Current standards of medical care for pregnant women in Poland are already inadequate and unsatisfactory, as already mentioned in a few articles posted last year (see for example: Poland Says No to Pain-Free Childbirth). And the Act, currently being debated within the Parliamentary Health Commission, may result in making the existing situation even worse. It is commonly acknowledged that women giving birth are not provided with sufficient level of medical care. The issue of anaesthetization could serve as an example here - the state budget cannot afford to ensure free anesthetization during childbirth to all Polish women. And furthermore, changes to be soon adopted by the Ministry of Health indicate that the above standards may deteriorate. For example, what will happen with prenatal examinations, asks Professor Mirosław Wielgoś, Gynecology Consultant in the Mazovia region.
Similar concerns are expressed by pediatricians, who call upon the Ministry not to change the previously binding provisions. They claim that the new regulations adopted by the Ministry of Health will create a loophole in law with regard to the vaccination process. "It would mainly concern those vaccinations that are now financed from public funds and therefore are automatically guaranteed," said Teresa Jackowska, vice-president of the Polish Pediatric Association.
The Ministry of Health defends itself, stating that all the existing regulations previously included in the 2004 Act, will be moved into new ordinances drawn up by the Ministry. However, the Polish doctors question the practicality of adopting such a solution. They rightly point out that ordinances, as acts located lower in the hierarchy of legislative acts, could be subject to amendments or modifications in much easier way. "Regulations adopted in a form of ordinances do not guarantee their adequate and effective implementation. Such regulations could also create an interpretation chaos," highlights Marek Michalak, the Ombudsman for Children's Rights, who also prepared a special petition on that issue submitted to the Parliamentary Health Commission.
In its response, the Ministry of Health points out that such a possibility to introduce changes to the ordinances will facilitate the process of adoption of modern methods of medical treatment or preventative treatment. Moreover, as stated by the Ministry officials, there is no need to specifically differentiate women and children in the law, because they will have access to medical examinations exactly to the same extent as provided for the rest of society.
But the above explanations are difficult to accept, even by members of the Polish parliament. They say it is guaranteed in the Polish Constitution that women and children should enjoy a special protection with regard to needed medical treatment. Article 68 (3) of the Constitution states that public authorities shall ensure special health care to children, pregnant women, handicapped people and persons of advanced age. So why then does a guaranteed protection disappear from the Act? By deleting the provisions that specifically refer to mothers and children, the Ministry presents evident proof for its negligence in observing the fundamental rules of law.
The entire situation, as described above, seems to be even more interesting, or strange, because of the fact that for a few months now the Ministry of Health has been working on establishing a new Department on Mother and Child, which was to initiate its operations in January 2009. Its major task shall be in particular to provide all necessary care to children as well as women during pregnancy and delivery. But what it will be doing in practice still remains to be seen.
]]>Abortion restrictions interfered with the most intimate aspects of their private and family lives without adequate justification, they say. This, they submit, is in violation of the European Convention on Human Rights, which provides a right to respect for one's "private and family life." In addition, they also claim the abortion laws impeded the ability of some of them to obtain necessary follow-up medical care upon their return to Ireland.
The women, who are represented by the Irish Family Planning Association, say there is a lack of any effective remedy at home and Irish law is in inadequate. They also say that taking a case to the Irish courts would have been costly, futile and could have forced them to relinquish their anonymity. The women's complaints are based on four alleged violations of articles in the European Convention on Human Rights, including protection from "inhuman or degrading treatment" and freedom from discrimination. First, the women argue that their human rights are being violated because Ireland's abortion ban violates their right to privacy in all family, home and personal interests, and their entitlement to no public interference from any public authority in exercising this right (Article 8 of the European Convention on Human Rights). Second, the ban violates their right to be free from inhumane and degrading treatment (Article 3) because women seeking abortions are stigmatized and suffer increased feelings of guilt, as well as difficulty securing follow-up care. Third, the ban breaches their right to life (Article 2) because the Irish government has not provided any clear legislation about when abortion may be legally carried out under the exception reserved for saving the mother's life. Fourth, the women allege that Irish abortion law discriminates on the basis of sex and financial status (Article 14). Thus, the women argue that forced travel and childbirth, endangerment of pregnant women's lives and discrimination based on sex and financial status violate their rights.
