Broad Social or Economic Grounds
Countries allowing abortion on broad social or economic grounds have laws that are generally interpreted liberally to permit abortion under a broad range of circumstances. These countries often take into account a woman or girl's actual or reasonably foreseeable environment and her social or economic circumstances in considering the potential impact of pregnancy and childbearing.
Human Rights Norms
UN Treaty Monitoring Bodies
Although UN Treaty Monitoring Bodies (TMBs) have not explicitly addressed access to abortion based on social and economic grounds, they have recognized the importance of ensuring that legal abortion services are accessible.1 The Human Rights Committee has made clear that where a state has legalized abortion, “it must establish an appropriate legal framework that allows women to exercise their right to it under conditions that guarantee the necessary legal security…”2 The Committee also recognized the importance of removing barriers that impede women’s to access to legal abortion services,3 and urged a state to prioritize the standardization of public health guidelines to provide legal abortion care throughout the country.4 The Committee on the Elimination of Discrimination Against Women also urged a state to guarantee access to safe abortion services in all regions of the country, and ensure that “conscientious objection by physicians does not impede women’s access to legal abortion services.”5 The Committee on the Rights of the Child also highlighted the importance of access to legal abortion services for girls under the age of 18, noting that a state should “take effective measures to ensure adolescent girls’ access to safe and legal abortion services, including by repealing legislative provisions which subject them to a mandatory waiting period.”6
TMBs have also issued concluding observations to countries with these laws, urging them to ensure access to safe and legal abortion services and post-abortion care.7 For example, the Committee on the Elimination of Discrimination Against Women urged India to ensure that women and girls can access “high-quality and safe abortion services.”8The Committee on the Rights of the Child urged the United Kingdom to decriminalize abortion in Northern Ireland in order to ensure that girls can access safe abortion and post-abortion services.9
African Human Rights Bodies
In General Comment 2 on Article 14 of the Maputo Protocol, the African Commission on Human and Peoples’ Rights explicitly states that the health ground for abortion articulated in the Maputo Protocol must be interpreted according to the World Health Organization’s (WHO) definition of health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”10 Therefore, laws permitting abortion on health grounds should be interpreted to include circumstances impacting a woman or girl’s social well-being, including her social or economic circumstances.
Global Medical Standards
In Safe abortion: technical and policy guidance for health systems, the WHO recognizes that evidence shows that “where abortion is legal on broad socioeconomic grounds and on a woman’s request, and where safe services are accessible, both unsafe abortion and abortion-related mortality and morbidity are reduced.”11 The WHO acknowledges that in countries that explicitly permit abortion for socioeconomic reasons, the legal grounds are usually interpreted by reference to whether continuing the pregnancy would affect the actual or foreseeable circumstances of the woman, “including her achievement of the highest attainable standard of health.”12
The WHO makes clear that in interpreting laws permitting abortion on health grounds, all WHO member states accept the definition of health enshrined in the WHO Constitution as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Therefore, a woman or girl’s social circumstances must be taken into account when assessing the health risks posed by continuing a pregnancy.13 The WHO also states that policies on abortion care should aim to “promote and protect the health of women, as a state of complete physical, mental and social well-being.”14
