1. Abortion in Europe: accessibility and availability
B. Pinter, Slovenia
E. Aubeny, France
G. Bartfai, Hungary
O. Loeber, the Netherlands
S. Ozalp, Turkey
A. Webb,  United Kingdom

2. Abortion – a response to unwanted pregnancy
50 million abortions occur annually
40% of abortions are unsafe, usually illegal
every day more than 200 women die of unsafe abortion
The main aim and the impact of better accessibility of abortion:  maternal morbidity and mortality rates!

3. Abortion laws in Europe
completely prohibited: Malta
to save woman’s life: Ireland
… protect her physical health: Poland
… to protect woman’s mental health: Northern Ireland, Portugal, Spain Switzerland

4. … on socioeconomic grounds: Great Britain, Finland
… on request: Albania, Austria, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, France, Germany, Greece, Hungary, Italy, Latvia, Lithuania, Macedonia, Republic of Moldova, the Netherlands, Norway, Romania, Russian Federation, Slovak Republic, Slovenia, Sweden, Ukraine, Turkey, Yugoslavia

5. Conditions of abortion practice (abortion on soc. - ec
Conditions of abortion practice (abortion on soc.- ec. grounds, on request)
Gestational limits: weeks, weeks
Facilities: authorized
Practitioners: gynecologists, GP’s
Parental consent: minors
Counselling: pre-abortion
Waiting period: to one week
Abortion fee: health insurance

6. Abortion rates in Western Europe (abortions/1,000 women years, 1996) Source: The Alan Guttmacher Institute. Sharing responsibility. Women society and abortion worldwide. New York: The Alan Guttmacher Institute, 1999: 54.

7. Abortion rates in Eastern Europe (abortions/1,000 women years, 1996) Source: The Alan Guttmacher Institute. Sharing responsibility. Women society and abortion worldwide. New York: The Alan Guttmacher Institute, 1999: 54.

8. Abortion: accessability in Europe
Different backgrounds
The Netherlands
France
United Kingdom
Slovenia
Hungary
Turkey

9. The Netherlands On request Gest. limit: 22 weeks Counselling: yes
Waiting period: 5 days
Parental consent: +/-
Ab. rate: 8/1000, years
Highest rates: years
Ab. ratio: 14/100 pregnancies
Eff. contr. use: 79%, TFR: 1.72
Repeated abortions: 35%

10. Facilities: special abortion clinics, rarely hospitals
Practitioners: GPs, well trained
Abortion fee: governmental separate insurance
Medical abortion: <1%
No illegal, unsafe abortion
Religion: no interference
Observations: rising ab. rates and repeated abortions

11. France On request Gest. limit: 12 weeks Counselling: only for minors
Waiting period: 7 days
Parental consent: -
Ab. rate: 15/1000, years
Highest rates: years
Ab. ratio: 18/100 pregnancies
Eff. contr. use: 79%, TFR: 1.89
Repeated abortions: 25%

12. Facilities: authorized centers
Practitioners: gynecologists, GPs, well trained
Abortion fee: health insurance
Medical abortion: 30%
No illegal, unsafe abortion
Religion: no interference
Observations: rising rates of medical abortion

13. United Kingdom On soc.-ec. grounds (GB) Gest. limit: 24 weeks
Counselling: no
Waiting period: no
Parental consent: +/-
Ab. rate (England&Wales) : 16/1000, years
Highest rates: years
Ab. ratio: 21/100 pregnancies
Eff. contr. use: 82%, TFR: 1.65
Repeated abortions: 30%

14. Facilities: authorized centers
Practitioners: gynecologists, spec. in C/RH, well trained
Abortion fee: health insurance in public service
Medical abortion: 11%
No illegal, unsafe abortion
Religion: no interference
Observations: limited public ab. services in some regions

15. Slovenia On request Gest. limit: 10 weeks Counselling: no
Waiting period: no
Parental consent: -
Ab. rate: 16/1000, years
Highest rates: years
Ab. ratio: 29/100 pregnancies
Eff. contr. use: 66%, TFR: 1.26
Repeated abortions: 29%

16. Facilities: authorized centers (hospitals)
Practitioners: gynecologists, well trained
Abortion fee: health insurance
Medical abortion: <1%
No illegal, unsafe abortion
Religion: small influence
Observations: trends towards limitation of abortion availability

17. Hungary On request Gest. limit: 12 weeks Counselling: yes, two rounds
Waiting period: 3 days
Parental consent: +
Ab. rate: 30/1000, years
Highest rates: years
Ab. ratio: 38/100 pregnancies
Eff. contr. use: 68%, TFR: 1.32
Repeated abortions: 40%

18. Facilities: authorized hospitals
Practitioners: gynecologists, some inadequately trained
Abortion fee: 80 EURO
Medical abortion: only WHO studies
No illegal, unsafe abortion
Religion: interference
Observations: low ab. access (two-round counselling, inad. training, ab. fee), high rates of repeated abortions

19. Turkey On request Gest. limit: 10 weeks Counselling: no
Waiting period: no
Parental consent: +, partner’s consent for married woman
Ab. rate: 25/1000, years
Highest rates: years
Ab. ratio: 15/100 pregnancies
Eff. contr. use: 38%, TFR: 2.5
Repeated abortions: 24%

20. Facilities: qualified services
Practitioners: gynecologists, GPs under supervision (EA), no standards in practice
Abortion fee: free, health insurance
Medical abortion: no
No data on illegal, unsafe abortion
Religion: no interference
Observations: accessability and quality depend on region

21. Conclusions
Determinants of accessibility and availability of abortion in Europe
abortion law
accessibility of abortion service
availability of qualified practitioners
abortion coverage
availability of medical abortion
interference of religion in abortion politics

22. Western Europe Eastern Europe
trends towards improvement of accessibility of abortion
Eastern Europe
trends towards limitation of accessibility of abortion