Political and legal maneuverings, far removed from the reality of the everyday populace’s concerns and desires, have seen the nation’s already draconian abortion rights measures be rolled back further to the detriment of those who wish to exercise their bodily autonomy and those who wish to assist them in such an endeavor.
A Healthcare System In Shambles
Poland, after nearly a decade, is baring witness to a new government taking office.
While the October 15th elections held in Poland saw the incumbent Law and Justice Party (PiS), having been in power for eight years, attain the most votes, they were unable to win an outright majority.
Instead, three opposition parties; the left, the Civic Coalition (KO), and the Third Way; won the necessary votes for a majority and have agreed to make up a novel coalition government.
Following approval by the Polish President, they are expected to take office towards the conclusion of November.
In light of the recent election result, an area of focus for medical professionals is the field of health, with doctors wishing for improvements to be made in what they describe as a healthcare system ruined by years of political mismanagement and neglect.
For some years Polish doctors have been raising alarm bells about the deteriorating nature of the nation’s healthcare system to the extent that, in certain cases, people have been holding demonstrations and hunger strikes.
Furthermore, while in office the PiS has even introduced measures that have made the already crumbling situation, worse.
Head of a resident doctors trade union, Porozumienie Rezydentów (PR OZZL), Sebastian Goncerz stated;
“Going into the elections, health care was a major issue among voters. People are fed up of many problems, not least long waiting times for appointments. We have a healthcare system which has been managed badly for decades… We don’t expect a huge raft of changes after the election, but we think it is worth fighting for better health care. The new government must take the problems in health care seriously”.
So serious was the issue of health care amongst voters that PR OZZL and OZZL, the national doctors’ trade union, in September 2023 proclaimed a coordinated protest action, with their demands including;
- Ensuring high standards for the education of medical students;
- Increasing healthcare spending to 8% of gross domestic product (GDP)
- Improving the doctor-to-patient ratio (which has become so low that it is endangering patients).
Adding to the second point, While the purported health spending in Poland is 6% of GDP, PR OZZL claims the genuine figure to be 4.8%, both figures of which are below the 9.9% EU GDP average health care spending.
With such gross negligence being taken of the nation’s healthcare, it is of no wonder why the country’s populace expressed their feelings by dislodging PiS from office.
On the other hand, another healthcare issue that has plagued the nation has not only suffered from the negligence of the outgoing government but also the active persecution of the administration risking people’s lives and livelihoods.
That issue is abortion-related healthcare.
The State of Abortion Access In Poland
The country has some of Europe’s most draconian abortion laws in place, with terminations permitted in only two scenarios.
This is despite polls highlighting that almost 84% of Poles desire abortion law liberalization.
The first is the women’s life or health being at risk and the second is if the pregnancy came about as a result of incest or rape.
Moreover, until two years prior abortions had been additionally permitted in instances where the fetus had congenital defects, although said allowance was removed by Poland’s constitutional court, the Constitutional Tribunal, in the form of a ruling in response to a challenge against the allowance by PiS party members.
It should be noted that before the aforementioned ruling, greater than 90% of the estimated 1,000 legal annual abortions in Poland were on these grounds.
Other challenges to an already dangerous situation come in the form of attacks on those who aid women in such vulnerable situations. This is because, while abortion may not be illegal in Poland, assisting someone in attaining one is.
In such desperate situations, women who wish to terminate their pregnancy have taken actions such as purchasing self-administer abortion pills online from aboard or even, if they have the resources to do so, traveling to another nearby nation where the abortion legislation is much less restrictive to undertake a termination, nations such as the Czech Republic or Germany.
Since the Polish law around abortion access was tightened, following the constitutional ruling, there have been reported cases of women dying subsequent to doctors not terminating their pregnancies, even in spite of complications that presented a danger to their health or their very lives.
Furthermore, there have been claims that, increasingly, Polish officials have undertaken investigations on unstable legal grounds against girls and women in search of miscarriage medical care or following having legal medical abortions, in addition to putting a spotlight on the doctors treating said women or others aiding women.
In particular, those who assist in the termination of pregnancies, such as doctors and other concerned parties, can possibly face up to three years in prison, if the act is undertaken up to the point of viability, or confront an even greater prison sentence of 8 years maximum beyond the point of viability.
