IPPF strongly condemns yesterday’s vote in the Italian Senate in favour of involving anti-abortion associations in abortion counselling services, family planning centres (consultori) and hospitals.  The recent adoption of a measure allowing anti-abortion activists to enter abortion consultation clinics in Italy is deeply troubling and represents a significant attack on women’s reproductive rights and bodily autonomy. This move undermines the fundamental right to access safe and legal abortion care. By allowing external interference in such intimate healthcare decisions, the Italian government is reinforcing stigma and harming women. The social and psychological implications of this measure create an atmosphere of intimidation and coercion for women seeking reproductive healthcare services. We must prioritise policies that safeguard fundamental rights and foster inclusivity, rather than catering to narrow agendas that undermine reproductive freedoms and social progress. Furthermore, the allocation of EU funds to support measures restricting access to sexual and reproductive health services, including safe and legal abortion, is deeply concerning and runs counter to the principles of equality and fundamental rights enshrined in EU treaties. We strongly condemn any use of EU funds to fund initiatives that infringe upon individuals’ rights to make autonomous decisions about their bodies and health.  This decision runs counter to the objectives of the National Recovery and Resilience Plan. In a recent statement, Veerle Nuyts, European Commission Spokesperson on economic and financial affairs already underlined that the provision concerning abortion does not belong in the Recovery and Resilience Fund. It is alarming that the Italian government is planning to misuse European funds to pay for harmful measures against women.  France has enshrined the right to abortion in its Constitution. The European Parliament voted to include it in the EU Charter of Fundamental Rights and explicitly asked to stop funding anti-gender and anti-choice organisations, and for Member States and local governments to increase their spending on programmes and subsidies to healthcare and family planning services. With yesterday's vote, Italy has done the opposite, underscoring an assault to the fundamental freedoms of millions of women, who have already been drastically affected by the funding cuts and subsequent closure of many family planning centres. We urge the Italian Government to reconsider its stance and prioritise policies that uphold the rights and dignity of all individuals, including comprehensive access to sexual and reproductive health services without discrimination or interference. We urge the EU to ensure the Italian Government cannot use EU funds to violate fundamental rights.   Photo credit: Emma Fabbri, unsplash

The International Planned Parenthood Federation congratulates France on its historic vote to enshrine the right to abortion in the Constitution. We are especially proud of the tremendous work and leadership of our French Member Association, Le Planning Familial.  We are now awaiting the final adoption of this constitutional reform by the French Congress, a step that must formally be instigated by French President Emmanuel Macron. 

For women and girls in the European Union, access to safe abortion care is a postcode lottery. A patchwork of policies and legislation shape whether abortion is free, safe, and legal. At the extreme end, a small minority of countries ban abortion in almost all circumstances, with devastating results. Most others allow abortion on a person’s own request or on broad social grounds, at least in the first trimester of pregnancy. But the devil is in the detail, and the detail frequently changes. Many EU countries impose medically unnecessary requirements prior to care, such as compulsory and discouraging counselling and waiting times – going against World Health Organization advice. In 22 out of 27 countries, doctors are still allowed to deny care based on their own personal beliefs – with dire repercussions for access. Hard-won progress can be swiftly unpicked. Issues such as gestational time limits, parental consent, denial of care by medical professionals, and care for rape survivors – among many other issues – remain subject to fierce debate and legislative change. These are debates that wreak havoc upon the lives of women and girls, but also their families. Denial of care is structural violence: in many of the 27 countries of the EU – a region that likes to present itself on the world stage as a model of progressive values – women and girls are harmed physically, emotionally, and mentally by abortion laws and policies, or the failure to uphold them.  International Safe Abortion Day (28 September) is a time to take stock of progress and threats to safe abortion access over the past year. This feature outlines some of the major developments in abortion legislation – good and bad – across the EU since last September. The rise of the right-wing Over the past few decades, the broad move in the EU has been towards liberalising laws around abortion care. Recently, however, the rise of chauvinist right-wing forces and politicians has seen energy and resources flooding into anti-abortion campaigns, fuelling structural violence against women and girls. In Italy, for example, the growing popularity of far-right and right-wing political parties, particularly in northern areas, has emboldened anti-abortion actors and legislators. With this in mind, the following section runs through some of the main policies and laws that harm people by limiting access to abortion care, introduced over the past 12 months – many of them linked to the rise of far-right and right-wing campaigns and networks in Europe and further afield.   The growth of new anti-abortion legislation Until recently, Malta was the only country in the EU to have a total ban on abortion. In June 2022, the government drew up new legislation, triggered by the case of American tourist Andrea Prudente who had to be airlifted to Spain for care after she suffered an incomplete miscarriage because doctors in Malta were banned and unwilling to intervene while foetal cardiac activity could be detected. In the new bill, the government proposed amending the Criminal Code to allow abortions when a woman’s health was at grave risk – hailed as a small but crucial step to improve abortion care access in this staunchly Catholic country. In the final months of 2022, the bill made steady progress through parliament. However, protests by hardline reproductive bullies, who said the bill’s definition of a health risk was too wide, forced the government to back down and introduce amendments. When the legislation was finally approved in June 2023, parliament voted to allow abortion care only when a woman’s life was at risk, and only with the consent of three specialists – a major bureaucratic hurdle. Maltese reproductive rights experts say this new law will put women’s lives even more at risk than the previous status quo. In Hungary, meanwhile, abortion is legal up to 12 weeks on medical grounds or if the woman is in severe crisis. But in September 2022, the country’s far-right government brought in by decree a measure that forces women seeking care to listen to embryonic cardiac activity before accessing healthcare. In response, IPPF European Network stated: “This requirement has no medical purpose and serves only to humiliate women. It will make accessing abortion more burdensome.” The legislation was brought in without public consultation or without hearing from women.

