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Abortion Care

IPPF works to ensure that every woman and girl has the human right to choose to be pregnant or not and we will continue to supply and support safe and legal abortion services and care. We are committed to reducing the number of deaths of women and girls who are forced to turn to unsafe abortion methods. Make Abortion Safe. Make Abortion Legal. For all Women and Girls. Everywhere.

Articles by Abortion Care

Illustration abortion care: Abortion is Freedom
08 October 2024

Croatia: Obstacles to abortion care make access virtually non-existent

Hitting the road in the desperate search for abortion care For thousands of women and girls in Croatia, getting an abortion involves travelling for hours, even days, across this small but poorly connected country in search of appointments. Whether by ferry, bus, or both, these journeys mark the beginning of an arduous and expensive ordeal – one that piles stress and costs onto people needing an abortion and forces many to leave Croatia altogether. On paper, a very different picture emerges. “By the law, abortion is quite accessible in Croatia,” says Marija Trcol of human rights and civic participation organisation PaRiter. Abortion on request is legal for up to ten weeks, and all public hospitals with obstetrics and gynaecology departments should provide care. But dig a little deeper and the extent of the crisis quickly reveals itself. “Actually there is no hospital with accessible abortion in Croatia,” Marija says. “There’s a really big discrepancy between [law and reality], which is why Croatia is perceived as a state with accessible abortion.” Different factors push people to travel far from home for care – from shortages in medical staff and problems rife within Croatian healthcare overall, to stigma and discrimination attached to abortion in this deeply Catholic country, where the growing influence of the church and chauvinist campaigners is intensifying structural violence against women. Scrutiny of these factors – among others – reveals catastrophic issues within Croatian healthcare and social attitudes to women, and why the struggle for abortion care is increasingly expensive and traumatic. Abortion’s hefty price tag For many people, the first barrier is Croatia’s complex geography: there is no abortion care in the islands or rural communities, and people must travel to mainland cities for appointments. In a nation of islands, mountains, and creakingly slow bus networks, this can be time-consuming and expensive. “It’s a small country but it’s really complicated to [reach] certain hospitals,” says Marija. “Public transport in Croatia is the worst – cities are not well-connected with buses, and it takes half of a day to a whole day just to travel to the hospital.” Ferries are expensive, costing €30-100 one-way. There are also no sick days for abortion care on request: people must book a day off, which can be complicated to arrange and lose you a day or more’s pay. Then there is the price of the abortion itself. Abortions on request are around €300 in public hospitals and up to €800 in private clinics. People with rhesus negative blood must pay an extra €50-80 euros for anti-D injections. Almost everyone has to fund their own care: the state only pays in specific cases of medical indication or rape, and the process for rape cases is deeply flawed, exacerbating trauma. These costs are “a massive chunk of your salary, especially if you are not economically stable, like women in some violent relationships,” says Marija. “For people with low socioeconomic status, I would say it’s impossible.” “The median salary in Croatia is around €900,” and women often work in low paid sectors or roles, she says. The country has a 12% gender pay gap, and 21% of women are at risk of poverty – shooting up to 48% for single women and 32% for single parents.  Many groups face additional cultural or logistical barriers to care. The Roma community has long experienced stigma and discrimination when attempting to access state services, including abortion care, Marija says. People with disabilities are also more vulnerable. “For people who need assistance to go to a doctor, this is something that the state does not provide at all,” she explains. “If you are deaf, for example, I don’t see how you can have an abortion without huge expenses.” These restrictions underline how transformative abortion telemedicine would be in Croatia, where it is currently banned. Croatian abortion law was drawn up in 1978 when abortions were exclusively surgical, meaning lawmakers decreed that procedures must take place in hospital. Fast forward five decades, and millions of people globally now use abortion pills at home in line with WHO guidelines, making abortion cheaper and more accessible, and reducing stigma. Spiralling denial of care One of the most significant barriers is the dramatic fall in the number of doctors and hospitals providing abortion care. ‘Conscientious objection’ – the practice of refusing to provide care on grounds of personal beliefs – lies at the crux of this crisis, as in many European countries. Since being legalised in 2003, it is now “normalised”, Marija says. The law doesn’t just apply to gynaecologists: any member of an abortion care team can invoke it, and a procedure will be cancelled if most of the team object, Marija explains. Even if no one objects, senior management can stop procedures going ahead, and hospital managers have sometimes fired staff for providing abortions, Marija says. This has had a catastrophic impact. By 2018, 59% of health workers were refusing to provide abortions. According to recent research by the gynaecologist Jasenka Grujić, there are now two hospitals in Croatia where all staff refuse to provide abortion care, 12 hospitals where 50-100% of staff refuse, and 9 hospitals where 1-49% of staff refuse.  Another problem is that “there is no regulation of denial of care in hospitals at a state level at all,” Marija says. For example, hospitals should ensure there is always at least one team available to provide abortions, but currently there is no government pressure on them to do this, she explains. Many abortion facilities are only open a few hours a day, a few days a week, and certain gynaecologists have become so notorious for being “really harsh to women” that people avoid them altogether. Forced to travel abroad for care A notorious case from 2022 reveals how doctors use denial of care and evasion to suppress reproductive justice. Mirela Čavadja was in the 24th week of pregnancy when doctors told her the fetus was unlikely to survive. Every hospital she contacted in Zagreb refused to provide abortion care – some citing ‘conscientious objection’, others saying “they were not equipped with knowledge and equipment to perform this kind of abortion, although by law this needs to be accessible in Croatia,” Marija explains. Finally, Mirela had to go to Slovenia for an abortion – a familiar path for women with medical indication in later pregnancy. Marija says doctors frequently tell such women to travel to Slovenia and foot the €5,000 bill themselves, despite the state being legally obligated to reimburse costs if Croatia lacks capacity to deliver care when it is medically indicated. This is yet another example of doctors participating in reproductive violence against women. Women at different stages of pregnancy also travel to Bosnia and Herzegovina or as far afield as the Netherlands to access abortion care – a shocking indictment of the state of abortion care coverage in Croatia Dearth of data The lack of data on abortion coverage exacerbates the struggle for appointments. Hospitals are supposed to send annual data reports to the Institute of Public Health, but there are no sanctions if they don’t and no way to find out if reporting is accurate, Marija says. Many hospitals say they provide abortion care, “and then the woman comes and they won’t do it,” she explains.  For women's rights activists, unreliable data seriously hampers their work. For women and girls, it means they can spend hours ringing around trying to get appointments, or turn up for an appointment and be turned away. “So this is something that we are going to campaign for – give us the true data and please give us the list of teams who are doing the abortions.” Data leaks linked to abortion stigma  The leaking of confidential patient data by medical staff to “shame” women who have had abortions is another serious problem – and yet another reason why women seek care far from home, Marija says. “If you live in a smaller place, then you sometimes choose to travel to a big city, because even if care is accessible, there’s a big chance of data being leaked and the whole place will know that you had an abortion,” she explains. Such leaks are illegal but completely normalised, and “there are no sanctions.” Even government ministers are involved: in the uproar following Mirela Čavadja’s case, the minister of health – himself a doctor – “went public with all of [Mirela’s] medical data” to the media. He remains in post. Misogynistic networks target abortion Growing links between anti-abortion actors, politicians, the church, the far right, and healthcare providers are a major threat to abortion care in Croatia. Since the breakup of Yugoslavia in the early 1990s, the power of the Catholic church has surged. “The church has a really big influence on politics and on the health system regarding reproductive health,” Marija says. With the entry of the far-right Homeland Movement into coalition government in April, Croatia’s government has shifted further right, and many in government have strong ties with the church and the growing anti-gender movement, Marija adds. She explains that different groups – including the ultraconservative Poland-linked ‘kneelers’, and ‘40 Days for Life’ abortion clinic picketers – target people providing or accessing abortion care, and are often backed by the church or global networks. The ‘kneelers’ are so entrenched that “they’re now part of the government,” Marija says. Women’s rights activists have been mobilising in response, including by calling for criminalisation of harassment of women seeking abortion care, but the threat remains dire, calling for massive, united efforts by campaigners. Mobilising to protect women This brings us back to the perception gap. Public support for abortion care is high at 65-75%, but this is a “quiet majority”, which hasn’t yet recognised the threats facing abortion access, Marija says. To galvanise people to speak up, campaigners need to expose gaps between perceptions and reality – and this calls for more trustworthy data. With this in mind, PaRiter is running a survey on abortion access and hopes that “through the next two years we’ll have established some kind of independent monitoring system on abortion,” with the support of other feminist organisations, within their capacities and means.   PaRiter is also scrutinising contradictions between Croatia’s stance on women’s rights and its European and international commitments, and plans to report yearly on findings. Despite the government’s shift rightwards, Marija says “our hope is that they are still going to want to look good in the EU’s eyes” and so constrain attacks on women’s rights, but “they are signing things like there is no tomorrow and are not doing anything to make things better.” Given the formidable forces lining up to attack women’s rights, civil society networks (national, regional and global) must work together to protect women’s rights, Marija says. For example, the Croatian coalition for My Voice, My Choice, a European citizens’ initiative calling for a financial mechanism to guarantee safe abortion access in the EU, has done a “fantastic job,” mobilising huge public support for safe abortion access, now and for generations to come. ***   Words by Imogen Mathers for IPPF EN Illustration by Alissa Thaler for IPPF EN   This content is funded by the European Union through the Citizens, Equality, Rights and Values Programme. Disclaimer: Views and opinions expressed are those of IPPF EN and do not necessarily reflect those of the European Union or the European Commission. Neither the European Union or the European Commission can be held responsible for them. 