Both of the aforementioned points, when examined in further depth, betray the horrific nature of accessing abortion services in Poland and the malicious hand of the state in upholding such barbaric legislation.
The Lives Scarred & Lost
The husband of Marta Sowinski, Krzysztof has wept every day since the death of his wife in 2022, who was five months pregnant, at the hands of sepsis.
His belief is that doctors endangered Marta’s life by failing to proffer them the choice of terminating the pregnancy while a fetal heartbeat was still able to be detected.
Another eerily similar case pertains to Janusz Kucharski losing Justyna, his partner, in the 5th month of her pregnancy to sepsis, leaving behind two children.
On the other hand, given how those aiding or performing an abortion can run the risk of landing in legal jeopardy, it develops a “chilling effect” with doctors avoiding undertaking the very same life-saving measures that may have saved the aforementioned lives.
As aptly stated by Warsaw’s Debski Clinic’s gynecologist Professor Marzena Debska,
“Patients are powerless and doctors are increasingly fearful”.
Such a reluctance to take action has, additionally, resulted in a rising infant mortality rate for the nation, according to the deputy director of Olesnica’s public hospital, and one of few gynecologists who still perform many of the few legal abortions that occur within the nation.
By performing such a role, Jagielska has stated that the anti-abortion movement has labeled her a “baby killer”.
Undeterred by such abuse, she commented that
“I act according to the law, using the premise of saving a woman’s life. I will continue to work no matter what, because who else will help these women?… I get threats, I am called the butcher of Olesnica. I’m not afraid. I only feel sorry for the couples who come to me for consultation. These are the most traumatic moments in their lives, and they have to hear that they are murderers.”
Looking at the figures overall, Poland in 2020 saw seven maternal fatalities with nine being reported for 2021.
While the figures may appear low, they have been viewed by certain parties as unreliable.
Take Warsaw’s Mother and Child Institute’s head of the epidemiology and biostatistics department Dr. Katarzyna, who stated that;
“Every year we estimate that there are almost three times as many deaths as appear in the statistics. If a patient dies in the intensive care unit, for example, and not in the gynecology and obstetrics department, nothing in the certificate will link her death to the pregnancy”.
All of the above cases of negligence, fatally so in certain cases, stems from the fear of acting prompted by the State.
However, the State’s authoritarian practices in regard to bodily autonomy have manifested in other ways.
Namely, active persecution by authorities.
The Police State
A video was released by Human Rights Watch (HRW) spotlighting how the government’s employment of its powers to pursue and prosecute “illegal” purported abortion-related activity, particularly those that aid those in need of one, threatens people’s autonomy, privacy rights, and health, amongst other issues.
An example is March 2023 witnessing the conviction of the Abortion Dream Team activist group co-founder Justyna Wydrzyńska, in a Warsaw court, of aiding a woman to attain abortion medication pills.
She is appealing the eight-month sentence consisting of community service.
HRW’s senior women’s rights researcher, Hillary Margolis, on the aforementioned point:
“Polish authorities’ ruthless pursuit of people trying to get or provide basic health care can only be described as a witch hunt… The government is misusing police and courts to advance its anti-rights agenda, taking its abusive policies into private homes, hospital rooms, and doctors’ offices.”
On the ground, HRW interviews of lawyers, doctors, and a woman who attained a legal medical abortion illustrate speculative and sweeping investigations, along with overboard searches.
Take the case of the 32-year-old woman Joanna who, in April, had the police demand her strip search subsequent to her self-administering a legal medical abortion.
She had telephoned her psychiatrist for aid with severe anxiety symptoms. She disclosed, whilst on the call, that she had had an abortion, which resulted in said psychiatrist contacting the police and ambulance services.
When the police, alongside the paramedic, arrived they escorted her to two different hospitals. The latter of which is where they demanded her to undress for what was, in essence, a cavity search.
Detailing the ordeal, Joanna said;
“They told me to take off my clothes, do squats, and cough… I was just standing in front of them, I didn’t take my underwear off…. I tried to take a step back but there was only a wall behind me. I felt I wasn’t a human being any more”.
However, such state-sanctioned humiliatory, and deadly laws and actions have seen a backlash from civil society.
The Response From Within The Nation
After the October 2020 Constitutional Court ruling further restricting abortion access, more than 1,000 demonstrations manifested across the nation, with over a million people taking part.
