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Roe

Roe v. Wade, commonly known as Roe, was a landmark decision by the United States Supreme Court issued on January 22, 1973, that established a constitutional right to abortion in the U.S. based on the right to privacy under the Due Process Clause of the Fourteenth Amendment, significantly influencing global discussions on reproductive rights.^[1]^[2] In a 7–2 ruling, the Court held that the Constitution protects a pregnant woman's right to choose an abortion without excessive government restriction. The case arose from a challenge by "Jane Roe," the pseudonym of Norma McCorvey, an unmarried pregnant woman in Texas denied an abortion under state laws criminalizing the procedure except to save the mother's life.^[3]^[4] The decision introduced a trimester framework for abortion regulation: states could not interfere during the first trimester; in the second trimester, regulations were allowed if related to maternal health; and in the third trimester, after fetal viability (around 24–28 weeks), states could prohibit abortion except to preserve the woman's life or health.^[1]^[2] This invalidated numerous state laws and shaped U.S. reproductive rights jurisprudence for nearly 50 years.^[5] However, on June 24, 2022, the Supreme Court overturned Roe in Dobbs v. Jackson Women's Health Organization, ruling that the Constitution does not confer a right to abortion and devolving authority to the states.^[6] The decision resulted in a patchwork of state laws, with some enacting near-total bans and others safeguarding access. In the November 2024 elections, voters in seven states approved constitutional amendments protecting abortion rights, while similar measures failed in three others.^[7]^[8]

Overview

Definition and Terminology

In the context of reproductive rights, "Roe" refers to the landmark 1973 United States Supreme Court case Roe v. Wade, which established a constitutional right to abortion for women in the United States.^[2] The decision held that the Due Process Clause of the Fourteenth Amendment protects a right to privacy, which encompasses a woman's decision whether or not to terminate her pregnancy. This right was later overturned in 2022 by the Supreme Court in Dobbs v. Jackson Women's Health Organization, eliminating federal protection and allowing states to regulate abortion independently.^[6] The pseudonym "Roe" in the case derives from "Jane Roe," the anonymous designation assigned to the plaintiff, Norma McCorvey, to protect her identity during the litigation; such pseudonyms are commonly used in legal proceedings involving sensitive personal matters.^[9] Key terminology from the Roe decision includes the "trimester framework," which divided pregnancy into three stages to balance a woman's privacy rights with potential state interests in maternal health and fetal life: the first trimester allowed nearly absolute choice without state interference, the second permitted regulations focused on health, and the third enabled broader restrictions post-viability except to preserve the woman's life or health.^[5] "Viability" is defined medically as the stage at which a fetus has a reasonable chance of survival outside the womb with or without medical support, typically around 24 weeks of gestation, though this threshold can vary based on advancements in neonatal care.^[10] Abortions are distinguished legally and medically into categories such as elective, therapeutic, and criminal. An elective abortion, also termed induced or non-therapeutic, is performed for personal or social reasons unrelated to immediate medical threats.^[11] In contrast, a therapeutic abortion is conducted out of medical necessity to protect the pregnant person's life or health, such as in cases of severe fetal anomalies or maternal conditions like eclampsia.^[12] A criminal abortion refers to any termination performed unlawfully under applicable statutes, often carrying legal penalties for providers and patients.^[13]

Historical Context

Abortion practices date back to ancient civilizations, where they were often integrated into medical and social frameworks without widespread legal prohibitions. In ancient Egypt, medical texts such as the Ebers Papyrus from around 1550 BCE document methods for inducing abortions using herbal remedies, reflecting a pragmatic approach to reproductive health amid high maternal mortality rates.^[14] Similarly, in ancient Greece, while the Hippocratic Oath—dating to the 5th century BCE—explicitly prohibited physicians from administering abortifacients to women, this stance contrasted with broader cultural acceptance of such practices among non-physicians, as evidenced by surviving medical writings that describe abortive techniques.^[15] In ancient Rome, abortion was generally legal and not viewed as homicide since the fetus was not considered a person under law; it was permitted under certain social and economic conditions, such as to control family size or preserve a woman's health, with Roman legal texts like the Digest of Justinian outlining penalties only for abortions that harmed the father's potential heirs without consent.^[16] During the medieval and early modern periods in Europe, the Christian Church exerted significant influence on attitudes toward abortion, shifting it toward criminalization based on theological concepts of fetal ensoulment. Church doctrine, drawing from Aristotelian and biblical interpretations, distinguished between pre- and post-"quickening" stages, where quickening—typically detected as fetal movement between 16 and 20 weeks of gestation—marked the entry of the soul into the fetus, rendering abortion after this point akin to homicide.^[17] Prior to quickening, abortions were often deemed sinful but not criminally punishable under canon law, allowing for some tolerance in cases of maternal necessity; this framework persisted into early modern common law, where secular courts rarely prosecuted pre-quickening procedures.^[18] The Church's evolving prohibitions, reinforced by figures like Thomas Aquinas in the 13th century, gradually tightened restrictions, laying the groundwork for stricter secular regulations. The 19th and early 20th centuries saw waves of criminalization across the United States and Europe, driven by medical professionalization, moral campaigns, and concerns over population demographics. In the U.S., starting in the 1820s, states began enacting laws restricting abortion, culminating in near-total bans by the 1880s through efforts led by physicians like Horatio Storer, who argued for fetal rights and aimed to elevate the medical profession's authority over midwives.^[19] European nations followed suit, with countries like Britain passing the Offences Against the Person Act of 1861 to criminalize abortion at all stages, influenced by similar religious and nationalist sentiments that viewed it as a threat to social order.^[20] A notable exception occurred in the Soviet Union, which in 1920 became the first modern state to decriminalize abortion through a decree aimed at protecting women's health amid post-revolutionary upheaval and high rates of unsafe procedures, framing it as a public health measure rather than a moral failing.^[21] Post-World War II, global shifts toward women's rights movements intersected with lingering eugenics debates, catalyzing abortion law reforms in the 1960s and 1970s. Advocacy for reproductive autonomy gained traction as part of broader feminist efforts to address gender inequalities, with organizations highlighting the dangers of illegal abortions and linking access to bodily autonomy.^[22] Eugenics influences, though discredited after the Holocaust, subtly persisted in discussions of population control and selective reproduction, particularly in Western contexts where reforms were sometimes justified by reducing "unwanted" births among marginalized groups.^[23] In the U.S., this era was marked by pivotal legal precedents, including the 1965 Supreme Court decision in Griswold v. Connecticut, which struck down a state ban on contraception for married couples by recognizing a constitutional right to privacy in marital relations, setting the stage for expanded reproductive protections.^[24]

