The European Union rules state that all participating member states should provide the same services and care to all EU citizens that local citizens receive. Even so, the bill is strongly opposed by deputies of the Christian Democratic Union (KDU-CSL), a junior governing party, who have concerns the Czech Republic will become an "abortion tourism destination" for EU citizens. Christian Democratic Union ministers in the cabinet, who approved the bill, are strongly being pressured to withdraw the bill before it is submitted to the Parliament by deputy party members, according to Ceske Noviny newspaper. As a reason for their opposition, the KDU MPs gave their "conscience objections" to the bill's provision enabling EU citizens to undergo abortion in the Czech Republic.
The bill is part of the crucial and controversial package of reform legislation promoted by Health Minister Tomas Julinek. Apart from abortion, the bill deals with rules of assisted fertilization, sex change, sterilization and other specific treatments.
The Christian Democrats have had long term reservations about the planned provisions on abortion. They have campaigned steadily in previous months against the abortion bill, as well as another that would loosen restrictions on in-vitro fertilization. The party had proposed abortion restriction legislation in April, which included a stricter time limit on health-related abortions and heightened consent requirements. The Christian Democrats proposed to limit abortions on "health grounds" to the 18th week of pregnancy and proposed to allow fathers to have a say in whether a child is aborted, although the father's opinion will not be a "veto." They also proposed to raise the age at which parental consent is required from 16 to 18 years old.
Under current Czech law, unrestricted abortion is allowed until 12 weeks gestation, and with "medical indications" until 24 weeks. Fetuses diagnosed with serious abnormalities can be legally aborted at any gestational age. Abortion was legalized under the communist regime in 1957. The only restrictions beyond these say that abortions must be spaced at least six months apart and the pregnant woman must be at least 16 years old, unless she has the permission of her parents.
The opponents also say the bill makes abortion rules excessively liberal, and that the Czech Republic might become an abortion tourism destination. The "abortion tourists" would most likely come from neighboring Poland, where abortion is permitted only in cases of rape, significant fetal abnormality, or the presence of a serious health threat to the mother. Abortion was made illegal in the country after the collapse of communism in 1993. Though coming to the Czech Republic for abortion care has been illegal until now according to Czech law, Polish women seeking abortion have traveled to the Czech Republic for the procedure.
It is important to add that in spite of very liberal abortion legislation, the number of abortions in the Czech Republic has been constantly dropping since the collapse of the communist regime in November 1989. In 1970 almost 148,000 children were born and 72,000 abortions were performed. In 2006, there were 25,400 abortions for a total population of 10,228,744 in the country. Last year, in 2007, over 114,000 children were born and 25,414 abortions performed.
"The reason for high abortions during communist times is that contraception was not available, and the abortion law was very permissive," said Radim Uzel, executive director of the Czech Family Planning Association.
Despite the Czech Republic having one of the lowest birth rates in the world - well below the replacement rate of 2.1, at 1.22 - the citizens of the Czech Republic continue to strongly favor abortion. A new public opinion poll conducted by the Public Opinion Research Center CVVM among residents of the Czech Republic in June 2008 finds more people are inclined to favor keeping abortions legal. The poll found about 75 percent of Czech citizens want abortions to stay legal, an increase of about three percent from the poll conducted in 2007. Some 15 percent said abortions should be limited to only legitimate health reasons, another 6 percent said abortions should only be allowed if the mother's life is threatened and one percent want all abortions made illegal.
The Institute of Health Information and Statistics of the Czech Republic reported that women who already have children were more likely to get an abortion. Some 35 percent of those obtaining abortions already have two children, for example. That figure is consistent with most other European countries.
]]>The document being drawn up at the Commissioner's office is to be submitted to the Minister of Health, Ewa Kopacz, before Christmas. Kochanowski's intention is for the charter to constitute a basis for defining the scope of medical, psychological and other types of care that every pregnant woman should be provided with. "We will demand the Ministry to fully respect the rights of women who are giving birth," claims the Commissioner.
A draft charter is already available at the Commissioner's website. It includes 10 major points related to various stages of pregnancy and childbirth. The Commissioner's demands focus on free-of-charge anesthetization during childbirth, family labor, single labor suites and assistance of a psychologist present in the labor and delivery suite at the hospital.
Right now in Poland there are no binding rules related to standards of medical care to be provided to pregnant women. As a consequence, women often give birth in unacceptable conditions and the infant mortality rate is constantly increasing. "What seems to be a luxury for a Polish woman, in the Western European countries is a standard procedure," says Janusz Kochanowski.
The main postulates in the charter include: free-of-charge anesthetization for every woman giving birth, right to family labor (which is becoming increasingly popular in Poland and is firmly accepted by majority of fathers: they want to provide safety for the partner and set up an early contact with the baby) and single labor suites, providing assistance of a psychologist to the labor and delivery suites at the hospitals, full coverage of birth school participation, and increasing number of beds at the hospitals, so women are not sent from one hospital to another. Many of the above-mentioned proposals have been promoted by various organizations (Foundation Rodzić po ludzku [Giving Birth in a Humane Way]) or in the media (Dziennik newspaper). But the Commissioner's demands go even further. He wants birth school participation and assistance of a psychologist covered by the Polish National Health Fund. Psychologists would be taking care of women who lost their child or suffered from birth trauma. "I would like to create a situation in which giving birth by a woman will no longer be associated with an unnecessary stress," says Kochanowski.