Poland PWS
03 October 2024

Poland: Acquittal of women's rights defenders a relief, but the trial was unjust

Three Polish feminists on trial for pro-abortion protests have been found not-guilty. Although positive news, this is not a complete win for activists around the world. Marta Lempart, Klementyna Suchanow and Agnieszka Czerederecka-Fabin - three leading women’s rights defenders from the Polish Women's Strike were facing eight years in prison in Poland for exercising their right to peaceful protest. At today’s trial they were found not guilty. Though the not guilty verdict is a relief, we can’t ignore the fact that this trial never should have happened in the first place. These women’s rights defenders were unfairly targeted because of their work, with the prosecution attempting to use the courts as a tool of intimidation. Defending reproductive rights is not a crime. It is deeply troubling that they were subjected to a sham trial that not only robbed them of time, energy and money, but also affected their mental well-being. Cases like this are designed to silence activists. They are a dangerous attack on fundamental human rights and democratic values.     In future, we urge the Polish government, and all governments, to focus on protecting rights, not prosecuting those who defend them.   Marta Lempart said "I'm looking forward to going back to work. Thank you for all the solidarity from the international community."

WHRDs
01 October 2024

Polish Women's Strike protests’ organizers on trial

Date: 3.10.2024 Time: 12.00 Courtroom: 224 Location: District Court in Warsaw, Solidarności 127 Press briefing after the verdict.   The criminal case against Polish Women's Strike pro abortion protests’ (2020) leaders is finally coming to an end in the District Court in Warsaw, Poland. Marta Lempart, Agnieszka Czerederecka and Klementyna Suchanow are charged under Article 165 of the Penal Code (endangering the public by organizing protests)  and Women's Strike leader Marta Lempart is additionally charged under Article 226 and Article 255 of the Penal Code. All three women face up to 8 years in prison. The announcement of the verdict will take place on October 3rd at noon in the District Court in Warsaw at 127 Solidarności Avenue (room: 224). This date is significant and symbolic for the entire movement that the Polish Women's Strike is. It was on October 3rd, 2016 that the Women's Strike organized the first mass protests in Poland in defense of abortion rights, which went down in history as Black Monday. At that time, women took to the streets of more than 160 cities and towns dressed in black in protest against the tightening of abortion law in Poland. On the 8th anniversary of the first Polish Women’s Strike protest (2016), activists will hear the verdict for their involvement in the 2020 100-days stress protests, brutally suppressed by the state police and secret services. It will be a verdict for their years of fighting in the streets, for the many days and nights spent protesting, in police cauldrons and in police detention. Judgment for their courage and determination, for their eyes burning with pain from the police gas, for their arms broken during the demonstrations, their spines physically damaged from the police batons. The judgment will therefore be symbolic not only for the anniversary of the Women's Strike, but above all for the fight for women's rights in contemporary Poland. The verdict will show which way we are heading - towards the shameful direction of maternity wards where women are dying, or towards the civilized part of Europe. Marta Lempart: Please be with us on that day. It is important that not only we, but also others who are still being dragged through the courts, know that they are not walking alone. Whatever happens this October 3rd or afterwards. See you there!   Media contact: +48 577 099 077 Marta Lempart [email protected]

Illustration: End obstacles to abortion care
27 September 2024

Germany's archaic abortion law creates huge burden for people needing care

For a country long reputed to have one of the more progressive healthcare systems in Europe, Germany’s law on abortion – a health issue affecting millions of people – remains firmly stuck in the past. “The law has negative impacts, and [these] are not accidental side-effects that need to be adjusted – they’re intentional,” says Stephanie Schlitt, board member of Pro Familia, an SRHR counselling and advocacy organisation and IPPF’s German Member Association. “By compelling women to do certain things, the law enforces abortion stigma.” Germany’s archaic law has a long and messy past, in which the trampling of women’s rights to reproductive justice has been a common thread. Abortion has been criminalised since 1871 and remains punishable with prison sentences for those obtaining and providing abortions (though prosecutions are rare). Exceptions are made up to 12 weeks of pregnancy under strict conditions, or where there is a medical necessity, or in cases of rape. The state’s longstanding treatment of abortion as a criminal rather than health issue has devastating repercussions. For people needing abortions, strict legislation makes accessing care a fraught process, involving high costs, complex paperwork, fear of criminalisation, and stigma. For doctors, the legal red tape, threat of prosecution, and growing harassment by anti-rights campaigners create “a huge disincentive for the provision of care”, Stephanie says. “What’s happening here simply isn’t good enough, because it goes completely against the needs of the people concerned and those who want to support them professionally – doctors and counsellors,” Stephanie says. “We can’t be surprised if, as a result of this law, [abortion] healthcare provision is difficult. Of course it will be – it’s geared towards making it difficult.” Outdated laws crush women’s rights    “Some of the barriers flow directly from the law as it’s framed, and some flow from the practice that results from that law,” Stephanie explains. Firstly, people seeking abortion care must undergo mandatory counselling at state-certified centres or online, and receive a certificate to present to their gynaecologist. Following counselling, there is a mandatory and medically unnecessary three-day waiting period – a delay that can affect treatment options for such a time-critical procedure and exacerbate stress. Making counselling a legal requirement creates difficult conditions for counsellor and client, Stephanie explains. Women “feel under pressure to justify themselves” during an already stressful period, while for counsellors, these conditions are “a huge burden because counselling should only happen on a voluntary basis.” Mandatory counselling and waiting periods contravene World Health Organization (WHO) advice on abortion care, and Germany is one of the few EU countries to impose both. “The point is that this law creates hurdles to good healthcare and actually makes the whole experience much more difficult than it needs to be,” Stephanie says. “An abortion needn’t be so emotionally, financially and socially burdensome.”

