Abortion is illegal in Poland, except in cases when pregnancy is considered a health risk, or is a consequence of a confirmed criminal act. Recent cases, however, have heightened public debate about these restrictions. EURACTIV Poland reports.

Poland is embroiled in a nationwide discussion about the right to abortion, sparked by two very controversial cases.

At the beginning of the week, one of the country’s weeklies reported the story of a woman who was refused an abortion, despite the fact that Polish law allowed it in her case (the child i question would be born with numerous defects and would not survive).

The story mobilised pro-choice advocates. Even the Prime Minister, Donald Tusk, reacted, saying that the doctor should have chosen the law over his personal religious beliefs.

Their opponents from the pro-life camp found their rallying cry, thanks to the story of a 11-years-old girl who got pregnant after being raped by her two (also underage) cousins. A court allowed her to undergo an abortion.

In the meantime, a conference of the Polish Episcopate produced a statement in support of pro-life doctors.

Poland’s strict abortion laws only grant women the right to terminate a pregnancy before 25 weeks, if a mother’s life is in grave danger, if a fetus is known to have severe birth defects, or if a pregnancy is a result of rape or incest.

World

Abortion is an extreme measure, taken by those who become pregnant unintentionally, often due to lack of knowledge or access to contraception. That is how the World Health Organization (WHO) explains the difference between Western and Eastern Europe. In the former, the abortion rate is 12 per 1000 women, in the latter it is 43. The WHO notes that the difference “reflects relatively low contraceptive use in Eastern Europe, as well as a high degree of reliance on methods with relatively high user failure rates, such as the condom, withdrawal and the rhythm method” (WHO report).

On the other hand, according to the Guttmacher Institute (an American think tank preparing reports on abortion in cooperation with WHO), the global abortion rate has been falling for the last 20 years. 45.6 million abortions were induced in 1995, as opposed to 43.8 million in 2008 (a 4% decrease). According to the WHO, however, differing methods of data gathering data in various countries mean that the results are not always precise.

Europe

According to European treaties, the right to an abortion does not lie within EU’s competences, and remains an issue regulated by the member states. Therefore, EU institutions, such as the European Commission and the European Parliament, cannot authorize the legalization, or the restriction, of abortion.

Among 28 EU countries, Malta is the only one that does not grant a woman the right to abortion, even when her life is at risk. However, it observes the principle of a so-called “double effect”: a treatment that may lead to miscarriage (such as some types of cancer treatment) is permitted if it is required to save a pregnant woman’s life.

In its accession treaty, Malta received a special guarantee that no European law, either already existing or passed in the future, will affect its abortion regulations. At the moment, inducing an abortion (with the exception of double effect cases) is punished by 18 months in prison and, if the guilty is a doctor, a perpetual interdiction of exercising his profession (source).

The next two countries where access to abortion is most severely limited are Poland and Ireland. With the exception of Malta, they are the only European countries that do not allow abortion on request. As noted earlier, there are only three circumstances in which abortion is permitted under Polish law: a mother’s life or health being at risk, a grave foetal defect, and an unwanted pregnancy resulting from a criminal act.

In practice, however, abortion may not always be possible even in those circumstances. For example, the 10 June edition of the Polish magazine Wprost relates the story of a mother who was not granted the right to abortion, even though her child would be born without skull, and would die soon after birth. In 2000, doctors refused to terminate Alicja Tysi?c’s pregnancy, despite the fact that the labour could put her health at risk. Eventually, it resulted in retinal hemorrhaging, which severely impaired Tysi?c’s sight.

In 2011, the Tak dla Kobiet (Yes for Women) campaign tried to introduce a law concerning conscious parenthood and other reproduction rights, including the liberalisation of the abortion law. However, the project did not collect the required 100,000 signatures to be considered by parliament.

In research published in February by a Polish statistics institute CBOS, 27% of respondents said that termination of pregnancy is “completely acceptable” or “rather acceptable”, whereas 65% answered that it is “rather unacceptable” or “completely unacceptable”. The percentage of abortion advocates has decreased by 4% since a similar survey in February 2009.

