1. From choice, a world of possibilities Abortion: Challenging the law An overview of international trends Marcel Vekemans Senior Medical Advisor IPPF Central Office London

2. Abortion laws An overview of international trends It is difficult to define a general trend: let’s assess the situation Indeed, there have been various and opposite changes: restrictions and liberalisations What influences the making / the changing of the abortion laws?

3. Guttmacher : reforms since 1995 Nineteen countries liberalized their abortion law: Albania, Nepal, South Africa, Switzerland (on request; 12 weeks); Cambodia (on request; 14 weeks); France (on request 12 → 14 weeks) Benin, Burkina Faso, Togo, Guinea Conakry (life, health, rape, incest, foetal impairment). Health? Rape? Chad (life, health, foetal impairment) Swaziland (mental health, rape, incest foetal impairment) Ethiopia (life, health, rape, incest, foetal impairment, minors, disabled) Mali (life, rape, incest) Colombia (rape) Mexico State (on request); Mexico Federal (health, foetal impairment) Australia: two States (Western Australia: on request; Capital Territory: decriminalization) St Lucia, Buthan. Mozambique?

4. Guttmacher : reforms since 1995 Six countries restricted their abortion law: El Salvador, Nicaragua (prohibited altogether) Poland (severely restricted) Hungary, Russian Federation (various restrictions), US (partial-birth abortion)

5. Recent positive decisions Defence of liberal aspects of abortion laws in courts, or rights obtained: Poland: minor, after rape European Court of Justice: a foetus is not a legal person (similar decisions in many countries, e.g. New Zealand) Sweden: foreign nationals Slovakia: liberal law confirmed by Constitutional Court Argentina: denied access examined by UN Human Rights Committee …

6. Recent difficulties Difficulties in access France, Spain, US, Canada: rural areas without services Portugal, Spain: conscientious objection +++ Police interventions Spain, Italy: clinics raided The Netherlands: woman imprisoned Laws challenged GB: 24 → 22 weeks did not go through US: imbroglio Prevention Chile: emergency contraception problems Vatican: modern contraception condemned From penal code to constitution (Ireland)

7. Other laws needed Sexuality education: still a worldwide catastrophe Parents- and child-friendly societies (child care) Women-friendly societies (education, work; stigma) Pregnant women-friendly societies (young women, unmarried)

8. What influences the making of abortion laws? Lobbies (pro-choice, anti-choice) Religions (discrete, liberal, restrictive, aggressively restrictive) Science (evidence-based… or not) Decision makers, governments, politicians, mass media: Conservatism (Eire, Northern Ireland, Poland, Malta,…) versus progressiveness (Sweden, France, South Africa,…). A continuous fight (US,…) Politics and demography Public opinion (liberal, divided, restrictive, punitive)

9. Politics, demography and abortion laws War: need for fighters (France WW I, Germany WW II) Population decrease (Europe, Russia) Overpopulation (Iran, Egypt, Philippines, Indonesia,…) Crisis (food, water, pollution, energy,…)

11. Conclusion In my opinion, the general trend is, despite exceptions, towards liberalization Liberal laws must be protected; services must be organized; providers must be trained The lack of sexuality education is highly problematic Prevention of unwanted pregnancy remains a challenge even where abortion laws are liberal.

12. … let us not forget that, typically, legal restrictions on abortion do not affect its incidence but induce death, diseases, and lots of suffering Thank You