International Frameworks

United Nations and Human Rights

The Universal Declaration of Human Rights (UDHR), adopted in 1948, establishes foundational principles that underpin bodily autonomy, including the right to life, liberty, and security of person (Article 3), freedom from torture or cruel, inhuman, or degrading treatment (Article 5), and protection against arbitrary interference with privacy (Article 12). These provisions have been interpreted by United Nations bodies to support women's reproductive autonomy, emphasizing that restrictions on personal decision-making in health matters, such as access to reproductive services, can undermine these core rights. For instance, UN reports highlight that bodily integrity, derived from UDHR protections, requires states to respect individuals' control over their own bodies, particularly in contexts of reproductive health where denial of autonomy may lead to violations of dignity and equality.^[25] The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), adopted in 1979, frames abortion access as integral to gender equality by addressing how discriminatory laws and practices disproportionately affect women's health and autonomy. The CEDAW Committee, in its General Recommendation No. 24 (1999) on women and health, urges states to prioritize prevention of unwanted pregnancies through family planning and to ensure non-discriminatory access to reproductive health services, including safe abortion where not prohibited by law, as restrictions often perpetuate gender-based violence and inequality. The Committee views such barriers as violations of Articles 12 (right to health) and 16 (marriage and family rights) of CEDAW, arguing that they reinforce stereotypes and limit women's equal participation in society. For example, in concluding observations on state reports, the Committee has repeatedly called for the removal of punitive measures against women seeking abortion services to advance substantive gender equality.^[26]^[27] Under the International Covenant on Civil and Political Rights (ICCPR, 1966) and the International Covenant on Economic, Social and Cultural Rights (ICESCR, 1966), the UN Human Rights Committee has interpreted strict abortion bans as potentially amounting to torture or other cruel, inhuman, or degrading treatment, particularly when they endanger life or health. In the landmark case of K.L. v. Peru (2005, CCPR/C/85/D/1153/2003), the Committee found that Peru's denial of a therapeutic abortion to a 17-year-old girl whose pregnancy posed a grave risk to her life and health violated Article 7 of the ICCPR, as it inflicted severe physical and mental suffering without justification. This decision underscores the Committees' view that states must balance fetal interests with women's rights under Articles 6 (right to life), 7, and 17 (privacy) of the ICCPR, and Article 12 (health) of the ICESCR, ensuring that reproductive restrictions do not impose disproportionate burdens. Subsequent interpretations have reinforced that such denials can also breach non-discrimination principles under both covenants.^[28] The Beijing Platform for Action, adopted in 1995 at the Fourth World Conference on Women, explicitly calls for expanded access to safe abortion services where legally permitted, recognizing unsafe abortions as a leading cause of maternal mortality that disproportionately impacts vulnerable women. In paragraph 96 of the health section, it states that "in no case should abortion be promoted as a method of family planning," but emphasizes the need to reduce the prevalence of unsafe procedures through comprehensive reproductive health care, education, and legal reforms to protect women's lives and rights. This platform integrates abortion access into broader commitments to gender equality and health, urging governments to address the determinants of unsafe abortions, such as poverty and lack of services, as a public health and human rights priority.^[29] UN resolutions on reducing maternal mortality further link these efforts to reproductive rights, with the Human Rights Council adopting multiple texts that frame preventable maternal deaths—often resulting from restricted abortion access—as human rights violations requiring urgent state action. For example, Resolution 11/8 (2009) and subsequent updates, such as Resolution 18/2 (2011) and Resolution 21/6 (2012), reaffirm that states must eliminate barriers to reproductive health services, including safe abortion, to fulfill obligations under international human rights law and reduce mortality rates. These resolutions, building on the Beijing Platform, call for accountability mechanisms and technical guidance to ensure women's access to quality care, tying maternal health improvements directly to the realization of rights to life, health, and non-discrimination. The 2025 update to the technical guidance (A/HRC/60/43) continues this emphasis, providing states with human rights-based strategies to address intersecting factors like stigma and legal restrictions.^[30]^[31]

