Author: Anna Arnold-Perry
January 30, 2024
Fifty years ago, the 1973 Supreme Court case Roe v. Wade made abortions legal and safer in the United States (Totenberg and McCammon). A year and a half ago, the historical case was reversed. The effects of this landmark reversal on reproductive rights were felt nationally and discussed globally. Was the reversal following a global trend or was it an outlier? To examine the global trend on access to abortions, we can compare the US’s stance on access to abortions to other countries by selecting the countries with the highest and lowest HDI (Human Development Index) values in various regions. This method of selection allows us to examine how the US compares to regions’ developing countries versus developed countries.
The Human Development Index (HDI) is a summary measure of three key dimensions of human development: health, education, and standard of living (United Nations Development Programme, Human Development Index). The health dimension is measured by life expectancy at birth (UNDP, HDI). Education is measured by the mean years of schooling of adults aged 25+ and the expected years of schooling of children entering school (UNDP, HDI). The standard of living is measured by gross national income (GNI) per capita (UNDP, HDI). The scores of the three indices are aggregated into a composite index using the geometric mean, yielding a country’s HDI value on a scale of 0 to 1, with 1 being the highest (UNDP, HDI). The HDI uses a range of information, emphasizing people and their capabilities to assess a country’s development instead of just economic growth (UNDP, HDI). The HDI captures a part of human development but doesn’t reflect on inequalities, poverty, human security, empowerment, etc. (UNDP, HDI). However, for this comparison, it is a useful tool to randomize selecting countries to examine differences in regional and global access to abortions. The data below is taken from the latest HDI dataset published in 2022 reflecting data collected in 2021; data is published annually.
Regions: North America, Near East (includes North Africa), East Asia and Pacific, South and Central Asia, Europe and Eurasia, Latin America and the Caribbean, and Sub-Saharan Africa
The HDI rank is out of 191 nations.
The GNI per capita data is from 2021 using 2017 PPP (Purchasing Power Parity), exchange rate, to dollars.
UNDP, Human Development Reports, (2021-22) (2022)
The Center for Reproductive Rights’ Map of The World’s Abortion Laws was used to examine the above countries’ access to abortions. The Center’s Map separates countries into five categories depending on the status of abortion laws. Category 1 is On Request (Gestational Limits Vary): abortions are permitted typically with gestational limits; the rigidity of these requirements varies across countries (The World’s Abortion Laws). Category 2 is Broad Social or Economic Grounds: abortion is available on grounds that take into account a pregnant person’s situation, economic circumstances, and well-being (The World’s Abortion Laws). Many countries permit abortions on specific grounds, such as pregnancy from rape, incest, or certain fetal diagnoses: these grounds can apply to categories 2-4 (The World’s Abortion Laws). Category 3 is To Preserve Health: abortions are permitted when the pregnancy poses a risk to the person’s health, including threats to preserve health in many of these laws (The World’s Abortion Laws). Category 4 is To Save a Person’s Life: abortion is permitted to preserve the pregnant person’s life (The World’s Abortion Laws). Category 5 is Prohibited Altogether (The World’s Abortion Laws).
Globally, as noted by The Center for Reproductive Rights notes, there is a trend toward liberalizing abortion laws with very few countries regressing since 1994 (“Abortion Law: Global Comparisons”). This trend occurs in industrialized (developed) countries and low-and middle-income countries (LMICs) (developing) countries (“Abortion Law: Global Comparisons;” Ishola et al., 2021).
Regionally, the Green Wave movement in Latin America is a reproductive rights movement advocating for expanded abortion access (Press, 2023). In 2017, Chile ended its 28-year total abortion ban when their Constitutional Court upheld a law decriminalizing abortion when the life of a pregnant woman is at risk, the fetus is unviable, or pregnancy resulting from rape (“World Report 2022: Rights Trends in Chile”). In Haiti, there is a total abortion ban despite illegal and unsafe abortions being common. However, a new penal code is scheduled to enter in 2024 that would legalize abortions in all circumstances until 12 weeks and at any time in cases of rape, incest, or risk to the mental or physical health of the pregnant woman (“World Report 2023: Rights Trends in Haiti.”). If this new penal code does take effect, Haiti would join many of the other countries in Latin America and the world that are decriminalizing and legalizing abortions, moving the country from Category 5 to Category 1.
