Restricting access to abortion services: Turkish government policy since 2012

During the pro-natalist period, the Turkish Penal Code, ratified in 1926, considered induced abortion to be a crime. (1) However, research showed that the practice of abortion continued on a large scale, irrespective of the laws or the penalties. (2) It was estimated at the end of the 1950s that the number of illegally induced abortions approached half a million per year, with around 10,000 deaths annually from complications. (3) Maternal mortality from other causes also remained high. According to a survey in 1959, the estimated maternal mortality ratio in rural areas was 280 deaths per 100,000 live births. It was also estimated that 53% of maternal deaths were abortion-related. (4,5)In 1965 a “population” law was enacted, allowing the sale and use of contraceptive methods. Abortion was permitted only to save the life or preserve the health of the pregnant woman and in cases of fetal impairment. (6) Abortion was then legalised in Turkey in 1983 up to 10 weeks of pregnancy on the decision of women. The decision has to be confirmed by the husband, however, if the woman is married, or by the parents/legal guardian if the woman is aged under 18. Pregnancies over ten weeks can be terminated only on medical grounds. (7)After 1983, the numbers of unsafe abortions and their adverse effects decreased sharply. The prevalence of induced abortions rose initially, but started to decline in the 1990s and continues to do so today. According to Turkey Demographic & Health Survey data, the number of abortions per 100 pregnancies dropped from 19.0 in 1983 to 4.7 in 2013. (8)Since 2012, there has been political opposition to the provision of abortion services. Some hospital clinics that provided both family planning and abortion services had to stop providing abortions. Thus, the availability of safe abortions depends not only on permissive legislation but also on political support and the ability of health professionals to provide it. If restrictions on accessing abortion services continue, the country will again be faced with an increase in women seeking abortions in unsafe conditions, resulting in increases in maternal morbidity and mortality.SOURCE: S Sinan Ozalp, Emeritus Prof. Eskişehir Osmangazi University Faculty of Medicine and Department of OB/GYN, Eskişehir, Turkey, October 2016 [References in Turkish available] ;PHOTO: PRI, by Bulent KilicSEE ALSO: Campaign newsletter, 5th article, 28 October 2016