Articles about Abortion Care

This year, Belgium marks the 25th anniversary of its legalisation of abortion. At a conference on abortion stigma on 3 April, IPPF EN’s Regional Director, a Belgian and former activist for that legal breakthrough, reflected on the historical journey towards abortion rights in Belgium, and the current state of play more broadly. Photo credit: Fonds La Cité collection Carhop By Vicky Claeys I really believe that Belgians can be proud of their ethical achievements. Our country has strong Catholic origins, but we have taken big legislative steps forward because society has been ready for change. At the moment we are one of the leading countries on same-sex marriage and euthanasia, and we have a workable abortion law which ensures – crucially for women - that abortions are fully reimbursed by the social security system. Along with the Netherlands, Belgium is one of the countries in the world with the lowest abortion rates AND with one of the lowest rates of teenage pregnancies. I don’t think it’s because sexuality education here is perfect, but we do we have a high level of modern contraceptive use, and of course we have a good functioning system on abortion. The story of how Belgium built the momentum needed for abortion to be legalised illustrates that illegal abortion does not always need to mean unsafe (although in most parts of the world it is!). On the other hand, we also know that legal does not always mean safe, for example in Russia where abortion is legal but women are still dying from unsafe practices. IPPF truly believes that safe and legal abortion, comprehensive sexuality education and access to modern contraceptives are the ingredients for healthy nations where women are able to finish education, have a healthy family, work and contribute to the economy, to be active citizens. Belgium’s long road to an abortion law Astonishingly, abortion is still mentioned in the Belgian Penal Code. This hangover from Napoleonic times, when it was totally illegal, is confusing in today’s context, and contributes to ongoing abortion stigma because it means it is still considered as crime rather than a health issue. There was a first attempt to change the law in 1971, and a medical doctor – Dr Willy Peers - was jailed for the first time for performing an abortion in 1973. Peers’ patient was a 16 year old girl with learning disabilities who had been raped by her father. This very sad case resulted in a big public reaction, a lot of debate and protests. It was not enough to force a change in the abortion legislation, but formed the basis for a trade-off to make contraception legal. It’s amazing to think that this was only 42 years ago, even if it was “in the past century,” as journalists tend to say these days! In 1975 the first of many high quality – but completely illegal - abortion centres was established. Belgium’s Ministry of Justice took no action in the hope that Parliament would update the legislation to bring it in line with the reality of life in the country.  But this did not happen quickly enough and from 1981 we saw a wave of prosecutions as judges decided to apply the law again in the hope that this would create a sense of urgency with the legislators. For medical professionals and the women they were there to help, this meant the start of 9 years of stress and despair channelled through fury and protests. In 1985, when the practice was still illegal, as head of the network of family planning clinics in Flanders (Federation CGSO), I started overseeing coordination between the Flemish abortion centres as they  worked together to ensure high quality standards throughout the system. The centres’ approach was always to place the women seeking an abortion at the centre of their work. This resulted in a “human rights-based approach” before the term was invented! Then in 1986, two MPs took a new initiative which led, after 4 long years of negotiations and compromise-seeking between the Catholics and Humanists, to a proposal for an abortion law. I’ll always remember how in March 1990 we thought we had finally got the change we had been fighting for, and then… the King famously refused to sign the Parliamentary agreement because of his conscientious objection. This caused a mini constitutional crisis to which then Prime Minister Wilfried Martens (a Christian Democrat!) had to find a solution. In the end, the King was asked to step down for the day to allow the Minister to sign. A couple of years later I was invited to speak to women’s rights activists in Ireland, and it was only then that I realised how exceptional it was to have had for so many years people who had put their careers on the line and risked prosecution because they believed that what they were doing was right. There are many of them, and all Belgian women, in particular the younger ones, should be aware of this history and know that the options they have today are the result of a long and relentless battle. This shows the importance of civil movements, building up pressure from within society to make politicians move in the right direction and bring legislation in line with new realities. Many battles still to be fought around the world Still today, no issue is as politicized and polarised as abortion, sexuality education, contraception, gender equality and women’s rights in general. We have a constant fight in countries like Spain and also at the EU level, at the Council of Europe and the United Nations. Good abortion legislation can easily be turned back as we are seeing in the US and in Eastern Europe, and with the ongoing threats in Spain. The