The “Heartbeat” Movement: Is the World Becoming More Restrictive on Abortion?

The “Heartbeat” Movement: Is the World Becoming More Restrictive on Abortion?

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BY: Jason Lo Hog Tian


Abortion has been a controversial topic with a long history of changes in public opinion.  Since its initial criminalization in the 1800s, attitudes toward abortion shifted to acceptance and advocacy in the early 20th century, on the back of multiple human rights movements and high-profile court cases. In 1973, the landmark Roe vs. Wade marked the culmination of shifting perspectives by lifting the ban on abortion in the United States of America (US). However, in early 2019 a wave of so called “heartbeat” bills were put forward by several US states, restricting abortion after the detection of a fetal heartbeat.1 The new “heartbeat” bill is just the latest initiative in a long list of attempts to control abortion practices appearing globally, which begs the question: is the world becoming more restrictive on abortion?

Abortion has been practiced since ancient times, but with the introduction of the legal system, abortion practices had to be refined and regulations had to be established. Countries differ on abortion ideology, however there are six main grounds, ranging from most to least restrictive under which a nation would grant an abortion: ground 1 – risk to life, ground 2 – rape or sexual abuse, ground 3 – serious fatal anomaly, ground 4 – risk to physical and sometimes mental health, ground 5 – social and economic reasons, and ground 6 – on request.2

Another important factor to consider is the gestational age at which an abortion is deemed legal. Again, countries have differing opinions on the gestational age threshold. Many countries allow abortion before 12 weeks of gestation with the highest being before 24 weeks in the United Kingdom.3 The recent “heartbeat” bills represent some of the strictest abortion criteria in history. These new policies restrict abortion after a fetal heartbeat can be detected unless there is a serious risk to the life of the mother (ground 1). Notably, appeals to amend the bills to include abortions performed on victims of rape or sexual abuse (ground 2) have been denied. With a large portion of the southern US either signing or pushing to sign similar bills, many are wondering if a ripple effect will cause a global shift of abortion laws.

When considering abortion laws and criteria around the world, it is apparent that governments often take a strong stance, with most laws being either strongly for or against abortion. Strikingly, very few governments take a compromising approach. There are many possible factors influencing a country’s stance on abortion, including level of development, economic growth, religion, demographics, and culture. For example, the southern, republican identifying US states of Alabama, Louisiana, Mississippi, Ohio, Georgia, Missouri, Kentucky, Arkansas, Utah, and Iowa have all put forward some form of “heartbeat” bill.1 Figure 1 shows the legal status of abortion around the world as of 2017 and we can start to see what factors may play a role in a country’s decision on abortion.

Despite gaining independence from colonizing nations, many African countries still govern with strict abortion laws, originally implemented by their colonizers. There has not been much change in abortion policy for many African nations and it remains one of the most restricted areas in the world.3 Similarly, South America has relatively restrictive laws, however this is more due to the strong influence of the Catholic Church and a highly patriarchal culture. Despite a surge of women’s rights movements, there are only a handful of South American countries that grant abortions. There does not appear to be any imminent change to this paradigm, even  after the 2015 Zika outbreak, which meant potential birth defects for pregnant women infected with the virus.4 Asia boasts a very diverse abortion landscape with some countries, such as Bangladesh and the Philippines, retaining very restrictive laws while others, such as China and India, have extremely liberal legislation in a response to high maternal mortality and to control population growth.5 In more developed regions such as Europe, North America, and Oceania, abortion is generally grated upon request. However, abortion policies are ever dynamic in these regions with initiatives such as the “heartbeat bill” representing the latest opposition to current legislation.

Many fears a global overturning of abortion policy following the recent US “heartbeat” movement but, while it is powerful having numerous states presenting such a united front, it is unlikely that it will provoke change at the federal level. Without change at a national level, the ‘heartbeat’ bills will likely not have a larger global impact. Federal judges have already overturned “heartbeat” bills in many states, but abortion opponents are still hopeful that they can use the bills already in place to leverage the Supreme Court into overturning their 1973 decision. This is yet another stalemate in a growing list of movements to change abortion legislature. After the first decriminalization of abortion in the Soviet Union, many countries quickly followed suit, however this seemingly rapid switch to liberalization has just as quickly plateaued.6 Despite the ever-increasing number of women’s rights advocates, there has been little movement in abortion legislature around the world. Rather than being afraid of global abortion policies moving against whatever your agenda may be, we may have to be worried of our ability to affect change in abortion policies at all.

It is important to refrain from being swept up in the politics and laws surrounding abortion. Many may get carried away with the politics and forget to consider if it will really have the desired effect. One argument against abortion is that legalizing it would lead to higher incidence of pregnancy terminations. However, this is often not the case since countries with liberal policies tend to have relatively low abortion rates, perhaps in part due to their emphasis on sexual education and access to contraception. Further, making abortion illegal does not necessarily have the intended effect of reducing abortion rates, with many women opting to travel abroad or turning to clandestine abortion services, drastically increasing the maternal mortality rate. This is not to say that completely legalizing abortion always has its intended impact either. Many countries use liberal abortion policies to cover up poor health education or control for overpopulation, sometimes going as far as coercing women into having abortions.5

The legal system plays an important role in modern society by protecting the rights and freedoms of all people, but laws are not the only factor in affecting change. Strict abortion laws will not prevent women from terminating pregnancy and liberal abortion laws will not make up for poor sexual education and limited access to contraception. The latest “heartbeat” movement is another attempt to leverage the law to push an agenda without considering all of the consequences. There has been little movement in abortion policies in the past few decades and we may have lost our ability to affect global policies. For real change to be achieved, countries need to focus on educating the public about their rights, both sides of the abortion argument, and other important secondary factors that contribute to the decision to terminate a pregnancy. Taken together we can begin to make informed decisions and not only change the law for the better, but have a real life impact on all those affected by abortion policies, laws, and attitudes in their regions.



  1. Levenson E. Alabama’s anti-abortion law isn’t alone. Here are all the states pushing to restrict access [Internet]. CNN. 2019 [cited 2019 Jun 21]. Available from:
  2. Berer M. Abortion Law and Policy Around the World: In Search of Decriminalization. Health Hum Rights. 2017;19(1):13–27.
  3. Guillaume A, Rossier C, Reeve P. Abortion Around the World: An Overview of Legislation, Measures, Trends, and Consequences. Population, English edition. 2018;73(2):217-306.
  4. Aiken ARA, Scott JG, Gomperts R, et al. Requests for abortion in Latin America related to concern about Zika virus exposure. New England Journal of Medicine. 2016;375(4):396–398.
  5. Attané I and Barbieri M. The demography of East and Southeast Asia from the 1950s to the 2000s: A summary assessment of changes and a statistical assessment. Population, English Edition. 2009;64(1):7–146.
  6. Arie S. Is abortion worldwide becoming more restrictive? BMJ. 2012;345:e8161.