Ireland (both Northern Ireland and the Republic) has an exceptionally restrictive law on abortion, which allows abortion only when the life of the woman is in danger. In practice, however, abortion is unavailable in Ireland in almost all circumstances due to ambiguity about when a physician may legally perform a life-saving operation. The law also fails to make any provision for a woman who is pregnant as a result of rape or incest, experiencing severe fetal abnormality or at risk of permanent bodily harm such as blindness, diabetes, kidney or heart disease. Official figures show that over 7,000 women travel each year to England for abortions from the Ireland. This figure is based upon the number of women providing Irish addresses (from the Republic and Northern Ireland) and vastly undercounts the actual number of women travelling, some of whom may give false addresses in England or travel to other countries like Belgium and the Netherlands.
All three women submitting the case to Strasbourg decided to travel to England to have an abortion. The group includes a woman who ran the risk of an ectopic pregnancy, where the fetus develops outside the womb. She had taken the morning-after pill the day after intercourse, but was advised by two different doctors that it had not only failed, but had given rise to a significant risk that it would be an ectopic pregnancy. Another of the women had undergone chemotherapy for cancer treatment. She was unable to find a doctor willing to make a determination about whether her life would be at risk if she continued to term, or to give her clear advice as to how the fetus might have been affected. The third woman, whose four children were placed in foster care as a result of problems she faced as an alcoholic and because she was unable to cope, was unmarried, unemployed and living in poverty.
The impossibility for these women to have an abortion in Ireland made the procedure unnecessarily expensive, traumatic and complicated.
The decision of the European Court of Human
Rights on the case is expected shortly. It shall be binding on Ireland
and must be complied with by the Irish authorities.
]]>
There has always been "abortion tourism." In Europe, there are two states from which women are "escaping" to terminate a pregnancy. The first is Ireland. Representatives from IFPA and the Safe and Legal Abortion Rights Campaign in Ireland reported that 200 women travel each week to the United Kingdom from the Republic and Northern Ireland to have an abortion. Abortion remains illegal on both sides of the island's border, and the penalty for helping a woman obtain an abortion is life imprisonment.
Economics also plays a part here - Irish women making the trip have to find at least £1000 to pay for it, which is completed in secrecy and silence. Therefore, socio-economic status plays a huge role in whether a woman can access safe abortion.
However, a trip abroad does not have to be more as expensive as some private Polish surgeries. Poland is the second European state where the "abortion tourism" exists. As already mentioned in a previous article (Even Legal Abortion Is Hard to Access in Poland), the anti-abortion law in Poland is one of the most restrictive in Europe. Therefore, Polish women very often look for a clinic in countries neighboring Poland, where it is much easier to get a safe abortion. These countries include Czech Republic, Germany or Ukraine. Just recently, Czech Republic's cabinet unanimously approved a bill that would extend abortion privileges and other health services to all European Union (EU) citizens (see: Czech Republic: Abortion Services Not "Abortion Tourism" for EU Citizens).
The opponents to the bill claim that the new regulations will enable "abortion tourism" from the other European states where termination of pregnancy is restricted, and here Poland comes as a main example.
It is difficult to measure the phenomenon in Poland, but it is still significant and growing, particularly after Poland's accession to the European Union, which has significantly increased the mobility of Polish women. The survey was undertaken by the Federation on Women and Family Planning in Poland, and included in the report entitled, Reproductive Rights in Poland: The Effects of the Anti-Abortion Law, showed that most often this is a dozen or so or several dozen cases annually. Abortion tourism has an individual character. It seems that organized abortion tourism does not currently exist on a large scale like it did in the early 90s, when there were agencies organizing trips for women to Belarus or to Russia for abortions. As a result of police operations, such agencies were liquidated.
The recent article published in Kyiv Post by Yuliya Popova suggests evidence that Ukraine has become one of the countries Polish women go to terminate pregnancies. Petro Gusak from the Lviv Institute of Family and Married Life said, "It's an entire industry. There are special tourist buses that take Polish women in reproductive age across the border to see the doctors."
