Who Are the Real Abortion Radicals? A Comparative Perspective

KEY TAKEAWAYS

• In the 50 years since Roe v. Wade determined that the point of fetal viability was the compelling factor for the interest in potential life (then thought to range from 24 to 28 weeks gestational age), the medical community has made remarkable strides in recognizing the biological reality and humanity of a baby in the mother’s womb. Despite these advances, U.S. federal and state abortion policies have increasingly embraced expanded access to abortion and increased availability of late-term abortion.
• Six U.S. states plus the District of Columbia do not have any state-level restrictions on when an abortion can take place—meaning that fully formed babies can be killed in the womb until the point of birth. Liberals have attempted to expand this type of radicalism to the entire Nation through passage of the “Women’s Health Protection Act” (117^th Congress) and similar state legislation.
• The U.S. is one of only six countries with laws permitting elective abortions throughout all nine months of pregnancy, making U.S. abortion laws more radical than the majority of the world and 94% of Europe. Even if abortion is made illegal after 15 weeks gestation, the Mississippi law at question in the Dobbs v. Jackson Women’s Health Organization will still be laxer than the laws of France, Germany, Italy, and Greece.
• Just one in five Americans (21%) share the absolutist view of those calling for unrestricted abortion at any time in pregnancy, believing that abortion should be “legal in all cases.” Only 5% believe “no restrictions should be placed on abortion.”

INTRODUCTION

Abortion has again taken center stage with the Supreme Court decision on Dobbs v. Jackson Women’s Health Organization expected imminently (LII Supreme Court Bulletin, 2021). If the recent unprecedented leak of the draft Dobbs decision proves to be accurate, the pending decision would reverse the judicial overreach of the 1973 Roe vs. Wade ruling and send the issue back to the people to decide (Gerstein & Ward, 2022). While it is understandable that Americans have strongly held views on the issue, the vilification of the pro-life movement stands out for its intensity. Just last week, an armed man was arrested outside the home of Supreme Court Justice Brett Kavanaugh on charges of attempted murder, and the homes of other conservative Supreme Court justices have been targeted by protestors since the draft Dobbs decision was leaked (Mangan, 2022). We are living in a time when standing up for the dignity of human life—from the moment of conception to natural death—invites the worst accusations of radicalism.

This false narrative distracts from the reality that policies permitting abortions in the U.S. are already extreme by global standards and would move even further in that direction, if the Left has its way. Liberals in America once thought abortion should be “safe, legal, and rare,” but today they are calling for late-term and free abortion—that is, abortions up until the time of birth and paid for by taxpayers. If adopted, this would mark the most radical pro-abortion stance of any Western country (North, 2019; Barrow, 2019; Jipping, 2022). Liberals often tout Western European policies as a model for the U.S., but when it comes to abortion, the U.S. is far more extreme than Western Europe and actually has more in common with China and North Korea—a red flag for any American who respects freedom and liberty.

This paper documents the radical nature of U.S. federal and state abortion policies, how current U.S. policies compare to the policies of other countries, and how out-of-step the Left’s radical positions are with the American people.  The primary objective is to provide an evidence-based assessment of the extremity of America’s current abortion policies relative to both the global mainstream and to U.S. public opinion.

UNITED STATES LAWS AND PRACTICES

Background

In 1973, the U.S. Supreme Court ruled in Roe v. Wade that, in regard to abortion, states had an interest in both “protecting the health and safety of the pregnant women and the potential human life within her" and made different determinations for the legality of state regulation and proscription of the procedure based on the stages of pregnancy (LII, n.d.). Citing the right to privacy said to be contained in the Due Process Clause of the Fourteenth Amendment, the court found that abortions prior to the end of the first trimester could not be subject to state regulation or proscription (Roe v Wade, 1973).[1]^,[2] During the second trimester, the Court found that states may regulate abortion procedures for preservation and protection of maternal health (Roe v Wade, 1973). For the interest in potential life, the Court found “the ‘compelling’ point is at viability” and ruled that the State may regulate and proscribe abortion after that point. Viability was cited as a range of 24 to 28 weeks in Roe v. Wade in 1973 (Roe v Wade, 1973).

