NETHERLANDS – Abortion law reform debated: can abortion pills be prescribed by family doctors? Can the five-day reflection period be abolished? 

A bill submitted to the Netherlands parliament by centre-left parties PvdA and GroenLinks, with the support of the liberal coalition parties VVD and D66, would allow family doctors to prescribe the pills directly. A majority of MPs are expected to back the bill, which had its first day of debate in the House of Representatives on 9 February 2022. Further debate had not been scheduled at that point.

While GP prescription would allow women a greater choice of provider, there is some concern that not all family doctors would be willing to help, which could even lead to delays and obstruction, while women know they will get access to the pills from the dedicated clinics. There are about 30,000 abortions per year in the Netherlands, about a third using abortion pills. On average, family doctors have to deal with unwanted pregnancies only 1 to 5 times a year.

Groups as different as the Socialist Party (SP) and the right-wing Party for Freedom have expressed doubts. For example, the SP wanted to be sure that having the abortion pill supplied by GPs would not be at the expense of the current good care provided by abortion clinics (which have less to do and may even have to close their doors if this goes through).

The Dutch College of General Practitioners (NHG) is open to the policy change on condition that GPs can decide for themselves whether or not they will dispense the pills in their practice. But as many GPs work in a group practice, it is thought everyone seeking the pills from a group practice will be taken care of as long as one doctor agrees. The Dutch Association of Abortion Doctors (NGvA) is “positively critical”; having seen obstruction by some GPs, they ask how will a woman know whether her GP is open to abortion assistance? They also raised the question of training, given how few women currently seek help for unwanted pregnancy from GPs.

On 10 February, there was a roll call vote in the House of Representatives on a private member’s bill again tabled by D66, VVD, PvdA and GroenLinks. It seeks to abolish the mandatory five-day “reflection period” for abortion, a leftover from the early days of legal abortion when it was thought women didn’t know their own minds. Unfortunately, “doctor knows best” apparently continues to dominate some of the thinking in this long-running debate. Some members still argue that “the doctor must always continue to determine whether the woman can voluntarily make a decision and the doctor will not perform (sic) an abortion if the woman is in doubt or is put under pressure”. They speak of a ‘flexible consultation period’, which is ‘tailored to the situation of the woman’.”

D66 party chairman Paternotte disagrees. Women who want to can take time to think if they need it, but most women have already done so, Paternotte said. He called the legal obligation “wrong, paternalistic and out of date”.

Under the new coalition government, it was agreed that on medico-ethical issues, MPs may have a free vote and not have to adhere to the position of their party. Both proposals also need to go to the Senate if passed by the House of Representatives.

SOURCES: NOS.NL, 9 February 2022 ; Dutch News, 9 February 2022 ; NOS.NL, 26 January 2022 ; PHOTO: Dutch Parliament, The Hague,