The US and Mexico are not included in the previous table as their abortion laws vary state by state but on opposite sides of the progressing spectrum. The US is one of four (El Salvador, Nicaragua, and Poland) that have removed legal grounds for abortions in the 21st century (The World’s Abortion Laws). The historic reversal of Roe v. Wade in the US made abortions regulated at the state level, making the US hard to place into one category. The states now fall on a spectrum, ranging from some falling in the category of “prohibited altogether” and others in the category of “on request.” Mexico, on the other hand, had a historic Supreme Court case in 2021 that removed abortions from the federal penal code and declared laws prohibiting the procedure as unconstitutional and violating women’s rights (Press). Mexican states are in the process of reforming their laws to comply with the Supreme Court decision, after which Mexico can be placed in the category of “on request” (The World’s Abortion Laws).
The topic of abortions is a complex political, public health, socio-cultural, and human rights issue. The complexities of which are beyond the scope of this comparison. However, the language of the 2018 United Nations Human Rights Committee’s General Comment on the Right to Life affirms that “abortion is a human right” (Goldberg, 2018). Barriers to abortion access, such as restrictive laws, lack of knowledge of abortion and abortion services, lack of local services, high cost of services, stigma, and judgmental provider services, to name a few, affect people all over the world regardless of a country’s development (Doran et al., 2015; Ishola et al., 2021). The framework of the General Comment on the Right to Like outlines that these restrictions violate women’s right to life, health, and non-discrimination (Goldberg, 2018). With the overturning of Roe v Wade in 2022, not only were fifty years of abortion rights overturned but fifty years of reproductive and women’s rights were affected. This comparison intended to highlight how the US’s regression on abortion rights is an outlier of the global trend, comparing the US’s access to abortions against countries with the highest and lowest HDI values of their respective regions.
Sources
Doran, Frances, and Susan Nancarrow. "Barriers and Facilitators of Access to First-Trimester Abortion Services for Women in the Developed World: A Systematic Review." The Journal of Family Planning and Reproductive Health Care, vol. 41, no. 3, 2015, pp. 170. ProQuest, http://mutex.gmu.edu/login?url=https://www.proquest.com/scholarly-journals/barriers-facilitators-access-first-trimester/docview/1779288951/se-2, doi:https://doi.org/10.1136/jfprhc-2013-100862.
Goldberg, Justin. “UN Human Rights Committee Asserts That Access to Abortion and Prevention of Maternal Mortality Are Human Rights.” Center for Reproductive Rights, 31 Oct. 2018, reproductiverights.org/un-human-rights-committee-asserts-that-access-to-abortion-and-prevention-of-maternal-mortality-are-human-rights/#:~:text=UN%20Human%20Rights%20Committee%20Asserts,Rights%20%7C%20Center%20for%20Reproductive%20Rights.
Ishola, Foluso, et al. “Impact of abortion law reforms on health services and health outcomes in low- and middle-income countries: A systematic review.” Health Policy and Planning, vol. 36, no. 9, 2021, pp. 1483–1498, https://doi.org/10.1093/heapol/czab069.
Press, The Associated. “Mexico Decriminalizes Abortion, Extending Latin American Trend of Widening Access.” NPR, NPR, 7 Sept. 2023, www.npr.org/2023/09/06/1198039758/mexico-abortion-decriminalization-supreme-court.
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Totenberg, Nina, and Sarah McCammon. “Supreme Court Overturns Roe v. Wade, Ending Right to Abortion Upheld for Decades.” NPR, NPR, 24 June 2022, www.npr.org/2022/06/24/1102305878/supreme-court-abortion-roe-v-wade-decision-overturn.
UNDP. “Human Development Index.” Human Development Reports, United National Development Programme (UNDP), 28 Nov. 2023, hdr.undp.org/data-center/human-development-index#/indicies/HDI.
UNDP, Human Development Report (2021-22) (2022)
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