What It's Like to Live In a Country With Restricted Abortion Rights

OpenDemocracy asked me, as a Pole and the author of a book about abortion, to describe what it's like to live in a country with restricted reproductive rights.

In short: it's lonely, humiliating, dangerous to life and health, and it undermines the rule of law. And it's expensive.

I fear that Texans, Mississippians and--if the US Supreme Court overthrows Roe v Wade--Americans in all Republican-controlled states are in for a similar ordeal. Banning abortion has never made it disappear. Instead, it invariably leads to unwanted pregnancies being outsourced elsewhere, discrimination against people on low incomes, and unnecessary suffering.

The abortion self-help network--in Poland, Abortion Without Borders--is invaluable in this situation, but it will not solve the basic problem. Only legislative change can make abortion legal, safe and financially affordable.

Izabela's story

Izabela was 22 weeks pregnant when her waters broke. At this stage, the chances of the foetus surviving were minimal, but the risk of infection increased every hour. Izabela was hospitalised with a fever, but the doctors told her that her pregnancy couldn't be terminated. The law forbade it.

"For now, thanks to the abortion law, I have to lie down. And there is nothing they can do. They have to wait for the heart to stop beating. My fever is growing," she told her mother.

Just 24 hours after being admitted to the hospital, Izabela died of sepsis. She was 30 years old.

This is not a story from the 1950s. Izabela died on 22 September in Pszczyna, a small town in Poland. Her death was tragic, senseless and cruel, and the result of three decades of a near-total ban on abortion, alongside relentless propaganda from the Catholic church and doctors' willingness to risk patients' lives rather than terminate their pregnancies.

Izabela was not the first victim of both the law and doctors' inaction. In 2004, Agata Lamczak died after she was refused treatment because it could harm her "unborn child". In 2000, Alicja Tysiac was forced to give birth despite severe myopia and a referral for an abortion due to the danger to her health; her eyesight deteriorated further. In 2008, two hospitals refused an abortion to a 14-year-old rape victim, and she was only permitted to terminate the pregnancy after a government minister intervened.

In 2014, Agnieszka (a pseudonym) had to give birth to a child with acrania--with half its skull missing--because the doctor delayed the diagnosis until it was too late to have an abortion. His conscience, you see, wouldn't allow him to terminate the pregnancy. It did, however, allow him to force the patient to watch her baby's brain rot for ten days until the infant's inevitable death.

The history of abortion in Poland

Abortion on demand was legalised in Poland in 1956. And because contraception in the People's Republic was either inaccessible or unreliable, abortion was treated as a form of birth control and wasn't particularly controversial.

This changed in 1989, after the collapse of the Eastern bloc. Politicians from Solidarity (Solidarnosc), supported by the Catholic Church, came to power, and the language around abortion changed immediately: within a year it became "killing the unborn".

In 1993, parliament passed the so-called 'abortion compromise'. This law bans abortion, but with three exceptions: if the pregnancy threatens the life or health of the woman, in cases of rape or incest, and in cases of severe or fatal foetal abnormality.

Even these exceptions have been difficult to enforce. Poland hasn't had its own George Tiller or Henry Morgentaler--gynaecologists who terminated pregnancies because they considered it the right thing to do, even when it was illegal or endangered their own life. In fact, doctors are known to restrict access to abortion.

The abortion ban didn't stop women from terminating pregnancies. What it did do was increase prices in private clinics. For years, underground abortion was semi-openly advertised in newspapers; "restoring menstruation" cost the equivalent of an average monthly salary.

After Poland joined the European Union in 2004, women could go abroad to have a surgical abortion. It is safer, more comfortable, usually cheaper--and abortion in Vienna or Berlin is treated as a normal procedure. Clinics near the Polish border now have Polish-speaking staff and websites in Polish. The procedure costs from about EUR400 ($450) in Slovakia up to the 12th week to EUR900 ($1,020) in the Netherlands up to 22 weeks.

Access to abortion was further democratised in the mid-2000s by the use of medical abortions. A set of pills costing EUR75 ($84) can be ordered from two international organisations, Women Help Women and Women on Web.

Since 1993, abortion in Poland has resembled 'Schrodinger's cat'--a creature both alive and dead at the same time. On the one hand, we had just over 1,000 legal abortions per year (in a country of 38 million), and the dominant narrative equated abortion if not with murder, then at least with tragedy.

On the other hand, it was common knowledge that Poles terminated their pregnancies illegally--NGOs estimate the number of such abortions at a minimum of 150,000 per year--and yet the ban wasn't really enforced.

A 'dirty secret'

What was enforced was silence. The stigma meant that Poles never talked about their abortions. Especially in public. There was no 'We Had Abortions' campaign on the cover of a Polish magazine, no celebrities admitting that they had terminated their pregnancies.

Individual confessions of abortion--unless it was a traumatic story of rape, illness or lethal foetal defect--were met with a wave of hate on the Right and accusations of hurting the cause on the Left.

For years, abortion was something that had to be dealt with on your own and then forgotten, kept as a dirty secret, untold. Privately, it was a practical problem to be solved; officially, a mortal sin and a crime.

For my book, I interviewed women who have had abortions, and they all shared the same experience: loneliness, fear and humiliation. They felt betrayed by their own state, which didn't help them in an already difficult situation but actually treated them like criminals.

What started to change attitudes towards abortion in Poland was, paradoxically, the victory of the right-wing Catholic populists, the Law and Justice party, in 2015.

A year later, Law and Justice supported a bill that banned abortion outright, but when tens of thousands took part in the Black Protest against the proposal, the government was forced to back down. Not for long, however. Last year, the constitutional tribunal--its judges mostly nominated by the Law and Justice party--ruled that termination of a pregnancy due to foetal defects was unconstitutional. As this exception accounted for 97% of legal procedures, the ruling made abortion illegal in almost every instance.

This time, not only big cities but also small towns took to the streets. The protests lasted two months and, although the ruling was upheld, today the public debate is very different. There are organisations, such as Abortion Dream Team, that openly facilitate abortions. Polls also show that people's views on abortion have become more liberal.

Total ban rejected

In response to this shift, ultra-conservatives recently drafted a bill aimed directly at groups that assist in abortion and women who refuse to stay silent about it. It proposed that abortion was treated as murder and that everyone involved was punished accordingly--up to life imprisonment. Last week, the bill was rejected in parliament by an overwhelming majority: it proved to be too much, even for the Catholic Right currently in power.

Poland is in the middle of a battle about what is acceptable to the mainstream on abortion. For almost 30 years, the 'compromise'--a ban with three exceptions--occupied the acceptable, common-sense centre. Today, the ruling party wants the new middle ground to be a ban with just two (very limited) exceptions. Meanwhile, the Left tries to shift the law towards the European norm: abortion on demand in the first trimester. Which option will prevail?