Currently, the Ministry of Health is not making any comments regarding that initiative. They want to wait until a final draft of a charter is submitted to the Ministry. Not long ago, the Minister of Health, Ewa Kopacz herself announced the plans to stop covering anaesthetization during childbirth. Her argument then was that there are not enough anesthesiologists in the Polish hospitals, therefore providing anaesthetization for free was not possible (Poland Says No to Pain-Free Childbirth).
According to the Commissioner, the idea of drafting such a charter came about some time ago. Voices in the media and in various medical conferences underlined cases of negligence in relation to health of mothers and children. And the Ministry of Health has failed to prepare the binding standards on medical care. Such lack of regulation has a negative impact on the health of the whole society. The evidence can be found in the recently published report of the National Institute of Hygiene in Poland. This report explicitly describes dangerous tendencies occurring in the last years. Decline in infant mortality rate has been slowing down recently, despite visible progress in Polish medicine. One of the main causes is the lack of a program specifically designed to provide effective care for pregnant women.
According to Professor Janusz Szymborski, plenipotentiary of the Commissioner for Civil Rights Protection responsible for family issues, it is possible to introduce the standards proposed in the charter. "Money should not be a problem here," he says. "Ensuring these standards would demand only a small part of the budget of the National Health Fund." Poland is obliged to invest into women's health and health of newborn children - the childbirth rate is rapidly decreasing, at the fastest pace in the whole European Union. The Polish population is projected to drop by 8 million by 2050.
All the proposals to be embodied in the charter are equally important. But preventative treatment seems to be the most crucial aspect of medical care. There should be one doctor taking care of a woman throughout her pregnancy state. She has to have a right to free of charge birth school participation, undergo all necessary medical examinations and injections. In the previous years, decrease in infant mortality rate was so high, that focus on preventative care diminished. "And that is why we are experiencing a reverse trend right now," says Szymborski. Infant mortality rate in Poland is, according to the available estimates, by 25% to 50% higher than EU average rate. The negligence in providing adequate preventative care led to worsening chances for Polish women to give birth in a dignified way.
A draft charter is now open for signatures. Anyone is invited to express its own approval of the proposed standards of care. Further steps are likely to be seen in a month or so, after the charter is presented to the Polish Ministry of Health.
]]>The 23-page instruction, entitled "Dignitas Personae," or "The Dignity of the Person," carries the approval and the authority of Pope Benedict XVI. The Instruction, released December 12, highlights "some anthropological, theological and ethical elements of fundamental importance" as well as "new problems regarding procreation" and "new procedures involving the manipulation of embryos and the human genetic patrimony." This Instruction was announced at the same time in Vatican and Warsaw, Poland, where it raised questions regarding the impact it may have on the Polish couples who consider IVF technique as the only treatment which is to combat their infertility.
Catholic Church officials regard this Instruction on bioethical issues as a guidance on how to respect human life and human procreation in everyday life. "Dignitas Personae" criticizes "embryo adoption," whereby infertile couples adopt embryos frozen during in vitro techniques, because it involves separating conception from the "conjugal act" and often results in the destruction of embryos. "The Church understands suffering of many infertile couples, but the desire to have a child cannot come first, before the dignity of every human life, including an embryo," said the Polish priest and professor Wojciech Bołos. The Church representatives underline that the ban on in vitro fertilization results from the fact that it violates the basic moral norms created by the Catholic Church.
The Instruction similarly opposes the techniques involved in IVF, because embryos are or can be destroyed. The Instruction's authors consider intentional selective abortion the deliberate and direct elimination of one or more innocent human beings in the initial phase of their existence. The authors also oppose pre-implantation diagnosis and embryo freezing, arguing that doing so exposes them to potential damage and manipulation, and that it raises the problem of what to do with frozen embryos that are not implanted. The document also says "no" to the morning-after pill, even if it doesn't cause an abortion, because an abortion was intended. The use of drugs such as RU-486, which causes the elimination of the embryo once it is implanted, is equivalent to the "sin of abortion," thus their use is "gravely immoral."
Experts say that there is little new in this document, but that it may still come as a surprise to many Catholics who are unaware of the church's ban on in vitro fertilization. However, Polish ethicists claim that Instruction should not change social attitudes towards IVF methods. "The document should be treated seriously, but one does not have to blindly accept its postulates," says Pawel Łukow, a Polish expert on bioethics.
Instead of IVF the Church supports adoption, and medical treatment of infertility or endometriosis. It does not oppose research on stem cells derived from adults; blood from umbilical cords; or fetuses "who have died of natural causes." The document does not prohibit the use of vaccines developed using "cell lines of illicit origin" if children's health is at stake. But it says that "everyone has the duty" to inform health care providers of personal objections to such vaccines.
