Romania: Sign The Petition - Draft Law Threatens To Impose Barriers On Women's Access To Legal Abortion Services

Dear Honorable:

[To be inserted]

The undersigned organizations respectfully submit this letter expressing our concern about the proposed law on the establishment, functioning and organization of crisis pregnancy counseling offices (the “Draft Law”) in Romania. We are alarmed about the establishment of crisis pregnancy counseling offices that provide mandatory biased counseling to women in connection with abortion services, and the imposition of a “reflection” period before women can access abortion services. The Draft Law imposes barriers on women’s access to legal abortion services. As such, it conflicts with women’s rights to life, privacy, physical integrity and autonomy, confidentiality, health, and non-discrimination, as protected by the Romanian Constitution and reflected in Romania’s international and regional human rights obligations.

The establishment of crisis pregnancy counseling offices that provide mandatory and biased “crisis pregnancy counseling” questions women’s decision-making authority and requires unnecessary, coercive and inaccurate medical information to be provided to women requesting an abortion. This information includes advising the woman about “the existence of … mental risks and complications from abortion on demand (such as sterility, psychological suffering, postabortion syndrome, etc.),” indicating that from conception “the embryo is a human being … whose life will end as a result of the medical procedure” and presenting “ultrasound exams of the pregnancy.”1 Biased counseling requirements are harmful to women seeking an abortion, creating barriers that do not serve an actual medical purpose. Imposing these barriers on women’s access to legal abortion services infringe upon women’s decision-making, perpetuate gender stereotypes about women’s ability to make reasonable decisions about reproduction, and thus,
discriminate against women. Moreover, the five day “reflection” period, which begins once a woman has completed a crisis pregnancy counseling session, further reinforces the notion that women are unable to make rational and thoughtful reproductive choices. Such mandatory waiting periods unnecessarily delay abortion, decrease the safety of abortion services and may drive some women, especially adolescents, to undergo illegal abortions or seek abortions outside of Romania. We strongly urge all members of the Romanian Parliament, as well as the representatives of the Romanian Government, to take into consideration medical guidelines and international and regional human rights standards in their consideration of the Draft Law.

The World Health Organization (WHO) guidelines on safe abortion provide concrete legal and policy guidance on the issues addressed in the Draft Law. These guidelines indicate that not medically required waiting periods constitute administrative and regulatory barriers to obtaining safe, legal abortion services that unnecessarily delay care and decrease safety.2 Such waiting periods may also lead women to risk self-induced abortion or clandestine services.3

The WHO guidelines also indicate that women should be treated with respect and understanding and thus be given information in a way they can understand so that they can make a choice about having or not having an abortion to the extent permitted by law and free of inducement, coercion or discrimination. 4

Accordingly, counseling in cases of requests for abortion should be voluntary, confidential and provided by a trained person.5 Specifically, “[a]t a minimum, abortion services should always provide medically accurate information about abortion, and offer non-directive counselling and contraceptive information and services….”6 However, in contravention of these guidelines, the information that the crisis pregnancy counseling centers would provide according to the Draft Law is not medically accurate. A new study published by the Academy of Medical Royal Colleges dispels the myth that women who procure abortions on demand are more likely to experience mental health risks or psychological suffering. 7

Instead, this study proves that “… for women with an unwanted pregnancy, abortion does not appear to harm their mental health.”8 Additionally, a recent U.S. study concluded that “among women who have a single, legal, first-trimester abortion of an unplanned pregnancy for nontherapeutic reasons, the relative risks of mental health problems are no greater than the risks among women who deliver an unplanned pregnancy.”9 This report also concluded that studies positing the existence of “postabortion syndrome” were methodically flawed.10 Notably, post-abortion syndrome is not a diagnosis recognized by credible American medical associations.11 Therefore, providing women with medically inaccurate information in an attempt to coerce them to carry unwanted pregnancies to term may actually expose them to a risk of psychological suffering, rather than deter mental health problems from occurring. Furthermore, counseling according to the Draft Law does not include information about contraceptive information and services. This contradicts WHO standards that recommend such counseling—provided in a voluntary, non-biased and scientifically accurate manner—as an integral part of pre- and post-abortion services. 12

