International human rights law recognizes that obtaining a safe and legal abortion is crucial to women's and girls’ effective enjoyment and exercise of their human rights, including, among others, the rights to life, non-discrimination, equality, health and privacy. UN treaty bodies have frequently expressed concern about the relationship between restrictive abortion laws, clandestine and unsafe abortions, and high rates of maternal mortality and morbidity. In cases of restrictive laws, the central problem is the difficulty of obtaining abortions even when women are legally entitled to undergo the procedure. According to the jurisprudence of the European Court of Human Rights, once the state adopts statutory regulations allowing abortion in some situations, it must not structure its legal framework in a way that would limit real possibilities to access it. UN treaty bodies have also affirmed that where abortion is legal, states must ensure that it is available, accessible, acceptable and of good quality. Both the Court of Human Rights and UN treaty bodies have also found that restrictive abortion laws can constitute inhuman and degrading treatment.
However, in several EU countries, women are facing or will soon face important challenges to accessing safe and legal abortions according to the mentioned human rights standards. Some of these countries are:
Spain
In December 2013, a draft bill "for the protection of the life of the fetus and of the rights of pregnant women" was approved by the Council of Ministers in Spain. The draft bill constituted a step backward in relation to the current law, introducing severe restrictions on women’s access to legal and safe abortion services. The draft legislation limited the possibilities to obtain legal and safe abortions only to two cases: where a woman’s physical or mental health is endangered, or where the pregnancy is the result of sexual violence. The bill also put in place a number of disproportionate barriers, including: a seven-day waiting period; mandatory counseling; third-party authorization requirements (for girls under the age of 18 and for women under legal guardianship); the use of conscientious objection by health providers without ensuring that women systematically receive timely referrals to another service provider; the requirement to obtain medical reports from two different specialist doctors excluding the doctor carrying out the abortion, affirming that the pregnancy poses a serious threat to the woman's life or physical or mental health; the lack of effective mechanisms to address and resolve conflicts of opinion among medical professionals or between the woman and medical professionals; a ban on all advertising by centers, establishments, or medical services and any publicity about means, techniques, or procedures for interrupting pregnancies; and the requirement for victims of sexual violence to have reported the violence to the police in order to access a legal abortion. These obstacles could have led women to seek illegal and unsafe abortions as well as drive them to terminate their pregnancies abroad.
Prime Minister Mariano Rajoy has announced the withdrawal of that draft bill, yet concerns remain as he has pledged to reform the current law to ensure that girls under 17 years of age require parental consent to terminate pregnancies. Furthermore, there is still a threat that a restrictive legal reform might be proposed again in the future, putting at risk girls' and women’s access to safe and legal abortion services.
Lithuania
The draft Law on the Protection of a Life in the Pre-Natal Phase, discussed in the Parliament in spring 2014, was another attempt by the state to regulate public morals at the expense of women’s right to privacy, health and life.
The draft bill allowed terminating the pregnancy in two cases only: when pregnancy poses an evident threat to the life of a mother, or when it occurs as a result of a criminal act, e.g., rape. In both cases, however, the pregnancy can be terminated only when not more than 12 weeks have passed from the day of inception. The bill put particularly vulnerable women - girls and women deprived of legal capacity - under obligation to obtain a written consent by one of the parents or a guardian. The amendments to the Criminal Code treated termination of pregnancy in all other cases to an offense punishable by community service, arrest or imprisonment. Under proposed amendments, even a mother who “inflicts serious harm on an unborn child” may be imprisoned for up to two years.
In its very recently adopted concluding observations on Lithuania, the UN Committee on the Elimination of Discrimination against Women called on the authorities to "refrain from adopting laws or amendments that would restrict women’s right to legal and safe abortion, and instead adopt the pending laws on reproductive health and assisted reproduction."
Whereas the draft bill has not yet put for voting, new initiatives aiming at introducing mandatory 72-hour abortion waiting period are now being discussed. Introducing a waiting period creates inhuman emotional and financial hardships for women who have already spent considerable time wrestling with one of the most difficult decisions they'll ever make.