The European Safe Abortion Networking Group is a group of national, regional and international SRHR organisations based in Europe, working for universal access to safe, legal abortion. The group was formed in 2019 and has been meeting online bi-monthly since the Covid pandemic began. Many people assume everything is OK with abortion in Europe. And it’s true that most of the countries in the region have very good laws and services compared to the rest of the world and that much has improved over the last years with strong national advocacy campaigns, feminist-run clinics, and active support from a long list of political parties, human rights bodies and the World Health Organization. But we still have a long way to go to make abortions universally accessible to everyone who seeks them. In many of our countries, even those with good laws on paper, access in practice is far from perfect, and making change happen is a slow process. We are going through a period where anti-rights movements are posing a serious threat to abortion access across the region. Most European countries allow abortion on request in the first 12-14 weeks of pregnancy - although not without any regulatory, practical or medically unnecessary obstacles. Access to second and especially third trimester abortions, however, can be very limited and hemmed in with conditions, restrictions and requiring third party approval (doctors, parents), even though later abortions are so few and needed in the most desperate of situations. In a number of countries, abortion is still in the penal code, which permits legal systems to prosecute individuals for having or providing abortions, and also adds to stigma and discrimination. Moreover, there are still countries where most or all abortions are illegal, including Malta, Andorra and Poland, and where women are compelled to seek abortions outside the law - especially the growing numbers using pills but not under a clinician’s control. Women having abortions, and advocates for abortion rights are being prosecuted too, in Poland, Andorra, Malta and England. Almost invisibly, across the whole panorama of legal and clinical restrictions, thousands of women are still having to travel within and between countries to get abortions, often supported by under-resourced grassroots organisations and collectives instead of being supported by the State. The pandemic years made many things more difficult. Medical abortion pills were scarce in some countries and still are - and some countries still do not even allow abortion pills at all (e.g. Slovakia, Hungary). Travel across borders for abortions, especially later abortions, obviously became more difficult. On the other hand, some countries have approved the use of telemedicine and self-managed abortion with pills up to some point in the first trimester and it has now become a permanent option in some countries (such as France and the UK) and is well-established as an option within the care pathway in Ireland. Here are some of the most important legal and service-related changes and improvements we are calling for and will campaign for in our countries and across the region going forward: Complete decriminalisation of abortion in all countries, both as a harm reduction strategy to reduce maternal mortality and morbidity but also to ensure the full enjoyment of human rights, bodily autonomy and voluntary motherhood. Universal access to safe, legal abortions, as early as possible and for as long as needed, with choice of method. Self-managed abortion with pills up to 12 weeks should be allowed in all countries as recommended by the World Health Organization. Statement and Call for Action by the European Safe Abortion Networking Group for International Safe Abortion Day, 28 September 2023 Approval of combined medical abortion pills, and approval of misoprostol as an abortifacient, in all countries. Medical abortion pills are a very safe method, not only in the first trimester but also for later abortion, and are on the WHO Essential Medicines List. All countries should implement the 2022 World Health Organization Abortion Care guidelines including training for the range of health care providers, including pharmacists, who can provide services. Increase access to abortion beyond 12 weeks through training and education for midwives, nurses and doctors. Policies must be gender inclusive, that is, applying to women, girls and all people who can become pregnant and who seek an abortion.  

