Some people who seek or obtain abortions can face prison time in more than 120 countries, according to an analysis published Monday that sheds new light on international penalties for the procedure.
More than 90 countries have maximum penalties of up to five years of prison time for certain abortion-seekers, while 25 have sentences of between five and 10 years, according to the research, which relied on a World Health Organization database of abortion policies.
The authors describe their work, published in the journal BMJ Global Health, as a comprehensive global analysis of the penalization of abortion.
"When [abortion] is regulated through the criminal law, there are consequences, which can include compounding the stigma associated with seeking or providing abortion care, creating a chilling effect," said co-author Antonella Lavelanet, a medical officer with the WHO’s Department of Sexual and Reproductive Health Services and Research.
Lavelanet and her co-authors used the WHO's Global Abortion Policies Database for their study, though it does not follow a uniform definition of abortion. (The practice is generally defined as termination of a pregnancy before fetal viability, around 24 weeks.) The database also does not specify the gestational limits after which penalties are imposed in different countries, so some may not apply until late into pregnancy.
In six countries — Kiribati, Solomon Islands, Tuvalu, Barbados, Belize and Jamaica — some abortion-seekers can face life in prison, according to the analysis.
Although most countries allow some level of access to abortion, 11 prohibit it entirely, Lavelanet said: Andorra, the Congo, the Dominican Republic, El Salvador, Haiti, Madagascar, Malta, Nicaragua, Palau, the Philippines and Suriname.
The study also found that some abortion-seekers can be fined in 48 countries, most of which impose the fines in addition to prison sentences.
The analysis included data from 182 countries through October. It did not include the U.S., since abortion regulations differ state by state following the Supreme Court's decision to overturn the constitutional right to abortion.
Some U.S. states with abortion bans — including Mississippi, Alabama and West Virginia — mandate prison time for providers of illegal abortions, according to FindLaw.com, an online legal database.
“As long as those criminal laws are on the books, it’s very difficult for women to exercise their affirmative rights to abortion and access essential health care,” said Rebecca Cook, a professor emerita at the University of Toronto Faculty of Law whose research has focused on the decriminalization of abortion.
Abortion providers can also face prison time
In many countries, abortion providers and those who assist them can be subject to harsher legal repercussions than abortion-seekers, the new study shows.
Some abortion providers can face up to five years in prison in 126 countries, and 10 years to life in prison in 14 countries. They can also be fined or face professional sanctions — including termination from employment or the closure of their practices — in dozens of countries.
Some laws also criminalize people only tangentially related to abortion services: In the Philippines, for example, the parents of someone who gets an abortion could be penalized.
Other countries impose alternative penalties for certain abortion providers or seekers. Syria, Russia and Ukraine, for example, mandate various forms of labor as penalties. Four countries — Mali, Algeria, Mauritania and Morocco — prohibit residence following an abortion.
Earlier this month, a Polish court convicted a human rights activist of illegally providing abortion pills, sentencing her to eight months of community service, a type of penalty at least four other countries also impose.
But the WHO database does not track the extent to which legal penalties are enforced, which is a limitation of the study, the authors noted.
Penalization doesn't stop abortions, experts say
In 34 countries, the dissemination of information about abortion services is also penalized in some circumstances, even when certain types of abortions may be legal. Germany abolished a law like this in June, Reuters reported.
"We want individuals to have access to quality abortion care, and that includes having information to access to counseling and information," Lavelanet said.
She added that some research suggests that laws against abortion don't necessarily reduce or stop it.
"Restricting access to safe abortion harms women — it leads to unsafe procedures, lack of access to information," she said, noting that in some circumstances, "it actually drives women and girls toward unsafe procedures."
Cook, the University of Toronto professor, said that criminalizing abortion also neglects the fact that "abortion really is an essential health care — particularly in cases where women are raped [or] adolescent incest."
"When it’s criminalized, it constructs women as potential criminals," she added.
The WHO's guidelines recommend decriminalizing abortion and removing any other medically unnecessary policies that create barriers to safe abortion.