World Health Organization Guidelines

The World Health Organization (WHO) defines an unsafe abortion as a procedure for terminating a pregnancy performed by individuals lacking the necessary skills or in an environment that does not conform to minimal medical, legal, or ethical standards.^[32] Globally, approximately 73 million induced abortions occur annually, with 45% classified as unsafe based on data from 2010–2014, though this proportion remains a significant concern in recent assessments.^[32] These unsafe procedures contribute to substantial morbidity, with an estimated 7 million women treated yearly for related complications in developing regions, and account for approximately 8% of all maternal deaths worldwide, according to a review from 2009–2020.^[32] In its Abortion Care Guideline (2022), which updates earlier technical and policy guidance from 2003 and 2012, WHO emphasizes that abortion is an essential health service and provides evidence-based recommendations to ensure safety and accessibility.^[33] For first-trimester abortions (up to 12–14 weeks gestation), the guidelines recommend provision through medical methods, such as self-managed abortion using quality-assured medications like mifepristone and misoprostol, which can be administered at home or in primary care settings with telemedicine support, performed by trained health workers or appropriately supported individuals.^[33] For second-trimester procedures (beyond 12 weeks), WHO advises protocols involving dilation and evacuation or medical induction, stressing the need for skilled providers in appropriately equipped facilities to minimize risks, and recommends against rigid gestational limits that could delay care and exacerbate health outcomes.^[33] WHO advocates for the full integration of abortion care into essential health services within universal health coverage frameworks, ensuring it is affordable, timely, and available without discrimination.^[33] This includes a strong emphasis on decriminalization to protect health workers from legal penalties for providing or assisting with abortions, thereby safeguarding their ability to deliver care without fear of prosecution or mandatory reporting.^[33] Post-abortion care standards, as outlined by WHO, require comprehensive management of complications—such as incomplete abortion, hemorrhage, or infection—regardless of the pregnancy's legal status or the method used, with services including emergency treatment, counseling, contraception, and follow-up to prevent future unintended pregnancies.^[32] These standards prioritize respectful, person-centered care to reduce stigma and ensure equitable access, treating post-abortion complications as a critical component of maternal health services.^[33]

By Region

Africa

In Africa, abortion laws exhibit significant regional trends characterized by high restrictiveness, with the majority of countries permitting the procedure only to save the woman's life or protect her physical and mental health. As of recent assessments, approximately 92% of women of reproductive age in sub-Saharan Africa reside in nations with highly or moderately restrictive laws that prohibit abortion on broader grounds, such as socioeconomic reasons or personal choice. Several countries, including Benin, Cape Verde, Mozambique, South Africa, and Tunisia, allow abortion on request up to certain gestational limits, reflecting a gradual shift toward more liberal frameworks in select jurisdictions.^[34]^[35]^[36] These legal patterns are deeply rooted in colonial legacies, where European penal codes imposed during the imperial era criminalized abortion across the continent. British common law, French civil law, and Portuguese codes, among others, established prohibitions that treated abortion as a criminal offense, often punishable by imprisonment, and these frameworks were largely retained post-independence in the mid-20th century. Subsequent reforms in some nations have expanded exceptions, influenced by evolving human rights norms, though many countries continue to adhere to these outdated colonial-era restrictions without substantial liberalization.^[37]^[38] A pivotal regional instrument addressing these issues is the African Union's Maputo Protocol, adopted in 2003, which advances reproductive rights through Article 14. This provision obligates state parties to guarantee women's sexual and reproductive health rights and to authorize safe abortion in cases of sexual assault, rape, incest, risks to the mother's life or health, or fetal impairment. Ratified by 46 African states as of 2025, with the Central African Republic becoming the 46th state to ratify in July 2025, the protocol represents a progressive counterpoint to restrictive national laws, promoting access to safe services and influencing advocacy for reforms, though implementation remains uneven due to domestic legal barriers.^[39]^[40]^[41] Unsafe abortions persist at alarmingly high rates amid these constraints, with an estimated 29 abortions per 1,000 women aged 15–44 occurring annually across Africa, the vast majority of which are unsafe and contribute to elevated maternal mortality—such as the 442 deaths per 100,000 live births in sub-Saharan Africa as reported by the World Health Organization (as of 2023). In sub-Saharan Africa specifically, around 6.2 million unsafe abortions take place each year, underscoring the scale of the public health crisis. Key challenges exacerbating this include pervasive social and religious stigma that discourages women from seeking care, insufficient trained providers and facilities in rural areas, and ongoing conflicts that disrupt healthcare infrastructure and increase complication severity in fragile settings.^[42]^[43]^[44]