Wanda Nowicka, Director of the Polish Federation for Women and Family Planning in Warsaw, said that women with higher income travel to EUcountries. Those earning much less go to Ukraine or Belarus. Many others buy special pills on the Web to abort a pregnancy at home. Nowicka, however, cannot produce any documented proof for Ukraine because "it's all done secretly," but, the article refers to Dr. Iryna Mykychak from the Lviv Regional Health Administration who denies any backstreet abortions in her district. "We have not had a single foreign woman seeking that service recently," she said.
But, unofficially it is said that Ukrainian doctors do not deny anyone their services, performing at least 200,000 abortions for Ukrainian women and possibly another few thousand for the Polish "tourists."
While the abortion opponents talk about abortion tourism, only the most privileged women can escape local pro-life laws. The rest, mostly poor and young women, simply suffer. They cannot find the money or the assistance to make such trips so they suffer the health consequences of unsafe and illegal abortions performed in their own countries.
]]>Generally, according to the German abortion law adopted in 1995, abortion within the first three months of pregnancy is an unlawful act but not a punishable offense if a woman visits a counseling center first, although she is not required to explain why she does not want to carry the fetus to full term. Abortions are also permitted in certain cases after the first trimester, when they are often referred to as "late-term abortions." In German law, a late-term abortion is a termination after the 20th week of a pregnancy, when there is a risk to the physical or mental health of the mother.
Late-term abortions are considered more controversial because the fetus is more developed and sometimes viable. Most late-term abortions are carried out when prenatal diagnosis reveals that the fetus has a severe disability. Statistics say that approximately 600 late-term abortions are performed in Germany each year, with 120,000 abortions total carried out every year.
The practice of late-term abortions in Germany is based on an article in the Penal Code that established abortion as "not punishable" when it is believed that the pregnancy or the birth of a child will gravely affect the life or health of the mother.
Discussions over late-term abortions initiated a few years ago. First meetings with church representatives were held in 2005, when it was observed that late-term abortions were on the rise. After years of debates, the lower house of the German parliament in Bonn - Bundestag decided on May 14, 2009 that women should be required to undergo a waiting period of at least three days before a physician makes a final decision on termination of the pregnancies.
As it is reported, among 612 parliamentarians involved in the vote, 326 delegates voted in favor of the consultation period which includes a doctor's psychological evaluation, 234 voted against and 52 abstained. Parliamentarians also voted in favor of increased consultations and support for families with handicapped children considering a termination. Despite several past attempts, the Social Democrats' (SPD) group and the Christian Democratic Union (CDU), Germany's two coalition partners, have never managed to find a common ground on late-term abortions.
The obligation of counseling from a doctor about the medical and psychological consequences of a late-term abortion aims to reduce the number of late-term abortions. The doctor should also inform the patient about living with a physically or mentally disabled child, and point her toward other means of support. A woman considering a late-term abortion would also have a three-day waiting period between the counseling session and the procedure to give her time to think about her options.
]]>
In March 2008, the Hungarian government declared the opposite. It would not provide any compensation to Ms. A.S., a woman who was sterilized by Hungarian doctors without her consent. Now, on February 24, 2009, after eight years of national and international legal proceedings, there is hope that the victim, as recommended by CEDAW Committee, "will be provided an appropriate compensation commensurate with the gravity of the violations of her rights."
Before CEDAW, Ms A.S. was represented by the European Roma Rights Center (ERRC) and the Legal Defense Bureau for National and Ethnic Minorities (NEKI). She claimed that on January 2, 2001, she was subjected to coerced sterilization by medical staff at one of the Hungarian hospitals, where she had been taken after labor pains.
While examining her, the attending physician found that the fetus had died in her womb and told her a caesarean section needed to be performed immediately in order to remove the dead fetus. While on the operating table, Ms. A.S. was asked to sign forms giving her consent to this operation as well as to her sterilization. However, the doctors did not explain the procedure, its nature, possible risks or the consequences of being sterilized. Only after the operation did Ms. A.S. learn that she had been sterilized. On October 15, 2001, Ms. A.S. and her attorney filed a civil claim for damages against the hospital. On appeal, the court held that the hospital doctors had indeed acted negligently. Nevertheless, the same court concluded that since Ms. A.S. had provided no proof that she had suffered a lasting detriment, she was not entitled to compensation.