IPPF EN is deeply worried by recent reports of denial of healthcare in Romania that speak to a shocking wider systemic problem. Last week, the case of Alexandra, a 25-year-old mother of three, who was denied emergency obstetric care in a hospital for seven hours, has ignited protests in Romania and heavy media coverage. The cause of death was an obstetric emergency which led to sepsis, acute cardio-respiratory insufficiency and acute pulmonary edema. Alexandra endured terrible pain for hours and asked for help from those whose duty was to save her, but her pleas went unanswered. The case is being investigated by the police. Alexandra's case is one of many pointing to a crumbling healthcare system that is harming all Romanian citizens. The country’s healthcare system is rated 34 out of 35 by the Euro Health Consumer Index. Things are especially dire for groups of people who are already made vulnerable by the system, such as women, Roma people and those living in poverty. Institutionalised stigma and discrimination run deep, with patients reporting being denied care or not being given quality care due to the colour of their skin or their ability to pay. The system is broken for everyone, but it is groups already facing challenging circumstances who bear the brunt. “From 2018 until 2021, there was an 183% increase in the maternal mortality rate. It’s unconceivable for an EU Member State to have such a high maternal and infant mortality rate. And it’s devastating that so many women have lost their lives, leaving their families behind. And while women’s health paints a grim picture, the problem is more widespread touching on all areas of health. Romania is among the countries that spends the least on healthcare as a share of GDP.” said Gabriel Brumariu from SECS, IPPF’s Romanian Member Association.

On 28 June, Malta’s Parliament adopted a new law, known as Bill 28, intended originally to increase protection for women by allowing abortion care in exceptional cases. However, the final version of the law specifies that abortion is only allowed when a woman is at risk of dying and denies life-saving care to a person experiencing an obstetric emergency unless she is in a licenced hospital and has the consent of a panel of three specialists. This is a devastating step backwards in the only European Union country to have a total ban on abortion in all circumstances. “The new law introduces dangerous and insurmountable obstacles to saving women’s lives, given that obstetric emergencies are very fast-moving situations in which you can die without rapid medical intervention – as we have seen in Poland, Ireland and Italy when access to abortion care was withheld until it was too late,” said IPPF EN’s Irene Donadio. The adoption of Bill 28 is all the more shocking given that the government’s objective when it announced the reform in 2022 was to ensure a bare minimum of access to abortion care in cases where a woman’s life or health was at severe risk*. Pro-choice doctors and activists in Malta had supported a bill that aimed to lessen just slightly the longstanding stranglehold of the law on pregnant women**. Instead, as a result of ultraconservative anti-choice opposition to women’s reproductive freedom and safety, the protections of the initial proposal were subsequently watered down to the point that on 23 June, prochoice doctors associations and groups for women rights withdrew their support for the bill. The Council of Europe’s Commissioner for Human Rights echoed their concerns on 26 June, calling for the Maltese parliament to pause and reflect to avoid steps backwards. But calls to change course were not heard. “This backtracking, and the subsequent adoption this week of a bill that not only fails to protect, but actively exacerbates the existing harm done to women by Malta’s medieval abortion legislation, is a humiliating miscalculation by the ruling party. The government has handed victory to Malta’s reproductive bullies on a plate,” continued Donadio. “The terrifying result of the government’s botched political move is that women can die under their watch. People will be deterred from visiting Malta, seeing that its leaders have doubled down on denying emergency medical care to anyone suffering an obstetric emergency. The only people to gain new protections are certain doctors who are afraid to shoulder responsibility for the lives of their patients. If the government wants to make the situation less desperate, it must decriminalise abortion so that at least women can take their health and lives into their own hands, with the support of brave pro-choice doctors and networks, and without the fear of prosecution,” she added.     --- *In 2022, facing scrutiny due to the high-profile emergency evacuation from Malta of Andrea Prudente, an American tourist undergoing a life-threatening miscarriage, the government proposed to amend the law to introduce a minimum of protection for women. **The original draft bill proposed to legalise abortion in cases where a woman’s health was at grave risk. --- For more information, contact: [email protected] [email protected] Additional background and latest information via Doctors for Choice and Voice for Choice.  

