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By the early twenty-first century, abortion has come to be one of the most heated political issues in the world. In many Western nations, abortion is a divisive issue between the political left and the political right, with those on the left supporting the rights of the mother to control her reproductive life. Abortion opponents, on the other hand, label abortion as murder, often insisting that the rights of the unborn child begin at the moment of conception. An estimated fifty million abortions are performed yearly in various parts of the world, and at least twenty millions of those are considered illegal. Around one-half of all abortions are performed under conditions detrimental to the mother’s health, and many lead to chronic health problems, loss of fertility, and a woman’s loss of life. In countries where abortion laws are the most restrictive, approximately one-fourth of all pregnancies are illegally terminated.
Until the turn of the nineteenth century, abortion before quickening—the point at which the mother feels the baby move—was generally legal in the United States and Europe. Quickening was generally believed to occur around the twelfth week of pregnancy. The use of quickening as the point of viability could be traced back to the ancient Greeks and Romans. Historically, some abortions were performed with the assistance of friends, family members, midwives, doctors, or apothecaries. Self-induced abortions, which had a low success rate, were attempted through a variety of methods that included applications of herbs and ointments to the skin, vigorous internal or external massage, insertion of foreign objects, stomach binding, running, lifting, leaping, excessive exercise, starving, bleeding, blistering, hot and cold baths, emotional distress, fretting, excessive laughing, purging, and vomiting. If all other methods failed, women sometimes resorted to infanticide.
By the mid-nineteenth century, the male-dominated medical profession had co-opted the birthing process. In the United States, the American Medical Association, founded in 1847, led the campaign to make abortion illegal. The move sent desperate women underground, and the number of self-induced and “back alley” abortions increased. Over time, outlawing abortion evolved into outlawing all methods of birth control.
The issue of abortion returned to the front burner in the mid-twentieth century when scores of babies with massive deformities were born to mothers who had contracted German measles or taken the tranquilizer drug thalidomide. Consequently, many countries passed laws legalizing abortions. In 1994, the United Nations Conference on Population and Development signaled a global shift toward improving the quality of life for women and produced new policies on family planning and abortion around the world.
The United States
Birth control was outlawed in a number of states until the 1960s, when the second wave of the feminist movement swelled in response to the publication of Betty Friedan’s The Feminine Mystique in 1963, and the U.S. Supreme Court held in Griswold v. Connecticut, 381 U.S. 479 (1965), that a constitutional right to privacy guaranteed married couples access to birth control. This right was extended to single couples in Eisenstadt v. Baird, 405 U.S. 438 (1972). Building on the right to privacy, Roe v. Wade, 410 U.S. 113 (1973), confirmed the right to privacy. In Roe, Justice Harry Blackmun developed the trimester method of deter mining a timetable for legal abortions based on the development of the fetus. Abortions were generally legal in the first trimester but restricted in the second and third trimesters.
The rise of conservatism in the 1980s added heat to the abortion debate. Under presidents Ronald Reagan and George H.W. Bush, views on abortion became a litmus test for appointment to the Supreme Court. Congress began attaching abortion riders to unrelated bills and regularly renewed the Hyde Amendment of 1976, which banned Medicaid-financed abortions. This antiabortion stance had grave consequences for women in developing nations because Congress appropriated foreign aid with restrictions that limited access to family planning as well as to abortion. After a respite from abortion restrictions in foreign aid under Bill Clinton, George W. Bush renewed them in 2001. Although the Supreme Court has continued to narrowly uphold Roe v. Wade, states were given authority to limit access to abortion in Webster v. Reproductive Health Services, 492 U.S. 490 (1989), and Planned Parenthood of Southeastern Pennsylvania v. Casey, 505 U.S. 833 (1992).
One of the most controversial aspects of the abortion battle has been the conflict between abortionist opponents, who claim that the right to protest outside abortion clinics is guaranteed by the First Amendment, and prochoice advocates, who object to practices that limit entry to family planning and abortion clinics. After an increase in violence and the murder of two abortion-providing physicians, the Supreme Court held in NOW v. Scheidler, 510 U.S. 249 (1994), that states could pass laws designed to deter violence with increased fines and punishment. As a result of violence and ongoing controversy, 87 percent of all counties in the United States have been left without abortion services. The appointment of John Roberts as chief justice of the Supreme Court in 2005 raised conservative hopes that Roe v. Wade would eventually be overturned.