Illustration abortion care: Leave no one behind
28 September 2024

High costs and broken health system freeze many out of abortion care in Romania

On paper, abortion care is legal up to 14 weeks in Romania – though only free in emergencies – and should be provided by all hospitals with obstetrics and gynaecology departments. The reality is very different. Abortion care is increasingly expensive, provided by fewer and fewer clinics, involves a labyrinth of red tape, and tends only to be available in cities. “Today, we are in the worst-case scenario [seen] in recent years,” says Gabriel Brumariu, director of SECS, IPPF’s Romanian Member Association. In the 1990s and 2000s, abortion care had rapidly improved in Romania. The post-Communist government had inherited a brutal system for women and children – a near-total ban on abortion and contraception between 1966 and 1989 had brought devastating repercussions. Following the 1989 revolution, the new government swiftly legalised abortion up to 14 weeks, and introduced free contraception (though this ended unexpectedly in 2013). This progress is now being destroyed at pace, Gabriel says. Many factors are making abortion care more expensive and less accessible – including cuts to sexual and reproductive health and rights (SRHR) programmes, clinic closures, and a slump in the number of doctors willing to perform procedures. Overall, the country’s health system is crumbling, and women are particularly vulnerable. Evidence has emerged of people dying after being denied access to obstetric care, and the maternal mortality rate rose by 183% between 2018 and 2022 – “inconceivable” for an EU state, Gabriel says. And, with the far right on the march in Romania and European donor states, often bankrolled by US anti-rights campaign groups, the rights of women are under severe attack. Exorbitant costs For many in Romania, the high price tag for abortion puts it out of reach – and prices are rising fast year on year. In public hospitals, abortions on request cost around $200-300; in private clinics, between $250-1000. These prices are “a huge proportion of a monthly salary,” says Gabriel, and in some cases exceed it. The new national monthly minimum wage is 3,700 Romanian lei (RON) – around US$812, before tax and deductions of over 40%. Women’s median monthly salary is $582.24 net, with higher salaries concentrated in cities. For undocumented migrants, day workers, and those working without legal papers, salaries are much lower, at around US$300 per month, Gabriel explains.   Rural communities left high and dry Other costs swiftly stack up: on top of treatment costs, people often have to travel hundreds of kilometres to access care, partly because many rural clinics have shut down. Almost half (44.8%) of Romania’s 19 million population live in rural areas. For these communities, accessing abortion care requires cash for transport, accommodation, childcare, time off work – the list goes on. Repeat visits further drive up costs, and, unlike several other European countries, Romania does not allow abortion telemedicine for medical abortions (pills taken at home) at all.  As a result, abortion on request is becoming the preserve of wealthier, urban communities, says Gabriel: “Of course, the ones that have money will [be able to] access abortion [...] in a private clinic. But if you are from a marginalised community, it’s almost impossible for you.” Women on the fringes Some of the most marginalised people in Romania include the country’s 2 million-strong Roma community. Abortion access for the Roma is fraught, with geography and income playing a role here too: Roma people’s salaries tend to be far lower than average, and they often live in segregated areas on the geographical and cultural fringes of mainstream Romanian society. These barriers intersect with systemic racism, classism, and entrenched stigma towards the community from medical staff, as our recent interview with Roma feminist organisation E-Romnja explains in detail.   The approximately 77,900 Ukrainian refugees living in Romania are another group facing barriers to abortion care. Access is now so limited that “some of them prefer to go in a country at war because it’s easier in Ukraine to access abortion than in Romania,” Gabriel says. A 2023 report by the Centre for Reproductive Rights found that being unable to get appropriate care pushes many refugees to pursue unsafe avenues or return to Ukraine to access abortion. Gabriel says funding for care has dried up: SECS used to receive humanitarian funding to support Ukrainian refugees to access abortion, but “now, all the funds for Ukrainians disappeared […] and we don’t have funds to pay for Romanian people or Ukrainian refugees.” Public hospitals failing mandates One major factor cutting abortion access is the increasing refusal of doctors to provide care in public hospitals, Gabriel explains. Many doctors work in both public and private practice, but “tend to take their patients to private clinics because they earn a lot of money by doing … an abortion [there],” he says. “There are counties [...] which offer zero chance [of abortion] in public hospitals.” The data reveals a crisis spiralling downwards fast. In 2019, research by the Black Sea found that 60 of 190 public hospitals contacted did not offer abortions. The COVID-19 pandemic made a bad situation worse: only 12 of 112 public hospitals (11%) contacted by women's rights organisation Centrul Filia in 2020-2021 provided abortion on request. In 2021, an investigation by Romanian media revealed that 11 out of 42 Romanian counties provided no abortion on request, with 62% of such procedures taking place in private clinics. In 2023-2024, a telephone survey by the Independent Midwives Association found that over 80% of public clinics do not offer abortion services, while 90% refuse to refer women to another clinic on request, despite being required to by the medical ethics code.   The increasing use of ‘conscientious objection’ laws that allow doctors to refuse care has also hit numbers of care providers. Data from Centrul Filia revealed that 70 out of 136 public hospitals use these laws as a basis for refusing to perform abortions. Doctors who refuse care are supposed to refer patients to another doctor or hospital, but often the personnel and infrastructure simply isn’t there, Gabriel says. Some doctors refuse to provide care in public hospitals on ‘conscience’ grounds but then offer the service privately, for a much higher fee. Chauvinist forces attack rights by stealth Many different groups are fomenting anti-abortion sentiment, Gabriel explains. As in other EU countries, abortion is a key battleground issue for Romania’s growing far right – “a more extreme far right party that’s bigger now and more powerful.” Meanwhile, ultra-conservative lobbying groups and evangelical Christian groups, often with US backing, have been consolidating influence on political parties, policies, and grassroots services. They often work covertly because public support for abortion is strong, Gabriel explains. Rather than pushing for a referendum on abortion and “making waves” – likely leading to public “revolt” – they focus on gaining political traction, influencing doctors, and lobbying for reducing gestational limits for abortion. Another tactic is to target women at the grassroots. ‘Pregnancy crisis centres’ run by Christian organisations – often with US links – are springing up across the country, often embedding themselves in public services, with the aim of dissuading women from having abortions. Romania’s powerful orthodox church – particularly strong in rural areas – is also a strong force opposing abortion. Far right influence also threatens SRHR organisations like SECS, Gabriel says. Such NGOs receive no government funding but rely on European donors and international organisations like IPPF, within an SRHR funding landscape that is already very constrained. Gabriel worries that if major European donor governments lurch rightwards, it will further diminish funding for SRHR and abortion care programmes in countries in east and southern Europe. Working together to protect future generations Fighting to protect and advance women’s rights within such an embattled landscape calls for strong partnerships, Gabriel says: “The most effective ways [for ensuring abortion access] are the advocacy interventions done by the civil society, united.” SECS is focusing on reviving an NGO advocacy platform that worked very hard to defeat the country's 2018 anti-LGBTI referendum. Such networks allow organisations to divvy up responsibilities and work strategically towards common goals. Through this “united” approach, SECS and partners plan to run robust campaigns backed by the collection and analysis of better data (currently, public data on many SRHR issues is often poor or non-existent). Working together, the focus is to mobilise public opinion, protect “good laws”, push for legislative change, and “facilitate real access to abortion services all around the country.” For example, SECS is currently pushing for the legalisation of abortion telemedicine, to make care more affordable and accessible to thousands of people – particularly those in remote rural areas, hundreds of kilometres from clinics – in the challenging years ahead. *** Words by Imogen Mathers for IPPF EN Illustration by Alissa Thaler for IPPF EN   This content is funded by the European Union through the Citizens, Equality, Rights and Values Programme. Disclaimer: Views and opinions expressed are those of IPPF EN and do not necessarily reflect those of the European Union or the European Commission. Neither the European Union or the European Commission can be held responsible for them. 

abortion is self care
27 August 2024

New Law in Norway Highlights Inequities in Abortion Access

The Norwegian government has proposed a new bill extending self-determined abortion rights from 12 weeks up to the 18th week. If the bill is passed by the Norwegian Parliament, it will mark a significant victory for sexual rights in Norway. However, this right will not be equally accessible across the country. Sex og Politikk, the Norwegian Member Association of IPPF, asserts that viability should not be a political decision and that respect for human life cannot be legislated. Sex og Politikk has been actively engaged in discussions on the new abortion law since the Government established a committee in 2022 to look into the country’s almost 50 year old abortion legislation. The organization has participated in a separate committee of feminist NGOs, closely following the development of the law and contributing to the debate. This month, Health and Care Minister Jan Christian Vestre and the government introduced proposals for a new abortion law. While welcoming this milestone in the fight for sexual and reproductive health and rights (SRHR), Sex og Politikk argues that the proposal needs revision on key points. Just three years ago, few would have anticipated a new abortion law in Norway. The government's proposal represents progress, but it also reveals significant weaknesses from an SRHR perspective. The law remains entrenched in outdated beliefs that abortions should only be conducted at regional hospitals. In reality, most abortions today are performed at home with medication, not through surgical interventions. Despite this, the government's proposal still limits abortion care to specialist healthcare providers, even as it calls for further investigation into the role of primary healthcare in offering abortion care. This limitation complicates access to abortion, especially for those living far from hospitals. "We need a law that simplifies, not complicates, access to abortion care," says Kjersti Augland, Assistant General Manager of Sex og Politikk. "For most women who currently undergo abortion at home after receiving medication from a hospital, direct access through primary healthcare would provide more compassionate and accessible care. The current law particularly disadvantages those living in remote areas, far from hospitals."   A Necessary and Increased Recognition Sex og Politikk supports the proposal to extend self-determination up to the 18th week, including the possibility to reduce the number of fetuses. This represents a necessary acknowledgment of a pregnant woman's right to make independent decisions about her body and life. The new law will effectively allow 98-99% of Norwegian women seeking abortions to make autonomous decisions about their bodies. Additionally, Sex og Politikk welcomes the bill's provisions that strengthen the independent right to be heard for people living with disabilities. The organization also supports the proposal that abortion should never be forced, and the right to complete a pregnancy should be legally protected.   Concerns About Statutory Discrimination Sex og Politikk is critical of the law's wording that it "must ensure respect for unborn life." The organization argues that this clause may impose guilt and shame on women rather than achieving the law’s aim to ensure the pregnant person’s right to decide over their own body without being subject to pressure. The bill also mandates follow-up medical interviews for those who have undergone an abortion. Sex og Politikk views this as statutory discrimination, as it creates unequal treatment between those who have had an abortion, those whose applications have been denied, and those who withdraw their applications. If follow-up rights are to be included, they should be available to all who need them.   Viability Should Not Be a Political Decision   Sex og Politikk also opposes the proposal to legislate a strict 22-week limit for abortion care. The organization argues that viability assessments are complex medical determinations that should be made on a case-by-case basis, not through rigid political decisions. It is inappropriate for politicians to assume the role of healthcare professionals in deciding viability. "The government's proposal is a step in the right direction toward a law that better reflects current realities and needs," concludes Kjersti Augland. "However, we believe the proposal requires revision on several key points." We will continue to follow these developments as the law makes its way through the parliament.   Illustration: Olga Mrozek for IPPF x Fine Acts

