A Question Of Life And Death- The Economist

A question of life and death May 17th 2007
From The Economist print edition

The struggle between “pro-choice” and “pro-life” forces around the world

The scan showed the four-month-old fetus had anencephaly, a rare, incurable condition; the baby would be born without a scalp or most of its brain. It could live only a few days. The mother, an unmarried 17-year-old known as Miss D, wanted an abortion. But in her native Ireland, abortion is banned unless the mother's life is at risk. The health authorities would not let her leave the country for a termination. On May 9th Ireland's High Court ruled that Miss D should be allowed to go to Britain to have the procedure. The unborn baby's “right to life”, enshrined in the constitution, did not take precedence over Miss D's right to travel, it suggested.

On the same day, Pope Benedict, starting his first visit to Latin America, reiterated the Vatican's deep opposition to abortion: the politicians in Mexico City who had just voted to legalise the practice were excommunicating themselves, he said. This was “not something arbitrary”, but part of long-established canon law.

At the other end of the debate over abortion is China, where the practice is controversial not because it is banned but because it is obligatory—for mothers whose pregnancy violates strict curbs on family size. News came this week of a father who was fined 600,000 yuan ($78,000) for breaking the “one-child” policy, which came into force in 1979. Meanwhile, in the United States, abortion promises once again to be a big issue in the next presidential race. Rudy Giuliani, the Republican front-runner, is struggling to avoid alienating conservative voters with his mildly “pro-choice” line.

Four decades after controversy over abortion and the law began to sweep the world, the battle between the “pro-lifers” and “pro-choicers”—with its heady mix of sex, religion and morality—rages on. Supporters of easier access to legal abortion say that despite reversals in some places, and staunch resistance in others, their cause is advancing. According to the New York-based Centre for Reproductive Rights, over 60% of the world's 6.5 billion people now live in countries where abortion is generally allowed. Just a quarter live in states where it is generally banned.

It is 12 years since the so-called Beijing Platform, signed by 189 states, urged a review of all laws that punish women for having abortions. Since then, 18 countries have made it easier for women to obtain a termination. But in at least four countries—America, Russia, Hungary and Poland—things have become more restrictive (with limits on the time, grounds or method), while another two, Nicaragua and El Salvador, have banned the practice outright. More than 50 countries now allow abortion virtually on demand up to at least the 12th week of pregnancy; some (including Britain) permit it up to 24 weeks, and some (like parts of China) have no time limit.

But for those who agree with a formula coined by Bill Clinton—that abortion should be “safe, legal and rare”—the world is still far from ideal. Of a total of 46m abortions thought to be carried out each year (more than one in four pregnancies are terminated), some 20m are illegal, resulting in the death of around 70,000 women a year, according to the World Health Organisation. Abortion is either banned outright or is confined to cases of rape, incest or risk to the mother's life across most of the Muslim world, Catholic Latin America and Africa.

Although China reports 7m abortions a year (the real figure is much higher), it does not have the world's highest rate. That place is held by Romania, where some three-quarters of pregnancies are terminated (the same ratio as in New York City and Shanghai). Russia, the first country to allow abortion (in 1920), comes second with two in three pregnancies terminated. Rates are high across the former Soviet block, with the termination of more than one in two pregnancies in most countries.

In the United States, Australia, Canada, Britain and most of the rest of western Europe, around 15-25% of pregnancies are terminated. In India, an estimated 6.4m abortions take place every year (most involving female fetuses), representing one in four pregnancies. In many African and Muslim countries the rate is probably less than 5%, says William Robert Johnston, an American pundit. But he notes that data are elusive, and that the link between law and reality is often tenuous.

Indeed, some of the world's highest abortion rates are to be found in Latin America, where it is all but outlawed. The Mexican legislators who voted to decriminalise abortion cited the brutal effects of this gap between theory and practice: an estimated 5,000 women die in Latin America every year from botched back-street or self-administered abortions; a further 800,000 have to be treated in hospital.

In the same spirit, Brazil's new health minister has called for a “wide-ranging debate” on abortion, despite the opposition of two-thirds of Brazilians to any change. The pope's visit and the Mexican move have exposed strong feelings on both sides. Most Colombians, Mexicans and Chileans oppose legalising abortion. But in Argentina, where perhaps four in ten pregnancies are illegally ended, over 75% say it should be legal in some cases.Like the Catholic church, Islam regards life as sacred from conception. But unlike the Vatican, Muslim thinkers tend to calibrate the gravity of the “sin” according to the timing—early abortions are viewed less seriously. Most Muslim countries outlaw the practice unless the mother's life is at risk; but Turkey and Tunisia allow abortion on demand during the first ten weeks or three months respectively.

In some countries, judges are stepping in. In May last year Colombia's Constitutional Court ruled that an outright ban on abortion was unconstitutional; it must be allowed in cases of rape, incest, severe deformity and danger to maternal health. In November, the Inter-American Commission on Human Rights said Nicaragua's total ban violated a woman's basic rights. And this March, the European Court of Human Rights ruled that governments must make it possible for women to have access to abortion, where it is legal.

As many states make abortion easier, America may be moving the other way. Last month the Supreme Court upheld a federal law, passed in 2003, banning “partial-birth” abortions, a late-term procedure involving the piercing of a fetus's skull. Some hope, and others fear, this could be a prelude to the overthrow of Roe v Wade, the 1973 ruling that has given America one of the strongest legal rights to abortion in the world. If that decision is quashed, abortion could be criminalised in about 30 states. Polls suggest that about half America's voters would approve.

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