Nevertheless, “even women who condemn abortion, still perform it”, Katarzyna Pabijanek from the Warsaw foundation Gender Center told euractiv.pl. Pabijanek is a lecturer of Gender Studies at the Polish Academy of Sciences and participated in the Yes for Women initiative.

According to Pabijanek, the abortion law has to be changed. “We don’t want to introduce obligatory abortion, our sole aim is giving access to it to women who need it. It’s also necessary to take note of the social implications of the current law, which discriminates against the less wealthy and less informed,” she said.

When asked by euractiv.pl to comment on the issue, The Polish Chamber of Physicians and Dentists said that the most controversial question is the conscience clause. It is a legal clause that allows a doctor to refuse a medical service, such as abortion, for reasons of conscience. Nevertheless, he is obliged to refer the patient to another doctor, who will provide the required service.

The council is of the opinion that the clause in its current shape forces a doctor to “be complicit in an action he deems immoral”, and therefore it conflicts with the Polish constitution. According to the council, “it is possible to reconcile the doctor’s right to protect his own conscience with the patient’s right to the required service, but it should be the State who informs the woman of subjects willing to terminate pregnancy, not the doctor who feels the action conflicts with his conscience”.

In other EU countries, abortion on demand is possible within the first twelve weeks of pregnancy. In most member states (except for Ireland, Malta and Poland), termination of pregnancy is also possible in exceptional medical or socioeconomic circumstances (such as a mother’s poverty).

Council of Europe

Among all European institutions concerned by the issue of abortion, the most important is the Council of Europe. Despite its name being similar to the Council of the European Union and the European Council, as well as the fact that 47 of its members belong to EU, the Council of Europe is a fully independent institution, concerned mainly with the protection of human rights in member states.

The Committee on Equal Opportunities for Women and Men in the Parliamentary Assembly of the Council of Europe maintains that “a ban on abortions does not result in fewer such operations, but mainly leads to clandestine abortions which are more traumatic and more dangerous”. The committee notes also that in “member states where abortion is legal, conditions are not always such as to guarantee women effective access to this right” (source).

The stance of the Parliamentary Assembly, where all member states are represented, was summarized by an Austrian deputy Gisela Wurm. “In no case should abortion be promoted as a method of family planning. But in circumstances where abortion is not against the law, such abortion should be safe and accessible”, she said.

Wurm also quoted a report of Rosmarie Zapfl-Helbling (available here) in which she summarized the attitude of chief European religions towards abortion. In short, the Roman Catholic and the Orthodox Church are against it, Islam and Judaism permit it if a mother’s life or health is at risk, and Protestant churches “are usually more tolerant on abortion, although the more charismatic and fundamentalist churches take a stricter stance”.

Illegal abortion methods

There are many methods of terminating unwanted pregnancies used by women without legal access to abortion. In Europe, the most common one is traveling to another country. For example, a Slovakian clinic was recently found to offer abortion service, including the transport of the patient from Poland.

Nevertheless, those who cannot afford to perform an abortion abroad, or pay the doctors that provide it illegally, have to resort to less safe measures. Such operations are usually conducted in unhygienic conditions, and the patient is offered no psychological help nor counseling.

In the most extreme cases, abortion is induced not by the ingestion of chemical substances, but by the physical removal of the fetus. It is provoked by insertion of an object into the uterus or by a violent abdominal massage (source). The growing accessibility of other methods reduces the frequency of such extreme measures.

One in ten pregnancies in the world is terminated by an unsafe abortion, or performed in inappropriate conditions. In Europe, the only region where it happens to a significant degree is Eastern Europe, where the number of such abortions in 2008 is estimated at 360,000.

Abortion may be qualified as ‘safe’ only if the appropriate medical procedures, equipment, and high quality medicines are accompanied by psychological counseling before and after the operation. Usually, none of these are present when abortion is banned, and women are forced resort to illegal measures.