In countries such as China and India, abortion is viewed as an acceptable means of controlling exploding populations. Both countries have liberal abortion policies, and women are more likely to abort female fetuses. Most Chinese women are restricted by the government’s one-child policy. As of 2005, the male to female birth ratio in China was 120 boys for every 100 girls, equating to an estimated thirty-two million more boy than girls. India’s birth ratio as of 2001 was 108 boys for every 100 girls. In Asian cultures, males are traditionally perceived as more valuable because they are honor bound to take care of aging parents. Such traditional thinking lingers despite modern lifestyle changes.
Abortions are performed less often in developing countries than in developed countries because high infant mortality rates and a need for cheap labor in the agricultural sector result in high fertility rates. In East Timor, for example, the poorest country in the world, with a per capita income of only US$400, the infant mortality rate is 45.89 children per one thousand live births and the fertility rate is 7.8 children per woman. In comparison, the infant mortality rate in the United Kingdom is 4.85 per one thousand live births and the fertility rate is 1.9 births per woman. In Japan, the infant mortality rate is 2.79 children per one thousand live births, with a fertility rate of 1.34 per woman.
In the transition countries of eastern Europe, former Soviet bloc nations are struggling economically as they attempt to reinvent themselves. Abortion on demand was prevalent under socialism because it was believed to increase the productivity of women. However, some restrictions have now been instituted, in part because of the influence of the Catholic Church. In Poland, for instance, the church was successful in overturning liberal abortion laws and removing sex education from classrooms in 1993. Three years later sex education was reintroduced, and some restrictions on abortion were removed.
Antiabortion forces within the church have been most successful in Ireland, where all abortions are illegal. Conversely, in France, where more than 80 percent of the population is Catholic, abortion rights have been guaranteed since 1974. Elsewhere in Europe, abortions are legal up to the twelfth week of pregnancy in Austria, Belgium, Bulgaria, the Czech Republic, Denmark, Germany, the Netherlands, Norway, Slovakia, Sweden, and Russia. Limited access to abortion is available in Britain, Finland, Hungary, Portugal, Spain, and Switzerland.
Africa And The Middle East
While Cape Verde, South Africa, and Tunisia allow unrestricted abortions, most other African nations retain restrictive and old colonial laws, as well as ineffective family planning, both of which contribute to high numbers of abortions. According to the World Health Organization, an estimated 4.2 million African women seek unsafe abortions each year, with thirty thousand maternal deaths resulting.
African women suffer disproportionately from unsafe abortion practices. While 10 percent of the world’s abortions occur in Africa each year, its women comprise half of the resultant deaths. In countries where abortion is legal, maternal death rates are much smaller. For instance, South Africa’s number of deaths due to unsafe abortions fell by 90 percent from 1984 to 2001, after that country legalized abortion.
Eighty percent of the countries in North Africa and the Middle East outlaw abortion in some fashion: 21 percent prohibit abortion under all circumstances, 55 percent prohibit abortion except to save the woman’s life, and 24 percent allow abortion to preserve the woman’s physical or mental health. The restrictive laws and, in many cases, lack of effective family planning programs contribute to the number of unsafe abortions and related deaths in this region.
In 1992, the Syrian Family Planning Association and International Planned Parenthood Federation’s Arab World Regional Office hosted a regional conference on unsafe abortion and sexual health. The attendees agreed that unsafe abortion was a major public health problem throughout the region. They determined the need to review policies and provide better family planning.
Lack of effective family planning services, including the availability of contraception, contributes to higher rates of abortion. For instance, abortions in Turkey decreased as the availability of family planning programs increased. Similarly, Tunisia legalized abortion for all women in 1973. Since then, the number of unsafe abortions has drastically decreased, as have the number of maternal deaths. For every one thousand women of reproductive age in 1990, eleven received abortions. By 2003, this number had dropped to seven out of every one thousand women of reproductive years.
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