Abortion law in the European Union.

One of the major issues in the United States (U.S.) presidential election is abortion. In June 2022, the nationwide right to abortion, which was based on the 1973 Roe v. Wade court ruling, was reversed by the U.S. Supreme Court. This allowed states (again) to decide individually what abortion laws apply. Since the nationwide right to abortion was reversed, 21 of the 50 U.S. states have made abortion beyond six weeks of pregnancy impossible or banned it altogether. As a result, birth rates have increased, especially among women in vulnerable economic positions. They, unlike those in a better economic position, are more often unable to afford travelling to another state to have an abortion here, if they would want or medically need it. In the process, the number of women who died during pregnancy has also increased.

With the U.S. presidential election approaching, Democrats in particular are fully committed to abortion rights. For example, in January of this year, Vice President and now presidential candidate for the Democrats, Kamala Harris, launched her Fight for Reproductive Rights Tour. Meetings included sharing what damage abortion bans have done. The tour is part of Harris’ campaign, which calls on Democrats to reclaim freedom. This is seen as the most central value in “the land of the free”. In the fierce political battle, Melania Trump, former First Lady and wife of Republican presidential candidate Donald Trump, also defended abortion rights. Remarkable, because her husband said at an anti-abortion event in 2021 that he actually wanted to protect “the right of every unborn child”.

Abortion is, thus, especially during election time, is a hot topic in the U.S. Very different than during the European Parliament elections in May 2024, where abortion was far from the main topic. This raises questions regarding the state of abortion rights in the European Union (EU). Do European citizens have a choice everywhere? Or does that remain to be seen?

What is abortion?

Abortion provocatus, or abortion for short, is the early termination of a pregnancy by human intervention. There are several, personal reasons for an abortion. Sometimes, a pregnancy is medically harmful; this can have both physical and mental reasons. Prospective parents also sometimes choose abortion if they discover that their baby has a severe disability, will have no quality of life, or that the viability of the fetus is zero. However, the most well-known reasons for abortion are so-called “social reasons”. Examples include a pregnancy from sexual abuse, sexual violence, or incest, not having the desire to have children, not having a (suitable) partner, getting pregnant at a young (and/or underage) age, getting pregnant at an older age, not having sufficient financial resources, not having a safe home situation, having just given birth, having a “complete family,” et cetera. Note: in several countries, including the Netherlands, the why is not relevant at all. If you want an abortion, it is available free of charge – whatever reason you have.

An unwanted pregnancy can happen to anyone. For example, two-thirds of Dutch people who choose to have an abortion have become pregnant despite the use of some form of contraception. In some cases, the unwanted pregnant person even took a morning-after pill, but it did not work. Most abortions (65%) eventually take place in the first eight weeks of pregnancy, 86% in the first 12 weeks.

The decision to have an abortion is not made lightly. Although the reasons vary, the experience itself is often intense – even when people are sure they have made the right decision. While many are relieved after the abortion, for others it causes emotional symptoms (such as grief). An abortion can also cause physical symptoms. These are usually similar to a heavy menstrual period, although there can always be more severe complications. It is a fable that an abortion results in reduced fertility.

The abortion procedure often takes place at the hospital or an abortion clinic. There are several ways to perform an abortion. Which way is chosen depends on the duration of the pregnancy. For example, for up to 9 weeks, the abortion pill is usually chosen, while between 18 and 24 weeks childbirth must be induced with prostaglandins (a hormone). 

The importance of the right to abortion

Tamar Stelling wrote in March 2024 for the Correspondent that nearly one in three pregnancies worldwide ends in abortion. Needless to say, there are many different views on abortion. Perhaps you are firmly against or pro-abortion, but many people express nuances, are unsure, or catch themselves in contradictions. So answering the question of whether and why abortion rights are important is not easy.

The abortion rate in the Netherlands is relatively low. This is mainly because citizens are knowledgeable about sex and contraception. Sex education is provided at school, contraception is relatively affordable and easily available and, not unimportantly, sex is not a big taboo in many households. A lack of sex education at school results in children hearing little to nothing about indicating and respecting boundaries or using contraception. They often come to associate sex with shame and something that should not be talked about. In communities, states, and countries where this is the case, abortion rates are high.

A good example of this is the U.S. state of Texas. In 1995, a law was signed here to ensure that schools would carry one message: “The only safe sex is no sex”. Sex education was seen as encouragement and therefore no longer provided. Joke van Kampen wrote in 2003 for the Groene Amsterdammer: “Sex education in Texas in 2003: a meeting with hundreds of fourteen-year-olds in an auditorium. In front of it stands a hip-dressed older youth evangelically shouting, “[…] Do you think this condom protects your heart? Go ahead, go ahead and use a condom. You’ll be known as a slut.” The teen pregnancy rate in Texas ended up being by far the highest in the U.S. – which, in turn, was already higher than anywhere else in the world. Van Kampen: “That is, it was so in 1997, because after that teenage pregnancies were not recorded as it looked bad in the international statistics. [Also] venereal diseases, declining in the U.S. as a whole, [peaked] like never before in Texas.” Meanwhile, the number of teenage pregnancies in Texas is being tracked again. After several years of decline, the number has risen again. 

