On 14 March 2019, the Macedonian Parliament adopted new abortion legislation which fully respects women’s rights and choice for pregnancy termination. HERA (Health Education and Research Association) and other civil society organisations (CSOs) were members of the Ministry of Health working group for drafting the new law. Some 90% of the clauses proposed by CSOs were included in the final text, meaning this law is indeed a great win for all women and women/gender organisations in Macedonia.
The former restrictive law, adopted in 2013, has now been replaced after six years of a continuous fight by Macedonian CSOs and a change in the political environment in 2017 with the election of the social democrats. There will be no more mandatory or biased counselling and no three-day waiting period. Any information provided to those asking for an abortion will be objective and evidence-based (according to WHO standards). Moreover, the woman will now have the right to refuse any abortion-related information under the law on patients’ rights. Abortion on request has been extended from 10 to 12 weeks of gestation.
Abortion from 12-22 weeks is now permitted for socio-economic reasons, fetal malformation, rape and incest, and medical indications. Approval from a hospital commission is no longer required. The doctor can ask for a second opinion from another specialist if necessary. The woman’s free will to have an abortion from 12-22 weeks is now guaranteed by law, regardless of the opinion of the doctor/s and the reason for the abortion; she just needs to sign a statement to state her reasons for abortion, upon which the hospital is obliged to provide it within three days. Supporting documentation from the Public Prosecutor will no longer be needed in cases of rape, which is in line with the Istanbul Convention. The statement of the woman will be sufficient.
The new legislation also introduces medical abortion pills as an option alongside the surgical method. The Ministry of Health is obliged to draft new clinical guidance for abortion care in the next three months, in which medical abortion pills will be included as part of comprehensive abortion care. In addition to ob-gyn clinics in hospitals, medical abortion pills can also be provided in primary health care ob-gyn clinics up to nine weeks of pregnancy. This will increase access to abortion services for women living in semi-urban and rural areas.
The new law also significantly reduces the penalties and fines for doctors (from € 30,000 to € 3.000) which is in line with the broader penalties for malpractice in healthcare.
A Commission for approval of abortion after 22 weeks of pregnancy will be established by the Ministry of Health and will include one member with significant gender expertise (five years) to ensure that decisions made by the Commission really reflect the needs of the woman.