Defend The Defenders
12 July 2024

Poland: Sejm fails to ease abortion law and protect women & their families

We are highly disappointed and angered by the vote today in the Sejm, who rejected a bill that would have decriminalised those helping women access abortion care. The bill failed to pass with a margin of only three votes. Members of Parliament voted against the safety, dignity and freedom of Polish women and against their families and loved ones, who can still be prosecuted for helping them access abortion care, together with reproductive rights defenders, and healthcare professionals. Decriminalising abortion assistance and provision would be the bare minimum. Yet Poland remains a country where women are dying because they are denied abortion care and where family and friends need to risk their freedom to help loved ones. Poland continues to be at odds with the rest of Europe. Currently, Poland has one of Europe’s most restrictive abortion laws, with access to care only permitted in situations of risk to the life or health of a pregnant woman, or if a pregnancy results from rape. In practice, however, it is almost impossible for those eligible for a legal abortion to obtain one. Those who help women access abortion care risk a prison sentence of up to three years. Last year, a women's rights advocate, Justyna Wydrzyńska, was convicted for sending self-administered abortion pills to a pregnant woman, a gynecologist was charged with unlawfully assisting patients in obtaining abortion pills, and a man was indicted for helping his partner obtain an abortion. The proposed bill would have completely decriminalised abortion assistance throughout a pregnancy and provision up to the 12th week of pregnancy and also removed penalties for abortion provision in cases of risks for the health or life of the pregnant woman or of a high probability of severe and irreversible fetal defects. Polish elected representatives once again failed to listen to the voice of Polish citizens who are in favour of liberalising abortion care laws. We need to end this terror campaign against those who help women and, ultimately, legalise abortion care and guarantee access for all women who need it. IPPF EN will continue to stand in solidarity with those fighting for reproductive freedom. The fight is not over.

Italy flag
24 April 2024

Italy’s vote to involve anti-abortion actors in counselling violates women’s rights

IPPF strongly condemns yesterday’s vote in the Italian Senate in favour of involving anti-abortion associations in abortion counselling services, family planning centres (consultori) and hospitals.  The recent adoption of a measure allowing anti-abortion activists to enter abortion consultation clinics in Italy is deeply troubling and represents a significant attack on women’s reproductive rights and bodily autonomy. This move undermines the fundamental right to access safe and legal abortion care. By allowing external interference in such intimate healthcare decisions, the Italian government is reinforcing stigma and harming women. The social and psychological implications of this measure create an atmosphere of intimidation and coercion for women seeking reproductive healthcare services. We must prioritise policies that safeguard fundamental rights and foster inclusivity, rather than catering to narrow agendas that undermine reproductive freedoms and social progress. Furthermore, the allocation of EU funds to support measures restricting access to sexual and reproductive health services, including safe and legal abortion, is deeply concerning and runs counter to the principles of equality and fundamental rights enshrined in EU treaties. We strongly condemn any use of EU funds to fund initiatives that infringe upon individuals’ rights to make autonomous decisions about their bodies and health.  This decision runs counter to the objectives of the National Recovery and Resilience Plan. In a recent statement, Veerle Nuyts, European Commission Spokesperson on economic and financial affairs already underlined that the provision concerning abortion does not belong in the Recovery and Resilience Fund. It is alarming that the Italian government is planning to misuse European funds to pay for harmful measures against women.  France has enshrined the right to abortion in its Constitution. The European Parliament voted to include it in the EU Charter of Fundamental Rights and explicitly asked to stop funding anti-gender and anti-choice organisations, and for Member States and local governments to increase their spending on programmes and subsidies to healthcare and family planning services. With yesterday's vote, Italy has done the opposite, underscoring an assault to the fundamental freedoms of millions of women, who have already been drastically affected by the funding cuts and subsequent closure of many family planning centres. We urge the Italian Government to reconsider its stance and prioritise policies that uphold the rights and dignity of all individuals, including comprehensive access to sexual and reproductive health services without discrimination or interference. We urge the EU to ensure the Italian Government cannot use EU funds to violate fundamental rights.   Photo credit: Emma Fabbri, unsplash

france
28 February 2024

France takes major step towards constitutional protection of abortion rights

The International Planned Parenthood Federation congratulates France on its historic vote to enshrine the right to abortion in the Constitution. We are especially proud of the tremendous work and leadership of our French Member Association, Le Planning Familial.  We are now awaiting the final adoption of this constitutional reform by the French Congress, a step that must formally be instigated by French President Emmanuel Macron. 

Medical Abortion
28 September 2023

A year of progress and threats to abortion care: fighting for a future where reproductive freedom is a reality

For women and girls in the European Union, access to safe abortion care is a postcode lottery. A patchwork of policies and legislation shape whether abortion is free, safe, and legal. At the extreme end, a small minority of countries ban abortion in almost all circumstances, with devastating results. Most others allow abortion on a person’s own request or on broad social grounds, at least in the first trimester of pregnancy. But the devil is in the detail, and the detail frequently changes. Many EU countries impose medically unnecessary requirements prior to care, such as compulsory and discouraging counselling and waiting times – going against World Health Organization advice. In 22 out of 27 countries, doctors are still allowed to deny care based on their own personal beliefs – with dire repercussions for access. Hard-won progress can be swiftly unpicked. Issues such as gestational time limits, parental consent, denial of care by medical professionals, and care for rape survivors – among many other issues – remain subject to fierce debate and legislative change. These are debates that wreak havoc upon the lives of women and girls, but also their families. Denial of care is structural violence: in many of the 27 countries of the EU – a region that likes to present itself on the world stage as a model of progressive values – women and girls are harmed physically, emotionally, and mentally by abortion laws and policies, or the failure to uphold them.  International Safe Abortion Day (28 September) is a time to take stock of progress and threats to safe abortion access over the past year. This feature outlines some of the major developments in abortion legislation – good and bad – across the EU since last September. The rise of the right-wing Over the past few decades, the broad move in the EU has been towards liberalising laws around abortion care. Recently, however, the rise of chauvinist right-wing forces and politicians has seen energy and resources flooding into anti-abortion campaigns, fuelling structural violence against women and girls. In Italy, for example, the growing popularity of far-right and right-wing political parties, particularly in northern areas, has emboldened anti-abortion actors and legislators. With this in mind, the following section runs through some of the main policies and laws that harm people by limiting access to abortion care, introduced over the past 12 months – many of them linked to the rise of far-right and right-wing campaigns and networks in Europe and further afield.   The growth of new anti-abortion legislation Until recently, Malta was the only country in the EU to have a total ban on abortion. In June 2022, the government drew up new legislation, triggered by the case of American tourist Andrea Prudente who had to be airlifted to Spain for care after she suffered an incomplete miscarriage because doctors in Malta were banned and unwilling to intervene while foetal cardiac activity could be detected. In the new bill, the government proposed amending the Criminal Code to allow abortions when a woman’s health was at grave risk – hailed as a small but crucial step to improve abortion care access in this staunchly Catholic country. In the final months of 2022, the bill made steady progress through parliament. However, protests by hardline reproductive bullies, who said the bill’s definition of a health risk was too wide, forced the government to back down and introduce amendments. When the legislation was finally approved in June 2023, parliament voted to allow abortion care only when a woman’s life was at risk, and only with the consent of three specialists – a major bureaucratic hurdle. Maltese reproductive rights experts say this new law will put women’s lives even more at risk than the previous status quo. In Hungary, meanwhile, abortion is legal up to 12 weeks on medical grounds or if the woman is in severe crisis. But in September 2022, the country’s far-right government brought in by decree a measure that forces women seeking care to listen to embryonic cardiac activity before accessing healthcare. In response, IPPF European Network stated: “This requirement has no medical purpose and serves only to humiliate women. It will make accessing abortion more burdensome.” The legislation was brought in without public consultation or without hearing from women.