Take the thousands of people who protested across the Polish nation on the 14th of June 2023 in opposition to the country’s restrictive abortion law, following the death of 33-year-old Dorota Lalik, who was five months pregnant, in May.
Marching through the capital Warsaw, on route to the headquarters of the health ministry, demonstrators chanted “Stop killing us” and held aloft placards reading “Hell for women” and “We want doctors, not missionaries”, conveying how the measure impacts those carrying a dangerous or unwanted pregnancy.
On the international legal stage, Poland is an outlier and recognised for their archaic laws and practices.
Poland’s Abortion Laws on the Global Stage
Over the prior three decades, while 60 nations have liberalized abortion-related laws, four nations; Nicaragua, U.S. Poland, and El Salvador; have undergone a process of regression.
Even prior to the draconic Constitutional Court ruling, the U.N Committee Against Torture arrived at the conclusion that, in certain circumstances, halting access to legal abortion entails such intense mental and physical suffering as to constitute torture, calling on Poland to act.
Moreover, evidence has without fail illustrated that laws restricting or criminalising abortion access as opposed to eliminating the practice, instead push people in search of abortion through methods that may place their physical and mental health at risk, along with reducing their dignity and bodily autonomy.
Such torture is evident in a client dealt with by Attorney Jolanta Budozowska, who said;
A year ago, I helped another pregnant woman who was told by doctors to wait four days until the fetus died… She got sepsis. She paid for it with depression.”
An opinion written on the case for the Office for Patient Rights, penned by Professor Krzysztof Preis of the Medical University of Gdansk, detailed that;
“the action prolonging the patient’s mental suffering was inhumane and cruel treatment, completely unjustified medically.”
Such an immoral and impractical legal standing has seen the fight for abortion access become legal as well as civil.
Taking the Fight to the Courts
Budozowska has taken up criminal negligence cases representing families against the doctors regarding pregnant women who suffered harm and died in hospitals.
In addition, the attorney has lodged a complaint against the Polish Government to the European Court of Human Rights, on behalf of certain families stating;
“I think there are more such cases. And even more where women are survivors, but they have gone through a trauma and want to forget about it.”
However, what is paramount, due to the recent electoral shift, is the actions of the new governing coalition in response to the issue of abortion healthcare.
The Future of the Nation
Leader of the KO party and soon-to-be the new Prime Minister of Poland, Donald Tusk has stated that a priority for his government would be to legalize abortion up to the first 12 weeks of gestation.
A priority whose progress will be followed closely by the populace with a Krakow gynecologist, Dominik Prezeszlakowski, who has been outspoken in their opposition to Poland’s abortion laws, stated that the new administration has an;
“obligation to open access to safe abortion for Polish women, and also the decriminalization [of abortions]… There is no question that strict abortion laws lead to worse health outcomes for women”.
On the other hand, while there is great hope and desire, pushing through such a legislative change will be no small feat as even members of the new governing coalition have voiced more conservative opinions on abortion than Tusk.
In addition, Andrzej Duda, the President of Poland until at least 2025 when new elections will be held, who is a former and still loyal member of PiS may equip his presidential veto to block any legislative alterations around abortion access.
From the Abortion Dream Team collective, Kinga Jelinska highlighted another issue, the attitudes held by certain gynecologists towards an abortion-related procedure:
“Legal change is, unfortunately, never a silver bullet. There are extremely few pro-choice doctors in the country, unfortunately. In Poland, when it comes to abortion, birth and contraception, obstetrics and gynecology [are] full of violence”.
In contrast, however, while Kinga expressed concerns about the President and Constitutional Tribunal potentially maneuvering to block any abortion access legislation changes, she did express that
“one thing is obvious from all the polls: abortion and women’s rights were a motivating factor for women to vote [in the elections]. The public wants the [law] changed. We will continue to support [a change in the law] and call for evidence-based practices”.
Clearly, there is apparent civil, legal, and political support and resources directed towards the cause of relaxing abortion access restrictions, in spite of certain speedbumps.
If such relaxation can be legislated for, women will be able to access abortion-related healthcare, exercising their bodily autonomy and safeguarding their physical and mental health.
A nation that can, hopefully, fully realize that accessible abortion-related healthcare is essential to life and liberty.