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Is the United States one of seven countries that ‘allow elective abortions after 20 weeks of pregnancy?’

This talking point is backed by data, and earns the coveted Geppetto Checkmark. (Video: Meg Kelly/The Washington Post)

“Seven out of 198 nations allow elective abortions after 20 weeks of pregnancy.”
— statement of Trump administration policy, Oct. 2, 2017

The House approved a ban on 20-week abortions this week, and this dramatic statistic caught our attention:

This debate is about late-term abortions after 20 weeks, which is the midpoint of a woman’s pregnancy, and before the fetus typically is considered viable to live outside the womb. Currently, states can decide to ban abortions after a certain point in the pregnancy, usually 20 to 24 weeks.

This one seemed a bit surprising, so we looked into it. And it turned out, it’s backed by data.

The Facts

The source of this claim is a 2014 report by the Charlotte Lozier Institute, which opposes abortion rights. It’s the most updated version of this report.

The group analyzed abortion laws in 198 countries and other independent or “semiautonomous” regions with more than 1 million residents.

There are 59 countries that allow abortion “without restriction as to reason,” or “elective,” or “abortion on demand.” These are countries where the letter of the federal law does not impose specific eligibility requirements for women. The other 139 countries “require some reason to obtain an abortion, ranging from most restrictive (to save the life of the mother or completely prohibited) to least restrictive (socioeconomic grounds) with various reasons in between (e.g., physical health, mental health),” the report says.

Only seven of the 59 countries allow elective abortions after 20 weeks, the group found: Canada, China, Netherlands, North Korea, Singapore, the United States and Vietnam.

This list of countries correlates with another similar report, also from 2014, published by a group that supports reproductive rights. (The gestational limit breakdown has remained consistent since the 2014 report with the exception of Mozambique, according to the group.)

That group’s report found 61 countries that allow abortion “without restriction as to reason,” though some of these countries had parental authorization or notification requirements. Most of the countries had a 12-week gestational limit on abortions.

Both reports use the fetus age measurement that is used by medical professionals and the Centers for Disease Control and Prevention, which is counting the fetus age from the first day of the pregnant woman’s last menstrual period (LMP). While critics of abortion rights often use a different method of fetal age measurement, the Charlotte Lozier Institute said all the gestational limits were converted to the LMP method because more than 80 percent of countries use it. (For more on the ways that antiabortion advocates count the fetus age, read this fact check.)

Here’s a look at the seven countries. We sorted them from the most liberal on gestational limits to the least:

  • North Korea and Vietnam: No specified gestational limit, though regulatory mechanisms vary.
  • China: “Abortion is virtually freely available in China, and there are no defined time limits for access to the procedure,” according to Pew Research Center. China now has a “two-child” policy, and human-rights advocates have criticized China’s population and family planning laws.
  • United States: No federal ban on gestational limit, but 43 states have prohibitions on gestational limits, from 20 to 24 weeks, or the point of “viability,” according to the Guttmacher Institute, a reproductive rights research group. There are some exceptions made, usually for the life or health of the mother.
  • Canada: No federal gestational limit, but provinces and territories vary as to whether they will offer abortion services after a certain gestational age. Some offer abortion services up to 12 weeks, others up to 24 weeks. (This is similar to how states operate in the U.S.) Abortions after 20 weeks are not always readily available for Canadians, so women are often referred to a clinic in the United States, according to an abortion rights group in Canada. These procedures may be paid in full or in part by provincial governments.
  • Netherlands: Abortions are allowed up to 24 weeks. After that period, abortions are allowed only if the unborn fetus has an untreatable disease and would have little to no chance of survival after birth, or for the physical or mental health of the pregnant woman.
  • Singapore: Abortions are allowed up to 24 weeks. After that, abortions are only allowed to save the life of, or for the physical or mental health of, the pregnant woman.

There are some minor caveats. Australia has no federal abortion law, and each state and territory can set its own abortion guidelines. They vary in how restrictive they are; some states do not allow any elective abortions, and others do. PolitiFact Virginia found that the Australian state of Victoria allows women to get abortions upon request up to 24 weeks.

We’ll also note that the fact that elective abortion is legal in a certain country does not mean all the women there have access to abortion services or to clinics. Plus, the quality and level of health care in all of the seven countries are not equal; for example, health care in the United States really can’t be compared to North Korea.

There are more than seven countries that allow abortion services after 20 weeks in limited circumstances, including to save the life of the mother. As you can see in the map below, most developed countries allow abortions “without restriction as to reason” (marked in gray). As you can see, most developed countries allow elective abortions, but have a gestational limits (generally up to 12 weeks).

Katherine Mayall, director of capacity building at the Center for Reproductive Rights Global Legal Program, said this talking point gives a simplistic view of abortion laws in the seven countries. The world map is an effort to distill complex abortion laws and policies that are not cut-and-dry, she said. It’s a look at the letter of the law, and it does not take into account whether the exceptions for women past the federal gestational limit are interpreted more liberally by lower levels of government.

[Update: After our fact check published, the Center for Reproductive Rights noted that the limits can be liberally interpreted “to permit abortion under many circumstances, including ones that would generally be considered ‘elective’, such as being based on a woman’s socioeconomic circumstances," and that the map does not take into account whether there are broad exceptions that apply after the gestational limits expire. The U.S. is unique in regulating abortion at both with the federal and state levels, and most countries only regulate abortion at the national level, the center said.]

The Pinocchio Test

This statistic seemed dubious at first, because it seemed extreme for just seven countries out of 198 to allow elective abortions after 20 weeks of pregnancy. But upon further digging, the data back up the claim. We should note that some of the seven countries allow abortions after 20 weeks, but ban it after 24 weeks. And other countries have no federal limits, but legislate at the state or provincial level, similar to the United States.

Further, what is telling that research from both sides of the reproductive rights debate confirm this figure. It’s not easy to boil down complex abortion laws in a cross-comparative manner like this, and there are some minor caveats associated with this talking point. Still, we did not find the caveats rise to the level of One Pinocchio.

We award the elusive Geppetto Checkmark when a factoid surprisingly turns out to be true, as in this case.

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“Seven out of 198 nations allow elective abortions after 20 weeks of pregnancy.”
in a statement of Trump administration policy
Monday, October 2, 2017