Alabama passed a near-total ban on abortion this week, strict enough to rival abortion rules in countries like Brunei, Guatemala and Syria.
Brought forward by conservative lawmakers and signed into law by its governor, the southern US state’s “Human Life Protection Act” makes no exemptions for victims of incest or rape. Doctors who attempt to carry out terminations will face 10 years in prison, while doctors who perform the procedure could be given a 99-year sentence.
The most stringent in the United States, Alabama’s abortion law allows only for exceptions “to avoid a serious health risk to the unborn child’s mother,” for ectopic pregnancies, and if the “unborn child has a lethal anomaly.”
In theory, the new law would become enforceable in six months but, given the number of legal challenges it’s likely to face by groups arguing it’s unconstitutional, it will likely be tied up in court for years, delaying enforcement.
Here’s how it compares to laws already in effect around the world.
Where abortion is banned
The United States is one of at least 49 countries that allow abortions at a woman’s request with no justification requirement, according to the World Health Organization.
However, access to the procedure varies in each US state. Most states restrict abortion after a specific point during pregnancy, known as a gestational limit, that typically varies from 20 to 28 weeks. Seven states and Washington D.C. do not set gestational limits on abortion.
In countries where abortion is illegal, exceptions may be made for a variety of cases, ranging from the victims of rape and incest to no exceptions at all.
Like Alabama, in countries such as Brunei, Guatemala, Libya and Syria, abortion laws do not make exceptions for cases of incest or rape, but do allow terminations to save the woman’s life.
In Qatar and Niger, abortion is only permitted in cases of fetal impairment or if the woman’s life or health is in danger.
Across Mexico, abortion is nearly entirely illegal, however, all states make an exception in the case of rape, while some states provide the procedure in cases of fetal impairment or for the physical or mental health of the woman.
Countries with more liberal laws include Finland, India and Japan, where provisions for abortion are made not only in cases of rape or risk to the woman’s health, but also on socioeconomic grounds.
The United Kingdom also has liberal abortion laws – except for in Northern Ireland, where abortion remains illegal in all cases except those where a woman’s life or health is at serious risk. Women in Northern Ireland seeking terminations often travel to England and, now, the Republic of Ireland, where abortion was made legal in 2018.
As in the case of Northern Ireland, women in Alabama seeking access to abortion services in the state may eventually need to cross state borders.
However, they likely won’t be able to travel to neighboring Mississippi and Georgia, just two of a growing list of states who have enacted, or have proposed, bills to ban abortion as early as six weeks of pregnancy – known as “heartbeat bills” – this year alone.
Like Alabama, doctors in Nicaragua also face prison time for performing abortions – up to six years for performing abortions, according to Human Rights Watch. They can also be disqualified from practicing medicine for two to 10 years.
That law has been shown to influence basic health care decisions: Amnesty International has reported that doctors are frightened to treat pregnant woman for illnesses such as cancer, malaria, HIV/AIDS or cardiac emergencies where treatment could cause injury or death to the fetus.
Women in Nicaragua seeking abortions also face imprisonment, while the Alabama law says it will not punish women.
What happens next
Legislators in several US states – including Alabama, Mississippi, Georgia and Ohio – are seeking to limit abortion rights in the hope that the resulting legal battles will make their way up to the US Supreme Court. This would give them an opportunity to make the case for overturning Roe v. Wade, the 1973 landmark Supreme Court ruling that legalized abortion in all 50 states.
There are now five conservative justices and four liberals on the US Supreme court, a makeup tipped towards anti-abortion sentiment as the newly appointed conservative Brett Kavanaugh – who wrote a 2003 memo that the Supreme Court “can always overrule” Roe v. Wade – has replaced a former swing voter.
It is impossible to predict how, and when, a challenge to US abortion law might be received. Abortion rights activists are worried, however, that the next time a serious challenge to Roe v. Wade is heard, the law could be repealed – which could make abortion illegal in the US.
The World Health Organization says that restrictive abortion laws jeopardize women’s lives and health. In countries that have complete abortion bans under any circumstance, including El Salvador, Nicaragua and Malta, the knock-on effects of such legislation can be felt throughout society.
In El Salvador, for example, there are no exceptions for rape, incest, or for the life of the mother. Even in cases of miscarriage, some women – many of whom are among the poorest in the country – are charged with aggravated homicide.
Studies show that banning abortion access (or funding to access) doesn’t stop abortions from happening. Instead, it drives people underground.
According to the reproductive rights think tank Guttmacher Institute, abortion rates in countries where the procedure is highly restricted and where it is broadly legal are similar.
The abortion rate is 37 per 1,000 women in countries where abortion is prohibited or permitted only to save the life of the pregnant woman, and 34 per 1,000 women in countries where abortion is not restricted as to reason, according to recent Guttmacher data published in The Lancet medical journal.
Globally, there were 25 million unsafe abortions annually between 2010 and 2014 (45% of all abortions) and at least 22,800 women died from complications related to them, according to a study by the World Health Organization and the Guttmacher Institute.