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

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Presentation on theme: "Medico-legal aspects of abortion in Europe Bojana Pinter University Dept. Of Ob/Gyn Ljubljana, Slovenia Why are teenagers still getting pregnant? 6th Seminar,"— Presentation transcript:

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 –culture –economic status –religion –law Aspects of abortion laws rates practices

5 ABORTION LAWS IN EUROPE Abortion: 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 –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: 78/1000 women yrs –abortion ratio: 63.0 –total ab. rate: 2.3

17 Abortion rates in Western Europe (abortions/1,000 women yrs) Source: 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: 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 200 mg mifepristone  g misoprostol

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


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