Compared to less-developed countries, women in Europe and North America enjoy a high level of reproductive freedom. However, even in these countries, access to high-quality comprehensive reproductive-health care, including safe, legal abortion, varies. Poor women bear the brunt of restrictive laws and policies and inequitable service distribution.

Although the standard of living is often higher and the abortion laws more liberal than in many developing countries in Latin America, Asia and Africa, women in the poorer countries of Central and Eastern Europe and the former Soviet Union undergo an alarming number of unsafe abortions. Of the half a million unsafe abortions that occur in Europe each year, 400,000 occur in Eastern Europe.^[1] The WHO estimates that unsafe abortions account for 24 percent of maternal deaths in the region.^[2] Use of outdated abortion techniques and inadequate pain management are common during abortion procedures. Postabortion contraception and counseling also remain inadequate, resulting in even more abortions.

Though women in Western Europe and the United States are often believed to be “liberated,” they may also experience significant barriers to exercising their reproductive rights. These countries have some of the most liberal abortion laws in the world, but not all women have equal access to safe abortion. In the United States, for example, a woman’s ability to access abortion varies from state to state. Only one-third of American women live in a county where there is an abortion provider,^[3] making access to services more myth than reality. Additionally, women who visit abortion facilities in the United States may be violently harassed. Though abortion has been legal in the United States since 1973, this right is challenged every year at both the state and federal levels. Recently, the United States has seen a substantial decrease in the number of abortion providers and a dwindling number of younger doctors who are trained to perform abortions. Every year 85 abortion providers retire without being replaced.^[4] This can be attributed to fear of harassment due to numerous well-publicized incidents of violence at abortion clinics and fewer opportunities for abortion training, among other factors.