Don’t Forget the Other Half of Europe’s Abortion Compromise

Posted by on June 8, 2023 9:32 am
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Republicans seem to have suddenly alighted on an answer to the unpopularity of abortion bans in the post-Dobbs era: a “compromise,” styled on most European countries’ abortion regimes, which permit abortion only in the first trimester of pregnancy and restrict it thereafter, with a few exceptions. North Carolina recently passed a law in this vein, over its governor’s veto; it will permit abortion in the first 12 weeks of pregnancy, with exceptions for rape until 20 weeks, for fetal anomalies until 24 weeks, and to save the life of the mother throughout the pregnancy. As some states have enacted more restrictive abortion laws, banning abortion from the moment of conception or at six weeks, North Carolina lawmakers have been able to mark the contrast, characterizing the 12-week ban as a “mainstream” and “reasonable” approach that should become a model for the rest of the nation. After all, it allows about 90 percent of abortions that American women undergo to remain legal.

This “European compromise” approach has gained adherents at the federal level as well. Senator Lindsey Graham proposed a federal 15-week abortion ban after Dobbs, seeking a national consensus that he describes as “in line with other developed nations.” During a recent Senate Judiciary Committee hearing on abortion in America after Dobbs, Graham noted that not one single European country permits abortion “on demand” after 15 weeks, insisting that only the most oppressive regimes, such as China and North Korea, permit the later-term abortions that Roe v. Wade appeared to protect. When it comes to protecting life, Republicans urge the United States to keep pace with its “civilized” European peers, rather than join the “inhumane” company of China and North Korea.

[David A. Graham: Has North Carolina found an abortion compromise?]

But Republicans are interested in only one part of the European approach to protecting life—the abortion restrictions. They seem to forget that every European country that protects unborn life by restricting abortion after the first trimester protects born life too, through prenatal health care, paid maternity leave, and a public infrastructure for child care and preschool. If Republicans are sincere in invoking Europe as a model, Democrats and other proponents of abortion access should seize this chance to find common ground on policies that would substantially improve the lives of mothers and children in this country. After Dobbs, Democrats should not let the outrage over losing Roe impede a new abortion compromise, one inspired by European countries that protect life not just by restricting abortion, but by ensuring healthy pregnancy and infancy.

Pro-life Republicans have long liked to criticize the United States as an outlier for legalizing pre-viability abortion without significant restriction under Roe v. Wade. But the country is an outlier in another sense as well: its abject failure to protect born, living children and the people who birth them. By comparison to similarly wealthy advanced democracies, the United States has higher rates of infant mortality. Maternal mortality rates are substantially higher in the United States as compared with these countries, especially for Black mothers. Studies have linked paid maternity leave to lower rates of infant mortality, but the United States is the only country in the Organization for Economic Cooperation and Development that doesn’t guarantee it. Senate Democrats recently introduced a paid-family-leave bill for the sixth time in 10 years. Thirty years after Congress guaranteed unpaid parental leave in the Family and Medical Leave Act, in 1993, the overwhelming majority of working mothers in America lack access to paid leave to cover the time off work necessary to give birth and care for a newborn. After a decade of legislative dysfunction, Congress finally passed the Pregnant Workers Fairness Act in December 2022, which guarantees reasonable accommodations to protect the health of pregnant workers and their wanted unborn children. Staying pregnant exacerbates women’s economic insecurity, a primary reason they seek abortions.

Beyond its restriction of abortion after 12 weeks, North Carolina’s Care for Women, Children, and Families Act makes modest gestures toward the European model: It expands paid leave for state employees, guaranteeing them eight weeks after giving birth or four weeks to care for a newborn. The law allocates $32 million the first year and $43 million the following year to child care. These measures fall significantly short of the infrastructures for universal health care, paid parental leave, and child care that are well established in nearly all the European countries that restrict abortion after 12 to 15 weeks. In Germany, for instance, the constitutional court has noted that a state can protect life through means other than abortion bans, such as by providing support for pregnant women. Protecting unborn life goes hand in hand with protecting lives when they are already born and in need of care. Therefore, a state that bans abortion without guaranteeing pre- and postnatal health care, paid parental leave, and child-care support is not genuinely protecting life.

