The right to an abortion is a hot topic in Belgium, as the new figures on abortion collected by the abortion evaluation commission show. The parliament is also to discuss a new abortion bill which will be voted on soon. The legislative change would extend the period within which women are able to end their pregnancies from 12 to 18 weeks. This is the perfect moment to compare the situation with different countries in Europe.
The survey showed that in 37 of the 42 participating European and Central Asian countries, abortion is still part of criminal law. According to international law this undermines the autonomy of women and girls. Not only is abortion criminalised, it is also only legally permitted up until a specific time. In 42 of the participating countries the average is 12 weeks. However, women often only realise they are pregnant when they are already in week 6, leaving only about a month to make a decision whether or not they want to terminate their pregnancy.
In addition, many countries have other types of restrictions, such as obligatory waiting periods, medical consent and bureaucratic hurdles, which undermines their access to reproductive health care.
The survey shows that substantial national differences continue to exist regarding abortion. If a woman or girl’s life is at risk, she might get the best access to care in the Netherlands or Montenegro; in case she needs an abortion as a result of sexual violence, she might be better off in Israel or the Republic of Northern Macedonia. In some countries women also face great pressure to not terminate their pregnancy. In Hungary for example, women are obliged to following informative sessions (e.g. on adoption, delivery and contraceptives) before they are allowed to start the procedure.
In all 42 reviewed countries, abortion is allowed if the mother’s life is at risk. However, the individual doctor’s judgement is decisive in what is considered life threathening. It is also striking that in 13 of the 42 countries, abortion following rape is considered illegal. 29 countries allow abortion following rape, but again access to abortion differs substantially. In many cases, women are obliged to undergo serious medical examinations, which reinforce the encountered trauma. Even more striking is that half of the countries do not explicitly refer to the right to abortion when a pregnancy is the result of incest. In Lithuania, a woman needs to prove in court that her pregnancy is the result of incest before she is granted access to abortion.
Power of conviction
The obligatory consultations that many countries require, are explicitly listed as ‘persuasion sessions’ to make women change their minds. This obviously undermines women’s autonomy. In Russia, women even need to undergo psychological screening during the procedure. In 31 countries girls between the ages of 14 and 18 need parental consent to terminate their pregnancy, which creates difficulties for young people in terms of access. Most young people are afraid to be a disappointment to their parents and/or to no longer be welcome at home.
Once women obtain permission, there are still barriers in terms of access to reproductive care, from institutional requirements to the location of the health care centres or clinics, the price, the attitude of medical staff and the access to information and post-abortion care.
Finally, one of the biggest challenges in a number of countries lies in the refusal of care by doctors, due to a conscientious objection. This creates situations when whole provinces and districts lack access to legal abortion care. In Belgium, doctors who have a conscientious objection are obliged to refer women to another doctor or facility that will assist them.