Americas

In the 19th century, abortion was broadly criminalized across the Americas through penal codes influenced by colonial legacies and emerging medical ethics, with most Latin American countries enacting total prohibitions by the late 1800s, often allowing exceptions only to save the woman's life.^[45] This wave of criminalization mirrored trends in the United States, where laws shifted from tolerating pre-quickening abortions to outright bans by the 1880s, driven by physicians' campaigns against unsafe practices.^[46] In the 20th century, reforms began to emerge, particularly influenced by the 1973 U.S. Supreme Court decision in Roe v. Wade, which established abortion as a constitutional right and inspired rights-based advocacy in Latin America, prompting limited decriminalizations in countries like Colombia (1930s for health risks) and influencing broader hemispheric discussions on reproductive autonomy.^[47] However, progress was uneven, with many nations retaining restrictive frameworks until the late 20th and early 21st centuries. The current landscape of abortion laws in the Americas reflects a stark spectrum, ranging from total bans to on-request access. El Salvador, Honduras, and Nicaragua maintain absolute prohibitions, criminalizing abortion in all circumstances with penalties up to 30 years imprisonment, even when the woman's life is at risk.^[48] In contrast, Canada provides abortion on request without gestational limits imposed by federal law, though access varies by province.^[49] Uruguay legalized abortion on request up to 12 weeks in 2012, and Argentina followed in 2020 through the "Green Wave" movement—a grassroots feminist campaign symbolized by green handkerchiefs that mobilized mass protests and led to decriminalization up to 14 weeks, marking a pivotal shift in regional norms.^[50] This progressive wave has extended to Colombia (up to 24 weeks since 2022) and parts of Mexico, contrasting sharply with persistent restrictions elsewhere.^[51] The Inter-American Court of Human Rights has played a crucial role in advancing reproductive rights through landmark rulings. In Artavia Murillo et al. v. Costa Rica (2012), the Court struck down Costa Rica's ban on in vitro fertilization as a violation of the American Convention on Human Rights, affirming the right to procreate and equality for infertile individuals while rejecting embryo personhood, which broadened protections for reproductive technologies and indirectly bolstered arguments against overly restrictive policies on assisted reproduction and abortion.^[52] The decision compelled Costa Rica to legalize IVF and integrate it into public health services, setting a precedent for state obligations to facilitate reproductive health without discrimination.^[53] In the United States, the 2022 Dobbs v. Jackson Women's Health Organization decision overturned Roe v. Wade, eliminating federal protections and enabling state-level restrictions; as of 2025, 12 states enforce near-total bans with limited exceptions, while 21 states protect access up to fetal viability (around 24 weeks).^[54] This fragmentation has ripple effects across the hemisphere, potentially emboldening conservative movements in Latin America.^[55] High adolescent pregnancy rates in Latin America have been a key driver of recent reforms, underscoring the public health crisis of unsafe abortions and limited access. The region reports the second-highest adolescent birth rate globally at 52 births per 1,000 girls aged 15-19, with rates declining from 69.9 per 1,000 in 2014 to 50.3 in 2024, yet still fueling advocacy for decriminalization to reduce maternal mortality and inequality.^[56] These trends, particularly acute among indigenous and low-income youth, have amplified calls for comprehensive sexual education and rights-based policies, as seen in the Green Wave's emphasis on preventing coerced pregnancies.^[57]

Asia

Abortion laws across Asia exhibit significant diversity, shaped by historical population control measures, religious doctrines, and efforts toward modernization. In several countries, access is broad and available on request. For instance, China has permitted abortion on request since the 1950s as part of national family planning initiatives aimed at controlling population growth.^[58] Similarly, Vietnam allows abortions up to 22 weeks of pregnancy without restrictions on grounds, provided free by the state healthcare system.^[59] In Central Asian former Soviet states such as Kazakhstan and Uzbekistan, liberal policies persist from the Soviet era, permitting abortions on request up to 12 weeks and for broader indications thereafter.^[60] In contrast, restrictive regimes prevail elsewhere; Indonesia prohibits abortion except in cases of rape or when the mother's life is endangered, while the Philippines maintains a near-total ban, allowing it solely to save the woman's life.^[61]^[62] Significant legal reforms have expanded access in key nations amid evolving social and health priorities. India's Medical Termination of Pregnancy Act of 1971 initially legalized abortion up to 20 weeks for reasons including health risks, fetal abnormalities, and contraceptive failure, marking a shift from colonial-era prohibitions.^[63] The 2021 amendment further broadened this by extending the limit to 24 weeks for vulnerable categories like survivors of rape and adolescents, and allowing opinions from one or two providers depending on gestation.^[63] South Korea achieved a landmark change in 2021 with the decriminalization of abortion, ending a 66-year ban that had criminalized the procedure since 1953 and restricted it to narrow exceptions.^[64] Religious influences profoundly affect policy variations, often balancing traditional interpretations with public health needs. In Muslim-majority Pakistan and Bangladesh, Islamic jurisprudence permits abortion to preserve the woman's physical or mental health, as well as in cases of rape or fetal impairment, though procedures remain regulated under penal codes with gestational limits around 120 days.^[60] In Hindu-majority Nepal, despite scriptural views historically deeming abortion sinful, the 2002 legalization act liberalized access up to 12 weeks on request and up to 18 weeks for rape or incest, driven by advocacy to reduce maternal mortality.^[65] Persistent challenges include sex-selective practices and safety concerns, exacerbated by uneven enforcement and cultural factors. In India and China, widespread son preference has led to skewed sex ratios at birth, prompting bans on prenatal sex determination—India's through the 1994 Pre-Conception and Pre-Natal Diagnostic Techniques Act and China's via family planning regulations prohibiting non-medical fetal sex disclosure.^[66] South Asia faces particularly high rates of unsafe abortions, with an estimated 8-10 million procedures annually, many clandestine due to legal ambiguities or access barriers, contributing to substantial maternal morbidity.^[67] These issues have drawn international scrutiny, including United Nations critiques of coercive population policies in contexts like China's former one-child framework.^[67]

