(NEW YORK) -- Last week, the United States became one of the only Western countries to roll back abortion access in the 21st century after the Supreme Court overturned Roe v. Wade.
The ruling means about half of American women may lose access to legal abortions.
Abortion rights groups and activists say women in the U.S. can look to Poland for a glimpse of what their futures might be -- and what can happen in the direst of circumstances.
Poland has one of the strictest abortion laws of any European country, with exceptions only if the mother's life or health is in danger, or if the pregnancy is a result of rape or incest.
"Because of the law, which is extremely restrictive in practice, we are facing almost a virtual ban on abortion," Irene Donadio, senior lead on strategy and partnerships at the International Planned Parenthood Federation European Network, told ABC News. "It's really affecting the life and the health of all women."
Poland's abortion history
Prior to 1932, abortion was illegal in Poland with no exceptions. That same year, the Criminal Code was amended to legalize abortion for if the mother's health was at risk or if the pregnancy was the result of a criminal act.
This law remained in place until 1956 -- through World War II and Poland coming under Soviet occupation -- after which abortion was decriminalized. Three years later, the country's minister of health allowed abortion to be available upon request.
During this time, more than 100,000 abortions occurred annually in the country, for about 10 years, according to data from the Council of Ministers.
After the fall of communism, the Catholic Church began exhibiting pressure on Poland -- a heavily Catholic country -- to ban abortion.
The number of annual abortions began to fall and, in 1993, lawmakers tightened the abortion law, only allowing it for certain exceptions.
The year the law was law passed, abortions in Poland dropped to 1,240 per year, data shows.
In October 2020, Poland's constitutional court found that abortion due to fetal malformations was unconstitutional, and a ban for abortion in these circumstances went into effect in January 2021.
"Doctors and providers are really scared to help women in need, and this means that even women who are experiencing a miscarriage or women who are discovering that they are pregnant and want prenatal care, they are denied proper, decent care," Donadio said.
"They are abandoned by the system, so what we see is a terrible law that is harming women, harming families, and harming society," she continued.
Annual abortions fell to their lowest point in 2001 at 124 but have since risen. In 2020, the latest year for which data is available, Poland recorded 1,076 annual abortions.
Further, local non-governmental organizations, or NGOs, such as the Foundation for Women and Family Planning FEDERA, estimate that between 80,000 and 200,000 Polish women have abortions every year, including those performed abroad or illegally.
"Just because we have such a law, it doesn't make the number of abortions lower," Jolanta Budzowska, a personal injury attorney based in Krakow who specializes in medical malpractice, told ABC News. "They'll just go take care of it elsewhere."
The case of Izabela Sajbor
Even though the law is supposed to allow for abortions to be performed if the woman's life is in danger, women have died, activists say.
"The women who died in Poland, they didn't die because of backstreet abortion, they died in hospitals, surrounded by doctors, by midwives and by nurses who were paralyzed by the law," Donadio said.
This is perhaps no better highlighted than in the case of Izabela Sajbor, a 30-year-old pregnant woman who died in September 2021.
Budzowska, who represents the family, told ABC News that Sajbor was in her second trimester when she was told her baby had Edwards' syndrome, a rare genetic disorder that causes physical growth delays and birth defects.
Most fetuses don't survive full-term, and so the mothers either miscarry or give birth to stillborn babies, according to the Cleveland Clinic.
Additionally, the fetus had other severe defects, Budzowska said, but doctors refused to perform an abortion because a heartbeat could still be detected.
"Her fetus had no chance to live," Budzowska said. "Everybody knew the fetus had no chance to live, and the doctors hesitated to do anything."
Sajbor was admitted to the hospital when she was 22 weeks pregnant after her water broke prematurely. Doctors waited to perform a Cesarean section until the fetus's heart stopped beating, Budzowska said.
By the time the fetus died and Sajbor was taken to the operating room, she had developed sepsis, according to Budzowska. She soon after went into cardiac arrest and died.
"This law has had a strong, cold, chilling effect on doctors," Budzowska said, explaining that doctors often choose not to act because they are worried about losing their right to practice or facing criminal charges. "This legal situation leaves women in real danger. Izabela asked for help, and no one helped her."
'More women might die'
Activists say that since Sajbor's death in 2021, at least two other women have died after being refused abortions and, although these deaths are rare, they say they are the result of what can happen in the worst-case scenarios.
"People shouldn't die; that's why [abortion] should be legal," Marta Lempert, founder of the All-Poland Women's Strike, who has been among the leaders for abortion rights in Poland, told ABC News. "The riskiest place in Poland you can go to is the hospital if you're pregnant because you might not get out of there alive."
Abortion rights supporters fear the same thing could occur in the U.S., either through illegal back-alley abortions or in hospitals by doctors too afraid to act.
"I am sorry to say, but I do believe that when you have such laws, women might die," Donadio said. "And that is just the tip of the iceberg."
"It will have a tragic impact not only leading to some women losing their lives, but [the laws are] terrorizing millions because the moment you become pregnant, there might be doctors that will not consider your life a priority if your health is at risk, because they will be too scared to be imprisoned," she said.
"For me, that's the most tragic effect of these laws that we will face in so many U.S. states," Donadio added.
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