anti-choice movement is becoming increasingly virulent and well organised, which is a big change from the past. According to the World Health Organisation, every year in the world there are an estimated 40-50 million abortions. This corresponds to approximately 125,000 abortions per day. 47,000 women die each year of unsafe abortion. We know and everybody knows perfectly well how to reduce the burden of abortion and especially the related morbidity and mortality: sexuality education, modern contraceptives and in general a positive attitude towards sexuality and a respect for human rights. The solutions are there but the political will is lacking in too many places, in particular where governments are implementing pro-natalist policies and/or where churches have a strong influence. So, let’s be clear about some facts. Abortion is a family planning method, although not the most desirable one. Improving sexuality education and increasing the use of modern contraceptives are necessary measures that will help reduce but will not erase abortion. Abortion is a fact of life and will always be there, recognizing this will reduce stigma. Also, while keeping track of abortion rates is important to monitor what is happening in society and, for instance, to increase prevention/information for certain groups of the population, these figures should not be the sole basis for discussions on how well a country is doing in responding to women’s need when she has an unwanted pregnancy. The question on how to reduce the stigma still attached to abortion as well for women and practitioners is important at this 25th anniversary of Belgium’s abortion law. There are a couple of changes that would certainly help in reducing stigma. Getting abortion out of the Penal Code would be a major one, as still today there are too many people who think abortion is illegal in Belgium. Extending the timeframe for abortion on demand would be very helpful as it would reduce the burden on the roughly 500 women who have to travel to the UK or The Netherlands every year because they are beyond the legal time frame of 12 weeks in Belgium. This is just exporting a problem to neighbouring countries. Belgium is on the right track, but having a government that would embrace this fact of life openly and a parliament that would introduce the necessary changes would definitely reduce stigma. I hope that official recognition of the ground-breaking work done by pioneers “last century”, as well as the broad media coverage this anniversary is getting, are paving the way for adjustments to make the law even better for women who need an abortion.

Every day, everywhere women have abortions. In fact, one in three women will have an abortion in their lifetime. Your sister, mother, daughter, partner, friend. Yourself. However, many countries around the world continue to restrict access to safe and legal abortion. Globally, 66 countries either prohibit abortion entirely or permit it only to save a woman's life. Approximately one quarter of the world's population resides in these countries. Too many women still do not have autonomy over their reproductive lives, and are not able to choose to end an unwanted pregnancy under safe conditions with the support of a trained provider. That is why on September 28, the Global Day of Action for Access to Safe and Legal Abortion, IPPF will join with partners across the world to call for universal access for safe and legal abortion. In our region, from Skopje to Stockholm, Tirana to Dublin, our Member Associations are marking the day with activities ranging from press conferences, advocacy workshops, public debates organised by youth activists and short movie launches to providing information and education materials to schools; dedicated social media campaigns; clinic open day with free sexual and reproductive health services, and appearing in newspapers and TV documentaries to make the case for safe and legal abortion. Criminalising abortion does not reduce the number of abortions, all it does is push abortion underground and rates of unsafe abortion increase. In fact, the lowest abortion rates in the world are in regions with some of the most liberal legal frameworks for the provision of abortion services. A woman’s right to safe, legal abortion is under threat in Europe too. The abandoning this week of a regressive anti-abortion bill in Spain is a step in the right direction and an illustration of what can be achieved through the joint action of civil society organisations. But the fact remains it should never have been on the legislature’s books in the first place. It shows that rights can be rolled back at anytime, anywhere. The women who suffer as a consequence of restrictive laws are not just numbers. Each woman who seeks an abortion does so under a unique set of circumstances. IPPF has produced a series of short films to tell the stories of some of these women. Women like Juliette from France, who just like millions of other women around the world, decided to have an abortion following an unintended pregnancy. In this video Juliette describes the challenges she faced in trying to find accurate and unbiased information about abortion, and she shares her thoughts on the role of men in the abortion process. You can watch the other videos in the series here. Unwanted pregnancies will always be a fact of life and abortions will continue. So, join us on September 28 in calling for governments to make abortion safe and legal abortion everywhere. Read a guest blog on the "state shambles" of abortion in Ireland by IFPA, IPPF's Irish Member Association here.