On February 12, 2004, the ERRC and NEKI jointly filed a complaint with CEDAW relating to the illegal sterilization under the CEDAW optional protocol. In support of the victim's claims, a brief was prepared by the Center for Reproductive Rights. The Center underlined that consent and the right to information are critical components of any sterilization procedure, and that human rights are violated when sterilization is performed without the full and informed consent of the patient.
In the case of Ms. A.S., by sterilizing a woman without her fully informed consent, Hungary, through the doctors at the public hospital, violated her right to decide on the number and spacing of children. As a result of the non-consensual sterilization that was performed, the woman no longer has, and will never have the freedom to make decisions as to the number and spacing of children.
In August 2006, the Committee found the Hungarian government to be in violation of the Convention. The Committee recommended the government provide appropriate compensation to Ms. A.S., review domestic legislation on the principle of informed consent in cases of sterilization and ensure its conformity with international human rights and medical standards. And in connection with that, consider amending the provision in the Public Health Act, which allows a physician "to deliver the sterilization without the information procedure generally specified when it seems to be appropriate in given circumstances," and monitor public and private health centers including hospitals and clinics that perform sterilization procedures to ensure that fully informed consent is given before any sterilization procedure is carried out, with appropriate sanctions in place in the event of a breach.
The
Committee also requested the Hungarian government to submit to the Committee,
within six months, a written response, including any information on any action
taken in the light of the views and recommendations of the Committee. But still,
a year later, in 2007, in its concluding
comments, the Committee expressed concern at the Hungarian government's
failure to implement the recommendations and again urged the government to
"provide appropriate compensation to Ms. A.S."
Only in 2008, following the Committee recommendations, the Hungarian Government amended the Public Health Act to ensure that appropriate information be given to patients in the context of sterilization procedures to ensure informed consent. And in February 2009, the government declared its willingness to pay an adequate compensation to Ms. A.S.
The compensation means not only justice to A.S., but the Hungarian Government's recognition of its obligations to all women under international law. It is an important step forward in ensuring respect for the optional protocol of the CEDAW Convention. "We hope that Hungary's actions will serve as an example to other countries, like the Czech Republic and Slovakia, where the problem of coercive sterilization still has not been fully addressed," said Ostalinda Maya, ERRC's Women's Rights Officer.
]]>The law was passed unanimously by the National Council, Monaco's parliament, in a 26-0 vote. This is significant because 90 percent of Monaco's population is formally Catholic. As generally known, the Roman Catholic Church believes that life begins at conception and opposes abortion under all circumstances. However, the modern Catholic position states a medical procedure needed to save the life of the mother, but that may result in the death of the "pre-born child" as a secondary effect, is morally acceptable.
Until now, Monaco has had one of the most restrictive abortion laws in Europe. Under Monaco's Criminal Code, there were no stated exceptions to a general prohibition of abortion. Nonetheless, under general criminal law principles of necessity, an abortion could be performed to save the life of a pregnant woman. Any person performing an illegal abortion was subject to one to five years imprisonment and a fine. A woman who induced her own abortion or consented to its being induced was subject to six months to three years imprisonment and a fine. Physicians, surgeons, midwives and pharmacists who performed abortions were liable to harsher penalties including suspension from their profession.
The process of adopting a new bill calling for increased abortion access took years of struggling against religious beliefs. Like many other Catholic Church representatives, Archbishop Pernard Barsi of Monaco said there are a few fundamental principles that come not from religious morality, but from the natural law itself, that applies to all modern civilized societies: Life begins at conception. "What we term ‘interruption of pregnancy,' no matter what the motive is, remains an abortion. One of the most fundamental human rights is the integrity of the person at all stages of life. Civil law must never abridge the moral law," he said.
The Catholic Church in Monaco continuously claimed that permitting deliberate abortion for medical reasons or rape would inevitably lead to abortion on demand, and sooner or later, to the total liberalization of abortion. Barsi was pointing to the progression of laws permitting abortion in countries with no restrictions on the procedure. Instead of focusing on termination of pregnancies, he suggested looking closer at the problems faced by women and families dealing with difficult pregnancies, and called for increased support in society for them. "It's not by legalizing the 'interruption of pregnancies for medical motives or rape' that we will help women, couples and families. We must in fact accompany women by putting in place concrete measures within our institutions to foster solidarity," he said.
