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How Alabama’s new abortion law echoes Communist Albania’s extreme abortion ban

With no contraception either, women had high maternal mortality — and a high abortion rate.

- May 17, 2019

Alabama’s new near-total abortion ban, the Alabama Human Life Protection Act, calls upon history at length. Its text notes that there have been 50 million abortions since Roe v. Wade in 1973, saying that number is “three times the number who were killed in German death camps, Chinese purges, Stalin’s gulags.”

But it fails to note the ways in which the bill itself has historical echoes. Its abortion regulations are comparable to those promulgated by one of the more pronatalist political regimes of the twentieth century, Enver Hoxha’s communist dictatorship in Albania (1944-1985).

No abortions except to save the mother’s life

The bill, which Gov. Kay Ivey (R) signed on Wednesday, stipulates that doctors may not perform an abortion once an embryo is “in utero.” This policy goes far beyond the recently passed Georgia law that outlaws abortions after the sixth week of pregnancy, counting from the date of the woman’s last menstrual period. Even in a conservative, largely antiabortion state, the fact that H.B. 314 makes no exceptions for rape or incest has raised eyebrows in Alabama; the only exception is serious risk to the life of “the unborn child’s mother.”

The law stipulates no punishment for women who obtain abortions, but doctors who perform them could be charged with a felony.

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All that resembles communist Albania’s antiabortion law. Albania during communism was a police state that even broke with the U.S.S.R. after Nikita Khrushchev’s loosened its repressiveness after Joseph Stalin’s death, known as the “thaw.” Communist Albanian leader Hoxha was so committed to anti-revisionist Marxist-Lenininism that he refused any policy liberalization, calling it “Eurocommunism.” Hoxha’s secret police Sigurimi purged and repressed dissenters by sending them to labor camps or executing them. Citizens were stripped of basic democratic freedoms — freedom of the press, freedom of speech, freedom of assembly and so on — and were banned from traveling abroad.

Hoxha’s government was aggressively pronatalist. His government saw population growth as essential for labor and prosperity, and for defending against the country’s enemies. Without a growing population, who would serve in the army, mine chrome and nickel, or work in agriculture?

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Not only did Hoxha’s regime forbid abortion; it also forbade the import of birth control in the country. The result was that Albania had the second-highest maternal mortality rate in Europe, as women frequently received unsafe abortions or tried to induce abortions on their own. Since women were unable to prevent conception, up to 50 percent of all pregnancies ended in abortion.

Do more restrictive policies really result in fewer abortions?

As in Alabama’s new law, communist Albania allowed legal abortion when the life of the mother depended on it — specifying 30 different medical conditions as possible reasons.

In communist Albania, women found guilty of having illegal abortions were either socially shamed by the party or sent to reeducation programs. The Alabama law stipulates that women will not be punished for having abortions, but it does echo communist Albania’s strictures on doctors.

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In 1977, Albania passed a new Albanian penal code that included specified penalties for a physician who performed illegal abortions: up to eight years in prison. Alabama’s law is far more punitive; a doctor could risk a 10-year prison term for merely attempting to perform an abortion and up to 99 years in prison for completing one.

That’s likely aimed at discouraging physicians from ignoring the law and offering abortions anyway. That didn’t work in Albania. The combination of inadequate birth control and abortion being outlawed meant that women in their reproductive years could have as many as 10 or 12 abortions.

Protests and student demonstrations and massive national discontent resulted in the end of communism in Albania around 1991. In 1992, in an effort to limit the high mortality resulting from illegally obtained abortions, the government passed an abortion law that allowed abortions for anyone over the age of 16 before the 12th week of pregnancy. Once abortion was allowed, because of inadequate contraception and poor economic conditions in the country, abortion rates were higher than that of live births.

The writers of the Alabama law seem acutely aware of history. If they are going to take a historical approach to what they are doing, they may wish to consider all relevant histories when evaluating the impact of the bill.

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Ani Kokobobo (@ani_kokobobo) is an associate professor in the Slavic department at the University of Kansas.