In 1992, the Supreme Court upheld key findings about the state’s involvement in abortion in Casey v. Planned Parenthood (LII, n.d.; LII Supreme Court Bulletin, 2021). Abortion law was next addressed legislatively in 2003 when Congress passed the “Partial-Birth Abortion Ban Act of 2003” which outlawed any abortion procedure “that kills the partially delivered living fetus” (108^th U.S. Congress, 2003-2004). This legislation was upheld by the Supreme Court in the 2007 decision of Gonzales v. Carhart (LII, n.d.)(Gonzales v Carhart, 2006).

In the nearly 50 years since Roe v. Wade, states have legislated a range of gestational limits for elective, or non-health-related, abortions. Currently, 22 states prohibit abortions at a specific gestational age prior to fetal viability but very few are in effect due to court orders (Kaiser Family Foundation, 2022). An additional 20 states prohibit elective abortions after fetal viability (Guttmacher, 2022). The Mississippi ban on all elective abortions after 15 weeks of pregnancy is being challenged in the Supreme Court in Dobbs v. Jackson Women’s Health Organization. The major issue at question in the case is the constitutionality of pre-viability prohibitions on elective abortions at the state level (LII Supreme Court Bulletin, 2021).

Stage of a Baby’s Development and Medical Advances Since 1973

In the 50 years since Roe v. Wade determined that the point of fetal viability was the compelling factor for the interest in potential life (then thought to range from 24 to 28 weeks gestational age), the medical community has made remarkable strides in recognizing the biological reality and humanity of a baby in the mother’s womb.

The Office on Women’s Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services describes a woman’s developing baby in four-week intervals in great detail (Office on Women’s Health, n.d.). For example, by eight weeks, the website describes “your baby’s heart beats with a regular rhythm.” At 16 weeks, one week after elective abortions are prohibited by the Mississippi law at question in the Dobbs case, it states “your baby makes sucking motions with the mouth (sucking reflex).” At 20 weeks, it says “your baby can hear and swallow.”

New technology such as the three-dimensional ultrasound and fetal echocardiograms have allowed doctors and parents to see and understand the early development of a baby in incredible detail—with the vivid facial features of a 20-week 3-D ultrasound a landmark for expectant mothers. In fact, a scientific review article of the history of sonography in obstetrics and gynecology states “Real Time 3D ultrasound imaging (i.e. 4D) is most useful in showing fetal movement and there is evidence that this has real benefit in improving maternal-fetal bonding (Figure 1) (Campbell, 2013).” For reference on how far ultrasound technology has advanced in the past 50 years, a second trimester ultrasound from 1972—the year before the Roe decision—is included from the academic article titled “A Short History of Sonography in Obstetrics and Gynaecology” (Campbell, 2013).

FIGURE 1

Source: Campbell S. (2013). A short history of sonography in obstetrics and gynecology. Facts, views & vision in ObGyn, 5(3), 213–229. Copyright: © 2013 Facts, Views & Vision. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987368/

FIGURE 2.

Source: Campbell S. (2013). A short history of sonography in obstetrics and gynecology. Facts, views & vision in ObGyn, 5(3), 213–229. Copyright: © 2013 Facts, Views & Vision. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987368/

New breakthrough treatments such as pulmonary surfactant and other advancements in neonatal intensive care have increased survival rates of extremely pre-term infants with the latest data showing a 78.3% rate of survival to hospital discharge among infants born at 22-28 weeks gestational age (Bell et al., 2022; Sardesai et al., 2016). Doctors can now perform a wide range of surgical procedures on babies before birth, including minimally invasive surgeries to treat conditions as early as 16 weeks gestation—well before current U.S. legal standards of viability (Koehler et al., 2017).

Despite the remarkable medical advances that afford new knowledge about developing babies since Roe in 1973, U.S. federal and state abortion policies have increasingly embraced expanded access to abortion and increased availability of late-term abortion.