The new law permits abortion for "hard cases" including rape, fetal deformity, fetal illness or danger to the life of the mother. Catholic authorities argue that new regulations on termination of pregnancy are "incompatible" with the constitution of Monaco, which recognizes the Catholic faith as the state religion. They fear, for example, that there will be further attempts to conform Monaco to what they consider lowest ethical standards.
Adoption of the new bill on abortion in Monaco should be regarded as an important step on the way to providing sufficient guarantees for women within the area of reproductive rights. The fact that currently there are only two states in Europe where abortion is illegal and therefore totally prohibited, is a genuine proof that societies can change mentality, despite religious constraints that very often constitute serious obstacles when discussing controversial matters, especially abortion. Monaco serves as a perfect example.
For 10 years now, the International Women's Day has been an opportunity for women to voice their opinions and persuade people that women share common interests and promote the idea that they should be more active and independent: do business, get into politics, demand equality within the family and in the workplace. For 10 years, the Polish organization called Porozumienie Kobiet 8 Marca (March 8 Women's Alliance), supported by many women's groups, has been organizing the biggest demonstration of women's rights supporters, widely known as Manifa (march of protesters). It has become a grassroots democratic movement. The Manifas are being organized in many Polish cities, by local committees, comprised of NGOs, university gender studies programs, scientific associations, and informal groups or individuals.
When organized for the first time, Manifa gathered only 200 participants, but last year there were almost 4,000 people. That also demonstrates the great need for having initiatives like that and for creating a spectacular event highlighting the role of women and the concerns and problems women face in our country. But in the beginning, media perceived these demonstrations as gatherings of "strange women feminists, showing their dislike of men." Today though, they already know that instead of, or rather, in addition to, flowers, women deserve to change of discrimination and stereotyped beliefs they suffer from. As one of the protesters in 2008 said, "Women are everywhere, they are 50% of the society. Yet their voice is not being heard. Women issues and problems women have are ignored and marginalised. We are fed up with this. Therefore it's high time we did something about it."
Each year Polish women taking part in Manifas are voicing different priorities within the area of women's rights, which for them seem to be the most important and need to be addressed immediately. Among the demands, they make are: easy access to contraception; abolishing the gender role stereotypes that people are socialized into; right to decide about oneself and one's body; no more treating women as sexual objects; proper sex education in schools; and treating equally women who are elderly, poor, homosexual, of different ethnicity, of low social standing or handicapped.
This year's Manifa, to be held on Sunday, March 8, 2009, is advertised by many women's organizations using the following words: "Come and Join Us Because ... Poland is Ill." It is therefore aiming to highlight the problems connected with health, including a new law addressing in-vitro fertilization, which is currently being drafted by a bioethics committee. The project is expected to regulate in vitro procedures including protecting the rights of an embryo, forbidding the sale of sperm and eggs, as well as banning the selection of eggs for fertilization. But, women's groups claim, the draft law is very much influenced by the Catholic ideology - the law will prevent single persons and also homosexual couples for accessing IVF. Also, the law will change the existing provisions which oblige a doctor to inform its patient who wants to undergo abortion about another doctor or clinic where such a procedure may be performed if he or she refuses to perform one. After adoption of a new law, a woman will not have a right to be provided with such information. The law may also criminalize the use of certain types of contraceptives, like coil, or morning-after pills, like Postinor.
The demonstrators will also underline controversial ideas of the Ministry of Health regarding registering pregnancies in Poland (see: Pregnant in Poland? Government Considers Tracking You for Illegal Abortion), and not allowing for voluntary anesthetization during delivery (see: Poland Says No to Pain-Free Childbirth), all of which raised serious concerns among women as to whether they are willing to become mothers, if basic health guarantees are not ensured or seem to be at stake.
It is clear that health is a fundamental prerequisite for a good life, for the ability to support oneself, and for the enjoyment of other human rights. Of course, the health of women matters, most of all, to women themselves. But it also matters to their families, communities and societies. Therefore, it should not be considered in isolation. In order to improve the health of women, other determinants of women's health status need to be analyzed. That includes, among others, inequality in employment between women and men, where equal pay is still practically inexistent - women are still paid 25% less than men while holding the same positions. And unemployment, where 60% of all unemployed are women. Both of which influence their ability to support themselves and their families, also in relation to healthcare.