Europe

Europe has witnessed significant liberalization of abortion laws over the past several decades, with most countries now permitting abortion on request during the first trimester, typically up to 12-14 weeks of pregnancy.^[68] This trend aligns with standards promoted by the Council of Europe, which emphasize access to safe and legal abortion as essential for women's health and rights, while allowing member states flexibility in implementation.^[69] Landmark legislation, such as France's 1975 Veil Law, legalized abortion up to 10 weeks (extended to 14 weeks in 2001) on request, marking a pivotal shift toward decriminalization across the continent.^[70] Similarly, the United Kingdom's 1967 Abortion Act permitted terminations up to 28 weeks (later reduced to 24 weeks) on broad grounds including risk to physical or mental health, effectively enabling access in early pregnancy without strict request-based limits.^[71] Despite this broad liberalization, significant variations persist among European countries. In 2018, Ireland repealed the Eighth Amendment of its constitution via referendum, with 66.4% of voters approving the change, allowing abortion on request up to 12 weeks and on broader grounds thereafter.^[72] Conversely, Poland tightened restrictions in 2020 when its Constitutional Tribunal ruled that abortions for fetal defects were unconstitutional, resulting in a near-total ban except in cases of rape, incest, or imminent threat to the woman's life or health.^[73] Malta maintains the strictest regime in the European Union, permitting abortion only to save the woman's life, following a 2023 legislative amendment that introduced this narrow exception but retained criminal penalties for other cases.^[74] The European Court of Human Rights (ECtHR) has played a crucial role in shaping access through key rulings. In A, B and C v. Ireland (2010), the Court found that Ireland's failure to provide effective access to lawful abortion for a woman with a fatal fetal anomaly violated her rights under Article 8 of the European Convention on Human Rights, prompting legislative reforms. Similarly, in P. and S. v. Poland (2012), the ECtHR ruled that Poland breached Articles 3, 8, and 14 by obstructing a 14-year-old rape victim's timely access to a legal abortion, highlighting state obligations to ensure unhindered provision of permitted procedures.^[75] European Union influences, while non-binding on individual member states, promote harmonization through the Charter of Fundamental Rights, which protects dignity, privacy, and healthcare access under Articles 1, 3, 7, and 35.^[76] In 2024, the European Parliament adopted a resolution urging the inclusion of abortion as a fundamental right in the Charter, underscoring efforts to address disparities in access across the bloc.^[77] Following the fall of communism in 1989, many Eastern European countries retained or expanded liberal abortion policies inherited from the Soviet era, such as on-request access in the first trimester, reflecting a broader transition toward women's reproductive autonomy.^[78] However, this liberalization was not uniform, with Poland introducing severe restrictions in the 1990s that have since intensified, contrasting with progressive reforms in countries like the Czech Republic and Hungary, where early-term abortions remain available on request.^[79]

Oceania

In Oceania, abortion laws reflect a legacy of British colonial influence, with progressive reforms in larger nations like Australia and New Zealand contrasting with more restrictive frameworks in many Pacific island states.^[80] These laws have evolved through decriminalization efforts, often driven by medical and human rights advocacy, aligning with broader Commonwealth trends toward liberalization.^[81] New Zealand's abortion framework originated with the Contraception, Sterilisation, and Abortion Act 1977, which permitted abortions on request up to 20 weeks of gestation after certification by two doctors that continuation would endanger the woman's life or health.^[82] The Abortion Legislation Act 2020 decriminalized abortion entirely, removing it from the Crimes Act and treating it as a health service, allowing unrestricted access up to 20 weeks without mandatory consultations.^[83] After 20 weeks, abortions require consultation and clinical appropriateness based on the woman's health, well-being, and fetal viability.^[84] In Australia, abortion regulation occurs at the state and territory level, with full decriminalization achieved across all jurisdictions by 2024.^[85] Queensland led reforms in 2018 by decriminalizing abortion and permitting it on request up to 22 weeks, with later approvals needing two doctors' certification for substantial risk to the woman's health.^[86] New South Wales followed in 2019, and Western Australia completed the process in March 2024, removing abortion from criminal codes and aligning limits around 23 weeks in most areas, while federal territories like the Australian Capital Territory have allowed access since 2002 without gestational caps in practice.^[87]^[88] Pacific island nations exhibit varied and generally restrictive laws, shaped by colonial-era statutes. In Fiji, abortion is permitted on broader grounds, including to preserve the woman's physical or mental health, risk to existing children, fetal impairment, or socioeconomic factors, making it one of the more permissive in the region.^[89] Conversely, Papua New Guinea limits abortions to cases where the procedure is necessary to save the woman's life, with penalties for other instances reflecting strict criminalization.^[90] Other islands, such as Vanuatu and the Solomon Islands, allow only life-saving exceptions, contributing to regional disparities in access.^[91] Reforms in Oceania stem from British common law traditions, which historically criminalized abortion under statutes like the UK's 1861 Offences Against the Person Act, imported during colonization.^[92] Recent changes, including New Zealand's 2020 act and Australia's state-level decriminalizations, were propelled by endorsements from medical bodies like the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, emphasizing evidence-based health policy over punitive measures.^[93] Despite legal advancements, access remains challenged by geographic remoteness in rural and remote areas, where women often travel long distances—sometimes hundreds of kilometers—to reach providers, exacerbating delays and costs.^[94] Indigenous populations, particularly Aboriginal and Torres Strait Islander women in Australia and Māori in New Zealand, face compounded disparities due to cultural stigma, limited local services, and socioeconomic barriers, with higher unintended pregnancy rates underscoring the need for targeted equity measures.^[95]

