As US states and nations such as Poland move towards restricting access to abortions, parts of Europe are seen as something of a safe haven for those looking to terminate pregnancies. However, a look at legislation across the continent shows vast discrepancies and how – even if the procedure is often legal – access to abortion is restricted by hurdles ranging from mandatory counselling to a lack of doctors willing to perform the procedure.
More than 95% of women in Europe live in countries that allow some access to abortion. Some 39 European countries have legalised abortion on request, albeit with some restrictions. Six countries have strict limits in place although only three (Andorra, Malta and San Marino) do not allow abortion at all.
Medical abortion (brought on by taking a pill) accounts for at least half of all abortions in most European countries and at least 90% of abortions took place before 13 weeks of pregnancy, according to a 2018 multinational study by the British Medical Journal.
Yet these figures belie a more challenging reality on the ground: Getting an abortion in many European countries is neither easy nor guaranteed. And even when the procedure is legal, short timeframes, complicated administrative steps, lack of access and social stigma can block access.
European countries with extremely restrictive laws such as Malta (where there is a total abortion ban) or Poland (which allows the procedure only in cases of sexual assault or a risk to life) are outliers. Yet those with liberal laws, such as the Netherlands, are also far from the norm. Access to abortion can vary even within a single country.
“Living in Europe is taking part in abortion lottery,” says Megan Clement, editor of the feminist newsletter Impact. “Access to abortion is extremely patchy and there is very little congruence between countries or even within countries. It totally depends where you live, as to whether you have access to a safe abortion within a reasonable timeframe.”
FRANCE 24 takes a look at what access to abortion looks like in countries across Europe.
Portugal: Ten weeks
- Legal timeframe: 10 weeks
- Exemptions: Threat to life, threat to health, rape
- Steps to go through: Mandatory counselling, mandatory waiting period
In Portugal, the clock starts ticking for people seeking abortions from the moment pregnancy is detected. Early symptoms of pregnancy typically appear at eight weeks, and a 2007 Portuguese law set the maximum limit for access to elective abortions at 10 weeks (with extensions for cases such as rape, a threat to the mother’s life or foetal malformation).
Ten weeks is one of the shortest windows for access to voluntary termination in Europe, allowing only about 14 days from the detection of a pregnancy for making a decision on whether to seek an abortion and going through the many necessary steps to access the procedure: Portuguese law requires a pre-abortion consultation with a doctor, a lab test and a three-day reflection period (with mandatory counselling) before the abortion itself.
Most other countries in Europe set the limit for elective abortions at 12 weeks. However, studies suggest that, for many, this is still not enough time: thousands of women seeking abortions travel to countries with more generous time limits each year.
In 2018, more than 3,000 European residents traveled to England and Wales (which allows elective abortion up to 24 weeks) for abortion care, mainly from Ireland, France, Germany, Denmark, Malta, Italy and Poland.
France: Medical deserts
- Legal timeframe: 14 weeks
- Exemptions: Threat to life, threat to health
- Steps to go through: Two medical consultations
France’s time limit on elective abortion is set at 14 weeks – a shorter timeframe than the proposed 15-week nationwide ban that has caused such uproar in the United States. And yet abortion care is reimbursed in full by France’s social security system.
There are also signs the government is moving towards increasing access to abortion. President Emmanuel Macron has announced plans to enshrine abortion in the French constitution. In 2022, the government passed a law extending the limit on elective abortions from 12 to 14 weeks, allowing midwifes to perform the procedure and stopping doctors refusing to do so.
Those in favour of the new law said it was necessary to mitigate the lack of medical professionals who can perform the procedure in rural areas of France, sometimes called “medical deserts” due to the lack of access to medical care.
“In France, it really depends on where you are for anything related to healthcare,” says Irene Donadio, spokesperson for the International Planned Parenthood Federation (IPPF). “People living in remote or rural areas in general get less access to healthcare than people living in urban areas.” This holds true for abortions, she says.
Such inequalities are typical in other European countries, where wealthier, urban and better-educated women are more likely to have access to information about abortion and access to care.
In France, one solution to such inequalities could be increasing the provision of medical abortions (also known as the abortion pill), which pregnant people can take at home, unsupervised. While the World Health Organisation says abortion pills can be safely self-administered within the first 12 weeks of pregnancy, French law only allows medical abortion within the first nine weeks of pregnancy (increased from seven during the Covid pandemic).
Italy: The right to refuse care
- Legal timeframe: 90 days (12.9 weeks)
- Exemptions: Threat to life, threat to health
- Steps to go through: Mandatory counselling, mandatory waiting period
One of the largest barriers to abortion access in Italy is the lack of medical practitioners willing to perform the procedure. Conscientious objection begins in medical school, says Donadio. “In a lot of faculties abortion is not taught as students have to choose in the first year of medicine if they want to become objectors or not. Then they risk finishing their studies in medicine – as gynaecologists – without knowing how to provide a safe abortion.”
This makes it difficult to access abortion care even when lives are at risk. A 2016 survey found that 71% of Italian gynaecologists were objectors, rising to almost 100% in some regions in the south.
While Italy is one of the most “flagrant examples” of conscientious objection in Europe, Donadio says it is not the only country where a lack of practitioners blocks access. “There is an issue in Croatia, there is a big issue in Germany, there is an issue in Spain – Italy is one of many.”
The influence of the Catholic Church looms large over the medical establishment and society in Italy, but other anti-abortion voices are also prevalent. Since her rise to power in October 2022, the country’s far-right leader, Giorgia Meloni, has posed a significant threat to abortion rights.