Manifas are designed to be cheerful events with lots of open-minded people, colorful clothes, but with a serious message. By organizing manifas in many various cities in Poland as part of the International Women's Day celebrations, this serious message could be heard more easily by a wider audience. ]]>The applicants were three non-governmental organizations particularly active in promoting the debate about reproductive rights - Women on Waves, a Dutch foundation based in Amsterdam, and two Portuguese associations, Clube Safo and Não te Prives (Group for the Defense of Sexual Rights), based in Santarém and Coimbra (Portugal). Women on Waves' mission is to prevent unsafe abortions and empower women to exercise their human right to physical and mental autonomy. The organization charters ships to sail to countries where abortion is illegal. After sailing to international waters doctors aboard the ship can provide early medical abortions safely and legally. National penal legislation, including abortion laws, extends only to territorial waters; outside that 12-miles radius the ship is only beholden to the law of the country of its registration.
In 2004 Women on Waves chartered the ship Borndiep and sailed towards Portugal after being invited by the two other applicant associations to campaign in favor of the decriminalization of abortion. At the time Portugal was the only country within the EU that actively prosecuted women and doctors for illegal abortion. Meetings on the prevention of sexually transmitted diseases, family planning and the decriminalization of abortion were planned to take place on board from August 30 to September 12, 2004. But on August 27, 2004 a ministerial order banned the ship from entering Portuguese territorial waters on the basis of maritime law and Portuguese health laws. A Portuguese warship blocked the Borndiep's entrance. On September 6, 2004 the Administrative Court rejected a request by the applicant associations for an order allowing the ship's immediate entry. The authorities indicated that they thought, erroneously, that the Women on Waves ship would give Portuguese women access to forbidden abortion procedures and medicines.
The applicant associations tried to appeal against that decision but without success. They subsequently applied to the Supreme Administrative Court, which found that the matter in dispute was not of sufficient legal or social significance to justify its intervention. Women on Waves' sources say that a number of demonstrations in support of the three associations took place in Portugal, attracting media attention.
The organizations decided to lodge an application with the European Court of Human Rights on August 18, 2005. Almost four years later, the Court decided that there had been a violation of Article 10 of the Convention for the Protection of Human Rights and Fundamental Freedoms. The European Court concluded that the interference by the authorities violated Article 10, as it had been disproportionate to the aims pursued. The Court not only noted that nothing indicated that the NGOs had wanted to administer abortion medicines, but, furthermore, because the NGOs' aim was to to inform people about reproductive health, the authorities should have respected their rights to hold sessions on the ship as they always had. The Court also noted that the use of a war vessel in itself to stop the ship may have had a chilling effect on the work of Women on Waves.
While the Court acknowledged the legitimate aims pursued by the Portuguese authorities, as the "prevention of disorder and the protection of health, it stated that pluralism, tolerance and broadmindedness towards ideas that offended, shocked or disturbed were prerequisites for a ‘democratic society.'" It pointed out that the right to freedom of expression included the choice of the form in which ideas were conveyed, without unreasonable interference by the authorities. The Court considered that in this case, the restrictions imposed by the authorities had affected the substance of the ideas and information imparted. It noted that the choice of the ship for the events planned had been crucially important to the applicant associations and in line with the activities that Women on Waves had carried out for some time in many European states. The Court highlighted that the applicant associations had not trespassed on private land or publicly owned property, and it noted the lack of sufficiently strong evidence of any intention to deliberately breach Portuguese abortion legislation.
In early December 2004, only two months after the ship's visit to Portugal, the Portuguese government dissolved. The Socialist Party won the elections in February 2005 with an overwhelming majority and promised to hold a national referendum on abortion law. Portugal subsequently legalized abortion in February 2007, two and half year after the Women on Waves ship visited Portugal.
While the length and difficulty of this case may be disheartening, it marks a great change in Portuguese society. When the last case involving dissemination of information on abortion was decided in 1992, it was a highly contentious case resulting in a divided court. In contrast, this 2009 judgment was unanimous.