Contemporary Issues

Access and Barriers

Access to safe abortion services remains uneven worldwide, hindered by conscientious objection provisions that permit healthcare providers to refuse care on moral or religious grounds. Approximately 87 jurisdictions globally have policies or laws allowing such refusals, often leading to delays, unavailability of services, and increased stigma for both providers and patients.^[96] These provisions can exacerbate barriers in regions where abortion is legally permitted, as they may result in entire facilities or regions lacking providers willing to perform procedures, compelling women to seek care elsewhere or forgo it altogether.^[97] Stigma surrounding abortion manifests as discrimination against patients and harassment or violence toward providers, creating a chilling effect on service delivery. Abortion rights defenders and healthcare workers frequently face threats, including physical attacks, online abuse, and professional isolation, with reports documenting repression in multiple countries that discourages open provision of care.^[98] For patients, this stigma can involve judgmental attitudes from staff, fear of social repercussions, or denial of care, further entrenching emotional and practical obstacles. Such experiences contribute to a broader culture of silence, where providers report feeling unsupported amid threats of criminalization.^[99] Economic factors pose significant hurdles, even in countries with permissive laws, where out-of-pocket costs for procedures, medications, and follow-up care can be prohibitive. In liberal settings, abortion expenses may range from hundreds to over a thousand dollars, straining low-income households and often requiring payment in cash without insurance reimbursement. Cross-border travel amplifies these burdens; for instance, women from Poland, where access is severely restricted, frequently travel to Germany, incurring average costs of around 962 euros for procedures, transportation, lodging, and lost wages, which can delay care beyond safe gestational limits.^[100] Innovations in digital and telehealth services have emerged as countermeasures, particularly following the COVID-19 pandemic, which accelerated the use of remote consultations for medication abortion using mifepristone and misoprostol. This approach has expanded access in underserved areas by allowing virtual prescribing and self-managed care, with studies showing high efficacy and safety comparable to in-clinic methods. Globally, post-pandemic adoption has grown in countries like the United States and Rwanda, where hybrid models have reached remote communities, reducing the need for physical travel and lowering costs.^[101]^[102] These barriers disproportionately affect low-income, rural, and minority women, who face compounded socioeconomic challenges. Women in low- and middle-income countries experience higher rates of unintended pregnancies, with 66% ending in abortion in middle-income settings compared to 40% in low-income ones, often due to limited contraceptive access and education. Rural residents encounter geographic isolation, with longer travel distances and fewer facilities, leading to higher likelihoods of continuing unintended pregnancies. Ethnic minorities, particularly in diverse regions, suffer from intersecting discriminations, including biased healthcare interactions and economic marginalization, which restrict timely care and elevate risks of unsafe procedures. Globally, these disparities contribute to unsafe abortions accounting for 45% of all procedures, resulting in an estimated 7 million women treated annually for complications in developing countries.^[32]^[103]^[104]

Recent Legal Changes

In a landmark decision on June 24, 2022, the U.S. Supreme Court ruled in Dobbs v. Jackson Women's Health Organization that the Constitution does not confer a right to abortion, effectively overturning Roe v. Wade and Planned Parenthood v. Casey, and returning regulatory authority to the states.^[6] This ruling led to immediate restrictions or bans in 14 states by mid-2023, with 12 states enforcing total bans as of November 2025 (down from 14 in mid-2023 due to legal challenges), including total prohibitions except to save the life of the pregnant person, with additional states enacting gestational limits.^[54] For example, Texas's pre-existing six-week ban under Senate Bill 8 was reinforced post-Dobbs, and its trigger law took effect on August 25, 2022, criminalizing most abortions with limited exceptions for life-threatening conditions.^[105] In response, 2024 saw voters in eight states—Arizona, California (reauthorization), Colorado, Maryland, Missouri, New York, Nevada, and Vermont—approve constitutional amendments protecting abortion rights, while measures failed in Florida, Nebraska, and South Dakota.^[106] In Latin America, Argentina became the first major country in the region to legalize abortion on request up to 14 weeks of pregnancy through Law 27.610, enacted on December 30, 2020, with no gestational limit in cases of rape or risk to life or health.^[107] Mexico's Supreme Court advanced decriminalization progressively: a September 7, 2021, ruling invalidated Coahuila's total ban and recognized abortion as a human right, prompting several states to reform by 2023; this culminated in a September 6, 2023, nationwide decision declaring all state-level criminal penalties unconstitutional and requiring federal legislation to regulate access up to 12 weeks.^[108] European developments included San Marino's September 26, 2021, referendum, where 77.3% of voters approved legalization, allowing abortion on request up to 12 weeks, or later for health risks, fetal anomalies, or socioeconomic reasons, ending a total ban in place since 1865.^[109] In the Czech Republic, a 2023 amendment to the abortion law removed outdated requirements, such as mandatory counseling and spousal consent in some cases, while expanding access provisions and clarifying rules for non-residents, though the core gestational limit remains 12 weeks.^[110] In 2024, France became the first country to enshrine the right to abortion in its constitution.^[111] In Asia, Thailand extended its 2021 decriminalization in September 2022 to permit abortions on request up to 20 weeks of pregnancy, or beyond in cases of fetal anomalies, health risks, or socioeconomic hardship, marking a near-total liberalization from prior restrictive frameworks.^[112] African progress featured South Africa's May 2023 High Court ruling in a case assisted by SECTION27, which affirmed a minor's right to abortion and condemned the misuse of conscientious objection by providers, with ongoing 2024 litigation reinforcing access under the 1996 Choice on Termination of Pregnancy Act.^[113] Implementations of the Maputo Protocol, which since 2003 has required states to authorize abortion in cases of sexual assault, rape, incest, or threats to health, have advanced recently in countries like the Democratic Republic of Congo through 2024 legislative efforts to domesticate its provisions, though challenges persist in full enforcement across the continent.^[114] Globally, since 1994, more than 60 countries have reformed abortion laws toward liberalization, including France's 2024 constitutional enshrinement of abortion rights, with over 60 changes between 2000 and 2025 alone, according to the Center for Reproductive Rights.^[48]

