The most liberal laws on abortion are found in the richest industrial countries. Does that matter? Advocates for reproductive health care say yes, because the abortion gap is often a bellwether indicating that health care for women in many developing countries offers few or no reproductive choices or respect for reproductive rights.
The issue has become more urgent as the United States, under the Trump administration, pursues its anti-abortion crusade on a global scale, tightening restrictions on nongovernmental organizations dealing with all aspects of women’s health and well-being.
The gap in women’s health and rights between the global North and South can widen further under the US global gag rule, reimposed by President Trump, which forbids even counseling on abortion at the risk of an NGO losing American funding. Family planning services also get cut, burdening women and girls more so. That leads them, in many cases, to unsafe abortions.
The lives of women fall into separate international worlds. In developing nations, NGO clinics are closing, depriving women of comprehensive health care and giving license to misogynist or repressive forces in communities where women without resources have no alternatives to NGO care, according to a recent report from the International Women’s Health Coalition.
“The policy is creating new opportunities for groups that oppose sexual and reproductive rights and women’s rights to expand their influence,” the coalition says in “Crisis In Care: Year Two Impact of Trump’s Global Gag Rule,” surveying four nations: Kenya, Nepal, Nigeria and South Africa. “It also provides individuals with regressive views an excuse to block progress on these matters within their professional capacities,” the report found. “Foreign governments have remained largely silent about the consequences of the policy on the health of their own people.”
In South Africa, NGOs that once provided good reproductive health, sound legal advice and referrals to safe and legal abortion services have been forced to curtail their activities. The deteriorating situation is recognized by government health workers. In a country with progressive abortion laws, “lack of knowledge about the legal status of abortion and how to access safe abortion services through the public health system are major barriers to access,” the coalition learned from its partners in the field.
“An abortion provider within the public health system explained how the Global Gag Rule impacts her work and threatens women’s health because it interferes with the ability of civil society organizations to provide referrals,” according to the report on developments in South Africa over the last two years.
The abortion provider who was interviewed, working in the Ministry of Health, told the coalition that often women simply don’t know they can legally demand an abortion and therefore they don’t have to find and risk an illegal and potentially dangerous procedure.
To illustrate the disparity between North and South in attitudes and laws on abortion, the Center for Reproductive Rights has produced an online interactive map it describes as the “definitive record of the legal status of abortion in countries across the globe, updated in real time.” The color-coded map shows an almost clear line between North and South and can be searched for data by country.
There are five categories into which countries’ laws are divided. In 26 countries, abortion is completely prohibited for any reason. Most of the restrictive governments are located in Africa and Latin America and the Caribbean, with a few outliers: Iraq and several nations in the Pacific region, for example. Thirty-nine countries scattered around the world permit abortion to save a mother’s life. Fifty-six governments allow the procedure for health reasons, including mental health, in some cases. Fourteen countries cite broad social or economic grounds for legal abortions.
The largest group of nations — 67 total — are categorized as permitting abortion on demand, within varying gestational limits. That is, the number of weeks into a pregnancy, commonly 12, according to the Center for Reproductive Rights, which concluded that “970 million women, representing 59 percent of women of reproductive age, live in countries that broadly allow abortion.”
The center, acknowledging that many advances in liberalizing abortion may be only steps, still sees an impressive move forward.
“Over the past several decades, monumental gains have been made in securing women’s right to abortion, with nearly 50 countries liberalizing their abortion laws,” as the new map and supporting documentation show.
“Some of this reform has been incremental, enabling women to access legal abortion only when there is a threat to her life or when pregnancy results from rape. But many of these changes have been truly transformative, overturning absolute bans on abortion in favor of women’s reproductive autonomy.”