]]>The Declaration on Human Rights, Sexual Orientation and Gender Identity, is a French-initiated statement presented to the United National General Assembly on December 18, 2008. The declaration condemns violence, harassment, discrimination, exclusion, stigmatization, and prejudice based on sexual orientation and gender identity. It also condemns killings and executions, torture, arbitrary arrest, and deprivation of economic, social, and cultural rights on those grounds. It is calling for an end to the laws criminalizing gay sex between consenting adults in private. It wants all States to ensure that sexual orientation or gender identity may under no circumstances be the basis for criminal penalties, in particular executions, arrests or detention. Sources say that "homosexuality" and gay sex between consenting adults in private is punishable by law in 77 countries and gay people can be executed in seven Islamic countries: Saudi Arabia, Iran, Yemen, Sudan, Mauritania and parts of Nigeria and Pakistan. On the other hand it is legal in 47 countries, while 57 other countries passed legislation to protect same-sex orientation. The declaration also urges States to ensure that human rights violations based on sexual orientation or gender identity are investigated and perpetrators held accountable and brought to justice and to ensure adequate protection of human rights defenders, and remove obstacles to them carrying out their work on issues of human rights and sexual orientation and gender identity. The declaration has been recognized as an important step on the way to fulfill human rights' objectives, finally breaking the taboo against speaking about LGBT rights in the United Nations.
Sixty-six of the United Nations' 192 member countries signed the declaration, including every member of the European Union and every major Western nation except the United States.
Among the first to voice opposition for the declaration was Vatican. "Despite the declaration's rightful condemnation of and protection from all forms of violence against homosexual persons, the document, when considered in its entirety, goes beyond this goal and instead gives rise to uncertainty in the law and challenges existing human rights norms," a Vatican statement said. In early December, 2008, the apostolic nuncio leading the Holy See's permanent observer mission to the United Nations, Celestino Migliore, claimed: "If adopted, it would create new and implacable discriminations. A declaration might be used to put pressure on or discriminate against countries that do not recognize same sex marriage." In a statement Archbishop Migliore noted: "In particular, the categories 'sexual orientation' and 'gender identity,' used in the text, find no recognition or clear and agreed definition in international law. If they had to be taken into consideration in the proclaiming and implementing of fundamental rights, these would create serious uncertainty in the law as well as undermine the ability of States to enter into and enforce new and existing human rights conventions and standards." The statement was widely criticized, for example by France, as well as by Amnesty International and gay rights groups and Italian press.
Fifty-seven of U.N. member states supported an opposing statement. The statement rejected the idea that sexual orientation is a matter of genetic coding and claimed that the two notions of sexual orientation and gender identity should not be linked to existing human rights instruments, adding that the statement "fell into matters that were in the domestic jurisdiction of states" and could possibly "legitimize many deplorable acts, such as pedophilia."
However, Archbishop Migliore also made clear the Vatican's opposition to legal discrimination against homosexuals, which is clearly stated in the Catechism of the Catholic Church. "The Holy See appreciates the attempts made in the Declaration on human rights, sexual orientation and gender identity. The Holy See continues to advocate that every sign of unjust discrimination towards homosexual persons should be avoided and urges States to do away with criminal penalties against them," said Archbishop while speaking to a session of the UN General Assembly.
Following the Vatican's controversial opposition to a UN declaration calling for an end to discrimination against homosexuals, Archbishop Celestino Migliore confirmed that the Holy See also refused to sign a U.N. Convention on the Rights of Persons with Disabilities in May 2008 because it did not condemn abortion or assert the rights of fetuses with birth defects. The Vatican made its position clear on the United Nations International Day of Disabled People. Father Federico Lombardi, the Pope's spokesman, said the Holy See's position was "already widely known." Archbishop Migliore said the Vatican supported the rights of the disabled, but could not accept a clause in the UN declaration affirming a right to "sexual health and reproduction" because "in some countries such rights include the right to abortion." The Holy See's position was criticized by the Italian Federation for the Handicapped.Not only do the governments in central and Eastern Europe neglect to provide sufficient access to RH supplies, the issue of RH supplies itself is not prioritized in the government policies. The report finds two main reasons for these problems. The first one is related to a strong influence of religion (cases of Georgia, Macedonia, Poland). The other one is connected to a prevalence of strong nationalist discourse (again in Poland and Macedonia). Such a discourse places women's health as secondary (or even worse) to national "health." The nations under the control of nationalists can become un-developed or re-patriarchalized, particularly when it comes to women's reproductive rights; there is a conservative anti-abortion drive and women's needs with regard to their reproductive health are not considered a priority, which results in lack of access to necessary supplies, including RH supplies. Albania is the only country studied where policy to increase the level of contraceptive use exists.