Illustration abortion care: Abortion is Freedom
08 October 2024

Croatia: Obstacles to abortion care make access virtually non-existent

Hitting the road in the desperate search for abortion care For thousands of women and girls in Croatia, getting an abortion involves travelling for hours, even days, across this small but poorly connected country in search of appointments. Whether by ferry, bus, or both, these journeys mark the beginning of an arduous and expensive ordeal – one that piles stress and costs onto people needing an abortion and forces many to leave Croatia altogether. On paper, a very different picture emerges. “By the law, abortion is quite accessible in Croatia,” says Marija Trcol of human rights and civic participation organisation PaRiter. Abortion on request is legal for up to ten weeks, and all public hospitals with obstetrics and gynaecology departments should provide care. But dig a little deeper and the extent of the crisis quickly reveals itself. “Actually there is no hospital with accessible abortion in Croatia,” Marija says. “There’s a really big discrepancy between [law and reality], which is why Croatia is perceived as a state with accessible abortion.” Different factors push people to travel far from home for care – from shortages in medical staff and problems rife within Croatian healthcare overall, to stigma and discrimination attached to abortion in this deeply Catholic country, where the growing influence of the church and chauvinist campaigners is intensifying structural violence against women. Scrutiny of these factors – among others – reveals catastrophic issues within Croatian healthcare and social attitudes to women, and why the struggle for abortion care is increasingly expensive and traumatic. Abortion’s hefty price tag For many people, the first barrier is Croatia’s complex geography: there is no abortion care in the islands or rural communities, and people must travel to mainland cities for appointments. In a nation of islands, mountains, and creakingly slow bus networks, this can be time-consuming and expensive. “It’s a small country but it’s really complicated to [reach] certain hospitals,” says Marija. “Public transport in Croatia is the worst – cities are not well-connected with buses, and it takes half of a day to a whole day just to travel to the hospital.” Ferries are expensive, costing €30-100 one-way. There are also no sick days for abortion care on request: people must book a day off, which can be complicated to arrange and lose you a day or more’s pay. Then there is the price of the abortion itself. Abortions on request are around €300 in public hospitals and up to €800 in private clinics. People with rhesus negative blood must pay an extra €50-80 euros for anti-D injections. Almost everyone has to fund their own care: the state only pays in specific cases of medical indication or rape, and the process for rape cases is deeply flawed, exacerbating trauma. These costs are “a massive chunk of your salary, especially if you are not economically stable, like women in some violent relationships,” says Marija. “For people with low socioeconomic status, I would say it’s impossible.” “The median salary in Croatia is around €900,” and women often work in low paid sectors or roles, she says. The country has a 12% gender pay gap, and 21% of women are at risk of poverty – shooting up to 48% for single women and 32% for single parents.  Many groups face additional cultural or logistical barriers to care. The Roma community has long experienced stigma and discrimination when attempting to access state services, including abortion care, Marija says. People with disabilities are also more vulnerable. “For people who need assistance to go to a doctor, this is something that the state does not provide at all,” she explains. “If you are deaf, for example, I don’t see how you can have an abortion without huge expenses.” These restrictions underline how transformative abortion telemedicine would be in Croatia, where it is currently banned. Croatian abortion law was drawn up in 1978 when abortions were exclusively surgical, meaning lawmakers decreed that procedures must take place in hospital. Fast forward five decades, and millions of people globally now use abortion pills at home in line with WHO guidelines, making abortion cheaper and more accessible, and reducing stigma. Spiralling denial of care One of the most significant barriers is the dramatic fall in the number of doctors and hospitals providing abortion care. ‘Conscientious objection’ – the practice of refusing to provide care on grounds of personal beliefs – lies at the crux of this crisis, as in many European countries. Since being legalised in 2003, it is now “normalised”, Marija says. The law doesn’t just apply to gynaecologists: any member of an abortion care team can invoke it, and a procedure will be cancelled if most of the team object, Marija explains. Even if no one objects, senior management can stop procedures going ahead, and hospital managers have sometimes fired staff for providing abortions, Marija says. This has had a catastrophic impact. By 2018, 59% of health workers were refusing to provide abortions. According to recent research by the gynaecologist Jasenka Grujić, there are now two hospitals in Croatia where all staff refuse to provide abortion care, 12 hospitals where 50-100% of staff refuse, and 9 hospitals where 1-49% of staff refuse.  Another problem is that “there is no regulation of denial of care in hospitals at a state level at all,” Marija says. For example, hospitals should ensure there is always at least one team available to provide abortions, but currently there is no government pressure on them to do this, she explains. Many abortion facilities are only open a few hours a day, a few days a week, and certain gynaecologists have become so notorious for being “really harsh to women” that people avoid them altogether. Forced to travel abroad for care A notorious case from 2022 reveals how doctors use denial of care and evasion to suppress reproductive justice. Mirela Čavadja was in the 24th week of pregnancy when doctors told her the fetus was unlikely to survive. Every hospital she contacted in Zagreb refused to provide abortion care – some citing ‘conscientious objection’, others saying “they were not equipped with knowledge and equipment to perform this kind of abortion, although by law this needs to be accessible in Croatia,” Marija explains. Finally, Mirela had to go to Slovenia for an abortion – a familiar path for women with medical indication in later pregnancy. Marija says doctors frequently tell such women to travel to Slovenia and foot the €5,000 bill themselves, despite the state being legally obligated to reimburse costs if Croatia lacks capacity to deliver care when it is medically indicated. This is yet another example of doctors participating in reproductive violence against women. Women at different stages of pregnancy also travel to Bosnia and Herzegovina or as far afield as the Netherlands to access abortion care – a shocking indictment of the state of abortion care coverage in Croatia Dearth of data The lack of data on abortion coverage exacerbates the struggle for appointments. Hospitals are supposed to send annual data reports to the Institute of Public Health, but there are no sanctions if they don’t and no way to find out if reporting is accurate, Marija says. Many hospitals say they provide abortion care, “and then the woman comes and they won’t do it,” she explains.  For women's rights activists, unreliable data seriously hampers their work. For women and girls, it means they can spend hours ringing around trying to get appointments, or turn up for an appointment and be turned away. “So this is something that we are going to campaign for – give us the true data and please give us the list of teams who are doing the abortions.” Data leaks linked to abortion stigma  The leaking of confidential patient data by medical staff to “shame” women who have had abortions is another serious problem – and yet another reason why women seek care far from home, Marija says. “If you live in a smaller place, then you sometimes choose to travel to a big city, because even if care is accessible, there’s a big chance of data being leaked and the whole place will know that you had an abortion,” she explains. Such leaks are illegal but completely normalised, and “there are no sanctions.” Even government ministers are involved: in the uproar following Mirela Čavadja’s case, the minister of health – himself a doctor – “went public with all of [Mirela’s] medical data” to the media. He remains in post. Misogynistic networks target abortion Growing links between anti-abortion actors, politicians, the church, the far right, and healthcare providers are a major threat to abortion care in Croatia. Since the breakup of Yugoslavia in the early 1990s, the power of the Catholic church has surged. “The church has a really big influence on politics and on the health system regarding reproductive health,” Marija says. With the entry of the far-right Homeland Movement into coalition government in April, Croatia’s government has shifted further right, and many in government have strong ties with the church and the growing anti-gender movement, Marija adds. She explains that different groups – including the ultraconservative Poland-linked ‘kneelers’, and ‘40 Days for Life’ abortion clinic picketers – target people providing or accessing abortion care, and are often backed by the church or global networks. The ‘kneelers’ are so entrenched that “they’re now part of the government,” Marija says. Women’s rights activists have been mobilising in response, including by calling for criminalisation of harassment of women seeking abortion care, but the threat remains dire, calling for massive, united efforts by campaigners. Mobilising to protect women This brings us back to the perception gap. Public support for abortion care is high at 65-75%, but this is a “quiet majority”, which hasn’t yet recognised the threats facing abortion access, Marija says. To galvanise people to speak up, campaigners need to expose gaps between perceptions and reality – and this calls for more trustworthy data. With this in mind, PaRiter is running a survey on abortion access and hopes that “through the next two years we’ll have established some kind of independent monitoring system on abortion,” with the support of other feminist organisations, within their capacities and means.   PaRiter is also scrutinising contradictions between Croatia’s stance on women’s rights and its European and international commitments, and plans to report yearly on findings. Despite the government’s shift rightwards, Marija says “our hope is that they are still going to want to look good in the EU’s eyes” and so constrain attacks on women’s rights, but “they are signing things like there is no tomorrow and are not doing anything to make things better.” Given the formidable forces lining up to attack women’s rights, civil society networks (national, regional and global) must work together to protect women’s rights, Marija says. For example, the Croatian coalition for My Voice, My Choice, a European citizens’ initiative calling for a financial mechanism to guarantee safe abortion access in the EU, has done a “fantastic job,” mobilising huge public support for safe abortion access, now and for generations to come. ***   Words by Imogen Mathers for IPPF EN Illustration by Alissa Thaler for IPPF EN   This content is funded by the European Union through the Citizens, Equality, Rights and Values Programme. Disclaimer: Views and opinions expressed are those of IPPF EN and do not necessarily reflect those of the European Union or the European Commission. Neither the European Union or the European Commission can be held responsible for them. 

