General information:

• Capital - Warsaw
• Population - 38,17 millions (2005)
• Women of reproductive age (15-44 years) - 9, 931000 (2004)
• Major languages - Polish

Law related to Abortion:

The Act of 7 January 1993 on Family Planning, Protection of the Human Embryo and Conditions for Termination of Pregnancy.

Brief history of the law:

Abortion had been legal in Poland since 1956 and abortion services were widely available. The public debate on abortion started in 1989, and in 1993 significant changes concerning women’s reproductive rights were introduced in Poland. The Act on Family Planning, Human Embryo Protection and Conditions of Permissibility of Abortion. The anti- abortion law was liberalized shortly in 1996 (enforced in 1997) to allow abortion until the 12th week of pregnancy on social grounds. The law was restricted again in 1997 (enforced in 1998) in response to the Constitutional Tribunal’s decision holding that abortion on social grounds is unconstitutional.

Short summary of conditions within the law:

• To protect  woman’s life - yes
• To preserve physical health - yes
• To preserve mental health - no
• Rape or incest - yes
• Fetal impairment - yes
• Socio-economic factors - no
• Available on request - no

Analysis of it being restrictive if at all

The Act of 1993 is extremely restrictive because it does not allow termination of pregnancy on social grounds and the reasons for termination of pregnancy included in the Act are set out in an extremely restrictive way, both in comparison with the regulatory environment before the act came into force, as well as in comparison with the regulatory environment in force in other countries (in European countries it is comparable only to Ireland and Malta).

Policy:

The government has a statutory obligation to prepare a report each year on the realisation of the act on family planning, however, it does not completely fulfil this obligation. In its reports, the government limits itself exclusively to providing the official number of terminations of pregnancy carried out in accordance with the law in public hospitals. It baulks at providing an estimate concerning the number of abortions carried out in the so-called abortion underground, in which the number of abortions significantly exceeds the official statistics. The unwillingness of the government to undertake such research on the scale of the abortion underground is most likely due to the fact that if any such research confirmed the actual scale of the underground, it would signify a total failure of the Act on Family Planning in liquidating or at least reducing the number of abortions.

Abortion services:

Main indications:

• the pregnancy constitutes a threat to the life or health of the pregnant woman,
• prenatal tests or other medical indications show a high probability of a severe and irreversible damage to the foetus or an incurable illness threatening its life,
• a justified reason exists to suspect that the pregnancy has arisen as a result of a criminal act.

Depending on different indications, the pregnancy is being terminated in the first trimester (in case of pregnancy being a result of a criminal act) or up to 23/24th week in case of decision about termination taken because of indications resulting from prenatal examinations.

Location of services - State hospital or private clinic. As abortion skills are hardly taught at medical academies. The main method of abortion used in Poland is still D&C. There is no objective to improve technical skills and to implement vacuum aspiration and RU-486 in accordance with modern standards.

Policy:

• abortion skills are not taught at medical academies
• conscientious objection enables doctors to deny women abortion
• lack of proper training of physicians and mid-level medical personnel, combined with a lack of reliable information on medical abortion may jeopardize the health of women using this method improperly.

Reproductive Health Perspective

Signatory to ICPD, CEDAW: Yes

Abortion Statistics:

Total abortion rate per woman - 0,02(2005)

Abortion ratio per 100 live births - 0,65

Total number of abortions (indicate source; period) - 340 (Reproductive Rights in Poland, Report of Federation for Women and Family Planning, 2008)

Public sector:

1st Trimester - in case of pregnancy being a result of a criminal act. 2nd Trimester - in case of decision about termination taken because of indications resulting from prenatal examinations. Cost - free of charge.

Private sector:

1st Trimester - in case of pregnancy being a result of a criminal act. 2nd Trimester - in case of decision about termination taken because of indications resulting from prenatal examinations. Cost - it varies, depending on provider.

Methods used :

D&C, EVA, MVA, MA with Mife+Miso (≤ LMP, regimen used), MA with Miso alone (≤ LMP, regimen used), MA with Methotrexate+Miso (≤ LMP, regimen used). 2nd Trimester with Ethacridine lactate, Misoprostol, D&E, Hysterotomy. In Poland D&C remains a prevailing method for termination of pregnancy.

Provider level allowed for surgical and  medical abortion:

Only Ob/Gyns are allowed to perform abortion (surgical).

Abortion related morbidity mortality statistics:

Data unavailable.

Manufacture and/or availability through import of abortion equipment (MVA syringes, EVA equipment):

MVA syringes nor EVA equipment are not imported as the prevailing abortion method is D&C.

Manufacture/ import of Mifepristone, Misoprostol:

They are not registered in Polish Drugs’ Registry.

Informal / illegal providers – if present who are they:

While Poland reported fewer than 200 “official” abortions in 2005, it is estimated that between 60,000 and 200,000 Polish women obtain abortions annually, either by paying for an illegal abortion in-country or traveling to a nearby country where abortion is legal.

Role of government:

The present government is pro-life and not showing any interest in providing infrastructure necessary to improve present situation. The government tends to ignore the pathologies resulting from a criminogenic law (abortion underground, abortion tourism, infanticide, abandonment of children).

The government is obliged (by the Act on Family Planning) to prepare annual report on the realization of the act on family planning, however it does not fulfil this obligation. The reports that had been prepared are limited to provide the official number of terminations of pregnancy and ignore the number of abortions carried out in the so-called abortion underground.

Role of religion/ religious leaders:

Catholic leaders, whose attitude is extremely restrictive,  influence both politicians and health professionals.

Local Ob Gyn societies:

Doctors are often reluctant to grant therapeutic abortions, even when their patients clearly qualify for one, because the law is vaguely worded and abortion is highly stigmatized.

Current status and potential of research:

• Federation for Women and Family Planning prepares reports on abortion and observance of family planning law.
• The government is reluctant to undertake research on factual abortion-related situation.

Awareness amongst community members:

Among women - almost none. Among medical providers - they are aware of its existence but they are not trained to perform it.

Role of member organization/ individual:

The Federation for Women and Family Planning is the most important pro-choice organization and Poland and  has been monitoring the implementation of the anti-abortion law since its very inception. It conducts counseling, legal interventions, educational publishing and awareness raising campaigns. It conducts permanent monitoring of the observance of human rights in Poland and informs public opinion and the relevant institutions in the country and abroad of the results.