The Vatican's intended audience is not only individual Roman Catholics, but also non-Catholic doctors, scientists, medical researchers and legislators who might consider regulating stem cell research and other recent developments in biomedical technology. With regard to the last group of addressees, the Vatican's statement is released just when the works on new bioethics law in Poland are being undertaken. Quite coincidently, a few days before the Vatican's Instruction was issued, the Church representatives in Poland for the Episcopate conference expressed their discontent regarding the idea of partial insurance coverage of in vitro fertilization methods, to be included into the new law on bioethics. Archbishop Józef Michalik said that "refunding IVF is paying for murder," and Archbishop Henryk Hoser stated that "it's moral schizophrenia." "There is no slightest doubt that IVF violates the right to life of conceived persons. At the price of one life, to give parents pleasure and give them a child, another one is killed," said Archbishop Józef Michalik, chairman of the Polish Episcopate Conference. However, Jarosław Gowin, the member of the Parliament, who is responsible for preparing a legal act on bioethics, was not surprised when he heard what the Polish Catholic Church authorities said, as well as the Vatican's instruction issued right after. And, even more importantly, he underlined that the new law would allow for the use of in vitro fertilization in Poland, because Poland is a secular state and while creating the law, his team did not take into consideration the Church's guidance related to reproductive methods.
The law will simply make legal all those practices which are already commonly used by many Polish couples suffering from infertility. Gowin is a co-author of a draft law which, although it goes against the Catholic Church ideology, radically improves the right to life. And Gowin still hopes for a positive opinion of the Polish Episcopate in that regard. But right now the Episcopate's acceptance is rather unrealistic. One may say that what the Church says should not be so important, but for some Catholic couples in Poland the decision over whether to undergo in vitro fertilization may become that much more difficult, knowing that the Church considers "a sin." It will certainly not make their lives easier.
]]>"We appeal to the Ministry of Health not to pull back Polish medicine to the nineteenth century and to take into account that anesthetization during childbirth has been recognized as a standard procedure for many years now in the whole Europe," said Joanna Kluzik-Rostkowska, former Ministry of Labor and Social Policy.
She underlined her disappointment in Kopacz's words, because these "difficult words addressed to women" have been expressed by "a minister, a woman, and a doctor."
"There have been many declarations stating that we have to do much more in order to make Poles decide more easily to have children, to encourage Polish women to have more children and now, what we are hearing is that they have to rely on the forces of nature," Kluzik-Rostkowska claimed. According to her, Kopacz's statement about lack of funds for anesthetization, as well as lack of anesthesiologists during childbirth, constitute "a sufficient argument for women to make it more difficult for them to decide about having a child."
During a discussion following the Ministry's declaration, advocates suggested that the Minister should be doing everything possible to ensure an adequate level of medical care, in order to guarantee that childbirth with anesthetization and with assistance of anesthesiologists, according to the standards of the twenty-first century, may take place at the hospital. The Minister seems to be forgetting the European standards she so often refers to when discussing other aspects of healthcare. In Western European countries, as well as in Poland's neighboring countries, childbirth anesthetization is considered a standard service provided to women. The question becomes, then, why do Polish women have to pay for it? This situation divides the Polish women into two groups: those who can afford to pay for anesthetization and those who cannot afford to pay for something to which they are entitled.
Resistance to pain depends inherently on personal features, and there are women who simply cannot imagine themselves experiencing childbirth in a natural way. That fear can cause negative consequences to the woman's physical health and therefore may endanger the security of a child, say experts of the Polish Gynecological Society. According to female MPs, the Minister should take all the necessary efforts to make such a process a safe and non-threatening experience for women and ensure access to anesthetization is refunded from the National Health Fund for all women in need.
The Ministry of Health prepared an official response to the article published in "Dziennik." Her response states that anaesthetization when instructed by a doctor is and will be financed from public funds. It is for a doctor to decide on the mode of delivery and potential use of anesthetization. The scope of services, including procedures used (anesthetization, cesarean section), depend on the health status of the patient, and the process of her pregnancy and delivery.
The Ministry also mentions a committee that will prepare health standards on childbirth and related issues. The committee's purpose is to draft a legal act describing standards of medical procedures during pregnancy and delivery. Services resulting from the standards prepared will be financed from public funds. Completion of the committee's work is closely connected with the works of the Polish Gynecological Society experts' team, acting independently and preparing recommendations related to medical procedures during childbirth.
The declarations of the Ministry of Health offer some hope that Poland may develop more precise and clear standards related to pregnancy and childbirth in particular. Information that Polish women have been given in the last few weeks have resulted in a state of uncertainty and fear, and those feelings are least welcome when planning a family or when already pregnant. It appears that the Polish Ministry of Health easily makes statements or disseminates information, but unfortunately does not take into consideration the consequences of these statements or information on the general public, and women especially. I do hope we will not have a chance to experience any more "interesting" solutions and the three times rule will not be applied here.
]]>The report confirms what is already known, that the situation in Europe regarding abortion is very diverse. Abortion is legal in the vast majority of the Council of Europe member states. In most of the Council of Europe member states (except Andorra and Malta), the law permits abortion in order to save women's life. Abortion on request is - in theory - available in all Council of Europe member states, but not in Andorra, Ireland, Malta, Monaco and Poland.
According to information provided by the International Planned Parenthood Federation (IPPF), abortion rates are generally on the decline in Europe, particularly in the countries of Central and Eastern Europe (based on data from World Health Organization Regional Office for Europe - in the European region the number of abortions per 1000 live births was 412.33 in 2005 and 391.56 in 2006; and in the Commonwealth of Independent States - the number of abortions per 1000 live births equaled 603.87 in 2005 and 557.3 in 2006). In the European Union, the figures remain rather stable (the number of abortions per 1000 live births was 252.54 in 2005 and 246.4 in 2006).