Hungary
The Fundamental Law that came into force in 2012 contains a constitutional clause that establishes that the fetus shall be protected from conception, which could lead to restrictions on abortion, even if the law that allows abortion up to the 12th week of pregnancy has not yet been modified. In addition, the government has, through legal and non-legal means, tried to undermine the right of self-determination of women. These include: a misleading abortion campaign, putting up billboards of a living and developed fetus to deter people from abortion with EU funding, violating the rules of the funding program; providing humiliating and deterring advice to women, and imposing a bureaucratic permission process with many opportunities for abuse; encouraging women to keep pregnancy as a secret and give the child up for adoption - in case the teenage mother chooses to give birth in “secret” and then give up the child for adoption, she is not obliged to notify her parents, while abortion would require the pregnant woman to notify her parents; and banning without scientific arguments the abortion pill, which forces patients, if it is financially possible for them, to go to Austria.
These measures have been criticized by the UN. The Committee on the Elimination of Discrimination investigated Hungary in February 2013, raising concerns with regards to women’s right to self-determination. It called on Hungary to provide access for every woman to abortion without the mandatory counseling, which is an unreasonable obligation. The Committee emphasized the need for the state to not intervene in a woman’s right to reproduce and to cease the campaign that stigmatizes abortion. In addition, the Committee also highlighted the importance of making contraception available.
Ireland
The Irish legislation on abortion might be one of the most restrictive laws in the EU. A Woman is allowed to interrupt her pregnancy only in cases of "real and substantive risk" to her life. Otherwise, Section 22 of the Protection of Life During Pregnancy Act punishes abortion with up to 14 years of imprisonment, including cases of rape, incest, fatal foetal abnormality and serious risks to the health of the mother. On the other hand, the law does not define what constitutes "real and substantive risk" to the life of the pregnant mother. Suicidal women are subject to an excessive degree of scrutiny by medical professionals, leading to further mental distress. Only women than can afford the trip can seek abortions abroad, which causes discrimination in the impact of the law. However, the law also imposes criminal sanctions to healthcare providers that refer women to abortion services outside Ireland. The UN Human Rights Committee expressed their concerns for this situation in their concluding observations on Ireland adopted in July 2014, calling the sate to, inter alia, "revise its legislation on abortion, including its Constitution, to provide for additional exceptions in cases of rape, incest, serious risks to the health of the mother, or fatal foetal abnormality" and make "more information on crisis pregnancy options available through a variety of channels, and ensure that healthcare providers who provide information on safe abortion services abroad are not subject to criminal sanctions."
Italy
Abortion in Italy is governed by Act 194 of 1978, which allows women to interrupt their pregnancy in a public facility during the first 90 days of gestation, and during the fourth and fifth month for health reasons. However, there are concerns for the very high rate of conscientious objection: nearly seven out of ten gynecologists belonging to the public health service now choose not to perform this procedure. Therefore, women who are legally entitled to terminate their pregnancy may be forced to move to another health facility, in Italy or abroad, or to terminate their pregnancy without the support and control of competent health authorities, or may even be deterred from accessing abortion services that they have are legally entitled to receive. In fact, the European Committee for Social Rights of the Council of Europe has expressed deep concerns for this high rate. In a 2013 decision, this body established that this situation is discriminatory and violates the right to health.
Romania
Although abortion is currently legal in Romania under certain circumstances, in the last few years there have been repeated attempts to impose excessive limitations on access to abortions at the expense of women’s rights. In 2012, there was a draft bill that sought to make it mandatory for women seeking an abortion to first attend a "counseling" session. During this counseling session, women would have to see videos and images showing how abortion is in fact a termination of life, after which they would have to wait five days before finally being able to access an abortion. The proposed bill, which was not passed despite strong support, basically sought to discourage women from seeking an abortion by showing them traumatizing imagery and putting a set of practical obstacle in their path.
We want to make sure that in the future, women’s rights are not threatened again by similar initiatives.
Poland
Poland's 1993 Act on Family Planning, Embryo Protection and Conditions for the Lawful Termination of Pregnancy is one of the most restrictive abortion laws in Europe. Women seeking an abortion on health grounds are required to obtain a certificate from a doctor specialized in the relevant field of medicine, or, in the event of foetal abnormalities, from a doctor specialized in genetic defects; in cases of rape or incest, a certificate from a prosecutor is needed. There is also a mandatory three-day waiting period and mandatory counseling. Women over the age of 13 have to file a written request for an abortion, while minors require written consent of their legal guardian or a court permission if authorization is refused. There is an extremely heavy reliance by medical doctors and hospitals on the conscience clause and the health care referral system is highly burdensome. Referrals are often refused. Since 2008, there is a possibility to appeal a doctor's opinion, but the procedure is lengthy and cumbersome, thus rendering abortion in these cases inaccessible in practice. All these obstacles and barriers make women's access to legal abortion services very difficult or even impossible in practice. The European Court of Human Rights has found in three important cases that Poland's abortion framework and practices violated its obligations under the Convention.
