By Agnieszka Wądołowska
The recent introduction of a near-total ban on abortion in Poland has not significantly reduced the number of women obtaining terminations, according to data from organisations that help them do so. Instead, it is forcing more to travel abroad for abortions and, doctors warn, causing great psychological harm to many women.
“Of course, there are still those women who come to terminate unwanted pregnancies [like before], but since autumn there is a totally new group,” Ciocia (Aunt) Basia, a collective from Berlin, tells Notes from Poland.
Before last year, around 1,000 legal abortions took place annually in Poland. However, in October the country’s constitutional court effectively banned over 90% of these by declaring terminations due to foetal abnormalities as unconstitutional.
Since that ruling, one organisation alone – Abortions Without Borders (Aborcja Bez Granic) – has helped 650 women in Poland to obtain abortions abroad. Half of them admitted that their reason for seeking an abortion was the discovery of congenital disorders in the foetus.
Financial support to these women has amounted to 420,000 zloty (€92,000), gathered through crowdfunding and individual donations. “We are buying each other abortions as the state has nothing to do with it, the state doesn’t care,” reads Abortion Without Borders’s website.
Since October, the organisation’s helpline has been called almost 7,000 times, while altogether over 18,000 people have turned to them through various channels – and the numbers are still increasing.
Another women’s rights organisation – the Federation for Women and Family Planning (Federa) – has noticed a similar trend. Before the ruling they had a few hundred calls to their helpline a year. Since October, they have already fielded over 2,000.
“Undoubtedly there is an increase in abortion migrations abroad,” Kamila Ferenc, a lawyer from Federa, tells Notes from Poland. “Most often destinations for the second trimester are the Netherlands, the UK and Spain, while for pregnancies at an earlier stage it is the Czech Republic and Germany.”
The Ciocia Basia collective is now helping around 20 Polish women who come to Germany each month and many more on the phone or through emails – double the figure from before the ruling. Services include assistance with transport, accommodation and various formalities.
One pro-choice organisation that sends abortion pills by post – Women Help Women – says it has responded to over 46,000 messages from Poland and provided help to 10,000 people since the Constitutional Tribunal ruling, reports Euronews.
The data are further evidence that, as indicated by information from the World Health Organisation and the Polish Academy of Sciences’ bioethics committee presented to the Polish parliament, the tightened abortion law has not curbed the number of abortions.
Instead, its impact has been to change the profile of those going abroad to seek terminations. Many are now women who wanted to get pregnant, but learnt that the foetus they are carrying is seriously, often incurably and lethally, damaged.
Even before the ruling entered into force in January, many women were already finding it difficult to find a doctor at a Polish public hospital, an activist from Ciocia Basia tells Notes from Poland.
Many medics and clinics were feeling the “chilling effect” of unclear legal consequences. The plight of many women at the time was worsened by travel restrictions as the second wave of the pandemic took hold.
The new group of women seeking abortions – those who have foetuses diagnosed with birth defects – presents fresh challenges, the activist admits.
“We never dealt before with women who wanted to be pregnant and wanted the babies, some of them went through IVF treatment,” she says. “We had to learn how to talk to them, how to support them best.”
A further difficulty is time. Most women learn about serious damage to the foetus in the 11th or 12th week of the pregnancy, while abortion in Germany is legal only up till the beginning of the 14th week.
Ciocia Wienia, a Vienna-based collective, launched in September 2020. Two to four women a week now terminate their pregnancies with their assistance.
“The people we help often tell us stories of how they were treated by the doctors in Poland and these are really revolting stories,” an activist from the collective tells Notes from Poland.
A further sister collective, Aunt Czesia, started in October in the Czech Republic. “We realised we need to take things into our own hands, and now we have a few dozen people reaching out to us a month. 34 people in April and 59 in May, and also 59 in June.”
The majority of these women contact the collective before the 12th week and, according to their rough estimates, around 30-40% give birth defects of the foetus as the reason.
“These are women of all ages and all backgrounds from all over Poland, from both small towns and big cities, of various financial and social status,” says Ferenc from Federa.