In 1983, religious conservative groups, fearing the Irish Supreme Court might infer a right to abortion into the Constitutional right to privacy, managed to insert an amendment in the Irish Constitution. This amendment equates the right to life of a woman with the right to life of the “unborn”. This amendment has caused untold damage to the health and well-being of women and girls in Ireland. It has also led to a succession of court cases and consistent condemnation from international human rights monitoring bodies. The amendment was intended to prevent abortion. It hasn’t achieved this aim. Instead it has forced thousands of women and girls to seek abortion services in another countries. Since 1983, at least 150,000 women and girls from Ireland have made that journey. Many others have been unable to travel due to a lack of resources. Almost immediately after its insertion, the amendment caused a legal battle over the right to receive information about abortion services in the UK. Newspapers carrying advertisements for UK abortion clinics were stopped at Dublin airport. Services providing abortion information were closed down. Legal challenges were brought to Irish courts, the European Court of Human Rights and the European Court of Justice.   Then in 1992, a 14 year old rape victim, known as X, was denied the right to travel to the UK for an abortion. This decision was overturned by the Supreme Court, which ruled that abortion is allowed if there is a real and substantial risk to a woman’s life including from a threat of suicide. Referenda on the right to receive information on and travel for abortion services in another country followed, both of which were passed with significant majorities. A third referendum to remove suicide risk as a ground for abortion, which was put to the people for a second time in 2002, was defeated. Despite the Supreme Court’s ruling in the X case, no legislation was enacted to implement its judgment. The following years saw more court cases against the State by girls and women in extremely vulnerable situations who were denied access to abortion services. In the 1997 Miss C case, the High Court ruled that Miss C, a 13 year old rape victim, was entitled to an abortion in Ireland. In the 2007 Miss D case, the High Court ruled that a 17 year old girl in the care of the State with an anencephalic pregnancy, who was refused permission to travel to the UK for an abortion, had a right to travel. Other women took their case to Europe. In 2010, in the case of A, B and C v Ireland, the European Court of Human Rights unanimously ruled that Ireland's failure to implement the existing constitutional right to abortion when a woman's life is at risk violated rights under the European Convention on Human Rights. All seventeen judges acknowledged that travelling for an abortion constituted a significant psychological, physical and financial burden. The Court was also clear that its door is open for another challenge to Irish abortion law, particularly in a case where a woman was unable to travel for abortion services. Following this ruling, the Protection of Life During Pregnancy Act 2013 was enacted to regulate the existing right to abortion when a woman’s life is at risk. However the Act poses new legal barriers to accessing an abortion even in such situations, particularly for women with mental health problems. The Act has also done nothing to diminish continued criticism from international human rights bodies. Only last July, the UN Human Rights Committee strongly criticised the discriminatory and harmful impact of Irish abortion law during its fourth periodic review of Ireland. Chair of the UN Human Rights Committee and former Special Rapporteur on Torture Nigel Rodley described women in Ireland raped and denied an abortion as being "treated as vessels and nothing more”, highlighting that “recognition of the primary right to life of the woman, an existent human being” has to prevail over prenatal life. The amendment inserted into the Irish Constitution in 1983 has led to the enactment of bad laws and the violation of human rights. It stands in the way of women and girls exercising their considered and conscientious choices about their pregnancy. It also stands in the way of service providers like the Irish Family Planning Association by limiting what support we can give to women seeking abortion services. But bad law can be changed. Irish opinion polls have consistently shown increased support for access to abortion. Only in September, a poll in the Sunday Independent newspaper showed that, of those who expressed an opinion, over 75% of people were in favour of holding a referendum to repeal the constitutional amendment on abortion. Despite the wishes of its own people and the condemnation of almost every human rights institution, the Irish State has continued to defend this shambles - a shambles entirely of its own making.   Denise Ryan is Communications Officer of the Irish Family Planning Association www.ifpa.ie

An overview of abortion legislation across Europe and Central Asia in 2012, covering all countries where IPPF EN Member Associations are situated.