The restrictive law didn’t cause drastic reduction of the legal abortions

It would’ve been good if Macedonia had solved the abortion issue. But, it hadn’t. Photo: Aleksandar Vučić. Source: Print screen

Formally, the statement by Serbia’s President Aleksandar Vučić that the number of legal abortions in Macedonia has been reduced after the restrictive amendments to the Law on Termination of Pregnancy is true. However, the big picture is far more complex and shows that the number of abortions had been going down for many years before the amendments, that there is expanding cloud of indication and information that the illegal abortion procedures have been growing, for which women from Macedonia pay both in the country and abroad, as well as that plethora of women had decided to terminate their pregnancy despite the legislative hurdles and the inductive and biased “counseling” and postponing of the procedure.

This article was written in cooperation with our partners from istinomer.rs, Republic of Serbia.header-logo

Formally, the statement by Serbia’s President Aleksandar Vučić that the number of legal abortions in Macedonia has been reduced after the restrictive amendments to the Law on Termination of Pregnancy is true. However, the big picture is far more complex and shows that the number of abortions had been going down for many years before the amendments, that there is expanding cloud of indication and information that the illegal abortion procedures have been growing, for which women from Macedonia pay both in the country and abroad, as well as that plethora of women had decided to terminate their pregnancy despite the legislative hurdles and the inductive and biased “counseling” and postponing of the procedure. Because of these instances, and numerous others, we assess Vučić’s statement as partially true

In a recent interview for the Serbian television Happy in which he spoke about the great number of abortions in Serbia, Serbia’s President, Aleksandar Vučić, highlighted Macedonia as a good example of a country that has used the law to solve this problem:

We lose entire population of Vršac or Prokuplje annually, or 35.000 people, and if we don’t solve this problem (the abortions, our remark) like the Russians, Macedonians, Danes, who have succeeded because of the self-conscience and the discipline of the protestant population.

Here it is different, we don’t interfere with that as a state, and most children are born in the poorest families. Usually, the richest ones are the most selfish ones.

The Macedonians have solved it by granting the right to abortion to everyone, but women who decide to undergo the procedure must spend two days in hospital.

They say when a woman hears the heartbeat of her baby, she feels different, and 10-15 percent of them change their mind – Vučić’s explanation on the Macedonian recipe in his appearance on Happy TV station.

[Source: vucic.rs; Date: 22 January 2018]

 

EXPLANATION:

This statement by the President of Serbia, Aleksandar Vučić, in which he says that the number of abortions in Macedonia has been reduced, viewed from the perspective of the numbers and only the numbers of legal abortions, is true. According to the data Truthmeter obtained from the Institute of Public Health of the Republic of Macedonia, the number of abortions has been reduced by 732 after the amendments to the Law on Termination of Pregnancy were passed in 2013, i.e. in the period 2013-2016. But, the registered abortions data for the period 2008-2013, when the previous law on termination of pregnancy was in effect, show that the number of abortions had been reduced for nearly 1.000 during this five-year period. More precisely, from 5.900 in 2008 to 4.983 in 2013. For only one year, in turn, in 2013 compared to 2012, the number of abortions dropped by 404 – from 5.387 in 2012 to 4.983 in 2013.

It’s debatable whether the reduced number of abortions in recent years (2013-2016, there are no official data for 2017 yet), which cannot be deemed drastic for truth’s sake, is due solely to the amendments to the Law on Termination of Pregnancy (also known as law on abortion) because downward trending in the number of completed procedures for termination of pregnancy is noticeable in years when the old legislation was in effect. It’s still a question whether the legislative norm Vučić invoked can be stressed as positive example, taking into account that NGO’s analyses and unofficial information published by the media show that the number of illegal abortions has risen after this restrictive law was passed. Therefore, we consider President Vučić’s statement to be partially true.

TOTAL NUMBER OF REGISTERED ABORTIONS AT ALL AGES, NUMBER OF ABORTIONS UNDER THE AGE OF 20 AND NUMBER OF ABORTIONS AT THE AGE OF 35+ IN THE REPUBLIC OF MACEDONIA, PERIOD 2008-2016

  2008 2009 2010 2011 2012 2013 2014 2015 2016
Number of registered abortions – all ages  

5.900

 5.601  5.078  5.324  5.387  4.983  4.738  4.587

 

4.251

 

Number of abortions under the age of 20  

146

 234  183  197  236  237  217  217

 

161

Number of abortions at the age of 35+  

1.980

 1.736  1.720  1.701  1.897  1.756  1.558  1.530

 

1.493

Source: Institute of Public Health of the Republic of Macedonia

Reactor, an NGO member of the Gender Equality Platform, yesterday commented for Truthmeter the last amendments to the popular Law on Abortion:

