1. Medico-legal aspects of abortion in Europe
Bojana Pinter
University Dept. Of Ob/Gyn
Ljubljana, Slovenia
Why are teenagers still getting pregnant?
6th Seminar, ESC, 8 Oct. 2001, Coimbra

2. Pregnancies in the world
210 million women get pregnant annually
15% miscarriages, stillbirths
22% induced abortions
63% live births

3. Abortion – a response to unwanted pregnancy
50 million abortions occur annually
20 million abortions are unsafe, usually illegal
every day more than 200 women die of unsafe abortion

4. Abortion in Europe Aspects of abortion laws rates practices culture
economic status
religion
law
Aspects of abortion
laws
rates
practices

5. ABORTION LAWS IN EUROPE
completely prohibited
to save woman’s life, protect her physical health
… to protect woman’s mental health
… on socioeconomic grounds
… on demand

6. Completely prohibited
Ireland
Malta

7. To save woman’s life, to protect her physical health
Poland (R, I, F)

8. … to protect woman’s mental health
Northern Ireland
Portugal (R,F)
Spain (R,F)
Switzerland

9. … on socioeconomic grounds
Finland
Great Britain
Hungary

10. … on demand Albania Austria Belarus Bosna-Hercegovina Belgium Bulgaria
Croatia
Czech Republic
Denmark
Estonia
France
Germany
Greece
Italy
Latvia
Lithuania
Macedonia
Moldova
Netherlands
Norway
Romania
Russia
Slovak Republic
Slovenia
Sweden
Ukraine
Turkey
Yugoslavia

11. Gestational limits 10 weeks: Slovenia, Turkey 12 weeks: others
14 weeks: Belgium
22 weeks: Netherlands

12. Consent parental consent partner consent
Austria, Czech Republic, Denmark, Germany, Greece, Hungary, Italy, Netherlands, Norway, Russia, Sweden, Turkey
partner consent
Turkey

13. Counselling and waiting period
counselling: Albania, Belgium, France, Germany, Hungary, Netherlands, Poland, Russia, Spain, Turkey
waiting period: 3 – 8 days: Belgium, France, Germany, Hungary, Netherlands, Poland

14. Accessability facilities: governmental, private
practitioner: Ob/Gyn spec., GPs
abortion charged: Czech Republic, Hungary, Latvia, Russia, Turkey
accessability?: Austria, Germany, Spain, Portugal

15. Data on illegal abortion
Poland?
Northern Ireland?
Portugal?
Russia?

16. ABORTION RATES IN EUROPE
Western Europe
Netherlands: 6.5/1000 women yrs
abortion ratio: 10.6
total ab. rate: 0.2
Eastern Europe
Romania: /1000 women yrs
abortion ratio: 63.0
total ab. rate: 2.3

17. Abortion rates in Western Europe (abortions/1,000 women yrs) Source: The Alan Guttmacher Institute. Sharing responsibility. Women society and abortion worldwide. New York: The Alan Guttmacher Institute, 1999: 54.

18. Abortion rates in Eastern Europe (abortions/1,000 women yrs) Source: The Alan Guttmacher Institute. Sharing responsibility. Women society and abortion worldwide. New York: The Alan Guttmacher Institute, 1999: 54.

19. ABORTION PRACTICES Safe abortion early in pregnancy
by well-trained practitioner
using surgical or medical method
in legal setting

20. First trimester abortion
vacuum aspiration
dilatation and curretage
medical abortion
mifepristone & prostaglandins
methotrexate & prostaglandins

21. The history of vacuum aspiration
1863: Simpson (Scotland)
1927: Bykov (Russia)
1958: Tsai, Wu, Wu (China)
1961: Zubejev (Russia)
1964: Novak (Slovenia)
1968: Novak - transfer to the West

22. Medical abortion (mifepristone & PG)
1992: France
49 days: 600 mg mifepristone g misoprostol
200 mg mifepristone g misoprostol
63 days: 600 mg mifepristone + 1 mg gemeprost

23. Availability of medical abortion
Available
Austria
Belgium
Denmark
France
Germany
Israel
Netherlands
Russia
Slovenia
Spain
Sweden
Switzerland
United Kingdom
Not available
Czech Republic
Greece
Hungary
Ireland
Italy
Poland
Portugal
Turkey

24. Second trimester abortion
medical induction with prostaglandins
dilatation and evacuation
intrauterine instillation of prostaglandins, hypertonic saline

25. CONCLUSION good family planning service
appropriate legislation of abortion law and practice
are the essential conditions
to reduce the need for abortion
to prevent unsafe abortion

26. Acknowledgments Ann Verougstraete Sven Skouby George Creatsas
David Cibula
Gyoergy Bartfai
Mary Short
Melanija Orlean
Jany Rademakers
Rob Beerthuizen
Medard Lech
Irina Savelieva
Vera Prilevskaia
Carme Coll
Sinan Ozalp
Ann Webb