U.S. Laws Expanding Access

Many states have focused on expanding access to abortion, including compelling taxpayers to fund it. This type of radicalism among elected state officials has resulted in the state-level codification of the “right to abortion” in 16 states plus the District of Columbia (Gonzalez, 2022).

Maryland’s General Assembly recently passed an abortion protection bill and overrode the veto of Gov. Larry Hogan on the “Abortion Care Access Act.” This bill would require private insurance companies to fully cover abortions, making them free at the point of service—likely at the expense of higher premiums for everybody else, expanding Medicaid funding for abortion, spending over $3 million in taxpayer funding for those who work in the abortion industry, and loosening the medical qualifications for those who are allowed to perform abortions (MD General Assembly, 2022).

Michigan Gov. Gretchen Whitmer has likewise filed a lawsuit asking the Michigan Supreme Court to “immediately resolve whether Michigan’s Constitution protects the right to abortion” and asked the court “to recognize a constitutional right to an abortion under the Due Process Clause of the Michigan Constitution” (MI Office of the Governor, 2022). New Jersey Gov. Phil Murphy recently signed a bill codifying the right to abortion into New Jersey State law (NJ Legislature, 2020-2021).

The West Coast has aggressively moved to expand abortion access as well. The Oregon legislature approved $15 million in one-time funding for the “Reproductive Health Equity Fund” in the state’s final budget bill (OR Office of the House Speaker). The funds can be spent on new equipment and workforce salaries for abortion providers. This money will also go to fund a call-in “hotline” for women seeking abortion in the state and help pay for travel and other abortion-related costs (Cerullo, 2022).

In March, Washington Gov. Jay Inslee signed a bill that prohibits the state from pursuing legal action against those seeking an abortion and those who provide assistance in that effort (WA State Legislature, 2022; LaCorte, 2022).

California’s Gov. Gavin Newsom has already acted to make abortion cheaper in the Golden State and signed a bill requiring private insurers and Medicaid to cover the full cost of an abortion procedure at the expense of likely higher insurance premiums and a heavier taxpayer burden (CA Legislative Information, 2022). He has also proposed generous tax breaks to companies looking to relocate from states with restricted abortion access such as Florida and Texas, and advocated for over $100 million in new spending to “maintain and improve availability of safe and accessible reproductive health care services and prepare for a potential influx of people from other states seeking reproductive health care and abortion services” (Hubler, 2022; CA Office of the Governor, 2022).

Radical Late-Term Abortion Laws in the United States

Today, in six states plus the District of Columbia, there are absolutely no state-level restrictions on when an abortion can take place—meaning that fully formed babies can be killed in the womb until the point of birth (Hubbard, 2022). The states of Alaska, Colorado, New Jersey, New Mexico, Oregon, and Vermont and the District of Columbia do not currently impose restrictions on abortion at any gestational period—permitting even late-term abortions. 

For example, in early April, Colorado Gov. Jared Polis signed into law the “Reproductive Health Equity Act,” which establishes a “fundamental right” to abortion in Colorado all the way up to the point of birth. This act goes so far as to declare that unborn persons do “not have independent or derivative rights under the laws of the state” (CO General Assembly, 2022). It is worth noting that this legal reasoning from the Colorado state legislature is completely inconsistent with Roe, which found that the state has an interest in both protecting “the health and safety of the pregnant woman and the potential human life within her.”

Liberals have attempted to expand this type of radicalism to the entire Nation through passage of the “Women’s Health Protection Act” (117th U.S. Congress, 2021-2022). This deceptively named bill would codify the “right to abortion” at any stage in a pregnancy—even up to the point of birth—going far beyond Roe v. Wade and allowing practices that are indistinguishable from infanticide.

The “Women’s Health Protection Act” previously failed in the Senate in February and failed again in a bipartisan 49-51 vote on May 11, 2022. Even though this bill did not gain a majority, U.S. Sen. Bernie Sanders went so far as to call for an end to the filibuster so that Congress can establish an unrestricted right to abortion as the law of the land (Scully, 2022).