Legislation varies considerably from country to country in Europe, ranging from complete liberalization to abortion being available only in extreme circumstances, such as rape, severe malformation of the fetus or if the woman's life is at risk. Abortion is generally available without restriction as to reason up to the 12th week and up to 18 weeks in Sweden. It is legal up to 22 weeks in most of the Caucasian countries for social or medical reasons; up to 24 weeks in the Netherlands and the United Kingdom in the event of social, medical or economic constraints. It is available only under certain conditions in Cyprus, Luxembourg, Poland, Portugal (the situation is, however, changing in Portugal, where a referendum was held in February 2007, and resulted in a liberalized abortion legislation) and Spain. Abortion is available only if the mother's life is in danger in Ireland and Northern Ireland and not at all in Malta.
Where access to abortion is so heavily restricted, it frequently results in women having to risk unsafe, illegal abortions, or facing financial difficulties resulting from the only available alternative: travelling to a country where abortion is available upon request. In other countries, although the abortion law may not be heavily restrictive, in practice it is often subject to limited interpretation. In Slovakia, many healthcare professionals uphold "conscientious objection'' and therefore refuse to perform abortions. This should never be a reason for refusing to refer a client for further help elsewhere.
The Committee on Equal Opportunities for Women and Men declares in its report that the aim should be to avoid abortions as much as possible. And the best way to avoid abortions is to avoid unwanted pregnancies by offering accessible and affordable contraception, and sex education for young adults (including in schools). The availability of affordable contraception has lowered abortion rates over the years, in particular in Central and Eastern Europe (in some countries, e.g. the then Soviet Union, abortion was used instead of contraception for decades).
Making methods of contraception available, however, is not enough to prevent abortions. It is also important to enable women to choose a suitable contraception of their own choice.
In order to avoid unwanted pregnancies, banning abortions is not be a solution. Women facing unintended pregnancy can only sometimes be persuaded to have a child, but most of them will try to have an abortion even if abortion is illegal in their country. Some will travel to other countries. The European Parliamentary Forum on Population and Development indicates that, according to the statistics of the Irish Family Planning Association, in the year 2006, 5042 Irish women went to Britain for an abortion. In Poland, where underground private abortion services are robust, as is "abortion tourism," women travel to neighboring countries, including Austria, Belarus, Belgium, the Czech Republic, Germany, Lithuania, the Netherlands, the Russian Federation, Slovakia and Ukraine, to have an abortion. But those who cannot afford to travel will resort to unsafe "backstreet" abortions or will even try to terminate their pregnancies themselves, at great risk to their health and even life (according to European Parliamentary Forum on Population and Development, the estimated number of unsafe abortions in Europe varies from 500,000 to 800,000 annually).
Restrictive legislation may also lead to the development of an "abortion underground." Some NGOs in Poland, where abortion is allowed only in the event of rape, incest or danger to the life or health of the mother, have complained about both women's limited access to abortion - the judgment of the European Court of Human Rights in the case of Tysiąc v. Poland confirmed that an ultimate decision on whether or not to carry a pregnancy to term has to be a matter for the woman, and that women's right to control their own bodies must be recognized (see Even Legal Abortion Is Hard to Access in Poland). These associations estimate that some 180,000 clandestine abortions are carried out in Poland every year.
It is often argued that giving women the legal right to abortion will only increase the number of abortions. But in fact, legal restrictions do not contribute at all to reduction of abortion rates and, rather the opposite, very often lead to increasing numbers of unsafe abortions. For example, the Netherlands and Belgium are among those countries in Europe with the lowest abortion rates in Europe - no wonder, as these countries have abortion legislation and services best developed. But unfortunately this is not the case for the whole of the European Union, and also many countries outside the EU.
Therefore, the report states that member states of the Council of Europe should be invited to: first of all decriminalize abortion, if they have not already done so; guarantee women's effective exercise of their right to abortion; allow women freedom of choice and offer the conditions of a free choice; lift restrictions which hinder, de jure or de facto, access to safe abortion, and in particular take the necessary steps to create the appropriate conditions for health, medical and psychological care and offer suitable financial cover; ensure that women have access to contraception at a reasonable cost, of a suitable nature for them, and chosen by them; introduce compulsory sex education for young people (in schools), so as to avoid as many unwanted pregnancies (and therefore abortions) as possible.
]]>Violence against women, including domestic violence, is one of the most serious forms of gender-based violations of human rights. It deprives women of their ability to enjoy fundamental freedoms and represents a serious obstacle to equality between women and men. Violence against women in its various forms is still widespread at all levels of society in all Council of Europe member states.
An overview of figures for the prevalence of violence against women suggests that one-fifth to one-quarter of all women have experienced physical violence at least once during their adult lives, and more than one-tenth have suffered sexual violence involving the use of force. Data analysis supports an estimate that about 12% to 15% of all women have been in a relationship of domestic abuse after the age of 16. Many more continue to suffer physical and sexual violence from former partners even after the break-up.