Unwanted pregnancies are common precisely where there is little education – as is the case in Texas. The fact that abortion is allowed in the same state only in very specific cases will not reduce the number of abortions. These will then either be performed in another state (which, by the way, is also becoming increasingly difficult, since several Texas Counties have banned the transportation of pregnant women if the purpose of the trip is an abortion) or take place illegally. Furthermore, some will attempt to perform an abortion on themselves, for example with an overdose of (morning-after) pills.

All of the above results in life-threatening situations: one in five illegal, and therefore unsafe, abortions ultimately lead to death, and millions more lead to mostly avoidable disabilities each year. In addition, the criminalization of abortion causes the stigmatization of girls, women, and others who are reproductively capable of becoming pregnant. In several countries and states, they risk persecution and punishment if they have had an illegal (and unsafe) abortion.

Finally, abortion bans are freedom-restricting. The autonomy of the pregnant person is severely compromised. According to Amnesty International and Human Rights Watch, among others, access to safe abortion is a human right. Decisions about your body can only be made by you. This is called bodily self-determination. When people are forced to carry an unwanted pregnancy, this right, as well as the right to privacy, is violated. The right to abortion also touches on other internationally protected rights, such as the right to liberty, protection from discrimination, the right to equality, the right to life, et cetera. Forced pregnancies and obstructing access to safe abortion are equivalent to undergoing torture, according to several organizations and experts. The former is, therefore, tragically a common war crime.

Abortion in Europe: the state of affairs

It varies widely within the EU during what period an abortion can be performed and under what conditions. For example, in the Netherlands, it can be done up to 24 weeks of pregnancy if there are serious health problems in the fetus or the carrier, while in Croatia it is possible up to 10 weeks. On average, abortion in Europe is possible up to 12 weeks of pregnancy. By the way, in several European microstates that are not part of the EU, such as Andorra, abortion is – under the influence of the Vatican – banned. Interestingly, abortion rules are also particularly strict in Denmark’s Faroe Islands, unlike in Denmark itself. Until recently, unwanted pregnant Faroese had to travel to Denmark to get an abortion.

In general, more Catholic and Orthodox Christian European countries have stricter abortion laws. In 2013, for example, Ireland, with its predominantly Catholic population, was the second-to-last EU member state to legalize abortion. This does include the condition that the woman’s life must be in danger. Until 2023 (!), abortion was prohibited under any condition in the also Catholic Malta. Only in that year was the same exception introduced as earlier in Ireland. With the cancellation of the Maltese absolute abortion ban, abortion is now possible in every EU member state. Or at least, in theory.

Reality shows that legislation regarding abortion is very strict in different countries. For example, in Poland, the morning-after pill can only be obtained from the family doctor by appointment, which means that it may be taken too late. Also, abortion is only possible in the case of incest, rape, or if the pregnant woman is in mortal danger. However, proving rape is difficult, so not everyone who should legally be eligible for an abortion can get one. As a result, fewer than 2,000 legal abortions take place each year in Poland. It is estimated that 150,000 to 200,000 Poles per year have an illegal abortion or travel abroad for the procedure.

Abortion is possible in several European countries, but the procedure is made unnecessarily difficult. For example, in certain countries, including thus Poland, Ireland, and Malta, abortion is allowed only under strict conditions. Underage, unwanted pregnant girls from Bulgaria, Denmark, Greece, Hungary, Italy, Luxembourg, Poland, Slovakia, or Spain need consent from the parent(s) or guardian for an abortion. On top of that, healthcare providers in most European countries are allowed to refuse an abortion for religious or moral reasons. An example is Italy, where over 70% of doctors refuse to perform an abortion. This percentage has increased in recent years, perhaps due to the growth of right-wing nationalism in the country. Finally, the abortion pill is scarce in some countries, is not allowed at all in Hungary and Slovakia, for example, and abortion activists are persecuted in several countries. 

Perhaps unexpectedly, but in Hungary, abortion is widely accepted socially; abortion has been legal there since 1950 and the rules are not as strict as in Poland. Nevertheless, under the right-conservative government of Viktor Orbán, rules are being introduced that should serve to make people doubt abortion. Hungarians are required to listen to the heartbeat of the fetus before having an abortion. In addition, they are required to attend two meetings before the abortion. At the first one, they are informed about other options, including adoption. At the second meeting, they are told about the “dangers” of abortion. Given that many dislike these unethical conditions, many unwanted pregnant Hungarians travel to neighboring Austria for abortions. 