Poland PWS
03 October 2024

Poland: Acquittal of women's rights defenders a relief, but the trial was unjust

Three Polish feminists on trial for pro-abortion protests have been found not-guilty. Although positive news, this is not a complete win for activists around the world. Marta Lempart, Klementyna Suchanow and Agnieszka Czerederecka-Fabin - three leading women’s rights defenders from the Polish Women's Strike were facing eight years in prison in Poland for exercising their right to peaceful protest. At today’s trial they were found not guilty. Though the not guilty verdict is a relief, we can’t ignore the fact that this trial never should have happened in the first place. These women’s rights defenders were unfairly targeted because of their work, with the prosecution attempting to use the courts as a tool of intimidation. Defending reproductive rights is not a crime. It is deeply troubling that they were subjected to a sham trial that not only robbed them of time, energy and money, but also affected their mental well-being. Cases like this are designed to silence activists. They are a dangerous attack on fundamental human rights and democratic values.     In future, we urge the Polish government, and all governments, to focus on protecting rights, not prosecuting those who defend them.   Marta Lempart said "I'm looking forward to going back to work. Thank you for all the solidarity from the international community."

WHRDs
01 October 2024

Polish Women's Strike protests’ organizers on trial

Date: 3.10.2024 Time: 12.00 Courtroom: 224 Location: District Court in Warsaw, Solidarności 127 Press briefing after the verdict.   The criminal case against Polish Women's Strike pro abortion protests’ (2020) leaders is finally coming to an end in the District Court in Warsaw, Poland. Marta Lempart, Agnieszka Czerederecka and Klementyna Suchanow are charged under Article 165 of the Penal Code (endangering the public by organizing protests)  and Women's Strike leader Marta Lempart is additionally charged under Article 226 and Article 255 of the Penal Code. All three women face up to 8 years in prison. The announcement of the verdict will take place on October 3rd at noon in the District Court in Warsaw at 127 Solidarności Avenue (room: 224). This date is significant and symbolic for the entire movement that the Polish Women's Strike is. It was on October 3rd, 2016 that the Women's Strike organized the first mass protests in Poland in defense of abortion rights, which went down in history as Black Monday. At that time, women took to the streets of more than 160 cities and towns dressed in black in protest against the tightening of abortion law in Poland. On the 8th anniversary of the first Polish Women’s Strike protest (2016), activists will hear the verdict for their involvement in the 2020 100-days stress protests, brutally suppressed by the state police and secret services. It will be a verdict for their years of fighting in the streets, for the many days and nights spent protesting, in police cauldrons and in police detention. Judgment for their courage and determination, for their eyes burning with pain from the police gas, for their arms broken during the demonstrations, their spines physically damaged from the police batons. The judgment will therefore be symbolic not only for the anniversary of the Women's Strike, but above all for the fight for women's rights in contemporary Poland. The verdict will show which way we are heading - towards the shameful direction of maternity wards where women are dying, or towards the civilized part of Europe. Marta Lempart: Please be with us on that day. It is important that not only we, but also others who are still being dragged through the courts, know that they are not walking alone. Whatever happens this October 3rd or afterwards. See you there!   Media contact: +48 577 099 077 Marta Lempart [email protected]

Illustration: End obstacles to abortion care
27 September 2024

Germany's archaic abortion law creates huge burden for people needing care

For a country long reputed to have one of the more progressive healthcare systems in Europe, Germany’s law on abortion – a health issue affecting millions of people – remains firmly stuck in the past. “The law has negative impacts, and [these] are not accidental side-effects that need to be adjusted – they’re intentional,” says Stephanie Schlitt, board member of Pro Familia, an SRHR counselling and advocacy organisation and IPPF’s German Member Association. “By compelling women to do certain things, the law enforces abortion stigma.” Germany’s archaic law has a long and messy past, in which the trampling of women’s rights to reproductive justice has been a common thread. Abortion has been criminalised since 1871 and remains punishable with prison sentences for those obtaining and providing abortions (though prosecutions are rare). Exceptions are made up to 12 weeks of pregnancy under strict conditions, or where there is a medical necessity, or in cases of rape. The state’s longstanding treatment of abortion as a criminal rather than health issue has devastating repercussions. For people needing abortions, strict legislation makes accessing care a fraught process, involving high costs, complex paperwork, fear of criminalisation, and stigma. For doctors, the legal red tape, threat of prosecution, and growing harassment by anti-rights campaigners create “a huge disincentive for the provision of care”, Stephanie says. “What’s happening here simply isn’t good enough, because it goes completely against the needs of the people concerned and those who want to support them professionally – doctors and counsellors,” Stephanie says. “We can’t be surprised if, as a result of this law, [abortion] healthcare provision is difficult. Of course it will be – it’s geared towards making it difficult.” Outdated laws crush women’s rights    “Some of the barriers flow directly from the law as it’s framed, and some flow from the practice that results from that law,” Stephanie explains. Firstly, people seeking abortion care must undergo mandatory counselling at state-certified centres or online, and receive a certificate to present to their gynaecologist. Following counselling, there is a mandatory and medically unnecessary three-day waiting period – a delay that can affect treatment options for such a time-critical procedure and exacerbate stress. Making counselling a legal requirement creates difficult conditions for counsellor and client, Stephanie explains. Women “feel under pressure to justify themselves” during an already stressful period, while for counsellors, these conditions are “a huge burden because counselling should only happen on a voluntary basis.” Mandatory counselling and waiting periods contravene World Health Organization (WHO) advice on abortion care, and Germany is one of the few EU countries to impose both. “The point is that this law creates hurdles to good healthcare and actually makes the whole experience much more difficult than it needs to be,” Stephanie says. “An abortion needn’t be so emotionally, financially and socially burdensome.”