>> Read more: Women’s rights denied: Abortion on the line as Italy’s far right eyes power
The same threat has materialised in many European countries where the right has a strong presence, Donadio says. “People should realise that abortion rights are a major battleground – not only for women's bodies – and we shouldn't let them go without a fight.”
Belgium: Waiting periods
- Legal timeframe: 12 weeks
- Exemptions: Threat to life, threat to health
- Steps to go through: Mandatory counselling, mandatory waiting period
Women must wait six days in Belgium between confirming the wish to have an abortion in a counselling session and having access to the procedure – one of the longest mandatory waiting periods in Europe.
Such waiting times are sometimes described as a “cooling-off period”, a time for reflection aimed at minimising post-abortion regret. But studies have shown that they can be detrimental to decision-making and cause emotional distress.
“It is a method to crush women's autonomy and freedom because it's a form of the state controlling woman's decision-making,” Donadio says. “It doesn't show trust. The woman is stopped by an authority telling her that, for some reason, she's incapable of thinking and that she needs to think more.”
The World Health Organization (WHO) advises against mandatory waiting periods and other “medically unnecessary” policy barriers to abortion. “Such barriers can lead to critical delays in accessing treatment and put women and girls at greater risk of unsafe abortion, stigmatization, and health complications, while increasing disruptions to education and their ability to work,” the WHO says.
Even so, mandatory waiting periods are in effect in 14 European countries including Albania, Armenia, Belgium, Georgia, Germany, Hungary, Ireland, Italy, Latvia, Luxembourg, Portugal, the Russian Federation, the Slovak Republic and Spain.
Germany: Mandatory counselling
- Legal timeframe: 12 weeks
- Exemptions: Threat to life, threat to health, rape
- Steps to go through: Mandatory counselling, mandatory waiting period
Germany is making moves towards liberalising abortion laws, with the government announcing plans in January to repeal a Nazi-era law banning so-called abortion advertising. The law meant doctors faced criminal charges if they published factual information about terminating pregnancies, making it difficult to access reliable information about abortion methods.
>> Read more: Germany: Fined for promoting abortions
Even so, Germany is still one of 12 European countries to require women to undergo mandatory counselling or receive mandatory information from their doctors prior to abortion.
In some countries, counselling leans strongly towards dissuading women from going through with termination while in others it is more factual. But debating the quality of the service misses the overall point, says Clement: “The word ‘mandatory’ in there shows that it's not giving people choice.”
Counselling requirements also work to push the limits on accessing the time-sensitive procedure – a particular concern for women who have the additional burden of travelling for abortions. Neighbouring Poland has a near-total ban on terminating pregnancies, making Germany, comparatively, somewhat of an “abortion haven, even though it has pretty unsatisfactory abortion laws itself”, says Clement.
>> Read more: Abortion pills at heart of reproductive rights challenges in Poland, US
Malta: Change coming for a restrictive law
- Legal timeframe: No legal allowance
- Exemptions: Exemptions under review
- Steps to go through: None
Malta remains one of the only European countries where abortion is illegal even in cases of rape, foetal impairment or if the mother's life is in danger.
In November 2022, legal amendments were submitted to parliament that would allow abortion in cases where a woman’s life is at risk.
The change came after an American tourist who had a partial miscarriage while in the country requested an abortion and was refused, putting Malta’s laws under international scrutiny. Andrea Prudente was 16 weeks pregnant in June when she began bleeding profusely and was told by doctors her pregnancy was no longer viable. Upon being refused an abortion in Malta she was airlifted to Spain for the procedure. (Prudente is now suing the Maltese government, arguing that the abortion ban put her life at risk and that she was subjected to inhumane and degrading treatment.)
Malta’s laws stipulated that doctors or health workers who provide abortions can be imprisoned for up to four years and banned for life from practicing medicine. Women who took abortion pills could also be sentenced to prison, as could anyone who helped a woman obtain an abortion.
Days after Prudente’s case was in the spotlight, a group of 135 doctors in Malta successfully called for a review of the country’s abortion laws, leading to the drafting of an amendment that would give some protection to women if they seek an abortion when their lives are at risk.
The Netherlands: Paying a premium
- Legal timeframe: 24 weeks
- Exemptions: Threat to life
- Steps to go through: None
The Netherlands has some of the most liberal abortion laws in Europe. The timeframe for legal abortions is up to 24 weeks and in 2022 the government voted to do away with the “demeaning” waiting periods required for the procedure.
As such, the Netherlands has become a destination for people seeking abortions from all over Europe, Clement says. “It is a place where a lot of people find themselves when there's really nowhere else to go and no other option.”
The situation has only worsened since Brexit, as the UK (which also has a 24-week upper limit for abortions) now requires EU citizens to show a passport on entry. For people who don’t have a passport when they find out they are pregnant, “it’s expensive to get one, and it’s too late to apply for one”, Clement says.
While abortions in the Netherlands are free for residents, non-residents must pay – and costs can be prohibitive. Depending on the type of abortion, the fee for the procedure alone can exceed €1,000 with additional costs for travel and accommodation.
Even as a last resort, abortion in the Netherlands is not an option available to all. Those who find it least attainable are likely people who already have limited access in their home countries: minors, undocumented migrants, people with disabilities, victims of violence, people living in remote areas and workers who cannot afford to take time off.
A more liberal system would make allowances for this inequality, rather than adding hurdles that restrict legal access to abortion, Donadio says. “The only way forward is to look at people’s circumstances, and then create a system that accompanies and supports them.”