Non-governmental organizations (NGOs) very often fill this void that governments leave, primarily with regard to education and counseling services. NGOs often face barriers in gaining financial support from their host governments to conduct their RH activities and therefore most of their programs are covered by foreign funds. In countries like Poland, where the Catholic Church has a very strong influence on the national policy, and most reproductive health programs are subsidized by foreign funds. Some organizations from the private sector have subsidized contraceptives in the region. The United Nations Population Fund (UNFPA), for example, had a limited stock of such supplies in Georgia and so only provided the free distribution of two types of oral contraceptives (Ovidon and Rigevidon) and one type of condom.
The main problems highlighted in the report include:
In most countries the report found no universal or reliable sexuality education programs. The major exception is Albania, where sexuality education classes in schools are obligatory, although they do not provide any information about other contraceptives other than condoms. While NGOs take a role in providing some education services, they can only do so to a limited extent and mostly in big cities, leaving most areas without sexuality education. In Poland, for example, the official educational programs run at schools are very much influenced by the Catholic ideology and tend to prefer natural methods of family planning.
The HIV epidemic rate is rising in Azerbaijan, Georgia, the Russian Federation (66% of newly reported HIV diagnoses) and Ukraine (21%), which has the highest adult HIV prevalence in Europe or Central Asia. The ASTRA member countries claim there is general access to free HIV VCT (voluntary counseling and testing) in urban areas. It is more limited in rural areas, especially in Azerbaijan, Albania, Georgia, and Russia, according to the report. In most countries, pregnant women in particularly encouraged to take HIV test (Armenia, Georgia, Macedonia, Poland, Russia, Ukraine).
The Report states that only 1 percent of
Albanian married women use hormonal contraceptives. Moreover, about 70 percent
of them use withdrawal. Only 5 percent of Macedonian women use hormonal
contraceptives and 24 percent use condoms. About 7 percent of Armenian women decide
to use hormonal contraceptives. In Georgia, only 25 percent of women aged 15-44
are currently using any method. In Poland, about 26.9 per cent of Polish women
are using hormonal contraceptives, while 25.9 per cent still choose natural
methods. In countries like Georgia and Albania women can get contraceptives
without prescription. But in other countries, like Poland and Macedonia, women
not only need prescriptions to legally get hormonal contraceptives, but doctors
in these two countries have the right to refuse a
prescription on moral grounds. Although condoms are widely available in the
surveyed countries, accessible in pharmacies and other stores, people in these
countries tend to underestimate the effectiveness of condoms as a preventative
for STIs.
The cost of condoms and contraceptives is relatively high in central and Eastern Europe, and access to subsidized or free contraceptives is very limited. The Report provides for a few examples: in Albania, where the average salary is $150 per month, contraceptive pills cost $5-13 and condoms cost $0.5-2; in Georgia where the average salary starts from $50, contraceptive pills cost $7 and condoms cost $3; and in Armenia, where the average salary is $170, contraceptive pills cost $2-22 and condoms cost $1-5. Armenians face a further challenge: there is no universal health care, so a lot of Armenians have to pay for all medical services except obstetrics (motherhood and childhood) which is included in the special package of services of Ministry of Health. In other countries health insurance does not cover costs of contraception. Only Poland covers 4 types of contraceptives
In most ASTRA countries, abortion is widely practiced as a primary birth control method. ASTRA's report states that Russia and Ukraine have higher abortion rates than the rest of the world. In 2004, the estimated abortion ratio in Russia was about five times higher than the rate in an average western European country such as Norway: 130 versus 25 abortions per 100 live births.
Because of financial barriers, few women get prenatal tests. Doctors in public hospitals very rarely suggest such tests even if there are indications to perform them, due to ideological reasons or because the cost of the tests is so high. In Poland, doctors fear that prenatal tests may be the first step towards abortion.
Many of the aforementioned problems are closely related to the ineffective health systems in these countries. Each country is at a different stage of implementing its health care system reforms, but very often even the most widely recognized issues are not discussed, and therefore not included into the new policy programs.
]]>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.
]]>