Generally, broad social or economic grounds for abortion are considered within the framework of women's health. For example, the laws of Great Britain, Belize, Hong Kong, and Zambia consider a woman's “actual or reasonably foreseeable environment” in determining whether the pregnancy endangers her physical or mental health.15 Rwanda, which adopted a Ministerial Order determining conditions to be satisfied for a medical doctor to perform an abortion in April 2019, defines health in accordance with the WHO definition, thereby expanding the legal grounds for abortion to include where the pregnancy poses a risk to the woman’s social well-being.16
Some countries permitting abortion on broad social or economic grounds provide examples of circumstances relevant for determining whether abortion is permissible. These are often quite broad, encompassing both social and economic circumstances. For instance, Iceland’s law permits abortion “when the woman and her closest family may be deemed unable to cope with the pregnancy and birth of a child, due to social circumstances beyond their control.” The law sets forth a number of circumstances that should be taken into account in making this assessment, such as whether only a short time has passed since the woman’s most recent birth, whether her economic situation is impacted due to a number of children or poor health of anyone in the home, and whether the woman’s age or maturity would impact her ability to raise the child, among others. The law makes clear that this list is not exhaustive and that other similar circumstances should also be considered.17
- 1. L.C. v. Peru, CEDAW Committee, Commc’n No. 22/2009, para. 8.17, U.N. Doc. CEDAW/C/50/D/22/2009 (2011); Human Rights Committee, Concluding Observations: Italy, para 17, U.N. Doc. CCPR/C/ITA/CO/6 (2017); CEDAW Committee, Concluding Observations: Canada, para. 41(a), U.N. Doc., CEDAW/C/CAN/CO/8-9 (2016); CESCR Committee, Concluding Observations: Poland, para. 47(a), U.N. Doc., CESCR/C.12/POL/CO/6 (2016); CRC Committee, Concluding Observations: Slovakia, para. 41(c), U.N. Doc., CRC/C/SVK/CO/3-5 (2016).
- 2. L.C. v. Peru, CEDAW Committee, Commc’n No. 22/2009, para. 8.17, U.N. Doc. CEDAW/C/50/D/22/2009 (2011).
- 3. Human Rights Committee, Concluding Observation: Colombia, para 21, U.N. Doc. CCPR/C/COL/CO/7.
- 4. Human Rights Committee, Concluding Observations: Poland, para. 24(a), U.N. Doc., CCPR/C /POL/CO/7 (2016).
- 5. CEDAW Committee, Concluding Observations: Canada, para. 41(a), U.N. Doc., CEDAW/C/CAN/CO/8-9 (2016).
- 6. CRC Committee, Concluding Observations: Slovakia, para. 41(c), U.N. Doc., CRC/C/SVK/CO/3-5 (2016).
- 7. CRC Committee, Concluding Observations: United Kingdom, para. 65(c) CRC/C/GBR/CO/5 (2016); CEDAW Committee, Concluding Observations: India, para. 31(b) CEDAW/C/IND/CO/4-5 (2014).
- 8. CEDAW Committee, Concluding Observations: India, para. 31(b) CEDAW/C/IND/CO/4-5 (2014).
- 9. CRC Committee, Concluding Observations: United Kingdom, para. 65(c) CRC/C/GBR/CO/5 (2016).
- 10. The African Commission on Human and Peoples’ Rights (African Commission), General Comment No. 2 on Article 14 (1) (a), (b), (c) and (f) and Article 14 (2) (a) and (c) of the Maputo Protocol, online: African Commission on Human and People’s Rights at para. 38 <http://www.achpr.org/files/instruments/general-comments-rights-women/achpr_instr_general_comment2_rights_of_women_in_africa_eng.pdf>.
- 11. World Health Organization, Safe Abortion: Technical and Policy Guidance for Health Systems 90 (2d ed. 2012) [hereinafter “Safe Abortion Guidelines”].
- 12. Id. at 93.
- 13. Id. at 92.
- 14. Id. at 98.
- 15. Abortion Act 1967, c. 87, §1(2) (Gr. Brit.); Criminal Code, Cap. 101 (2000) §112(2) (Belize); Offences against the Persons Act, (2017) Cap. 212, §47A(2) (H.K.); Termination of Pregnancy Act, Cap. 304 (1994) §3(2) (Zam.).
- 16. Ministerial Order determining conditions to be satisfied for a medical doctor to perform an abortion, Official Gazette No.14 of 08/04/2019, Art 3(5°) (Rwanda).
- 17. Act on Counselling and Education regarding Sex and Childbirth and on Abortion and Sterilisation Procedures 1975, No. 25/1975, Art 9(1) (Ice.).