References

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Roe v. Wade | 410 U.S. 113 (1973) - Justia U.S. Supreme Court Center
Roe v. Wade: A person may choose to have an abortion until a fetus becomes viable, based on the right to privacy contained in the Due Process Clause of the ...
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Roe v. Wade | Oyez
A case in which the Court struck down several Texas laws that criminalized abortion, holding that laws that impose an undue burden on a woman's right to ...
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Roe v. Wade Case Summary: What You Need to Know - FindLaw
Mar 17, 2023 · Roe v. Wade is a 1973 lawsuit that famously led to the Supreme Court making a ruling on abortion rights. Jane Roe, an unmarried pregnant woman, ...
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Roe v. Wade (1973) - The National Constitution Center
The decision leaves the State free to place increasing restrictions on abortion as the period of pregnancy lengthens, so long as those restrictions are tailored ...
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Roe v. Wade - Center for Reproductive Rights
In 1973, the U.S. Supreme Court's ruling in Roe v. Wade recognized that the decision whether to continue or end a pregnancy belongs to the individual, ...
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[PDF] 19-1392 Dobbs v. Jackson Women's Health Organization (06/24/2022)
Jun 24, 2022 · Roe held that the abortion right is part of a right to privacy that springs from the First, Fourth, Fifth, Ninth, and. Fourteenth Amendments.
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Supreme Court overturns Roe v. Wade, ending right to abortion ...
Jun 24, 2022 · The US Supreme Court officially reversed Roe v. Wade on Friday, declaring that the constitutional right to abortion, upheld for nearly a half century, no ...<|control11|><|separator|>
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Oct 13, 2022 · Roe refers to Jane Roe, the pseudonym in this case for the woman who originally sought the abortion: Norma McCorvey.
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Abortion Policy: Gestational Limits and Exceptions - KFF
Viability is the point when a fetus can survive outside the womb and is generally presumed to occur at around 24 weeks gestation. However, viability has never ...Missing: authoritative | Show results with:authoritative
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Therapeutic and induced abortions: Clinical sciences - Osmosis
Therapeutic abortion refers to termination of pregnancy for medical indications; while an induced abortion, also known as an elective abortion, is performed.
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Abortion Can Be Medically Necessary - ACOG
Sep 25, 2019 · There are situations where pregnancy termination in the form of an abortion is the only medical intervention that can preserve a patient's health or save their ...
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Abortion - StatPearls - NCBI Bookshelf - NIH
Avoiding further stigmatization of abortion care requires refraining from terms such as "medically necessary" and "therapeutic," as they imply that some ...Introduction · Indications · Preparation · Technique or Treatment
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[PDF] Law and Cultural Attitudes Towards Abortion - PDXScholar
Apr 1, 2023 · Abortion was also practiced throughout Ancient Egypt. Proof of the practice is embedded within the Ebers Papyrus, a medical text of herbal ...Missing: sources | Show results with:sources
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[PDF] The History of the Hippocratic Oath: Outdated, Inauthentic, and Yet ...
The Hippocratic Oath, composed over 2,400 years ago, is a covenant with deity, teachers, students, and patients, and is the oldest and most popular medical ...
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(PDF) An investigation into the ancient abortion laws - ResearchGate
Aug 7, 2025 · ... In ancient Rome, the foetus was not considered to be a person, hence abortion was legal. The procedure was performed for economic and social ...
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[PDF] abortion, medieval christianity, and the christian far-right: the harms ...
prior to “quickening.” Medieval Christian religion believed that after quickening, the soul entered the fetus and therefore before ensoulment and quickening an ...
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[PDF] Medieval and Modern Attitudes to Abortion
This article will discuss various ideas from prominent theologians of the high Middle Ages to show that one consistent per- spective on reproductive control did ...
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Abortion in the Nineteenth Century Through the Lens of Ann Lohman
Criminalization of abortion during Lohman's lifetime parallels the restrictions occurring in the present day. Considering the motivations for and impact of laws ...
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Nov 26, 2012 · ... legal weight, criminalized abortion during all stages of pregnancy by the late 1880s. British criminalization began with Lord Ellenborough's act ...
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[PDF] Roe's Race: The Supreme Court, Population Control, and ...
movements for population control, eugenics, and abortion rights in arguing that ... In the 1970s, some population controllers did have ties to the eugenic legal ...
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Griswold v. Connecticut | 381 U.S. 479 (1965)
The Supreme Court held that a right to privacy, inferred from the Bill of Rights, prevents states from making contraception illegal for married couples.
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In 1999, the. CEDAW Committee called, in its General Recommendation 24 on health, to “Prioritize the prevention of unwanted pregnancy through family planning ...
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[PDF] General Recommendations 1-25 - English 10 Dec 07
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General recommendations | OHCHR
As of December 2024, the Committee has adopted 40 general recommendations. The full list of final general recommendations are available in the database, with ...
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Peru compensates woman in historic UN Human Rights abortion case
Jan 18, 2016 · K.L. was forced to carry the pregnancy to full term and breast feed the baby for the four days that it lived.
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Prevention of unwanted pregnancies must always be given the highest priority and every attempt should be made to eliminate the need for abortion. Women who have ...
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The present report contains concise technical guidance, in accordance with the request made by the Human Rights Council in its resolution 18/2.
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May 17, 2024 · An “unsafe abortion” is defined as a procedure for terminating a pregnancy performed by persons lacking the necessary information or skills or ...
