Legal models of abortion regulation and their significance for family, motherhood and childhood policy

Context and relevance. Against the background of demographic challenges, abortion regulation is often discussed as one of the instruments of family and demographic policy. However, international experience shows that legal restrictions and actual access to medical care may diverge, while the consequences of different regulatory models depend on the state of health care, family support, access to contraception, and the quality of social counselling for women facing reproductive choices. Objective. To identify the main legal models of abortion regulation and assess their relevance for family, motherhood and childhood policies. Methods and materials. The article uses qualitative comparative legal analysis of legislation and research concerning Russia, Poland, El Salvador, Malta, the United States, Germany, the United Kingdom, the Netherlands, Canada and the Nordic countries; elements of descriptive statistical analysis are also used to examine abortion and fertility trends in Russia. Results. The article distinguishes prohibitive, restrictive, moderately permissive, liberal and fragmented models. It shows that prohibitive and strongly restrictive regimes do not eliminate the demand for abortion but may increase inequalities in access, risks of unsafe practices and pressure on health-care systems. A moderately permissive model requires assessment not only of legal provisions but also of practical barriers, including waiting periods, availability of providers, counselling and regional implementation. Liberal models indicate that low abortion rates may be achieved not primarily through penalties, but through prevention of unintended pregnancy, access to contraception and family support. Conclusions. For family, motherhood and childhood policy, the key issue is not legal prohibition alone but a comprehensive set of measures aimed at reducing crisis pregnancies, supporting motherhood, strengthening the health of women and children, and ensuring informed social support.

1. Денисов, Б.П., Сакевич, В.И. (2014). Аборты в постсоветской России: есть ли основания для оптимизма? Демографическое обозрение, 1(1), 144—169. https://doi.org/10.17323/demreview.v1i7698
   Denisov, B.P., Sakevich, V.I. (2014). Abortions in post-Soviet Russia: Is there any reason for optimism? Demographic Review, 1(1), 144—169. (In Russ.). https://doi.org/10.17323/demreview.v1i1.7698
2. Autorino, T., Mattioli, F., Mencarini, L. (2020). The impact of gynecologists' conscientious objection on abortion access. Social Science Research, 87, Article 102403. https://doi.org/10.1016/j.ssresearch.2020.102403
3. Charrier, L., Bo, M., Koumantakis, E., Zotti, C.M. (2022). The impact of conscientious objection on voluntary abortion in Italy in the last two decades. European Journal of Public Health, 32(S3), Article ckac129.670. https://doi.org/10.1093/eurpub/ckac129.670
4. Erdman, J.N., Bergallo, P. (2024). Abortion law illiberalism and feminist politics in comparative perspective. Annual Review of Law and Social Science, 20, 273—291. https://doi.org/10.1146/annurev-lawsocsci-041822-030149
5. Fernández, J.J., Juif, D. (2023). Does abortion liberalisation accelerate fertility decline? A worldwide time-series analysis. European Journal of Population, 39, Article 36. https://doi.org/10.1007/s10680-023-09687-y
6. Krawutschke, R., Pastrana, T., Schmitz, D. (2024). Conscientious objection and barriers to abortion within a specific regional context – an expert interview study. BMC Medical Ethics, 25, Article 14. https://doi.org/10.1186/s12910-024-01007-1
7. Levine, P.B., Staiger, D. (2004). Abortion policy and fertility outcomes: The Eastern European experience. The Journal of Law and Economics, 47(1), 223— https://doi.org/10.1086/380475
8. Matysiak, A., van der Velde, L. (2025). The short-term fertility impact of abortion law restrictions: A research note. Warsaw: University of Warsaw, Faculty of Economic Sciences. https://doi.org/10.33138/2957-0506.2025.12.475
9. Mayall, K., Ajayi, L., Gruer, C. (2025). Global progress in abortion law reform: A comparative legal analysis since the International Conference on Population and Development (1994-2023). Sexual and Reproductive Health Matters, 33(1), Article 2499324. https://doi.org/10.1080/26410397.2025.2499324
10. Minerva, F. (2015). Conscientious objection in Italy. Journal of Medical Ethics, 41(2), 170— https://doi.org/10.1136/medethics-2013-101656
11. Sedgh, G., Singh, S., Shah, I.H., Ahman, E., Henshaw, S.K., Bankole, A. (2012). Induced abortion: Incidence and trends worldwide from 1995 to 2008. The Lancet, 379(9816), 625— https://doi.org/10.1016/S0140-6736(11)61786-8
12. Wallays, A., Van Ryckeghem, L., De Kort, L., Van de Velde, S. (2025). Women's trajectories to abortion care in Flanders, Belgium: A qualitative study. SSM – Qualitative Research in Health, 8, Article 100636. https://doi.org/10.1016/j.ssmqr.2025.100636