One of the primary concerns of the Council of Europe is to safeguard and to protect human rights. Violence against women, including domestic violence, undermines the core values which the Council of Europe is based on. The Council of Europe, in particular its Steering Committee for the Equality between Women and Men (CDEG), has undertaken a series of initiatives to promote the protection of women against violence. In April 2002, the Council of Europe adopted Recommendation Rec (2002)5 of the Committee of Ministers to member states on the protection of women against violence. This legal instrument was the first international instrument to propose a global strategy to prevent violence and to protect victims, covering all forms of gender-based violence. Its implementation is regularly monitored using a monitoring framework to evaluate progress. Moreover, the Task Force to Combat Violence against Women, including domestic violence was set up in 2006 to evaluate progress at the national level. It is composed of eight international experts in the field of preventing and combating violence against women.
The campaign had numerous goals: it aimed to raise awareness that violence against women is a human rights violation and to encourage every citizen to challenge it, to urge member states to demonstrate political will by providing adequate resources to deliver concrete results in eradicating violence against women, and finally to promote the implementation of effective measures for preventing and combating violence against women through legislation and national action plans to regularly monitor progress.
The campaign received widespread
support from key actors in local, regional and national governments
as well as parliaments and it ensured that the messages of the campaign
reached a large and varied audience. The Council of Europe member states
contributed significantly to the success of the campaign: more than
half of all member states carried out national awareness raising campaigns,
while many others reviewed their policies and legislation or implemented
other measures. Many national parliaments placed the issue of domestic
violence on their agenda through parliamentary debates, hearings or
tabling amendments to the law.
The primary result of the campaign
has been the recognition by the different actors that violence against
women is a human rights violation - not a private matter. Secondly,
the campaign placed violence against women at the highest level of the
political agenda of member states. Thirdly, it has shown that joint
public action of all national and international actors is necessary
to combat violence against women. Lastly, promoting the implementation
of measures contained in Recommendation Rec(2002)5 has yielded significant
results.
The recent information from the monitoring framework show that a large proportion of member states have recognized domestic violence as a grave problem which has to be dealt with on a solid legal foundation. Recent changes in legislation on domestic violence seem to focus on providing physical distance between victim and perpetrator, mainly by the legal provision of non-molestation, occupation orders and police barring orders. The analysis based on monitoring the national situation in various member states revealed that there is an alarming lack of rape crisis centers or other appropriate services for rape victims in Europe.
This corresponds to the extremely low and sinking level of prosecution and conviction, although for the majority of rapes reported to the police
the perpetrator is known. There should be no legal exceptions or privileges that condone or permit any kind of violence within the family or intimate relationships.
Such exceptions are incompatible with basic human rights and should be removed without delay in all member states.
All member states
should be encouraged to develop national Plans of Action, to
review them, report on the outcomes, and draw up progressive plans for
further activities. An important element in all such action plans will
be securing education and specialized training for professionals in
all relevant fields, as well as actions to improve public awareness
and media treatment of gender-based violence and all related issues.
Differences exist between the eastern and western part of Europe. The legislation on violence in most east eastern European countries is based on the criminal system and rarely has specific provisions for domestic violence. Western European member states are more likely to focus on protection provided by police and civil law. Either way is effective only if appropriate implementation measures are provided.
]]>At an informal meeting with journalists on September 11, the Minister of Health, Ewa Kopacz, declared that she had plans to establish a new department within the Ministry office - the Department on Mother and Child. This department will design a new social and health program concerning pregnant women - and it will be responsible for maintaining a registry of pregnant women.
If a woman agrees to join the program, her data will be registered in a "special system", to enable doctors and nurses to keep contact with her, stated Ms. Kopacz. Women participating in the program will have a chance to undertake additional medical examinations, and they will not wait long hours for a visit with the gynecologist.
That is how the Ministry of Health envisions its fight against illegal abortion. It wants to register pregnant women and afterwards to undertake control as to whether or not a woman gives birth to a child in the end. In Poland, abortion is legal only to save a woman's life or preserve her health.
If a woman participating in the program does not attend medical checks as previously agreed, it will be the responsibility of a midwife to establish contact with her, Minister Kopacz emphasized.
"If we find out that a woman registered in the system is not yet pregnant before her pregnancy due date, it could mean that she has had a miscarriage or she has terminated her pregnancy," said Jakub Gołąb, a spokesman of the Ministry. "That way, we shall receive information about the scope of abortion underground in Poland." Gołąb claimed that the fight against underground or illegal abortion will be an indirect consequence of introducing the program. He could not say whether doctors would be obliged to report to the Ministry and submit all data related to women who declared they had undergone an abortion. We do know that all doctors will be given instructions by the Ministry, according to which - after confirming a woman's pregnancy - they will be obliged to record it in a special register.
The program is set to start running in January of next year. But it is still an idea in need of elaboration. The new Department on Mother and Child is also supposed to deal with the monitoring of announcements in newspapers concerning illegal abortion. "These are hidden under expressions like: 'regaining menstruation,'" said the Minister of Health. "Our aim is to fight against all forms of illegal abortion," she declared.
Many groups have been shocked upon hearing of the Ministry's plans. Women's rights activists objected to the plan as a violation of privacy:
"Registration of pregnant women is a breach of a Constitutional right to privacy and in a way a comeback of totalitarian regime - said Agnieszka Graff from Feminoteka foundation. "That is an attack on women's rights to medical care, because the whole situation will result in women with unwanted pregnancies not visiting their doctors."
By way of protesting, the Polish feminists decided to send to the Ministry of Health tampons with a few drops of raspberry juice. "We would like to show Ms. Minister how grotesque the idea is. If a state wants to control our intimate sphere, here you go," said Graff.