In 2013, the Law on Termination of Pregnancy got amendments related to the limitation of the right of women to safe and secure abortion. The law was passed in a summary proceeding without prior consultation with experts, women’s organizations and other stakeholders. The amendments to this law was one of the series of measures aiming at re-traditionalizing women’s role as a mother, i.e. its goal is to affect the demographic policies/natality in the country. The introduction of compulsory waiting period before the intervention, the biased counseling and the fines for doctors are some of the factors that limit women’s access to safe abortion as well as their right to choice. (Reactor)

With regard to the effects caused by the aforesaid amendments to the Law on Termination of Pregnancy, the NGO HERA for Truthmeter said:

There is no empirical data showing that the legislative barriers have any effect on the rise of birthrate, and on the other hand, surveys have found that legal limitations have dramatic impact on women’s access to safe abortion. Dealing with complications caused by unsafe abortion creates additional burden, i.e. exposes the state to healthcare, social and economic costs.

All in all, a reduced number of abortions cannot be reached by limiting the access to legal abortion, but through measures which we all strive for: introducing all-embracing sex education in schools and improving the access to contraception i.e. putting contraceptive methods on the positive list of the Health Insurance Fund of the Republic of Macedonia. (HERA).

Between April and July 2017, the Health Education and Research Association – HERA and the Center for Reproductive Rights carried out detailed interviews with fourteen stakeholders in Macedonia in order to investigate their views and experiences with the new legislative provisions. The interviews were carried out with seven women who have induced abortion after the new legislative conditions were promulgated as well as with two gynecologists, one sociologist, one social worker and three representatives of nongovernmental organizations. The interviewees are from different towns in Macedonia, including Bitola, Kumanovo and Skopje, as well.

Key findings in the research, among others, are:

  • Interviewees believe that abortion in Macedonia is still being stigmatized, and is closely linked to stereotypes that women’s primary role in society is the role of a mother and a spouse.
  • All interviewed women, who had to go through the compulsory waiting period after the counseling, say that it didn’t affect their decision and this precondition has no effect.
  • Interviewees emphasized that the compulsory waiting period ought to be repealed.
  • All women we talked to said that the counseling didn’t make them change their mind on the abortion. Some of them said they had been forced to watch images of the fetus or listen to the heartbeat, which is a negative experience for them.
  • Some of the interviewees talk about the horrendous effect of the legislative provisions which stipulate increasing of fines as well as criminal sanctions for health services providers who have violated the law. Fines reach up to 50.000 euros for health institutions and up to 6.000 for health workers. The law also lays down a prison sentence of up to three years for health workers who have violated the law.

The summary of the research contains multiple recommendations, among which:

  • Taking measures for altering and transforming both the abortion-related stigma and the pernicious gender stereotypes, including cancellation of public campaigns that stigmatize the abortion and underestimate women’s ability to make informed and individual decisions on their own pregnancy.
  • Repealing legislative provisions asking women to go through compulsory waiting period after counseling and to repeal the partial counseling prior the abortion.
  • The entire counseling regarding abortion ought to be voluntary, non-inductive and fit every woman’s individual needs and wishes.
  • Access to information on all birth control methods for all women seeking abortion.
  • Guarantee that health workers offer medically correct information on abortion based on evidence only and that medical staff is trained for the importance of informed consent, in keeping with World Health Organization’s guidelines.
  • One of the problems resulting from the legal limitation of the right to termination of pregnancy with bureaucratic procedures is illegally induced abortion.

It should be said that in recent years, media outlets had published testimonies of women who had opted for “wild” abortion. Such story was published on 7 October 2017 by NOVA TV news website titled: “The illegal abortions are on the rise, the legal ones are expensive for the poor”:

I have five children, and I got pregnant with sixth. I can’t raise it because we are very poor, my partner collects food and clothes from dumpsters. That’s why I decided to induce abortion in a private clinic that provides those services by breaching the law. I borrowed money from my brother because I couldn’t wait any longer, I was between two and three months pregnant so I paid the gynecologist to induce abortion – the testimony for NOVA TV of a young Roma woman who lives in substandard living conditions in Shuto Orizari.

CHRONOLOGY OF THE RESTRICTIVE LAW

The amendments to the Law on Termination of Pregnancy, which were passed by the Parliament on 10 June 2013, caused a drumfire of criticism. While the Parliament was in session, after which it promulgated the Law, civil society organizations were protesting in front of the Parliament’s building stressing that these amendments to the Law on Termination of Pregnancy will take this country fifty years back in terms of health protection and women’s rights.

These amendments significantly complicate the abortion procedure by introducing veiled impediments and countless formalities to the procedure in which women terminate their pregnancy. The new law seriously limits the abortion after 10 weeks by bounding women who want to undergo abortion to file a request for termination of pregnancy, mandatory ultrasound check up and mandatory counseling and three-day post counseling waiting period.

