion laws

In the Americas, the federal U.S. abortion law remains one of the least restrictive in the region. But as conservative states push to pass legislation making access to abortion more difficult, countries in Latin America are seeing a “green wave,” or a push toward liberalization.

In addition to recent legal changes in Mexico and Argentina, Colombia’s constitutional court is expected to soon rule on whether abortion should be decriminalized. Ecuador decriminalized abortion in cases of rape in April.

In many Latin American countries, contraception can be easier to access than in the United States. Brazil, Colombia and Nicaragua, where abortion is either banned or only allowed under some circumstances, have some of the highest contraception prevalence rates in the world, according to the latest statistics from the World Bank.

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Paula Avila-Guillen, executive director of the Women’s Equality Center, compared the new Texas law “to the total abortion bans that El Salvador and Honduras have. And both of those laws were passed 20 years ago.” While Texas hasn’t banned abortion outright, very few women are aware they are pregnant at six weeks, especially if that pregnancy is unintended.

Protesters stand outside the Texas Capitol in Austin earlier this year. (Sergio Flores for The Washington Post)

The Texas law also incentivizes the public to report and sue those who are breaking it, with the possibility of a $10,000 reward, raising the stakes for medical providers and abortion rights advocates.

“It’s been very overwhelming just trying to figure out how to get people the care that they need,” said Zaena Zamora, executive director of the Frontera Fund, an advocacy group based in the Rio Grande Valley that helps women pay for and travel to abortions. She added, “I’m concerned about the viability of my organization. I don’t want to get sued into the ground so that I can’t do my work.”

Zamora said she suspected that if abortions become more available in Mexico, she could see a lot of people going there from Texas for care. But she noted that many of the people she helps are undocumented.

“They can’t go into Mexico because they won’t be able to come back.”

About this story

Post analysis and graphics based on information from the World Abortion Laws Map from the Center for Reproductive Rights and the Global Abortion Policies Database from the World Health Organization. Many countries have several laws that guide abortion access, ranging from criminal codes, health acts, medical ethics codes and abortion specific laws. Some policies are contradictory or vague. There are also countries that do not offer English translations of their laws, making it difficult to compare the nuance of legal definitions and specific terms across countries.

Editing by Reem Akkad, Danielle Rindler and Ann Gerhart. Copy editing by Anjelica Tan. Photo editing by Chloe Coleman.

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