The current administration is fully aligned with this effort: President Joe Biden released a statement saying that “we need more pro-choice senators and a pro-choice majority in the House to adopt legislation that codifies Roe, which I will work to pass and sign into law” (White House Briefing Room, 2022).” The Biden Administration also released a Statement of Administration Policy supporting the “Women’s Health Protection Act” regarding the May 11, 2022, vote (EOP OMB, 2022).

An examination of current late-term abortion practices reveals how these extreme policies are implemented by doctors who took an oath to do no harm.

Late-Term Abortion In Practice

Some abortion clinics and hospitals performing late-term abortions in states where it is legal readily advertise the availability of their services and the details of the procedures. While the definition of late-term abortion can vary depending on the laws in each state and the advances of modern medicine, it is generally accepted to be after viability. That means the health care providers offering late-term abortions describe the mechanism to end a life   so late in intrauterine development that the infant could survive outside the womb.

For example, Colorado’s Boulder Abortion Clinic outlines the four-day procedure for a third-term abortion in cold, clinical detail. Specifically, the steps for “induced fetal demise” state: “An injection is done on the first day that stops the fetal heart. This injection is done through the patient’s abdomen, into the fetus, under local anesthesia” (Boulder Abortion Clinic, n.d.).

Similarly, New Mexico’s Southwestern Women’s clinic describes its procedures for pregnancies up to 32 weeks and then after on a case-by-case basis (Southwestern Women’s, n.d.). The procedure description outlines that “an injection of Digoxin will be administered to stop the fetal heartbeat.” After cervical dilation, the procedure description concludes with “...medications will be administered which will start labor and result in the delivery of a stillborn.”

The District of Columbia has gained a reputation for being our Nation’s abortion tourism capital, as 68.7% of abortions in D.C. are performed on out-of-state residents (Kortsmit et al, 2019). This makes D.C. a “hotspot” for the morbid “abortion tourism” industry. For example, Capital Women’s Services has state-specific resources that outline late-term abortion availability in the state and advertise that they “may be able to help you in getting late-term abortion care” at up to 36 weeks by coordinating doctor’s visits and travel to Washington, D.C. (Capital Women’s Group NJ, n.d.). States as close as New Jersey and far as Hawaii are included (Capital Women’s Group NJ, n.d.; Capital Women’s Group HI, n.d.). Another Washington, D.C. clinic, the DuPont Clinic, performs abortions after 26 weeks in a three-day procedure called the “DuPont Induction-Evacuation” (DuPont Clinic, n.d.).

In contrast to the procedure descriptions from abortion providers, Oregon’s Pregnancy Care Centers offer a depiction of late-term abortion procedures in particularly graphic detail:

“This procedure typically takes 2–3 days and is associated with increased risk to the life and health of the mother. General anesthesia is usually recommended, if available. Drugs may be injected into the fetus or the amniotic fluid to stop the baby’s heart before starting the procedure. The cervix is opened wide, the amniotic sac is broken, and forceps are used to dismember the fetus. The ‘Intact D&E’ pulls the fetus out legs first, then crushes the skull in order to remove the fetus in one piece” (Pregnancy Care Centers, n.d.).

Considering this graphic description, it is not surprising that most abortion providers avoid transparency on the details of their procedures. While liberal leaders want to expand access to these gruesome procedures across more American communities, a comparison of current U.S. abortion laws with other countries offers tremendous insight into the radical nature of this position.

WHICH COUNTRIES DO U.S. ABORTION LAWS MOST ALIGN WITH?

The U.S. is one of only six countries with laws permitting elective abortions  during all nine months of pregnancy, meaning we have more liberal laws than the vast majority of the world (Figure 3) (Szoch et al., 2022).  The Left’s assertion that abortion at any stage is a widely accepted and unassailable human right and that the unborn have no such rights is out of sync with the reality around the world. There is no broad, global consensus that abortion should be legal, especially after 14 weeks of pregnancy. The Family Research Council’s 2022 analysis of how U.S. abortion law compares to worldwide laws found that 77 countries outlaw abortion completely or allow it only to preserve a woman’s physical health, 57 countries ban abortion after 14 weeks, and five ban abortion after 24 weeks (Szoch et al., 2022).

