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:
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
Pregnancies in the world 210 million women get pregnant annually –15% miscarriages, stillbirths –22% induced abortions –63% live births
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
Abortion in Europe –culture –economic status –religion –law Aspects of abortion laws rates practices
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
Completely prohibited Ireland Malta
To save woman’s life, to protect her physical health Poland (R, I, F)
… to protect woman’s mental health Northern Ireland Portugal (R,F) Spain (R,F) Switzerland
… on socioeconomic grounds Finland Great Britain Hungary
… 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
Data on illegal abortion Poland? Northern Ireland? Portugal? Russia?
ABORTION RATES IN EUROPE Western Europe Netherlands: 6.5/1000 women 15-44 yrs –abortion ratio: 10.6 –total ab. rate: 0.2 Eastern Europe Romania: 78/1000 women 15-44 yrs –abortion ratio: 63.0 –total ab. rate: 2.3
Abortion rates in Western Europe (abortions/1,000 women 15-44 yrs) Source: Abortion rates in Western Europe (abortions/1,000 women 15-44 yrs) Source: The Alan Guttmacher Institute. Sharing responsibility. Women society and abortion worldwide. New York: The Alan Guttmacher Institute, 1999: 54.
Abortion rates in Eastern Europe (abortions/1,000 women 15-44 yrs) Source: Abortion rates in Eastern Europe (abortions/1,000 women 15-44 yrs) Source: The Alan Guttmacher Institute. Sharing responsibility. Women society and abortion worldwide. New York: The Alan Guttmacher Institute, 1999: 54.
ABORTION PRACTICES Safe abortion –early in pregnancy –by well-trained practitioner –using surgical or medical method –in legal setting
First trimester abortion vacuum aspiration dilatation and curretage medical abortion –mifepristone & prostaglandins –methotrexate & prostaglandins
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
Medical abortion (mifepristone & PG) 1992: France –49 days: 600 mg mifepristone + 400 g misoprostol 200 mg mifepristone + 800 g misoprostol –63 days: 600 mg mifepristone + 1 mg gemeprost 200 mg mifepristone + 800 g misoprostol
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
Second trimester abortion medical induction with prostaglandins dilatation and evacuation intrauterine instillation of prostaglandins, hypertonic saline
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
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