Opponents of the Ministry's idea argue that there are other ways to counteract illegal abortion - there are police and prosecutor's offices. And putting pressure on pregnant women to register is an irrational solution.
The Ministry explains that through the registration process it wants to encourage future mothers to undergo regular medical checks. But others say that future mothers can take care of themselves and that type of state's assistance is not really necessary or helpful.
On the very next day, September 12, the Ministry's representative said that there would be no mandatory registration of pregnant women or control over women who are pregnant. He further stated that the discussion which followed on the news had been adversely interpreted by journalists. He emphasized that there would only be data collected on women who freely joined the program.
Let us hope this time that the news is properly interpreted and all pregnant women in Poland do not face the problem of registering with the government when the new Department on Mother and Child is set to implement its projects in January of next year.
]]>A set of actions for the advancement of women in various areas of their lives was agreed to at the United Nations World Conference on Women in 1995, as the follow-up to the Beijing Platform for Action. Then, in December 1995, the European Council of the European Union concluded that the implementation of the Beijing Platform for Action, in the Member States and institutions of the European Union would be reviewed on an annual basis. Since 1999 the Council has adopted conclusions on indicators and benchmarks, thus making the annual monitoring process more focused and structured. Sets of quantitative and qualitative indicators have been developed by the EU presidencies in themes, relating to the 12 critical areas of concern of the Beijing Platform for Action (a few examples: in 2000 the French Presidency adopted indicators on women in the economy, or the reconciliation of work and family life, in 2002 Danish Presidency adopted indicators on violence against women or in 2004 the Dutch Presidency adopted indicators on sexual harassment in the workplace).
And this year, the European
Council has looked at the next critical area of concern specified in
the follow-up to the Beijing
Platform for Action -- the girl child.
The girl child as a social group is declared to be the most invisible
entity in society and as such is left behind in human development. The
two most important international instruments for girls' rights, the Convention on
the Rights of the Child
(CRC) and the Convention on the Elimination of All
Forms of Discrimination Against Women
(CEDAW), are not being implemented adequately. The issue of the girl
child is regionally and locally conditioned and it is therefore insufficient
to address it at the level of the state. Therefore the above-mentioned
document relates to age segmentation, since it confirms that many interventions
target young children or older adolescents. As a result, many at-risk
girls between the age of 6 and 14 years are left out.
In the Conclusions on the Girl Child, the Council stresses, among other things, that access to sexual and reproductive health care and education, and the elimination of all forms of violence against the girl child, including trafficking, are crucial for the empowerment of girls and women, and encourages the member states to develop sexual and relationship education. The Conclusions contain three indicators to monitor and improve the position of girls in the EU:
1. Sex and relationship education: parameters of sexuality-related education in schooling (primary and secondary) -- assesses the sex and relationship education provided in school programs and analyses the key elements of such education which plays an important role in the development of the girl child's sexual and reproductive health, and gender roles and relations, and is therefore a necessary prerequisite for gender equality.
2. Body self-image: dissatisfaction of girls and boys with their bodies -- examines different self-perception of girls and boys regarding their body image, which has implications for public health. Girls' and young women's dissatisfaction with their bodies does not always reflect a physical condition, but may be the result of culturally imposed norms and images which are significantly influenced by the media. It is therefore important to tackle the reasons underlying the dissatisfaction of girls and boys with their bodies.
3. Educational accomplishments:
comparison of 15-year-old students' performance in mathematics
and science and the proportion of girl students in tertiary education
in the field
of science, mathematics and computing and in the field of
teacher training and education science -- addresses the discrepancy between the
aptitude of girls in mathematics and science literacy (which does not
significantly differ from that of boys), as compared with their subsequent
choice of further educational field at the tertiary level, where boys
and girls continue to follow traditional educational paths. The indicator
helps to assess the potential impact of policies and measures to encourage
both girls and boys to explore non-traditional educational paths and
thus to use their talents and potential to the full.
All these indicators help to focus country's efforts in relation to the girl child status, and urge further actions to be taken to protect and empower the girl children. First of all, there should be measures adopted to prevent and eradicate child prostitution and pornography, as well as actions to enable girls, including pregnant girls and teenage mothers, to continue their education. It is also necessary to provide information and services to girls with regard to sexually transmitted diseases, as well as reproductive and sexual health. For example, education programs on sexual and reproductive health have been developed in the Czech Republic or Latvia. The Czech Republic also established programs to educate young people about HIV/AIDS. Looking at the situation in many Eastern European countries (very recent examples from Romania and Poland, but also many others which we do not know about), it is clear that information campaigns and workshops to prevent teenage pregnancy have to be launched.
Whether the indicators prepared by the European Union institutions really work in practice or are helpful in analysing the progress made, is still difficult to assess, but it seems to me that any type of guidance which is more concrete and explicit in terms of benchmarks may prove to be more effective than declarations contained in various international documents. The EU has always played a role of a guardian of commonly accepted rules and standards; let's just hope it will be more demanding towards its member states with regard to the critical areas of concern described in the Beijing Platform for Action and its adequate implementation. The status of the girl child in many countries has not been discussed at all, so the above documents should be understood as a first little step in a good direction, although, as mentioned above, more intensive steps have to be yet undertaken.