FIGURE 3.

Source: U.S. Abortion Law in Comparison with the Globe, Szoch et al. Family Research Council (Jan. 2022).

U.S. law and the present liberal proposals for more lenient abortion legislation align more with China, Vietnam, and North Korea—countries known for their atrocious human rights records and lack of respect for their citizens—than our allies in the West that better uphold the dignity of human life. Europe and the U.S. are generally aligned in upholding the highest standards of protecting human rights, compared to the rest of the world. Yet in the case of abortion, the U.S. champions policies alienating us from any reasonable political or cultural comparison to our western allies. Chief Justice John Roberts expressed concern about the global comparison during the Dobbs hearings, saying “When you get to the viability standard, we share that standard with the People’s Republic of China and North Korea. And I don't think you have to be in favor of looking to international law to set our constitutional standards to be concerned…” (Fritze 2021; SCOTUS, 2021 p. 54). Under the current Roe v. Wade standard and among free, democratic countries, Canada is the only nation with equally liberal abortion laws.

Countries with no nation-wide legal restrictions on abortion are:

• • Canada
  • United States
  • China
  • North Korea
  • South Korea
  • Vietnam

Countries allowing elective abortions until 24 weeks:

• • Colombia[1]
  • Singapore
  • Netherlands
  • New Zealand
  • Sweden
  • Iceland

Laws In Europe

No European nations permit abortion past 24 weeks. Elective abortion is permitted in the first trimester in most European nations, and medical staff maintain the right of conscientious objection (European Data Journalism Network, n.d.). An overwhelming majority of nations (40 of 52) only allow elective abortion until week 12, and only three countries permit it past 15 weeks of pregnancy (Szoch et al., 2022). This means that if the Supreme Court upholds the 15-week elective abortion ban in Mississippi in the Dobbs case, Mississippi would still have more lenient abortion laws than 94% of European countries.

The sentiment that Europe has embraced abortion, and that the U.S. needs to “catch up” cannot be farther from the truth when many more socially and politically progressive nations have more restrictive abortion laws.

A Small Minority with Legal Abortion Beyond 14 Weeks

The Netherlands is the only country in Europe that allows abortion during weeks 20-24 of pregnancy, but it also requires a five-day waiting period for women to contemplate their decision (Ministry of Health, Welfare, and Sport, n.d.). Similar mandatory waiting periods are in effect in 15 European countries, and Iceland and Sweden are the only other nations that allow abortions past 15 weeks (RFSU, 2020; Ciric, 2019). In Great Britain, abortion is allowed until week 24, but only if doctors decide that “having the baby would pose a greater risk to the physical or mental health of the woman than a termination” (BBC News, 2019).

Additional Policies and Perspectives

Even Germany, which only allows abortion in the first trimester, has laws requiring women to receive counseling and wait three days before undergoing a procedure (German Criminal Code, n.d.). France, Spain, and Italy allow abortion on request until week 14, which is the same limit for Hungary—another nation that mandates two sessions of counseling before abortion procedures take place (Martuscelli & Bencharif, 2022). However, in Italy, abortion providers may be less formally limited, as a 2020 study revealed that 71% of gynecologists are registered as conscientious objectors and refuse to perform abortions due to their religious and moral beliefs (Autorino et al., 2020).

Tight restrictions

Elective abortion is severely restricted or illegal in Poland, Malta, Andorra, Lichtenstein and Vatican City. The tightening of restrictions in 2020 in Poland drew worldwide attention, as it moved to ban abortion except in medical emergencies and situations in which pregnancy was a result of a crime (Polish Journal of Laws of 2021, 2021; Pronczuk, 2020). The pro-life movement in Poland has grown since the 1980s, when the people suffered under an oppressive Soviet Communist regime that legalized abortion and persecuted outspoken defenders of human life (Szoch et al, 2022).

