Abortion in Italy is broadly legal and free, but nearly three-quarters of doctors there have registered as conscientious objectors, and are exempted from performing abortions for religious or moral reasons. Other doctors feel pressure from colleagues not to provide abortions, Professor Mishtal and colleagues found. “It has a chilling effect,” she said. “There is an enormous discrepancy between the law and the actual access.”
How the United States stands out
In other rich democracies, abortion is covered by public health insurance. So are other forms of reproductive health care, including contraception. In Ireland, for example, the cost of an abortion is fully covered, the procedure can be performed by a general practitioner, and there is a government help line on how to get an abortion or reach a nurse during recovery.
The United States prohibits federal funding of abortions in most cases. Also, abortions tend to be provided only in special clinics, often far from where women live. In peer nations, they are more likely to be offered at ordinary hospitals and medical clinics.
Most European countries have arrived at their abortion laws through legislation involving political compromise. In the U.S., the viability threshold originated in the Supreme Court. Michael New, a law professor at the Catholic University of America who supports more U.S. restrictions on abortion, said this process difference may explain why the gestational limit in U.S. law is later than in most of its peer nations.
“A legal debate, built upon precedent, can be very different from a democratic debate or moral debate,” he said in an email.
The United States is also unusual in having such a wide range of laws by state, a feature that will be magnified if Roe is overturned. “In California, abortion access is fairly similar to abortion access in the United Kingdom, whereas in Texas right now, abortion access is really among the most restrictive in the world,” said Caitlin Gerdts, a vice president at Ibis Reproductive Health, a research group.
Illegal abortion is becoming easier and safer
The very nature of illegal abortion worldwide is transforming because of the availability of pills that can end a pregnancy. Historically, countries without legal abortion tended to have high rates of unsafe abortion. But pills that cause abortions are safe and easy to transport. The most effective studied protocol involves two drugs. But just one, misoprostol, an ulcer drug on the World Health Organization’s list of “essential medicines,” causes a complete abortion in around 80 percent of cases or more, according to recent research.