The International Federation of Gynecology and Obstetrics (FIGO) have provided guidance on the right to informed consent to medical procedures. FIGO has indicated that in connection with the respect for a woman’s fundamental rights, states have the “obligation to obtain the informed consent of a woman
before any medical intervention is undertaken.”13 Informed consent is a process of communication between a health care provider and patient. It requires the patient’s consent to be given freely and voluntarily, without threats or inducements, after the patient has been counseled on available risks,
potential side effects, and different methods, in a manner that is understandable to the patient. 14 Such a process is central to ensuring a woman’s right to be involved in medical decision making. 15 However, providing information that is intended to mislead women, such as the inaccurate medical information mandated by the Draft Law, is an outright violation of a woman’s right to provide informed consent to a medical procedure. The WHO has also indicated that in connection with their right to informed consent, patients have a “right not to be informed.”16 Therefore, to the extent that crisis pregnancy counseling includes “presenting ultrasound exams of the pregnancy and handing a photographic or video record, when this is possible” despite the woman’s indicated preference not to receive this information, the crisis pregnancy counseling likewise violates her rights. The Draft Law is not designed to increase women’s knowledge about their health but to force or coerce them to continue their pregnancy despite their wishes. If the Romanian Government instead would take into consideration the aforementioned medical standards, this would strengthen the capacity of the health system in Romania to provide effective access to safe and legal abortion and thereby strengthen women’s rights to health, self-determination, privacy, and non-discrimination.

Regional and international human rights standards also support ensuring access and removing barriers to abortion. The recent Parliamentary Assembly of the Council of Europe (PACE) Resolution 1607 (2008) Access to safe and legal abortion in Europe reiterated these principles and added that the
decision on whether or not to have an abortion should be a matter for the woman concerned, and she should have the means of exercising this right in an effective way.17 The European Court of Human Rights (the Court) has also stated in the case of Tysiac v. Poland and subsequently reiterated that the
state’s positive obligation to secure effective respect for a pregnant woman’s right to private life requires that the regulation of the legal termination of pregnancy is not structured in a way “which would limit real possibilities to obtain [legal abortion].”18 States must establish effective procedural safeguards to ensure women’s access to legal abortion services in practice. In relation to access to information related to abortion, the Court held last year that denial of comprehensive information to a pregnant woman who was considering undergoing an abortion on her health status and that of the fetus amounted to violations of the rights to private life and freedom from inhuman and degrading treatment. The Court stated that in the context of pregnancy, the effective access to relevant information on the mother’s health and fetus’ development, where legislation allows for abortion in certain situations, is directly relevant for the exercise of personal autonomy.19 It noted that women are entitled to access information about their health
and the health status of the pregnancy free from discrimination, coercion, or violence in order to “preserve their bodily integrity by making reproductive health care decisions.” 20 Moreover, the European Parliament has recommended to member states “that, in order to safeguard women's reproductive health and rights, abortion should be made legal, safe and accessible to all.” 21

United Nations Human Rights Treaty Monitoring Bodies (UNTMBs) have consistently advised states to ensure access to reproductive health care services by removing barriers to legal abortion and ensuring that women and girls do not have to undergo life-threatening clandestine abortions.22 Moreover, they have recognized the issue of maternal mortality due to unsafe abortion and framed this issue as a violation of the right to life.23 Notably, contrary to the Preamble of the Draft Law, international human rights treaties do not recognize a fundamental right to life of the unborn child. As illustrated by the history of negotiations of some of the major human rights treaties, right to life provisions are not intended to protect a prenatal right to life.24 Additionally, UNTMBs, through general comments, concluding observations, and decisions in individual cases, consistently emphasize the importance of protecting women’s rights, and assert that to guarantee women’s fundamental rights to life and health, among others, states must remove barriers to the full enjoyment of those rights, such as barriers on abortion services.25

We thank you for your consideration of this letter and express our hope that Romania will continue to ensure that its laws and policies on abortion respect women’s rights and include protection for informed and non-coercive decision-making, in compliance with regional and international human rights and
medical standards.

Respectfully yours,

Organizations:

Center for Reproductive Rights, U.S.A.

Please respond to me (Johanna Westeson, jwesteson@reprorights.org) and Iustina Ionescu (iionescu@ecpi.ro) with your signatures.

The letter will be translated and sent to the following:

- President of Romania, Traian Basescu

- Prime Minister, Mihai Razvan Ungureanu

- President of the Romanian Senate, Vasile Blaga

- President of the Romanian Chamber of Representatives, Roberta Alma Anastase

- Presidents of the commissions from the Senate & Chamber of Representatives assigned with drafting the report/advice on the draft law

An unofficial translation of the draft law is included for your information here.