If the North Carolina law is to be entertained as a reasonable model for national legislation, the provision of universal paid parental leave and child care must be seen as a bare-minimum part of the bargain. North Carolina’s steps in that direction are inadequate; Senator Graham’s proposed 15-week ban contains no such provisions. Furthermore, at the federal level, although Congress expanded child-care funding during the COVID-19 emergency, it was temporary. The Build Back Better package passed by the House in 2021 would have pumped $400 billion into child care, but it was blocked by Republicans, with the help of Joe Manchin, in the Senate. Ultimately, the Senate passed a much-modified Inflation Reduction Act without including a penny for child care.

Congressional Democrats’ primary response to Dobbs has been to seek to codify Roe in the Women’s Health Protection Act. But Roe was itself a compromise; it kept pre-viability abortions legal (about 20 to 24 weeks of gestation), but it allowed the Hyde Amendment’s withholding of public funds for abortions that were medically necessary to protect the pregnant person’s health. Roe’s constitutional reasoning was that childbearing is a private matter in which the government should not intervene, making it hard to justify a governmental duty to support childbearing through paid parental leave and child care. The Women’s Health Protection Act—which was passed by the Democratic House but filibustered twice by Republicans in the Senate last session—would reinstate that compromise, as its Democratic supporters have insisted that it would leave the Hyde Amendment intact. Although paid family leave and child care have some bipartisan support, these policies have not been the basis for a new abortion bargain at the federal level.

[Read: When a right becomes a privilege]

Now, following Dobbs, Democrats should take the European model in its entirety more seriously as an alternative to codifying Roe. Doing so would be more responsive to public opinion on abortion than either the near-total abortion bans adopted by some state legislatures on the one hand—such as South Carolina’s six-week ban passed last month—or Roe v. Wade on the other. A majority of Americans say abortion should be legal in many but not all cases. Even a lot of those who believe abortion should be illegal in most cases support exceptions, and even the most restrictive state abortion bans passed after Dobbs allow abortions when the mother’s life is threatened. A reasonable compromise responsive to Americans’ complex views could package a 12-to-15-week ban—which would protect 90 percent of all abortions and include humane and workable exceptions for the remaining later-term abortions—with universal prenatal and postpartum health care, paid leave, and child care, which should be considered basic protections for born life.

Furthermore, European countries that restrict abortion after 12 to 15 weeks include exceptions in their abortion laws for situations in later pregnancy deemed by physicians to pose risks to the pregnant woman’s health—beyond emergency life-threatening situations. Such broader constructions of the exceptions acknowledge that the line between a risk to the pregnant woman’s health and a risk to her life is hard to draw in complicated and rapidly changing actual situations of pregnancy. One woman’s testimony at the April Senate Judiciary Committee hearing told of her experience with an infection that developed during a spontaneous miscarriage, during which doctors could not intervene until the infection nearly killed her. In Ireland, the death of a woman under similar circumstances led the nation to rethink and eventually repeal its constitutional protection of unborn life. Irish law now permits abortion in the first 12 weeks of pregnancy and authorizes the procedure after 12 weeks when doctors deem it necessary to protect the health of the pregnant person. Such health exceptions are typical across Europe after 12 to 15 weeks, acknowledging that a real and serious commitment to the lives of pregnant women—the born, living people necessary for the unborn to be born—requires strong protections for their health. Furthermore, many European countries’ abortion laws construe the risk to the mother’s life and health to include mental health and suicide risks.

After Dobbs, a national 12- or 15-week abortion ban written to invalidate the state laws that ban abortion at conception or six weeks would allow the majority of the pre-viability abortions protected under Roe. Packaged with paid family leave and child-care expansion, as well as exceptions to save women’s lives and health in later pregnancy, a European-style compromise may be the only way out of the women’s-health crisis triggered by Dobbs. By prioritizing the needs of pregnant women and infants while protecting access to abortion in early pregnancy, many other countries found a more humane compromise on abortion than we had under Roe. After Dobbs, it is a path that Americans need to consider.

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