]]>The Committee considered the recent official reports from Lithuania as well as a shadow letter submitted by the Seimos Planavimo ir Seksualines Sveikatos Asociacija (The Family Planning and Sexual Health Association-FPSHA) based in Vilnius, Lithuania and the Center for Reproductive Rights, based in New York. In their letter of June 5, 2008, organizations brought to the Committee's attention the pending restrictive abortion legislation. And during Lithuania's review, CEDAW committee members pressed the government delegation not only on access to contraception but also on proposed legislation that seeks to defend prenatal life and would pose restrictions on access to abortion. Japanese committee member Yoko Hayashi stated that governmental restrictions on abortion "contradict the full enjoyment of women's reproductive health rights that are protected by CEDAW."
Committees of the Lithuanian Parliament are considering a draft law (known as the Act of the Republic of Lithuania on the protection of the human life in the prenatal stage) that aims to severely limit access to abortion and would create one of the most restrictive laws on abortion in Europe. The draft provides for only three situations in which abortion would be lawful within very strict time-limits: when the pregnancy involves a risk to the life or health of the pregnant woman, and when there are reasonable grounds to believe that the pregnancy is the consequence of criminal acts. Access to abortion in cases of fetal impairment is not guaranteed. In February 2008, a group of more than 110 Members of the European Parliament signed a letter urging the Lithuanian Parliament to reject this draft law because it would represent a serious backlash to women's reproductive health rights in Lithuania, limiting their right to life, health and dignity. On April 16, 2008, the Human Rights Committee of the Lithuanian Parliament issued its supportive opinion on the law. According to one of the members of Lithuanian delegation to CEDAW session, the discussions are being continued, as the Ministry of Health responsible for presenting the final conclusions on the draft did not support the act in its current wording. Delegation members also explained that because the draft is very controversial and because it is influenced by the Catholic Church authorities, it is extremely difficult to predict the outcome of debates.
Taking the above into consideration, in its concluding observations, the CEDAW Committee expressed concern about this draft law on the protection of human life in the prenatal phase. Since, according to the law, abortion under circumstances apart from three situations mentioned in the act may be considered a punishable offense under Lithuanian law, the Committee is concerned that the adoption of such a law may lead women to seek illegal abortions, which may bring negative consequences to their health. The Committee has called on Lithuania "to consider the impact on women of the draft law on the protection of human life in the prenatal stage to ensure that the draft law is in line with the Convention and accordingly will not lead to women seeking unsafe medical procedures, such as illegal abortion, which may seriously risk their health and lives and may contribute to a rise in maternal mortality."
Lithuania seems to be considering more restrictive regulations on abortion as a solution to reducing high numbers of abortions performed annually throughout the country. However, as rightly pointed out by many organizations working on reproductive rights, banning abortion will negatively affect only low-income women, while wealthy women will still be able to meet their reproductive health needs by travelling abroad and performing abortions in other countries of the European Union. The example of Poland shows ‘abortion underground' seems to be a direct result of introducing restrictive laws not allowing for abortions in many justifiable situations. The Center for Reproductive Rights rightly pointed out in the written comments on the proposed legislation that "the Irish and Polish laws, by severely restricting legal abortion access, have not succeeded in achieving their policy goals of reducing the number of abortions women seek and in increasing the number of children born. [...] In addition, both the Irish and Polish laws have been analyzed by national as well as international courts. Both countries' laws have been challenged for violating women's fundamental human rights before the European Court of Human Rights (see Even Legal Abortion Is Hard to Access in Poland).
The experiences of countries like Ireland or Poland show that restrictive abortion laws have not led to reduced numbers of abortions or resulted in population growth. Hence, as also requested by the CEDAW Committee, instead of changing the laws, Lithuania should arrange for family planning methods, "such as a comprehensive range of contraceptives, including emergency contraception, more widely available and affordable, provide mandatory sexual education in schools and increase knowledge and awareness about family planning among women as well as men." Lithuanian legislators should take this into account before it is too late.
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Having such
a strict law in force, the Poles' opinions about the legal regulation
of abortion are intriguing; even more so if you take into consideration
the fact that Poland is a Catholic country and a Catholic doctrine prohibits
abortion without any exceptions. The most recent public opinion polls
show that proportions
of those who believe that abortion should be legal (overall 47%) and
those who are oppose legalization (45%) are almost equal. Thirty-five percent of respondents think that abortion should be legal, although with certain restrictions, and 12% oppose any restrictions. For those who think abortion should be outlawed, 32% believe there should be certain exceptions, and 13% opt for an absolute
ban on terminating pregnancy. Public
opinion polling from September 2007 shows that half of Polish adult population
accepts that a woman - if she so decides - should have a right to
abortion during the first weeks of her pregnancy.
So generally Poles accept terminating pregnancy in the situations in which the current regulations allow it. The belief that abortion should be possible when the mother's life or health is in danger is almost universal. A vast majority of the respondents also believe that abortion should be legal when pregnancy is a result of rape or incest. Moreover, the opinions about acceptability of abortion when the mother's life or health is in danger or when the pregnancy is a result of rape or incest practically did not change between 1992 and 2007. A clear majority have always supported the view that abortion should be legal in such cases.