Illustration abortion care: Leave no one behind
28 September 2024

High costs and broken health system freeze many out of abortion care in Romania

On paper, abortion care is legal up to 14 weeks in Romania – though only free in emergencies – and should be provided by all hospitals with obstetrics and gynaecology departments. The reality is very different. Abortion care is increasingly expensive, provided by fewer and fewer clinics, involves a labyrinth of red tape, and tends only to be available in cities. “Today, we are in the worst-case scenario [seen] in recent years,” says Gabriel Brumariu, director of SECS, IPPF’s Romanian Member Association. In the 1990s and 2000s, abortion care had rapidly improved in Romania. The post-Communist government had inherited a brutal system for women and children – a near-total ban on abortion and contraception between 1966 and 1989 had brought devastating repercussions. Following the 1989 revolution, the new government swiftly legalised abortion up to 14 weeks, and introduced free contraception (though this ended unexpectedly in 2013). This progress is now being destroyed at pace, Gabriel says. Many factors are making abortion care more expensive and less accessible – including cuts to sexual and reproductive health and rights (SRHR) programmes, clinic closures, and a slump in the number of doctors willing to perform procedures. Overall, the country’s health system is crumbling, and women are particularly vulnerable. Evidence has emerged of people dying after being denied access to obstetric care, and the maternal mortality rate rose by 183% between 2018 and 2022 – “inconceivable” for an EU state, Gabriel says. And, with the far right on the march in Romania and European donor states, often bankrolled by US anti-rights campaign groups, the rights of women are under severe attack. Exorbitant costs For many in Romania, the high price tag for abortion puts it out of reach – and prices are rising fast year on year. In public hospitals, abortions on request cost around $200-300; in private clinics, between $250-1000. These prices are “a huge proportion of a monthly salary,” says Gabriel, and in some cases exceed it. The new national monthly minimum wage is 3,700 Romanian lei (RON) – around US$812, before tax and deductions of over 40%. Women’s median monthly salary is $582.24 net, with higher salaries concentrated in cities. For undocumented migrants, day workers, and those working without legal papers, salaries are much lower, at around US$300 per month, Gabriel explains.   Rural communities left high and dry Other costs swiftly stack up: on top of treatment costs, people often have to travel hundreds of kilometres to access care, partly because many rural clinics have shut down. Almost half (44.8%) of Romania’s 19 million population live in rural areas. For these communities, accessing abortion care requires cash for transport, accommodation, childcare, time off work – the list goes on. Repeat visits further drive up costs, and, unlike several other European countries, Romania does not allow abortion telemedicine for medical abortions (pills taken at home) at all.  As a result, abortion on request is becoming the preserve of wealthier, urban communities, says Gabriel: “Of course, the ones that have money will [be able to] access abortion [...] in a private clinic. But if you are from a marginalised community, it’s almost impossible for you.” Women on the fringes Some of the most marginalised people in Romania include the country’s 2 million-strong Roma community. Abortion access for the Roma is fraught, with geography and income playing a role here too: Roma people’s salaries tend to be far lower than average, and they often live in segregated areas on the geographical and cultural fringes of mainstream Romanian society. These barriers intersect with systemic racism, classism, and entrenched stigma towards the community from medical staff, as our recent interview with Roma feminist organisation E-Romnja explains in detail.   The approximately 77,900 Ukrainian refugees living in Romania are another group facing barriers to abortion care. Access is now so limited that “some of them prefer to go in a country at war because it’s easier in Ukraine to access abortion than in Romania,” Gabriel says. A 2023 report by the Centre for Reproductive Rights found that being unable to get appropriate care pushes many refugees to pursue unsafe avenues or return to Ukraine to access abortion. Gabriel says funding for care has dried up: SECS used to receive humanitarian funding to support Ukrainian refugees to access abortion, but “now, all the funds for Ukrainians disappeared […] and we don’t have funds to pay for Romanian people or Ukrainian refugees.” Public hospitals failing mandates One major factor cutting abortion access is the increasing refusal of doctors to provide care in public hospitals, Gabriel explains. Many doctors work in both public and private practice, but “tend to take their patients to private clinics because they earn a lot of money by doing … an abortion [there],” he says. “There are counties [...] which offer zero chance [of abortion] in public hospitals.” The data reveals a crisis spiralling downwards fast. In 2019, research by the Black Sea found that 60 of 190 public hospitals contacted did not offer abortions. The COVID-19 pandemic made a bad situation worse: only 12 of 112 public hospitals (11%) contacted by women's rights organisation Centrul Filia in 2020-2021 provided abortion on request. In 2021, an investigation by Romanian media revealed that 11 out of 42 Romanian counties provided no abortion on request, with 62% of such procedures taking place in private clinics. In 2023-2024, a telephone survey by the Independent Midwives Association found that over 80% of public clinics do not offer abortion services, while 90% refuse to refer women to another clinic on request, despite being required to by the medical ethics code.   The increasing use of ‘conscientious objection’ laws that allow doctors to refuse care has also hit numbers of care providers. Data from Centrul Filia revealed that 70 out of 136 public hospitals use these laws as a basis for refusing to perform abortions. Doctors who refuse care are supposed to refer patients to another doctor or hospital, but often the personnel and infrastructure simply isn’t there, Gabriel says. Some doctors refuse to provide care in public hospitals on ‘conscience’ grounds but then offer the service privately, for a much higher fee. Chauvinist forces attack rights by stealth Many different groups are fomenting anti-abortion sentiment, Gabriel explains. As in other EU countries, abortion is a key battleground issue for Romania’s growing far right – “a more extreme far right party that’s bigger now and more powerful.” Meanwhile, ultra-conservative lobbying groups and evangelical Christian groups, often with US backing, have been consolidating influence on political parties, policies, and grassroots services. They often work covertly because public support for abortion is strong, Gabriel explains. Rather than pushing for a referendum on abortion and “making waves” – likely leading to public “revolt” – they focus on gaining political traction, influencing doctors, and lobbying for reducing gestational limits for abortion. Another tactic is to target women at the grassroots. ‘Pregnancy crisis centres’ run by Christian organisations – often with US links – are springing up across the country, often embedding themselves in public services, with the aim of dissuading women from having abortions. Romania’s powerful orthodox church – particularly strong in rural areas – is also a strong force opposing abortion. Far right influence also threatens SRHR organisations like SECS, Gabriel says. Such NGOs receive no government funding but rely on European donors and international organisations like IPPF, within an SRHR funding landscape that is already very constrained. Gabriel worries that if major European donor governments lurch rightwards, it will further diminish funding for SRHR and abortion care programmes in countries in east and southern Europe. Working together to protect future generations Fighting to protect and advance women’s rights within such an embattled landscape calls for strong partnerships, Gabriel says: “The most effective ways [for ensuring abortion access] are the advocacy interventions done by the civil society, united.” SECS is focusing on reviving an NGO advocacy platform that worked very hard to defeat the country's 2018 anti-LGBTI referendum. Such networks allow organisations to divvy up responsibilities and work strategically towards common goals. Through this “united” approach, SECS and partners plan to run robust campaigns backed by the collection and analysis of better data (currently, public data on many SRHR issues is often poor or non-existent). Working together, the focus is to mobilise public opinion, protect “good laws”, push for legislative change, and “facilitate real access to abortion services all around the country.” For example, SECS is currently pushing for the legalisation of abortion telemedicine, to make care more affordable and accessible to thousands of people – particularly those in remote rural areas, hundreds of kilometres from clinics – in the challenging years ahead. *** Words by Imogen Mathers for IPPF EN Illustration by Alissa Thaler for IPPF EN   This content is funded by the European Union through the Citizens, Equality, Rights and Values Programme. Disclaimer: Views and opinions expressed are those of IPPF EN and do not necessarily reflect those of the European Union or the European Commission. Neither the European Union or the European Commission can be held responsible for them. 

abortion is self care
27 August 2024

New Law in Norway Highlights Inequities in Abortion Access

The Norwegian government has proposed a new bill extending self-determined abortion rights from 12 weeks up to the 18th week. If the bill is passed by the Norwegian Parliament, it will mark a significant victory for sexual rights in Norway. However, this right will not be equally accessible across the country. Sex og Politikk, the Norwegian Member Association of IPPF, asserts that viability should not be a political decision and that respect for human life cannot be legislated. Sex og Politikk has been actively engaged in discussions on the new abortion law since the Government established a committee in 2022 to look into the country’s almost 50 year old abortion legislation. The organization has participated in a separate committee of feminist NGOs, closely following the development of the law and contributing to the debate. This month, Health and Care Minister Jan Christian Vestre and the government introduced proposals for a new abortion law. While welcoming this milestone in the fight for sexual and reproductive health and rights (SRHR), Sex og Politikk argues that the proposal needs revision on key points. Just three years ago, few would have anticipated a new abortion law in Norway. The government's proposal represents progress, but it also reveals significant weaknesses from an SRHR perspective. The law remains entrenched in outdated beliefs that abortions should only be conducted at regional hospitals. In reality, most abortions today are performed at home with medication, not through surgical interventions. Despite this, the government's proposal still limits abortion care to specialist healthcare providers, even as it calls for further investigation into the role of primary healthcare in offering abortion care. This limitation complicates access to abortion, especially for those living far from hospitals. "We need a law that simplifies, not complicates, access to abortion care," says Kjersti Augland, Assistant General Manager of Sex og Politikk. "For most women who currently undergo abortion at home after receiving medication from a hospital, direct access through primary healthcare would provide more compassionate and accessible care. The current law particularly disadvantages those living in remote areas, far from hospitals."   A Necessary and Increased Recognition Sex og Politikk supports the proposal to extend self-determination up to the 18th week, including the possibility to reduce the number of fetuses. This represents a necessary acknowledgment of a pregnant woman's right to make independent decisions about her body and life. The new law will effectively allow 98-99% of Norwegian women seeking abortions to make autonomous decisions about their bodies. Additionally, Sex og Politikk welcomes the bill's provisions that strengthen the independent right to be heard for people living with disabilities. The organization also supports the proposal that abortion should never be forced, and the right to complete a pregnancy should be legally protected.   Concerns About Statutory Discrimination Sex og Politikk is critical of the law's wording that it "must ensure respect for unborn life." The organization argues that this clause may impose guilt and shame on women rather than achieving the law’s aim to ensure the pregnant person’s right to decide over their own body without being subject to pressure. The bill also mandates follow-up medical interviews for those who have undergone an abortion. Sex og Politikk views this as statutory discrimination, as it creates unequal treatment between those who have had an abortion, those whose applications have been denied, and those who withdraw their applications. If follow-up rights are to be included, they should be available to all who need them.   Viability Should Not Be a Political Decision   Sex og Politikk also opposes the proposal to legislate a strict 22-week limit for abortion care. The organization argues that viability assessments are complex medical determinations that should be made on a case-by-case basis, not through rigid political decisions. It is inappropriate for politicians to assume the role of healthcare professionals in deciding viability. "The government's proposal is a step in the right direction toward a law that better reflects current realities and needs," concludes Kjersti Augland. "However, we believe the proposal requires revision on several key points." We will continue to follow these developments as the law makes its way through the parliament.   Illustration: Olga Mrozek for IPPF x Fine Acts