Protests will be held across Poland on June 14 as the news of yet another woman losing her life shakes Polish society. The 33-year-old woman, identified only as Dorota, went to the hospital after her water broke in the fifth month of her pregnancy. She died there of sepsis three days later. She was told to lie in her hospital bed with her legs up because this might help restore amniotic fluid and was given limited medical care and information about her state. No one from the medical staff explained to her or her family the real danger she was in and that there was little to no chance that the fetus would survive. Sepsis develops very rapidly in situations such as Dorota’s, yet lifesaving medical care was delayed and Dorota and her family were denied the right to know that abortion care would have been possible and would have saved Dorota from a death sentence. Prosecutors and the patients’ ombudsman in Poland are investigating the death of Dorota amid the family’s accusations that the doctors kept them in the dark and didn't take the necessary steps to save her. Two years ago, Poland's conservative government severely restricted access to abortion care, but the law does allow for doctors to intervene and perform an abortion if the woman's health or life is in danger. Yet, we have seen time and time again with the cases of Iza, Agnieszka, Anna, and now Dorota, that this law is killing women and hurting families.  Denying access to abortion care is a sinister form of gender-based violence which can amount to femicide. This law has real consequences on women, life and death consequences, and it’s beyond inexplicable how the ruling party can continue to cause so much needless suffering. But make no mistake, doctors continue to have the responsibility to protect the health of women. Fear of prosecution needs to stop being used as an excuse in a country where no doctor has ever been the target of law enforcement in cases where abortion care was provided when the life or health of women were at risk. Yes, those holding political power are responsible for violating women’s rights and causing this suffering, but doctors who do not help a person in need are complicit. The wellbeing of patients should come first not only when it comes to abortion care, but regarding all reproductive matters. Gynaecological and obstetric violence is widespread in Poland and we want doctors to speak out and work towards social change. Their silence and lack of action, their betrayal of the trust patients place in them, leads to tragedy. We ask doctors to stop sitting on the sidelines while their patients are suffering and even dying. And we ask the government to lift this draconian virtual ban on abortion care. See you in the streets.

Today, the District Court in Warsaw found Justyna Wydrzyńska guilty for helping a woman in an abusive relationship to access abortion pills. She was sentenced to eight months of community service for 30 hours/month and will now have a criminal record. "We are deeply saddened by the decision and outraged by the entire process. Condemning a person for an act of empathy and compassion towards another human being is unconceivable. We are in awe of Justyna’s bravery in the face of 18 months of judicial persecution by an apparatus targeting anyone who dares challenge the state’s immoral attacks on healthcare and human rights", said Irene Donadio of the International Planned Parenthood Federation, European Network (IPPF EN).

Woman human rights defender, Vanessa Mendoza Cortés, from Andorra could soon face trial for speaking out on women’s rights and the right to abortion before the United Nations (UN). If Vanessa is convicted, she faces a big fine of 30.000 Euros and could have a criminal record.  Vanessa Mendoza Cortés is a psychologist and the president of the women’s rights organization, Stop Violence, (Associació Stop Violències, in Catalan), which focuses on gender-based violence, sexual and reproductive rights, and advocates for safe and legal abortion in Andorra. Vanessa has been targeted by her government for the past four years, simply for exercising her right to freedom of expression and criticising the full ban on abortion care in the country. Vanessa spoke in front of the United Nations Committee on the Elimination of Discrimination against Women (CEDAW) in 2019, as part of the regular and critical exchange of information conducted between this UN body and human rights defenders around the world.  Following a complaint from the Andorran government, the public prosecutor brought charges against her. While previous charges of defamation, which carried prison sentences, were dropped in 2021, thanks to international pressure, Vanessa continues to be harassed by the prosecution, who is accusing her of crime ‘against the prestige of the institutions’.  

Spain has introduced new legislation allowing gender self-determination, banning conversion therapy, introducing menstrual leave and easing abortion limits. Here’s what you need to know: Anyone aged 16+ can change their gender on official documents without medical supervision Conversion therapy, in any form, intended to change a person's sexual orientation or identity or gender expression is banned New abortion legislation makes it easier for women to access medical or surgical abortions in public hospitals and clinics  Arbitrary and medically unnecessary three-day waiting period before accessing abortion care is suppressed  Denial of abortion care based on personal beliefs will now become more transparent due to a new registry that takes stock of medical professionals in the public health system who refuse to perform abortions The previous requirement for women aged 16 and 17 to obtain parental consent for abortions is scrapped, along with the 3-day period of reflection and the obligation to provide information on maternity benefits for those seeking abortion care Up to 5 days of menstrual leave for people with painful periods - thus Spain becomes the first country in Europe to introduce menstrual leave Provision of free sanitary products in schools, prisons and women’s centers and free hormonal contraceptives and the morning after pill at state-run health centers Paid leave before childbirth additional to the maternity leave, from the 39th week until the moment of birth Compulsory comprehensive sexual education at all stages of education, reinforcing previous regulations. The bill on sexual and reproductive health and abortion care recognizes rights that were already in the 2010 Spanish law and had subsequently been restricted, and includes new measures that entail the normalization of important aspects of sexual and reproductive health.