As US states implement abortion bans, remember: they simply do not work

The Supreme Court has unleashed pro-life policies whose only certain effect is to increase maternal death

June 26, 2022
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Bob Korn / Alamy Stock Photo

When the US Supreme Court overturned Roe v Wade on 24th June, it was the culmination of years of activism by a movement that hopes to outlaw abortion across the United States.

The 1973 ruling established a woman’s constitutional right to terminate her pregnancy, but in the ensuing decades “pro-life” activists have slowly chipped away at that right to the point that it was almost impossible to access in some areas of the US, even before this devastating reversal. Now, around two dozen US states are expected to ban or heavily restrict abortion. Some had “trigger laws” in place that would allow them to quickly implement bans if Roe v Wade was overturned. Just two days after the Supreme Court ruling, abortion is already banned in nine states, including Utah, South Dakota, Oklahoma, Arkansas, Alabama, Kentucky, Louisiana, Missouri and Wisconsin (although the situation there, which is now relying on a law from 1849, is complex), with more set to follow.

Women should have the right to abortion regardless of whether such bans are effective or not. But evidence shows they don’t even work. Abortion bans do not reduce the number of abortions that are carried outindeed, those countries with bans in place appear on some measures to have a higher abortion rate. What’s certain is that they simply reduce the number of safe abortions.

To see the true impact of such policies, consider a 2020 study published in the Lancet Global Health journal, led by researchers at the Guttmacher Institute and World Health Organisation. They found that between 2015 and 2019, the abortion rate per 1,000 women was the same in countries where abortion is “broadly legal” as in those where it is completely prohibited.

Digging deeper, the picture might be even starker: the abortion rate was significantly lower in countries where abortion is legal when China and India were excludedresearchers found that these countries were “atypical” for the group, and they have such large populations that they tend to skew the results of international comparisons in a way that can cloud rather than highlight important patterns.

Without them, the abortion rate in countries where it was “broadly legal” was 26 per 1,000 women over the four-year period, compared to 40 per 1,000 women in countries where it was completely prohibited. That is likely because countries where abortion is legal also tend to have better sex education and access to contraceptivesthings that remain an issue in some parts of the USso the rate of unintended pregnancy falls.

Excluding China and India, the researchers found that “around half of unintended pregnancies ended in abortion—whether abortion is restricted or broadly legal.” Instead, what changes when abortion is banned is that women are forced to use unsafe methods. 

In the weeks since the US Supreme Court’s intentions became clear, women have offered harrowing accounts of abortion in the time before Roe v Wade. It often involved being blindfolded and taken to isolated locations with strangers who had no medical training. It involved agonising procedures in unsanitary conditions, sometimes having to endure the pain in silence so as not to alert anyone to what was happening. It could be carried out with coat hangers or sticks or mysterious pills. Afterwards, you might bleed alone for hours or days, unable to seek help.

In many parts of the world, that situation continuesand not everyone survives the experience. Each year, tens of thousands of women die as a result of unsafe abortions, making it a leading cause of maternal deathalthough exact figures will never be known as so many cases necessarily go unreported.

Forcing women to carry unwanted or unintended pregnancies to term also comes with physical and mental health risks. Even in countries that ban abortion but have an exemption for saving the life of the motheras is the case for all US states with trigger laws in placethe fear of criminalisation means it does not always play out like this. In Poland, for example, there have been cases where women have died after being denied an abortion, even though such an exemption is supposed to exist.

For decades, the anti-abortion movement has latched onto the “pro-life” framing to advocate for its cause. The legislation being used to ban abortions now is often branded as pro-lifefor example the Arkansas Human Life Protection Act, which was signed into effect on Friday, makes performing an abortion a crime punishable by up to 10 years in prison.

Donald Trump described Friday’s Supreme Court decision as “the biggest win for life in a generation.” But that’s simply not borne out by the facts. Instead, the evidence reveals these “pro-life” policies as nothing of the sort.