On Wednesday, Alabama Gov. Kay Ivey (R) signed one of the nation’s most restrictive abortion bans in the United States into law.

The ban only allows for abortion in cases where it would save the mother’s life — it does not make exceptions for victims of rape or incest. While women would not face jail time, doctors who perform the procedure outside of strict legal parameters could face up to 99 years in prison.

The bill’s passage through the Alabama legislature comes at a time when fierce debate has emerged across the United States over abortion rights, after Georgia’s governor signed a “heartbeat bill” into law last week, essentially restricting doctors’ ability to provide abortions past around six weeks of pregnancy, before many women realize they are pregnant.

The strict nature of recent U.S. legislation would feel familiar to residents of countries where existing laws, including some that are even more harsh, have led to women and doctors being jailed over suspicions they’ve received or carried out an abortion.

There are many countries around the world where abortion is essentially banned. These are just a few examples of places with some of the world’s strictest bans, both for women and their medical providers.

El Salvador

In 2017, then-United Nations High Commissioner for Human Rights Zeid Ra’ad Al Hussein said in a statement that he was “appalled that as a result of El Salvador’s absolute prohibition on abortion, women are being punished for apparent miscarriages and other obstetric emergencies, accused and convicted of having induced termination of pregnancy.”

Abortion has been completely criminalized in El Salvador since the late 1990s. And as of last year, more than 20 women and girls were in prison under the country’s abortion ban. Many of them were sentenced to decades in prison after prosecutors tacked homicide charges on top of abortion charges.

In December 2018, Imelda Cortez was freed after around 18 months behind bars. She had given birth to a baby in a latrine, and the infant survived, but prosecutors claimed her behavior — the fact she had hidden her pregnancy and didn’t take the baby to the hospital — amounted to attempted murder. She said she hadn’t realized she was pregnant and that the father of the child was her own stepfather who had raped her. A paternity test later confirmed that he was the father.

After more than a year in limbo, a Salvadoran court unexpectedly ruled her not guilty of any crime, even once prosecutors dropped the abortion charge and suggested she be charged with child abandonment instead.

It was doctors Cortez saw for her own post-delivery needs who reported her to the police, after questioning whether she might have attempted an abortion. Like women, doctors there must be careful not to be either falsely accused of providing an abortion or of being caught providing underground abortions, as they can also face jail time if convicted of carrying out clandestine abortions.

Other women who have recently been released in El Salvador include Maira Veronica Figueroa Marroquin, who said she suffered from a still birth but was sentenced to 30 years in prison anyway, and released last year after 15 years behind bars.

Dominican Republic

Like in El Salvador, abortion is illegal in the Dominican Republic under any circumstances.

In 2012, Rosaura Almonte Hernández, a pregnant 16-year-old diagnosed with leukemia, was banned from seeking chemotherapy over concerns the treatment could harm her fetus. Eventually, doctors relented and began chemotherapy, but Hernández soon died. Her case was included in a 2018 Human Rights Watch report.

A number of women who received clandestine abortions in the Dominican Republic relayed their accounts to the watchdog group, which determined “[t]he ban does not stop abortion but drives it underground and makes it less safe.”

Women and girls who are found to have received abortions in the Dominican Republic can face up to two years in prison, the group reported. It’s medical professionals who pay an even higher price: They can face up to 20 years in prison for providing an abortion.

Although there has been repeated discussion among lawmakers over the possibility of loosening the restrictions, the ban remains in place. The Human Rights Watch report said there was a clear pattern of distress among the women and girls they interviewed about abortions. Interviewees repeatedly used words like “depressed,” “terrified” and “desperate” to describe how they felt when they learned they were pregnant, the watchdog group said.

Nicaragua

Nicaragua once allowed for abortions under certain reasons, but in 2006 passed a law that dramatically restricted women’s access to the procedure. According to Human Rights Watch, those who terminate their pregnancies can face up to two years in prison. Medical professionals who assist them can face up to six.

The watchdog group reported a similar pattern to other countries in Nicaragua, saying that clandestine abortions continue to happen despite the ban, but that many women are afraid to report complications to their doctors, who might feel compelled to report them to authorities. “Medical providers, caught in a conflict between the law and medical ethics, have reported women and girls to police for suspected abortions,” a 2017 report said.

Ireland and Northern Ireland

Last year, in a landslide vote, Ireland repealed a long-standing abortion ban, one that had been among the most restrictive in the developed world. Now abortion in Ireland is unrestricted during the first 12 weeks of a pregnancy and is also permitted after that time for certain health reasons.

Before that vote, a 1983 Irish amendment had banned nearly all abortions, even for victims of rape and incest. In 2013, lawmakers tweaked the ban to make exceptions for women whose lives were in danger. At the time, the Irish Department of Health said that thousands of women traveled from Ireland to Britain each year to seek abortions.

That vote came a year after Savita Halappanavar, 31, died from blood poisoning in Ireland after doctors refused to perform an abortion for her even though she was miscarrying. But even after legal exceptions were made to the ban, women and girls who sought abortions at home and medical professionals who performed them still faced serious punishment: up to 14 years in prison.

Activists in Northern Ireland hoped the Irish vote last year would change things across the border, too. But this week, they said they think their legislation is even more strict than what was proposed in Alabama, the Guardian reported. In Northern Ireland, abortions are banned under all circumstances except if doctors believe the life of the mother or her mental health are at risk. Reuters reported last year that those who perform or receive an abortion can face life in prison.

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