Everybody should have the right to decide if, when and how to start a family, with whom as well as how many children to have – this is commonly referred to as “sexual and reproductive rights” (SRR).
SRRs touch every aspect of our lives, they concern all people in Europe and are thus rightly considered basic human rights. When governments fail in their duty to uphold these human rights, the resulting abuse (forced pregnancy, gender-based violence, lack of access to healthcare) constitute a form of violence, often disproportionately affecting women and girls, as we in the European Parliament affirmed in our resolutions of 16 January 2019.
To enjoy reproductive rights, individuals should have unrestricted access to health services, which cater to these reproductive health needs, including access to contraception.
However, research carried out by the European Parliamentary Forum for Sexual and Reproductive Rights reveals that, while most countries in the EU include affordable contraceptives and reliable online information on contraceptives in their public health policies, access to contraception remains uneven across the EU.
According to the study, contraceptive access in Poland, where I come from, ranks bottom not only in the EU27, but across all of Europe.
Moreover, under the ruling conservative Law and Justice Party, Poland’s score dropped further from the still very low score of 44 percent as a result of several recent decisions which significantly narrowed Poles’ access to reproductive health services since coming to power in 2015.
“While most countries in the EU include affordable contraceptives and reliable online information on contraceptives in their public health policies, access to contraception remains uneven across the EU”
In Poland, a prescription is necessary to access any hormonal contraception methods and they are not subsidised under public health insurance schemes.
Moreover, since 2017, women need to obtain a prescription from a doctor to access emergency contraception, thus creating an additional non-medically required administrative barrier for women to access healthcare.
Another challenge is the number of gynaecologists: there are only 11 gynaecologists per 100,000 residents and many municipalities do not have a gynaecological office at all.
In some regions of Poland there is just one gynaecological office per 27,000 women. The main barriers we face in Poland are thus administrative, financial and a lack of qualified personnel.
However, women in Poland face an additional informal barrier; not only do Polish women have to find a doctor, they also have to find one who will value their opinion.
Many physicians and family doctors deny prescription requests, claiming that only specialised gynaecologists are allowed to prescribe contraceptives.
“A ‘conscience clause’ which allows physicians to place their personal philosophical beliefs above the needs of their patient, results in numerous gynaecologists refusing to perform a termination of pregnancy according to the already limited conditions permitted by Polish law”
Moreover, some pharmacies intentionally refuse to sell contraception and many do not maintain an adequate stock of contraceptives.
In addition, a “conscience clause” which allows physicians to place their personal philosophical beliefs above the needs of their patient, results in numerous gynaecologists refusing to perform a termination of pregnancy according to the already limited conditions permitted by Polish law.
Finally, the challenges are even more pronounced for adolescent girls, who are legally required to be accompanied by a parent when consulting a doctor, the absence of which may lead the physician to turn down the consultation and any related information and services.
As Europe copes with the COVID-19 pandemic, there are many lessons to be learned, both good and bad, about access to reproductive health.
While the initial response of governments calling for ‘lockdowns’ on very short notice resulted in severe deterioration of access to sexual and reproductive health services (for example: lack of access to medical consultations, medically unjustified refusal of a prescription for prolonging permanent contraception or emergency contraception, technical problems issuing e-prescriptions, high prices, no substitutes, shortages in pharmacies and long delays for ordered contraceptives ), the response by some governments has been exemplary.
For example, France, Ireland and the UK introduced legislation to increase access to emergency contraception and medical abortion such as enabling the use of telemedicine. This proves that when governments listen to women, solutions to their needs are within reach, even in such trying times as we are currently experiencing.
“When governments listen to women, solutions to their needs are within reach, even in such trying times as we are currently experiencing”
Thus, while we are justifiably proud of the social progress we have made in the European Union, resulting in our region having among the highest standards of living in the world, there remains unfinished work in some key areas.
The Contraception Atlas shows us that the answers are within our reach as we can see and learn from positive examples from across the EU.
We have it within our power to prioritise contraception coverage under national health systems, ensuring that women have access to the most modern and efficient contraceptive methods, such as long-acting reversible contraception (LARCs), as well as devising supporting mechanisms for vulnerable groups such as adolescents, the unemployed, people with a low income or disabilities, or people living in a rural area, to make sure that everyone has equal chances to fulfil their potential.
The COVID-19 pandemic is an opportunity to change the way we have done things for so long, reduce unnecessary burdens and obstacles to women and have governments take a constructive and proactive step in helping all women realise their family aspirations, whether they live in Barcelona, Budapest, Stockholm or Warsaw.