Abortion in Europe: accessibility and
availability
B. Pinter*, E. Aubeny**, G. Bartfai***, O. Loeber****, S.
Ozalp*****, A. Webb******.
*Dept. of Ob/Gyn,
University Medical Center, Ljubljana, Slovenia. **Family planning Center,
Broussais Hospital, Paris, France; ***Dept. of Ob/Gyn, Faculty of General
Medicine, Szeged, Hungary. **** The Mildredhouse, Center for sexuality,
anticonception and abortion, Nijmegen, The Netherlands. ******Dept. of Ob/Gyn,
Faculty of Medicine, Osmangazi University, Eskisehir, Turkey. ******Abacus
Centres for Contraception and Reproductive Health, Liverpool, United
Kingdom.
Objectives: The accessibility and availability of abortion is a
reflection of abortion law and the accessibility and availability of abortion
service in a particular country. The examples from some European countries with
different political, cultural, social and religious backgrounds (the
Netherlands, France, United Kingdom, Slovenia, Hungary and Turkey) are
presented.
Results: Abortion laws in Europe range from complete
prohibition to complete liberalisation of abortion law (abortion on request).
In the Netherlands, with one the lowest abortion rates in the world (8/1000
women aged 15-44 years), abortion can be performed on request until 22 weeks of
pregnancy, but in the other countries mainly until 10-12 weeks of pregnancy. In
Great Britain abortion is permitted on socio-economic grounds until 24 weeks of
pregnancy. Some countries demand waiting period for the procedure (the
Netherlands, France, Hungary), pre-abortion counselling (the Netherlands,
France-for minors only, Hungary) and parental approval for minors (the
Netherlands-conditionally, Great Britain-conditionally, Hungary, Turkey) and in
the others (e.g. Slovenia) there is no obligation. Abortions are generally
performed in authorized facilities by gynaecologists or general practitioners –
GPs (the Netherlands, France; in Turkey GPs, with a qualification certificate,
can perform only menstrual regulation, under the supervision of a
gynaecologist) or only gynaecologists (Slovenia, Hungary). In Great Britain
abortions are performed by gynaecologists or by specialists in contraception
and reproductive health. Abortion service is easy accessible, in terms of
available facilities and health insurance coverage of the procedure, in the
Netherlands, France and Slovenia. Abortion service is less accessible in Great
Britain (due to limited availability of abortion service in some regions), in
Hungary (due to high abortion fees not covered by health insurance) and Turkey
(due to limited access to abortion service in rural areas). There is no report
on illegal and unsafe abortions in these countries. The main religion in a
particular country mostly does not interfere with the abortion policy; however,
there has been a tendency is some Eastern European countries in the last
decade, through the activities of Catholic Church, to limit the availability
and access to abortion.
Conclusions: Abortion in Europe is mainly well accessible in terms
of abortion law. Some differences are evident in accessibility of abortion
service among different countries and in some countries, among different areas
in the country. Western European countries have in general improved the
availability and access to abortion lately. On the other hand, in the last
decade in some Eastern European countries, in the transition period of the
political systems, trends towards limitation of availability and access to
abortion have been noted, influenced mainly by religion.