The conscience clause is misused by medical doctors. Sometimes there are whole hospitals that rely on the conscience clause to refuse legal abortions in their institutions. There is still a lack of effective mechanisms for review of doctors’ decisions. The present regulations of the Act on Patients’ Rights introduced in the wake of the judgment in Tysiąc v. Poland do not provide effective measures to challenge a doctor’s decision before the Medical Board. The enforcement of this judgment is still subject to supervision by the Committee of Ministers of the Council of Europe.
Greece
The conditions for abortion in Greece are described in the Criminal Code, manifesting the moral disapproval of the action. Provision 304 of the Criminal Code describes four conditions under which abortion is legal: in all cases before the 12th week of the pregnancy; before the 19th week, if pregnancy is the product of criminal action (rape, etc.); before the 24th week if prenatal screening tests show serious heath issues for the baby; and at any time during the pregnancy if there is a serious threat for the life of the mother or her mental health.
The challenges in Greece are related to the access to contraceptives and sex education, especially to adolescents. The UN Committee on the Elimination of Discrimination against Women expressed in 2013 its concerns for the "very low use of high quality, efficient methods of contraception, which means that women resort to abortions as a method of family planning," urging Greece to "improve and increase access, as well as use of effective and affordable methods of contraception, including by subsidizing them." On the other hand, the UN Committee on the Rights of the Child noted "with concern the limited knowledge among adolescents about reproductive health," urging the state to "increase the availability of confidential and youth-friendly health services throughout the country, enhance the availability of contraceptive services and promote sex education targeted at adolescents."
Bulgaria
In Bulgaria, women can interrupt their pregnancy until the 12th week of pregnancy. After the 12th week and until the 20th, abortion is allowed only in the event women suffer from a documented case of a disease that could endanger their health or life or the viability of the fetus. After that, abortion is permitted only if the woman's life is in danger or evidence is found of severe foetal impairment. As in Greece, the issues of concern in Bulgaria are related to the lack of access to sexual and reproductive health services and to affordable contraceptives. Public health insurance in Bulgaria does not cover any methods of contraception, nor abortion unless it is performed for medical reasons. Access to legal abortion is restricted by law, requiring written authorization from parents for girls under 18 and from legal guardians for women under legal guardianship. Termination of pregnancy for medical reasons has to be authorized by a special medical commission. In 2012, the UN Economic and Social Council urged the state to "ensure that sexual and reproductive health services are effectively accessible to adolescents, and that all pregnant women and girls have access to specialized medical care." Also in 2012, the UN Committee on the Elimination of Discrimination against Women called upon Bulgaria to "step up its efforts to systematically promote education on sexual and reproductive health rights and to target adolescent girls and boys, including in vocational training schools, paying special attention to the prevention of early pregnancy, and to provide adequate family planning services and affordable contraceptives." Similar recommendations were issued by the UN Committee on the Rights of the Child in its 2008 concluding observations to Bulgaria.
Conclusion
Banning abortion or making it nearly impossible to access safe abortion in practice, even when it is legal, will only make women's lives more difficult in these already stressful and complex situations, and will endanger lives. Cornering a woman will not solve her complicated case, but it will almost certainly lead her to risk her health and life or run away to a more civilized state where she can access the procedure. If you care about the lives of women and unborn children alike, you should ask the European Parliament to adopt measures to guarantee that member states respect human rights standards, including facilitating and ensuring access to safe and legal abortion services for all women. Every EU country should offer access to affordable contraceptives and support services for women in all member states, and when abortion is the chosen option by a woman, countries must ensure that she can get timely and effective access to the procedure in a safe and professional environment, and without unjustified barriers and prejudice.
This campaign is the initiative of the following civil society organizations: Rights International Spain, Hungarian Civil Liberties Union, the Italian Coalition for Civil Rights and Freedoms (CILD), Human Rights Monitoring Institute (Lithuania), Polish Helsinki Foundation for Human Rights, Association for the Defense of Human Rights in Romania-the Helsinki Committee (APADOR-CH), Hellenic League for Human Rights, Greek Helsinki Monitor, and Bulgarian Helsinki Committee.