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Mar 8, 2022 · The objective of this guideline is to present the complete set of all WHO recommendations and best practice statements relating to abortion.<|control11|><|separator|>
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As of 2019,. 92% of the region's women of reproductive age live in the 43 countries with highly or moder- ately restrictive laws. These laws either prohibit.
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[PDF] Abortion in Africa - Guttmacher Institute
liberal abortion laws: Zambia permits abortion for health and socioeconomic reasons, whereas Cape Verde, South. Africa and Tunisia permit abortion with- out ...
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[PDF] Human Rights and African Abortion Laws - KELIN Kenya
A common feature of colonial abortion laws was criminalisation of abortion, whether the laws originated from Belgium, France, Italy, Spain or Portugal.
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Mar 30, 2023 · The historical criminalisation of abortion is used to illustrate the coloniality of African abortion laws as well as make a case for ...
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Article 14. Health and Reproductive Rights. 1. States Parties shall ensure that the right to health of women, including sexual and reproductive health is ...
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[PDF] Abortion in Africa
slightly by region, ranging from 38 per 1,000 women of childbearing age in Northern Africa to 31 per 1,000 in. Western Africa. In Eastern, Middle and. Southern ...
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Dec 31, 2020 · This report on induced abortion in Sub-Saharan Africa offers an overview of the legality of abortion and describes how often and how safely abortions occur in ...
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Countries in which Abortion is Completely Illegal/Prohibited*. AfghanistanAntigua and BarbudaDominicaEgyptEl SalvadorGuatemalaHondurasIraqJamaicaLaosMalta ...
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Oct 30, 2025 · In Argentina, a 2020 law decriminalizing abortion up to 14 weeks of pregnancy. Before, Argentina had allowed abortion only in cases of rape ...
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Costa Rica's absolute ban on in vitro fertilization deemed a human ...
A landmark decision denying legal personhood to in vitro fertilization (IVF) embryos was issued by the Inter-American Court of Human Rights.
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41 states have abortion bans, with 12 having total bans, 29 based on gestational duration, 7 at or before 18 weeks, and 22 after 18 weeks.
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Jul 6, 2022 · The Supreme Court decision “may diminish Latin American judges' and legislators' willingness to take bold action on abortion in their respective ...
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44. (1) Women shall be entitled to have an abortion if they so desire, to undergo medical examinations and treatment for gynecological diseases and to receive ...
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The aim of this paper is to provide a panoramic view of laws and policies on abortion around the world, giving a range of country-based examples.
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Art. 257. Unintentional abortion. – The penalty of prision correccional in its minimum and medium period shall be imposed upon any person who shall cause an ...
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□ Because abortion is broadly legal in the region's two most populous countries,. China and India, the majority of women in Asia live under liberal abortion ...
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As of 2025, abortion is now legal in almost all European countries, with most allowing abortion on request at least during the early stages of pregnancy.
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An Act to amend and clarify the law relating to termination of pregnancy by registered medical practitioners.1. · Content · 4. · Web pagetable of contents
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Poland rules abortion due to foetal defects unconstitutional
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Jun 28, 2023 · Maltese lawmakers have unanimously approved legislation to ease the strictest abortion laws in the EU, voting to allow terminations – but only in cases where a ...
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It was reported that the first applicant had travelled to Warsaw with her mother in order to have an abortion performed there. The first applicant was under ...
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Apr 11, 2024 · Urges all Member State governments to guarantee access to safe, legal and free abortion care, to pre-natal and maternal healthcare services and ...
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Apr 5, 2024 · The right to abortion should be included in the EU Charter of Fundamental Rights, MEPs are set to say in a resolution to be put to a vote on Thursday.
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The Act allows abortions up to 20 weeks. After 20 weeks, it requires clinical appropriateness, consultation, and consideration of health, well-being, and fetus ...
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Mar 27, 2024 · The changes mean that as of today, patients in Australia can no longer be criminalised for abortion care access.
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Decriminalization legislation in 2002 delivered “the most minimal legal model regulating abortion in Australia.”24 Abortion no longer appears in the Crimes Act ...
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Apr 10, 2025 · We call on all political parties and candidates to commit to ensuring affordable, accessible abortion care in Australia.Missing: issues | Show results with:issues<|control11|><|separator|>
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Abortion stigma is the discrediting of individuals associated with abortion, affecting women, providers, and supporters, and is a negative attribute marking ...
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Aug 14, 2025 · To determine whether a hybrid telemedicine/in-person appointment model could expand access to medication abortions, researchers from UC Berkeley ...
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Forty-five percent of all abortions globally are deemed unsafe. 7 million. women and girls are injured or disabled due to unsafe abortions every year.
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Sep 27, 2022 · Thailand will allow abortions up to the 20th week of pregnancy under new regulations issued by the Public Health Ministry.
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SECTION27 assists a 14-year old to assert her right to a safe abortion
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