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Abortion, i.e. the procedure of deliberate termination of pregnancy, is the subject of many studies, arousing numerous controversies in connection with the protection of the conceived life. In Poland, it is illegal, if it does not result from specific reasons, and punished with imprisonment of up to 3 years. Abortion may be legally performed only in some cases.
The word abortion is derived from the Latin language, more precisely from the word abortionwhich means a miscarriage. However, not every miscarriage is an abortion as it is commonly used. Namely, only an artificial miscarriage (i.e. caused by a factor external to the mother’s or child’s body), performed with the consent of the woman and resulting in the termination of the pregnancy, should be considered an abortion in the strict sense of the word.
And so, abortion is a procedure aimed at artificially terminating a pregnancy at an early stage, which in turn causes the expulsion of the embryo or fetus outside the mother’s body.
Abortion is also defined as termination of pregnancy, termination of pregnancy, scratching, abortion, artificial miscarriage, induction of menstruation.
Access to safe abortion has been established as a human right by many international organizations, such as: The UN Human Rights Committee, the European Court of Human Rights, the Inter-American Court of Human Rights and the African Commission on Human and Nations Rights. At the 1994 Cairo International Conference on Population and Development, 179 governments signed a program of action that included a commitment to prevent unsafe abortion.
The World Health Organization (WHO) first recognized unsafe abortion as a public health problem in 1967, and in 2003 developed technical and policy guidelines that contain recommendations and regulations on abortion to protect women’s health.
Also read: Embryo implantation – everything you need to know
Models of legal protection of the conceived life
At present, there are three models of legal protection of the conceived life. Each of these models specifies different assumptions as to the permissibility of termination of pregnancy or its complete prohibition.
Model of indications (permissions) defines the strict circumstances in which a woman may terminate a pregnancy without criminal liability. In a country where this model is valid, a list of specific indications must apply. The most common indications are:
- medical,
- legal,
- eugenic.
The first ones concern the threat to life, sometimes also the health of a woman, the second – the occurrence of pregnancy as a result of a criminal act, most often rape, incest, sexual abuse of a minor, the last – when the fetus is genetically burdened and its permanent and irremovable damage was found. This model is used in most countries of the world.
Forward model, also referred to as abortion on demand, it is a model in which an abortion can be performed on request in the early stages of pregnancy. In the light of this model, it is recognized that the fetus in the early stage of pregnancy is a limited part of the mother and only she can decide about the possibility of termination of pregnancy. In countries where this type of legal model for the protection of unborn life is in force, women can terminate pregnancy up to the 12th week of pregnancy at their own request, without any criminal liability.
Later in pregnancy, an abortion may be performed, but there must be certain medical, legal and eugenic reasons. On the other hand, in Our Country, termination of pregnancy may be allowed if the social situation of the mother does not allow for the proper upbringing of the child. These premises are strictly defined. A woman can have an abortion if:
- proves that she became pregnant as a result of rape,
- has been deprived of parental rights under a court judgment,
- was put in prison,
- the father will die or will be clearly disabled, which will contribute to the inability to provide the mother of her child with adequate living conditions.
The timely model of termination of pregnancy occurs, inter alia, in Denmark, Austria, Norway, Sweden, Turkey, Singapore, China and Vietnam.
The last model is this the model of a total ban on abortion. This model protects the baby at every stage of pregnancy. Termination of pregnancy is considered a crime in this model. This type of legal regulation is in force in the Vatican, El Salvador and Malta.
Read: Half of Poles oppose the right to abortion
Abortion – statistics in Poland and in the world
According to WHO there are approximately 40-50 million abortions worldwide each year. This is equivalent to approx 125 abortions a day. It is estimated that 25% of all pregnancies ended in abortion. There were 35 abortions for 1000 women aged 15 to 44 years. The abortion rate was significantly higher in developing countries than in developed countries. There are approximately 25 million unsafe abortions worldwide each year, almost all in developing countries.
In Poland, 2018 abortions were performed in 1076 and 2017 in 1057. The largest group (1050) were abortions performed as a result of prenatal examination or other medical indications of a high probability of severe and irreversible fetal impairment or an incurable life-threatening disease. 25 abortions were performed because the pregnancy posed a threat to the life and health of the pregnant woman. One abortion was performed because there was a reasonable suspicion that the pregnancy was a result of a criminal act (such as rape or incest).
The highest number of abortion procedures was recorded among women over 35, there were 409 women. The second age group consisted of women aged 30-34 (283), 57 procedures were performed in women under 18 years of age.
By comparison, in the United States, about 22% of all pregnancies end in abortion. It is estimated that four out of 10 pregnancies end in termination. This is about 3000 abortions a day.
See: Is it possible that over 4 million Polish women terminated their pregnancies?
Abortion – legal conditions in Poland
In Poland, legal regulations on termination of pregnancy are included in the Act of January 7, 1993 About family planning, protection of the human fetus and conditions for permitting termination of pregnancy. It states that termination of pregnancy may only be performed by a doctor (in hospital) if:
- pregnancy poses a threat to the life or health of a pregnant woman,
- prenatal tests or other medical indications indicate a high probability of severe and irreversible impairment of the fetus or an incurable life-threatening disease,
- there is a justified suspicion that the pregnancy resulted from a prohibited act.
In the first and second cases, termination of pregnancy is allowed until the fetus is able to live independently outside the pregnant woman’s body. With regard to the well-founded suspicion that the pregnancy resulted from a prohibited act, termination of pregnancy is allowed if no more than 12 weeks have elapsed from its beginning.