Defend The Defenders
12 July 2024

Poland: Sejm fails to ease abortion law and protect women & their families

We are highly disappointed and angered by the vote today in the Sejm, who rejected a bill that would have decriminalised those helping women access abortion care. The bill failed to pass with a margin of only three votes. Members of Parliament voted against the safety, dignity and freedom of Polish women and against their families and loved ones, who can still be prosecuted for helping them access abortion care, together with reproductive rights defenders, and healthcare professionals. Decriminalising abortion assistance and provision would be the bare minimum. Yet Poland remains a country where women are dying because they are denied abortion care and where family and friends need to risk their freedom to help loved ones. Poland continues to be at odds with the rest of Europe. Currently, Poland has one of Europe’s most restrictive abortion laws, with access to care only permitted in situations of risk to the life or health of a pregnant woman, or if a pregnancy results from rape. In practice, however, it is almost impossible for those eligible for a legal abortion to obtain one. Those who help women access abortion care risk a prison sentence of up to three years. Last year, a women's rights advocate, Justyna Wydrzyńska, was convicted for sending self-administered abortion pills to a pregnant woman, a gynecologist was charged with unlawfully assisting patients in obtaining abortion pills, and a man was indicted for helping his partner obtain an abortion. The proposed bill would have completely decriminalised abortion assistance throughout a pregnancy and provision up to the 12th week of pregnancy and also removed penalties for abortion provision in cases of risks for the health or life of the pregnant woman or of a high probability of severe and irreversible fetal defects. Polish elected representatives once again failed to listen to the voice of Polish citizens who are in favour of liberalising abortion care laws. We need to end this terror campaign against those who help women and, ultimately, legalise abortion care and guarantee access for all women who need it. IPPF EN will continue to stand in solidarity with those fighting for reproductive freedom. The fight is not over.

Italy flag
24 April 2024

Italy’s vote to involve anti-abortion actors in counselling violates women’s rights

IPPF strongly condemns yesterday’s vote in the Italian Senate in favour of involving anti-abortion associations in abortion counselling services, family planning centres (consultori) and hospitals.  The recent adoption of a measure allowing anti-abortion activists to enter abortion consultation clinics in Italy is deeply troubling and represents a significant attack on women’s reproductive rights and bodily autonomy. This move undermines the fundamental right to access safe and legal abortion care. By allowing external interference in such intimate healthcare decisions, the Italian government is reinforcing stigma and harming women. The social and psychological implications of this measure create an atmosphere of intimidation and coercion for women seeking reproductive healthcare services. We must prioritise policies that safeguard fundamental rights and foster inclusivity, rather than catering to narrow agendas that undermine reproductive freedoms and social progress. Furthermore, the allocation of EU funds to support measures restricting access to sexual and reproductive health services, including safe and legal abortion, is deeply concerning and runs counter to the principles of equality and fundamental rights enshrined in EU treaties. We strongly condemn any use of EU funds to fund initiatives that infringe upon individuals’ rights to make autonomous decisions about their bodies and health.  This decision runs counter to the objectives of the National Recovery and Resilience Plan. In a recent statement, Veerle Nuyts, European Commission Spokesperson on economic and financial affairs already underlined that the provision concerning abortion does not belong in the Recovery and Resilience Fund. It is alarming that the Italian government is planning to misuse European funds to pay for harmful measures against women.  France has enshrined the right to abortion in its Constitution. The European Parliament voted to include it in the EU Charter of Fundamental Rights and explicitly asked to stop funding anti-gender and anti-choice organisations, and for Member States and local governments to increase their spending on programmes and subsidies to healthcare and family planning services. With yesterday's vote, Italy has done the opposite, underscoring an assault to the fundamental freedoms of millions of women, who have already been drastically affected by the funding cuts and subsequent closure of many family planning centres. We urge the Italian Government to reconsider its stance and prioritise policies that uphold the rights and dignity of all individuals, including comprehensive access to sexual and reproductive health services without discrimination or interference. We urge the EU to ensure the Italian Government cannot use EU funds to violate fundamental rights.   Photo credit: Emma Fabbri, unsplash

france
28 February 2024

France takes major step towards constitutional protection of abortion rights

The International Planned Parenthood Federation congratulates France on its historic vote to enshrine the right to abortion in the Constitution. We are especially proud of the tremendous work and leadership of our French Member Association, Le Planning Familial.  We are now awaiting the final adoption of this constitutional reform by the French Congress, a step that must formally be instigated by French President Emmanuel Macron. 

Medical Abortion
28 September 2023

A year of progress and threats to abortion care: fighting for a future where reproductive freedom is a reality

For women and girls in the European Union, access to safe abortion care is a postcode lottery. A patchwork of policies and legislation shape whether abortion is free, safe, and legal. At the extreme end, a small minority of countries ban abortion in almost all circumstances, with devastating results. Most others allow abortion on a person’s own request or on broad social grounds, at least in the first trimester of pregnancy. But the devil is in the detail, and the detail frequently changes. Many EU countries impose medically unnecessary requirements prior to care, such as compulsory and discouraging counselling and waiting times – going against World Health Organization advice. In 22 out of 27 countries, doctors are still allowed to deny care based on their own personal beliefs – with dire repercussions for access. Hard-won progress can be swiftly unpicked. Issues such as gestational time limits, parental consent, denial of care by medical professionals, and care for rape survivors – among many other issues – remain subject to fierce debate and legislative change. These are debates that wreak havoc upon the lives of women and girls, but also their families. Denial of care is structural violence: in many of the 27 countries of the EU – a region that likes to present itself on the world stage as a model of progressive values – women and girls are harmed physically, emotionally, and mentally by abortion laws and policies, or the failure to uphold them.  International Safe Abortion Day (28 September) is a time to take stock of progress and threats to safe abortion access over the past year. This feature outlines some of the major developments in abortion legislation – good and bad – across the EU since last September. The rise of the right-wing Over the past few decades, the broad move in the EU has been towards liberalising laws around abortion care. Recently, however, the rise of chauvinist right-wing forces and politicians has seen energy and resources flooding into anti-abortion campaigns, fuelling structural violence against women and girls. In Italy, for example, the growing popularity of far-right and right-wing political parties, particularly in northern areas, has emboldened anti-abortion actors and legislators. With this in mind, the following section runs through some of the main policies and laws that harm people by limiting access to abortion care, introduced over the past 12 months – many of them linked to the rise of far-right and right-wing campaigns and networks in Europe and further afield.   The growth of new anti-abortion legislation Until recently, Malta was the only country in the EU to have a total ban on abortion. In June 2022, the government drew up new legislation, triggered by the case of American tourist Andrea Prudente who had to be airlifted to Spain for care after she suffered an incomplete miscarriage because doctors in Malta were banned and unwilling to intervene while foetal cardiac activity could be detected. In the new bill, the government proposed amending the Criminal Code to allow abortions when a woman’s health was at grave risk – hailed as a small but crucial step to improve abortion care access in this staunchly Catholic country. In the final months of 2022, the bill made steady progress through parliament. However, protests by hardline reproductive bullies, who said the bill’s definition of a health risk was too wide, forced the government to back down and introduce amendments. When the legislation was finally approved in June 2023, parliament voted to allow abortion care only when a woman’s life was at risk, and only with the consent of three specialists – a major bureaucratic hurdle. Maltese reproductive rights experts say this new law will put women’s lives even more at risk than the previous status quo. In Hungary, meanwhile, abortion is legal up to 12 weeks on medical grounds or if the woman is in severe crisis. But in September 2022, the country’s far-right government brought in by decree a measure that forces women seeking care to listen to embryonic cardiac activity before accessing healthcare. In response, IPPF European Network stated: “This requirement has no medical purpose and serves only to humiliate women. It will make accessing abortion more burdensome.” The legislation was brought in without public consultation or without hearing from women.