Both the women themselves and their partners call the helpline. “I think that some women don’t have enough strength to talk about it,” Ferenc tells us. “There is still this idea – totally unnecessary, but rooted in the Polish culture – of shame of women who even think about abortion.”
“The change of the way the doctors deal with their patients is devastating,” said Maciej Socha, from Saint Wojciech hospital in Gdańsk and the department of maternal-foetal medicine at Nicolaus Copernicus University in Toruń, at a special hearing in the Polish parliament.
Doctors specialising in maternal and foetal medicine point to the alarming impact of the tightened law in their everyday practice.
Socha spoke of a patient – Magda – who came to him begging for help in the 17th week of her pregnancy as the foetus had been diagnosed with cyclopia, a rare, incurable and fatal genetic disorder.
“The doctor who conducted the screening in the 12th week did not inform the woman or her partner about any of it. When they went back to him and asked about his motives, he simply said: ‘Why would you need that information? There is nothing that can be done, you still have to keep the pregnancy’,” Socha recalled.
The doctor described this as one of the most difficult moments of his career as he was helpless to help as the woman’s mental state deteriorated. “There was nothing I could do. They disappeared for some time as it was possible for them to travel abroad,” he added.
But for other women, obtaining terminations abroad can be difficult, and not only for financial reasons, Socha added.
“Doctor, I don’t want to be a living coffin for my child,” another patient whose foetus was in a severe condition told him. The woman, from a small village, was afraid of being stigmatised. “If I travel anywhere, everybody will know”.
Grzegorz Pietras, a gynaecologist from the University of Lublin, said that even before the ruling women often had to travel around Poland to find a clinic that would conduct an abortion. “Now, it’s simply tragic.”
He also points to another aspect of the new law – the availability of prenatal screenings that can reveal the defects. No clinic offers them in Podkarpackie Province, for example – not because of a lack of specialists, but because doctors face pressure to sign a “conscience clause’’, which permits medical personnel to decline certain procedures on the grounds that it conflicts with their personal values or beliefs.
In January and February 2021, 26,600 screenings took place nationwide, down from 30,400 a year before, reports the Dziennik Gazeta Prawna daily. Some of the discrepancy is linked to a lower number of pregnancies in general in Poland after the year of pandemic. Yet doctors, including Pietras, also say there has been a chilling effect that has led some to fear conducting even lawful procedures.
Under the current law, a termination is still permissible if a psychiatrist issues a certificate stating that the pregnancy threatens the woman’s life or health. Aleksandra Krasowska, founder of the Doctors for Women initiative, is a psychiatrist who issues such certificates.
“It’s not a loophole,” she stresses. “We need to understand that we have brought upon women a situation in which they have to confront a threat to their [mental] health and life as such due to the current law. It’s the law itself that endangers them.”
Krasowska says that most patients who seek her help eventually find a public hospital where the certificate is recognised, although they usually have to travel to do so. She adds that this is a totally new group of patients:
Women who have never received any psychiatric treatment now come to doctors facing a serious mental crisis, often with suicidal thoughts, due to the fact that they are pregnant and a lethal defect was diagnosed and they have been deprived of the right to choose a termination. It’s traumatic on many levels, confronting such a diagnosis is a great burden, and when it’s to continue it’s even harder knowing that the child is bound to die.
Krasowska points out that such pregnancy actually threatens the life of the pregnant woman – sometimes not instantly but in the longer run. She adds that, in the public discourse, mental illnesses and disorders are belittled and depression is often called just “bad time” and not as potentially threatening the life and health of a pregnant woman.
Earlier this year, the Polish justice ministry was criticised after outlining plans to support women forced to give birth to foetuses with fatal defects. Among its suggestions was for them to get a “personal room” and the “chance to have a cry”.
“Such an idea has nothing to do with current psychiatric knowledge,” says Krasowska. At the clinic where she works, patients must wait two years even for a visit. “The Polish mental health system was overburdened even before these new patients appeared.”
Main image credit: Adrianna Bochenek/Agencja Gazeta
Agnieszka Wądołowska is deputy editor of Notes from Poland. She has previously worked for Gazeta.pl and Tokfm.pl and contributed to Gazeta Wyborcza, Wysokie Obcasy, Duży Format, Midrasz and Kultura Liberalna