In each of the above-mentioned cases, a written consent of the patient is required. If an abortion is to be performed on a teenager who has reached the age of 13, the consent of her legal representative and herself is required. In a situation where she is under the age of 13, consent must be given by the guardianship court, but the minor herself has the right to express her opinion.
Persons covered by social insurance and persons entitled under separate provisions to free medical care are entitled to free termination of pregnancy in a public health care institution.
Abortion – legal conditions in the world
Here are examples of legal regulations in some countries relating to abortion.
Chiny – liberalized their right to abortion in the 50s and promoted the practice as part of the one-child policy that was introduced in 1979 (to limit population growth by limiting families to one child). The policy that made abortion services widely available included severe coercive measures – including fines, compulsory sterilization and abortion – to stop unauthorized births. In 2016, China raised this long-term limit – Chinese families can have two children.
Irlandia – in 2018, the Irish parliament legalized termination of pregnancy before twelve weeks, as well as in cases where the mother’s health is at risk. Earlier, Ireland had one of the most restrictive abortion laws in Europe, effectively banning the practice. In 2019, abortion was legalized in Northern Ireland.
Francja – abortion in France has been legal since 1975. A woman may terminate her pregnancy on demand up to the 12th week of its duration. In order to have an abortion, two medical consultations are necessary. Abortion can also be performed in France after the 12th week of pregnancy, if as a result the woman’s health and life is at risk. Single women who become pregnant do not need the consent of the child’s father for the procedure. The doctor has the right to refuse to perform an abortion and should refer the woman to a family planning organization or a doctor who can help her.
Zambia – is one of the few countries in Africa where abortion is allowed for economic and social reasons. Unfortunately, despite having liberal law, structural and cultural barriers make it difficult for Zambian women to access abortion. Zambia has less than one practicing physician in 60 inhabitants, and for over 30% of Zambia’s rural population, healthcare professionals are unavailable. The law states that only a registered doctor, not a nurse or midwife, can perform an abortion. Zambia has a high maternal mortality rate from unsafe abortion, and XNUMX% of maternal deaths are due to abortion complications.
Read: A liberal abortion law enters into force in Spain
An abortion can be performed in three ways.
1. First – by pharmacological agents. Then, after a potential fertilization, a special pill is taken, which destroys the trophoblast or damages the embryo, and then causes uterine contractions, which results in its expulsion along with the uterine lining. However, it should be remembered that this method is effective only in the first weeks of pregnancy (usually 9 weeks of pregnancy).
Medical abortion is a combination of two drugs, mifepristone and misoprostol. Mifepristone was formerly known as RU486 and is sometimes called the “abortion pill”.
2. The second method of abortion – surgical – involves the expansion of the cervix, followed by aspiration (i.e. aspiration of the embryo with the use of pressure) and curettage of the fetus.
3. The last method of abortion is early laparotomy. It is the greatest interference for a woman’s body, because in her case the abdominal cavity is surgically opened, which is also associated with the removal of the appendages. Laparotomy is usually performed on women who have a serious uterine disease.
The World Health Organization (WHO) states that abortion is safe for the health and life of a woman when it is performed in accordance with the method recommended by this institution – that is, appropriate for the duration of pregnancy and based on professional training of employees performing this procedure. Such abortions can be performed by pharmacological means and an appropriate medical procedure.
However, it should be remembered that each woman’s body is different and may react differently to termination of pregnancy. One woman will not develop complications, while the other woman may develop serious complications.
See: Reverse abortion – what is it?
Abortion – the abortion underground
Abortion underground, this is the colloquial definition of places where abortion procedures are performed, which are performed outside the official medical care system. The abortion underground is looking for women (of course not in all cases) who have been refused an abortion in a public medical facility or simply do not seek help in such places – in their thinking, they want to be anonymous.
In the press and on the Internet, there are advertisements such as: “safe induction of menstruation”, “gynecological consultations – full range”, “gynecological services – full offer”. Through these ads, the abortion underground is being promoted.
It should be noted, however, that not always qualified medical workers work in such “offices”, not to mention their qualifications for termination of pregnancy.
The World Health Organization (WHO) points out that abortions performed in the “abortion underground” by people who are incompetent, lack the necessary skills or in an environment that does not meet minimum medical standards, or both are unsafe abortions.
In addition, abortion is less secure when it is performed using outdated methods such as acute curettage, even if the healthcare professional is trained to do so. Termination procedures are dangerous or the least safe when they involve taking corrosive substances or when untrained people use dangerous methods, such as inserting foreign bodies or using traditional potions.
Based on data from 2010-2014, it is estimated that about 25 million unsafe abortions are performed each year. Of these, a third or about 8 million were performed in the most unsafe conditions by untrained people using dangerous and invasive methods. Dangerous abortions lead to nearly 7 million different complications.
Data show that in developed regions, for every 100 unsafe abortions, 000 women die. This figure rises to 30 deaths per 220 unsafe abortions in developing regions and 100 deaths per 000 unsafe abortions in sub-Saharan Africa.
After having an unsafe abortion, women can experience a number of negative health consequences that affect their quality of life and overall well-being. It also happens that some women experience life-threatening complications.
The main life-threatening complications of the least safe abortions are haemorrhage, infection, and damage to the genitals and internal organs. Dangerous abortions performed in the most unsafe conditions can lead to complications such as:
- incomplete abortion (failure to remove or expel all pregnancy tissue from the uterus),
- haemorrhage (heavy bleeding)
- infection,
- perforation of the uterus (caused by a sharp object puncturing the uterus)
- damage to the genitals and internal organs by inserting dangerous objects into the vagina or anus.
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