But, even though the law allows for three fundamental reasons to legally terminate pregnancy, and the majority of Polish population supports legal abortion in certain circumstances, in practice, women do not have real abortion access. Because there is still a social stigma attached to performing abortions, very often doctors refuse care using a "conscience clause." They are also afraid to perfom abortions because it is a criminalized action, if perfomed outside a specified exceptions. Doctors tend not to refer women to other doctors and there is no clear mechanism in place which would help women to get an urgent assistance and where they could apply for a final decision.
The practical application
of the existing law has been dealt with many times by the United Nations
organs: the UN Human Rights Committee, which monitors state compliance
with the International Covenant on Civil and Political Rights, has been
stating in its reports that the despite legalization in certain circumstances, actual access to abortion
has not been changed. Just recently, in April 2008, the
UN Human Rights Council put pressure
on Poland with regard to abortion -- Norway
requested elaboration on what is done to facilitate access to abortion
for women who qualify for this under the Polish law.
Looking closer at the recent cases pursued both by the national as well as international courts, we see that the limited access to abortion may be somehow ‘cured' by applying the court rulings which also directly constitute a guideline as to how women whose rights have been violated can exercise their rights. Here, the ruling of the European Court of Human Rights in Tysiąc vs. Poland, could serve as an example of a successfully resolved case on the protection of reproductive health. Alicja Tysiac was denied abortion because doctors couldn't see the direct link between her pregnancy and deterioration of her eyesight. But because the anti-abortion law mentions a 'threat' to health and not certainty, the European Court of Human Rights ruled that Alicja's right to private life was violated. She should have been able to decide whether or not to have an abortion because her health was at stake.
But execution of the judgment includes also making appropriate changes in the law to guarantee that similar violations of human rights will not occur in the future. The European Court of Human Rights found that the Polish legal framework did not provide an effective mechanism to resolve disagreements as to the availability or legality of therapeutic termination in any case, either between a pregnant woman and doctors or between medical staff themselves. Therefore, an effective appeal mechanisms which would make it possible to obtain binding and final decisions related to termination of pregnancy should be introduced in the Polish system. The Polish Government has not yet presented any plan of reform, but the case inevitably created a firm basis for further developments in this area.
]]>With this post RH Reality Check is delighted to introduce our newest Global Perspectives correspondent, Anna Wilkowska-Landowska, a human rights lawyer and women's health advocate living in Poland and reporting on Eastern Europe. Welcome, Anna!
Two cases of young girls, age 11 and 14, who got pregnant and were desperately looking for help, totally dependent on the decisions of others, hit headlines in their home countries of Romania and Poland, and beyond, recently. Two cases, which resulted in controversial discussions and strong attitudes of various social groups. Two cases attracting lots of public attention. Do they have something in common?
In the Polish case, everything seemed to be clear - there was an official statement allowing for termination of pregnancy as well as parent's and child's consent to proceed. Agata had a right to terminate her pregnancy because it resulted from an illegal act - a sexual intercourse with a minor (under the age of 15). Her right was therefore unquestionable. But, even so, obtaining abortion care proved to be a real problem. Hospitals, which are public institutions, refused to terminate Agata's pregnancy. Moreover, a priest appeared in a hospital trying to persuade Agata not to terminate her pregnancy.
Her own religious views seemed to be irrelevant. The fact that the hospital is a public institution, not directly connected with religious authorities, seemed to be irrelevant. Nobody asked Agata or her mother whether they wanted to consult with anyone; nobody asked them whether they wanted to talk to a Catholic priest. That type of interference constituted an example of an obvious violation of a person's right to privacy -- a right which is already very problematic in Polish circumstances, especially with regard to abortion. The case generated a lively discussion in Poland about abortion and right to privacy. Anti-abortion campaigners have started a new campaign against Poland's Minister of Health, Ewa Kopacz. She intervened in the Agata case at the last minute to find a hospital willing to perform abortion. Now campaigners are calling for her to be excommunicated.
In Romania, an 11-year-old Romanian girl, Florina, was found to be 21 weeks pregnant after being raped by an uncle. Romanian law permits abortion until the fourteenth week of pregnancy if the pregnancy endangers the mother's health or if the fetus has some kind of malformation; abortions can only be carried out later than 14 weeks to save the life of the mother. Here, we have a situation where a pregnancy, despite being a result of an illegal act, cannot be terminated because it is already beyond the 14-week limit set by law.
But even though it is forbidden by law, and despite strong pressure from a number of religious groups, a government committee ruled that the girl could have an abortion in Romania, due to the "exceptional circumstances" of this case. According to BBC News, the fact that the girl was raped was a major factor in this decision, as she faced "major risks to her mental health." The case attracted attention of anti-choice Christian Orthodox groups, which had urged the family to keep the child, and offered to raise it in a church institution. But, most importantly, the official position of the Orthodox Church, to which more than 80 percent of Romanians belong, said the girl's pregnancy was "an exceptional situation which must be treated in an exceptional manner and the family is the only one to make this decision." The church spokesman said the church considers abortion a crime, but this belief applies to normal circumstances and not to incest or rape. That is a very different point of view from that presented by the church authorities in the Polish case.
Agata and Florina finally terminated their pregnancies. The end result is the same, but the processes that had led to the terminations seem to differ considerably in both cases. Do these cases have something in common? Both of these young women required high levels of protection during the decision-making process, especially because of their vulnerability to emotional distress connected with abortion. ]]>