Soon after the amendments were passed, six members of the European Parliament sent a letter to the authorities in Skopje on 13 June 2013:

The manner in which this legislation is proposed and debated is itself a telling sign of a country’s readiness to join the European Union and ability to meet the Union’s democratic criteria.

Termination of pregnancy is both a public health issue and human rights issue, concretely linked to woman’s right of self-determination.

The members of the European Parliament underlined that none of the proposed measures is related to women’s needs and also that they are not medically necessary.

On the contrary, many of the measures oppose women’s rights to access to appropriate health protection, privacy, autonomy, confidentiality and dignity, all guaranteed by the Constitution of the Republic of Macedonia and are basic components of the EU accession process, the letter underscores.

On 27 September 2013, the Health Education and Research Association – HERA, in cooperation with the Helsinki Committee for Human Rights, Coalition for Sexual and Health Rights of Marginalized Communities, Reactor – Research in Action and the professor Karolina Ristova Asterud submitted an Initiative for assessing the constitutionality and lawfulness of the Law on Termination of Pregnancy to the Constitutional Court of the RM. This initiative covered 16 disputable articles of the Law, which, according to the ones who submitted the initiative, limit, decay and restrict woman’s reproductive rights. It accentuates the administrative barriers, above all, which are laid down in the Law on Termination of Pregnancy and are related to the mandatory written abortion request, mandatory and biased counseling and mandatory three-day waiting period.

A year later, in October 2014, the Constitutional Court debated, but didn’t initiate a proceeding regarding the Law on Termination of Pregnancy. Court’s opinion was that the Law doesn’t question the freedom of decision, it just regulates the procedure and entrusts it to committee experts, according to the majority of judges. Unlike them, the Constitutional Court judge Natasha Gaber-Damjanovska thought that the state meddles excessively in woman’s personal life. She says:

The disputable articles have been inserted deliberately in order to complicate the abortion procedure with the aim to persuade women to waive their intention, because there are new administrative obligations, written statements, approval by a committee, counseling and three-day post counseling waiting period, which prolongs the entire process and one rather intimate issue becomes partially public.

In 2015, UN Human Rights Committee urged Macedonia to amend the 2013 Law on Termination of Pregnancy, which puts the health and life of women at risk. UN Committee on Economic, Social and Cultural Rights reached a conclusion that provisions of the law intimidate the physicians, which may lead to unsafe abortions, compulsory counseling prior abortion is acceptable only if it is neutral, informative and supports woman’s free decision. Therefore a revision of the Law’s restrictive measures was recommended.

On 2 December 2016, the Gender Equality Platform called all political parties to sign a Declaration and commit to amend the 2013 Law on Termination of Pregnancy after the elections (11 December 2016). The Declaration was signed by 10 political parties: VMRO – Narodna Partija, Demokratska obnova na Makedonija (DOM), Dostoinstvo, Levica, Liberalna Partija (LP), Liberalno Demokratska partija (LDP), Nova socijaldemokratska partija (NSDP), Obedineti za Makedonija (OM), Partija za celosna emancipacija na Romite (PCER) and Socialdemokratski sojuz na Makedonija (SDSM). They committed that amendments will be made to the Law on Termination of Pregnancy, especially to the provisions that limit women’s access to abortion in health institutions and jeopardize the right to health protection as well as the reproductive rights.

On 28 September 2017, the Gender Equality Platform asked the Government to pass a new or to amend the current Law on Termination of Pregnancy.

We have testimonies of multiple women expressing their negative experience with the new legislation who also believe that their right to free choice has been violated by health workers during these procedures. (HERA)

Back then, the Gender Equality Platform asked the Government to issue an order for permanent ban of the video ads from the anti-abortion campaign “Choose life”, as well as implementation of raising awareness campaign on modern birth control and cutting down of the previous government’s anti-abortion campaign that had been airing for years. The Platform pointed out that although the number of abortions has decreased statistically, plenty remain unregistered and are being conducted illegally.

Up to this time, (31 January 2018) the aforesaid Law hasn’t been amended.

SOURCES:

Assessed by: Olivera Vojnovska


This article was created within the framework of the Project to increase the accountability of the politicians and political parties Truthmeter implemented by Metamorphosis. The article is made possible by the generous support of the National Endowment for Democracy(NED) and The Balkan Trust for Democracy (BTD), a project of the German Marshall Fund of the United States, an initiative that supports democracy, good governance, and Euroatlantic integration in Southeastern Europe. The content is the responsibility of its author and does not necessarily reflect the views of Metamorphosis, National Endowment for Democracy, the Balkan Trust for Democracy, the German Marshall Fund of the United States, or its partners.