KRAKOW, Poland — Reproductive rights activists in Poland, where abortion laws are among Europe's strictest, have a stark message for their American counterparts: It's going to be a long struggle. And some people are going to die unnecessarily.
In this predominantly Roman Catholic country on Europe's eastern edge, where a hard-right ruling party holds sway, legal prohibitions on abortion are strikingly similar to those in U.S. states that have embraced the Supreme Court's dramatic unraveling of half a century of American abortion rights.
That hasn't always been the case in Poland. Decades ago, especially in the 1970s, when much of Europe had stricter abortion laws, the procedure's availability made this nation a destination for those seeking to end unwanted pregnancies.
After the country shook off Communist rule in the 1990s, however, an intense campaign by religious authorities — Pope John Paul II was born 30 miles from this southern city of cathedrals, crucifixes and stained glass — yielded a swift reversal of most abortion rights.
But even here sentiments are shifting.
"We very much want this child," said Basia, a heavily pregnant 24-year-old strolling on a cloudy day with her husband beside a verdant park on Krakow's outskirts. But she did not want her full name used, because she knew that what she said next would be anathema to many close relatives.
If she had accidentally become pregnant while her husband was finishing up his graduate degree and the two were scraping by on her meager salary, she said, she would likely have sought an abortion. He nodded in sober agreement.
The fight to outlaw abortion fits neatly with the conservative-nationalist agenda of the Law and Justice Party, which took power in 2015. Since then, it has waged what critics say is a broad assault on the rule of law and Poland's independent judiciary, drawing strength from a traditionalist constituency whose worldview would not be out of step with that in much of red-state America.
During the party's time in power, restrictions inexorably tightened, and by 2021, the ban had been broadened to scrap a final major exemption: cases of confirmed fetal abnormalities. Today, many Polish citizens — and some Ukrainian refugees who have taken shelter here — routinely travel elsewhere, or obtain abortion pills, often from abroad, to end unwanted pregnancies.
The increasingly severe restrictions at home, however, have given rise to a small-scale but horrifying phenomenon: patients who suffer late-term pregnancy complications being denied lifesaving care if a fetal heartbeat can still be detected.
"Izabela was dying," said Jolanta Budzowska, a personal injury attorney based in Krakow. She represents the family of Izabela Sajbor, a 30-year-old hairdresser whose death is now one of at least three maternal fatalities blamed by abortion rights advocates on restrictive laws and the medical system's overly zealous response to them.
Already the mother of a young daughter, Sajbor had learned in the second trimester of a wanted pregnancy that the fetus she was carrying had severe defects, her family said. The complication, a chromosomal abnormality known as Edwards syndrome, generally results in fetal death, or only brief survival for a baby carried to full term.
Sajbor was hospitalized in September 2021, after her water broke prematurely. Alone in the hospital due to COVID-19 restrictions in place at the time, she declared, in her final agonizing hours, that the country's abortion measures reduced women to "incubators."
In frantic texts she sent to her mother and husband, she wrote that doctors' only real concern seemed to be the detection of a fetal heartbeat — not her own worsening state.
Polish abortion law does allow for exceptions to the ban if the woman's life or health is in danger. But Budzowska says the chilling effect of restrictions, and ambiguities in legal interpretation, mean some medical professionals delay or reject intervention even when it is clear the woman is in peril.
"In the case of Izabela, abortion was theoretically permissible," said Budzowska. But even once Sajbor had developed sepsis, a life-threatening reaction to infection, doctors "assumed that the fetus would die on its own, and they would not have to explain about performing an abortion or terminating a live pregnancy," the lawyer said.
In Ireland, the similarly harrowing death of 31-year-old Savita Halappanavar in 2012 galvanized the legalization of abortion to protect the woman's life; in 2018, first-trimester abortions became legal after a referendum repealed a constitutional ban.
Across the European Union, abortion access in some form is the general norm, with Poland and Malta as the bloc's main outliers. Last week, the European Parliament voted in favor of a resolution calling for safe and legal abortion to be included in the EU's charter of fundamental rights. It also condemned the U.S. Supreme Court ruling.
Liberalization efforts in Poland have repeatedly been stymied, even though the near-ban on abortion set off some of the biggest street protests of the post-Communist era. From 2016 onward, demonstrators by the thousands wielded black umbrellas, even on clear days, as a symbol of what they called the government's oppression and intrusion into private lives.
Although Polish public sentiment appears mixed about the degree of restrictions that should remain in place, opinion polls point to solid majority backing for legal abortion under at least some circumstances.
"The number of people supporting a more progressive law is increasing," said Kamila Ferenc of the Federation for Women and Family Planning, a Warsaw-based advocacy group known as FEDERA.
But so far, public opinion alone has not been sufficient to bring about change. The final significant exemptions to the abortion ban were scrapped by Poland's highest court, which is controlled by judges loyal to Law and Justice. The conservative party is also the largest in Parliament, which last month rejected a measure that would have allowed terminations during the first 12 weeks of pregnancy.
As for any external pressure on Poland, the war in Ukraine is seen as giving the ruling party greater leverage in its dealings with the EU. Poland, a staunch supporter of Ukrainian President Volodymyr Zelenskyy's government, has played a key role in helping arm Ukraine, and has taken in millions of Ukrainian refugees.
In the meantime, recent years have seen a pattern ominously familiar to abortion rights advocates in the United States: a growing campaign to criminalize assistance to those seeking abortion. Activists can face prison for providing abortion pills to those in need.
One such activist, Justyna Wydrzynska, is currently on trial and scheduled to appear in court this week. She fears that authorities may seek to make an example of her; if convicted, she could be jailed for three years, or even longer. That didn't keep her from acknowledging that in 2020, she tried to send pills to someone who begged her for help, under circumstances that were wrenchingly familiar.
"That same thing had happened to me," said Wydrzynska, 47, a mother of three who escaped what she described as an abusive relationship with a man who tried to force her to go through with an unwanted pregnancy. She defied him and obtained an abortion; three years later, in 2009, she managed to divorce.
"I knew the risks; still, I wanted to help," she said. Now, as part of a pan-European network called Abortion Without Borders, Wydrzynska confines her efforts to counseling Polish women about where to obtain pills and how to use them — not providing them directly.
The turmoil has served only to heighten the determination of groups fighting to seal off what they consider to be remaining loopholes in Polish abortion ban. Chief among them is the Catholic organization Ordo Iuris, which lobbied hard for the end of the exemption over fetal abnormalities.
Katarzyna Gesiak, who directs the group's Center for Medical Law and Bioethics, said allowing for such exceptions amounted to "eugenics," and denied that the law as it stands strips women of necessary medical protections.
"We were very happy about this judgment; that was the main issue that we wanted changed," she said. But Gesiak was critical of prosecutors she said were insufficiently rigorous in pursuing those who help women obtain medication abortions.
"They don't want to chase these crimes," she said.
In the face of calls for an even harsher judicial environment, Polish abortion rights advocates say their struggle is a lonely one at times, but that they are bolstered by their European partnerships.
That sense of sympathy and solidarity with Polish counterparts now extends across the Atlantic as well, said Irene Donadio of International Planned Parenthood Federation's European network.
"Watching what is happening in a country that has stood for freedom" — the United States — "is a shock to see," said Donadio, who, along with other advocates, views abortion access as a basic human right.
"But what has inspired me in Poland is the fight of citizens, when they're so determined," she said. "When it comes to protecting rights, we can all learn from one another."
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