Health Minister in Netherlands seeks to bring early medical abortion provision by GPs under the abortion law

The Netherlands has one of the lowest abortion rates in the world, at 8.5 per 1,000 women.The Dutch Health Minister Edith Schippers wants to make medical abortion available from GPs, and plans to introduce legislation to allow that at the end of this year, because many women would like that and many get contraception from their GPs. The pills are currently only available in hospitals and abortion clinics. Another change she intends is that doctors will have to report all prescriptions to the Health Ministry Inspectorate, thus bringing early abortions under the Dutch abortion law.These changes were proposed already last year, but MPs from the small Christian parties refused to back the measures. Support from several other conservative parties is also uncertain.Abortion rights advocates are also concerned about the changes, because early medical abortion is not currently governed by criminal law if provided without a licence. This is because, in the Netherlands, so-called “real abortions” are considered to happen only after 45 days. Early abortion (with amenorrhoea up to 45 days = 17 days after a missed period), has never been considered to be an abortion for which a licence or registration of the abortion with the Health Inspectorate is required. While most early abortions are in fact registered anyway, the imposition of the five-day waiting period for “real abortions” would become obligatory too, which delays abortions without clinical justification.In fact, over half of all abortions in the Netherlands take place in the first seven weeks of pregnancy, so these would all come under the abortion law with the proposed changes. Moreover, not all women want to get the pills from their GP or local pharmacy, especially in small towns and rural areas where they want to remain anonymous, and so prefer going to an abortion clinic.Thus, on the one hand, the law proposal would expand provision by giving GPs the right to prescribe the pills and allows pharmacies to fill prescriptions. But the restrictions in the law would also be applied. Overall, it is thought that the reform as packaged might not be a good thing at all.SOURCE: Dutch, 27 June 2016 ; PHOTO: Olga Loeber, Reproductive Health Matters, 2010 + Personal communications