Several European countries, including Belgium, Germany, Italy, and Luxembourg, have a mandatory reflection period for abortion. In the Netherlands, the mandatory five-day reflection period has now been converted to a flexible reflection period. Ineke van der Vlugt, program manager for Contraception and Abortion at Rutgers, welcomed this: “A mandatory five-day reconsideration period is patronizing, too rigid and unnecessarily burdensome for many women. It ignores their right to self-determination. Women are quite capable of making a well-considered choice for an abortion themselves and taking the time they deem necessary for this. A doctor always reviews whether the decision was made carefully and deliberately and can work with the client to see whether or not more time for reflection is needed.” Interestingly, in many European countries, the reflection period differs in terms of duration. On this, Uruguayan legal philosopher Lucía Berro Pizzarossa says: “In Slovenia, you have to think for two days, in Italy seven days. What, do Italians think slower than Slovenians? If you want to give people the opportunity to think, give them the option to talk to a psychologist about their decision, about having children and raising them, and give them financial advice. Do they do that? No. They just send you home.”

Finally, (the prohibition of) abortion is enshrined in the penal code in nine European countries, including the Netherlands. This criminalizes and morally disapproves this medical treatment. A positive exception is France, where – as the first country in the world – abortion rights are enshrined in the constitution. Many conservative politicians, including Marine Le Pen, also voted in favor of this bill. However, the implementation of the law lags. For example, two doctors must authorize an abortion in France. The result: many French people still cross the border for an abortion.

Abortion and the EU’s responsibility

Overall, we in Europe are fortunately in a much better position than the U.S. when it comes to abortion. That does not mean that nothing needs to change. First of all, the right to a legal and safe abortion should be included in the Charter of Fundamental Rights of the European Union (which Poland has an opt-out for, by the way). Although the European Parliament has already voted for this, all individual EU member states would also have to agree to amend the Charter. The chances of this happening are unfortunately slim, but the recommendation remains in full force.

If abortion rights do become part of the Charter, international agreements on abortion should be made. The same (liberal) rules everywhere in Europe: the same time limits, no obligatory reconsideration time, and legal, safe abortion regardless of the reason. Not only does this ensure safe abortions everywhere in the EU, but it also eliminates the need for unwanted pregnant Europeans to cross borders for health care – something they cannot always afford. In addition, the abortion pill, now only readily available in some member states, should be distributed fairly across the Union based on population. Until this happens, it is good that the doors of abortion clinics remain open to people from countries where the rules are very strict. 

Another recommendation is the decriminalization of abortion or the removal of abortion from the criminal code. EU member states should be encouraged to take this step. An example that we can cite here is Canada, where abortion is not covered by criminal law, but by civil law. Hospitals there have well-trained doctors who can perform abortions. Abortion in Canada is a legal health service and is available regardless of the reason. 

Research shows that the number of abortions decreases when proper sex education is provided and contraception is widely accessible. Everyone – including the more conservative Europeans – should, therefore, be in favor of this. Moreover, member states should ensure that information is tailored to various target groups. It would be good if a European program were launched to promote sex education among young people. A bonus: European youth will also be better able to set their own boundaries and respect those of others. Liberal EU member states should also speak out more strongly in favor of safe, legal abortion worldwide and offer support to citizens of countries where this care is under pressure. Abortion should also be a bigger issue in the next European Parliament elections. 

The nice thing about abortion rights is that no one is forced to use them. If you are a European citizen who is against abortion, you are allowed to have those beliefs, and you are allowed to demonstrate against it – preferably in a respectful manner. What is important, however, is that as Europeans we stand up for bodily integrity and freedom of choice for everyone. This also means stepping back when someone else makes a decision you might not make yourself. Therefore, many people are not necessarily pro-abortion but pro-choice: this means that an individual should be able to choose for themselves whether or not to have an abortion. The EU has a responsibility to stand for this so that everyone within Europe has access to safe and legal care when needed. Fortunately, there are regular debates about abortion in the European Parliament. The focus here is often on Poland, given the strict regulations there. While it is already very good that this is happening, we need to broaden our view and look critically at all member states. In a Union that respects diversity of beliefs, abortion as a basic right should be protected everywhere in the EU.

Loes ter Horst has a master’s degree in Crisis and Security Management (Leiden University) and a master’s degree in Middle East Studies (University of Amsterdam). Prior to this, she earned a bachelor’s degree in Liberal Arts and Sciences with a major in International Governance (USBO, Utrecht University).

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