PUBLIC OPINION

Even Americans do not accept this false narrative of universal support for extreme abortion policies. Just one in five Americans (21%) share the absolutist view of those calling for unrestricted abortion at any time in pregnancy, believing that abortion should be “legal in all cases” (Rasmussen, 2022). Similarly, in May 2022, just one in five Americans think abortion should be legal in the last three months of pregnancy—a position supported by liberal leaders that goes beyond Roe’s framework of viability (Gallup, n.d.). Further, only 5% believe “no restrictions should be placed on abortion,” when provided with examples such as “notifying the father, notifying the parents of teenagers, and waiting periods” (Rasmussen, 2022) In May 2021, just after the Supreme Court agreed to hear the Dobbs case, 34% of Americans believed abortion should be legal only in the first stages of pregnancy, and only 15% approved of second trimester abortion, which Roe legalized nationwide (Crary & Fingerhut, 2021).

Currently, 65% of Americans think the abortion issue should be decided by voters and their elected representatives, compared to only 18% who prefer to leave it up to judges and courts. Another 73% think that there are two lives at stake in the abortion conversation—the life of both the mother and the unborn child—and voters prefer a candidate who would restrict abortion to the first trimester over one who would allow abortion up to the point of birth by a 2-to-1 margin (Scott Rasmussen National Survey, 2022).

CONCLUSION

Though Americans clearly align with the beliefs of the pro-life movement, Leftists relentlessly attack these views as extreme (Rollins et al., 2022). In reality, the Left’s positions are furthest removed from sentiments of the American people and are drastically more extreme than most of the world.

This global comparison also debunks the Left’s narrative that abortion is widely practiced and unrestricted around the world. Rather, it exposes U.S. abortion policies as the outlier—more on par with those in China and North Korea than with our peers of developed and democratic countries—or the mainstream views of the American public. In truth, the most radical views are held by those calling for a complete absence of abortion restrictions. Few Western nations embrace this radical agenda, whereas it has been by regimes that are notoriously oppressive.

Few countries have adopted the extremism of the proposed Women’s Health Protection Act, which carries a deeply deceptive notion that elective abortion protects women’s healthcare the same way as other medical treatment, or Colorado’s Reproductive Health Equity Act, which codifies the right to abortion in the state at any point of a pregnancy (CO General Assembly, 2022).

This global outlook reveals the striking and largely undiscussed reality that U.S. laws are more radical than the majority of the world and 94% of Europe. Even if abortion is made illegal after 15 weeks gestation, the Mississippi law at question in Dobbs will still be laxer than that of France, Germany, Italy, or Greece (Gray, 2022). More than 75% of European nations permitting elective abortion place limits at 12 weeks gestation in most cases, putting into perspective the radical nature of Roe v Wade, which permits the termination of a child’s life after double that time in the womb (Szoch et al., 2022 ).

The U.S. was founded by the belief that human life is sacred and has led the world in policymaking that upholds the dignity of the human person. Medical advances in the past half century have only increased the evidence that a baby in the womb is a life worth protecting. We cannot expect to honor our Nation, and our exceptionalism with policies that undermine our most essential values. 

After 50 years of Roe v. Wade, Americans may finally be granted the chance to determine the issue for themselves through their elected representatives. Unfortunately, the pro-choice movement, fueled by radical liberals, only offers women facing difficult circumstances one solution: termination of the life of her unborn child. Putting Americans first means rejecting abortion radicalism and upholding our values by protecting the most vulnerable, especially as the abortion debate moves to the states.

AUTHOR BIOGRAPHIES

Pastor Paula White-Cain is the Chair of the Center for American Values at the America First Policy Institute.

Heidi Overton, M.D., Ph.D. is the Director of the Center for a Healthy America at the America First Policy Institute.  

Kristen Ziccarelli is a Policy Analyst at the America First Policy Institute.

Garrison Grisedale is a Policy Analyst at the America First Policy Institute.