ASTRA Central and Eastern European Women’s Network for Sexual and Reproductive Rights and Health

Aug 09 2016

A new government came into power at the end of January 2016. Since then, Croatia has turned towards the far right with a noticeable rise in nationalism, ethnic intolerance towards the Serbian minority, and conservativism, with one of the main objectives being a ban on abortion. The new government also tried to stop a planned educational reform by introducing more conservative members into the expert group. Their vision for education consists of patriotic history, literature conveying traditional and Christian virtues, and conservative sexual education. However, the coalition between the two largest parties broken down several months ago, and new elections are expected later in the year.

Protests regarding the shift in focus of educational reform brought around 50,000 people all over Croatia into the streets to express their discontent with the government’s vision on 1 June 2016, in contrast to the 7,000 who marched against abortion rights in May. But in January 2016, against the expectations of pro-choice campaigners, the Constitutional Court announced the start of a constitutional review of the law, which currently allows abortion until the 10th week of pregnancy.

In an investigation into access to abortion in hospitals in Croatia for the Balkan Fellowship for Journalistic Excellence, Masenjka Bacic reports the following findings:

Abortion is legal in Croatia, but increasingly feels forbidden. In 1990, on the eve of its independence, 46,679 legal abortions were carried out. Last year, according to official figures, there were 8,181, one of the lowest rates in Europe. In 2014, of 375 gynaecologists employed in Croatian hospitals where abortions can be carried out, 166 do so. Others refuse on religious grounds.

I began calling hospitals, telling those who answered that I was pregnant and asking whether I could have an abortion in their hospital. It went like this:

“Hospital in Pakrac:

– We do not do the abortions in this hospital.

– OK, can you please tell me where can I do it?

– No. I don’t know. (Hangs up).

Hospital in Knin:

– First, you need to go to the gynaecologist and then come here with findings. But, you know, you don’t have to do it here. You can go also to Zadar or Šibenik. In Šibenik, you can do it in private clinics.

Hospital in Slavonski Brod:

– If you are not from this county, you cannot do it.

Hospital in Bjelovar:

– The doctor that does abortions is on vacation. Try to call the outpatient clinic.

I turned to the Internet, typing into Google ‘clinics for abortion’ in Croatian. I clicked on the top result; a site opened, with a picture slideshow, purporting to be that of an abortion clinic. Picture 1: Bloodied scissors. Picture 2: A young baby in a woman’s arms.

Clicking on an icon entitled ‘Consequences of abortion’, I was told that women who abort risk death, breast cancer, sexual dysfunction and suicidal thoughts.

This was my first encounter with the phenomenon of ‘fake’ abortion clinics advertising online with the aim of actually dissuading women from aborting. Croatia’s public attorney for gender equality has reported such sites to the Interior Ministry but they continue to operate.

I spent hours trawling the Internet, reading forums. Gradually it became clear to me: information on abortion in Croatia is travelling mainly by word of mouth, whispered by women hidden by the anonymity of online forums. As if it was illegal.

Source: International Campaign for Women's Right to Safe Abortion

Aug 04 2016
A draft seeking to liberalise Poland's abortion laws prepared by the "Save the Women" Legislative Initiative Committee reached the Sejm (lower house) on Thursday. The committee collected over 160,000 signatures under the draft. Under the "Save the Women" draft, women are entitled to have an abortion up to 12 weeks into the pregnancy. After that abortion would be permissible along the same rules as those in effect today. Additionally, in cases of severe and irreversible impairment of the foetus or an incurable disease, abortion would be permitted up to the 24th week. Abortion would be permissible up to the 18th week if the pregnancy is the result of a crime. The proposed changes have been initiated by the Polish Initiative Association founded by former United Left leader Barbara Nowacka and several NGOs, among them Federation for Women and Family Planning, serving as ASTRA Secretariat.
The committee held a press conference on Thursday and submitted the draft and signatures at the Sejm (lower house).
A citizen's anti-abortion bill completely banning abortion and making it punishable by a prison term reached the Sejm in July.
Under Poland’s current abortion regulations, abortion is illegal except when the pregnancy poses a threat to the woman's health or life, if it results from a crime such as incest or rape, or when if there is a high probability that the foetus is severely and irreversibly deformed.
According to official Health Ministry statistics, fewer than 1,000 abortions are performed in Poland every year. In 2014, their official number stood at 977. Poland's NGOs believe that the number of abortions in Poland ranges from 80,000 to 190,000 annually.
Source: PAP
Jul 22 2016

Protect women’s sexual and reproductive health and rights

In these times of resurgent threats to women’s rights and gender equality, we must redouble our efforts to protect women’s sexual and reproductive health and rights. Among the international and European legal instruments that protect these rights, the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) guarantees women’s rights to decide freely and responsibly about the number and spacing of their children and to have access to information, education and means to enable them to exercise these rights.

Sexual and reproductive health and rights are fundamentally linked to the enjoyment of many other human rights, as recently stated by the UN Committee on Economic, Social and Cultural Rights. As widely illustrated by the case-law and guidelines of human rights bodies, sexual and reproductive health is often the context in which human rights are violated, including the right to the highest attainable standard of physical and mental health, but also the prohibition of torture and inhuman or degrading treatment and the right to private life. The right to be free from discrimination on grounds of sex or gender is also at stake, as this right is breached when reproductive health services that only women require are not provided.

Access to sexual and reproductive rights is a precondition for the realisation of other human rights, including in the fields of education and employment. At the same time, impediments in access to sexual and reproductive health services are the result of violations of other human rights, not least the long-standing discrimination and harmful gender stereotyping against women that still need to be fully eradicated in Europe. I have expressed concern at the development in recent years of regressive trends and attempts to exert control over women’s bodies and sexuality which could further hamper women’s access to these rights and endanger progress achieved so far in the field of gender equality.

The pivotal role of access to sexuality education

Teaching sexuality education to all boys and girls in schools is essential to guarantee women’s sexual and reproductive rights and is a full component of the rights to education and to health. Both the European Committee of Social Rights and the UN Committee on the Rights of the Child have stressed that adolescents should have access to appropriate and objective information on sexual and reproductive issues, including family planning, contraception and the prevention of sexually transmitted diseases, as part of the ordinary school curriculum and provided without discrimination on any ground.

However, sexuality education at school has been met with strong resistance from some parents and other stakeholders. In some places, parents can decide to exempt their children from sexuality education classes. Those teaching sexuality education sometimes lack the necessary training and knowledge. In other cases, sexuality education teaching can contain misleading information and value judgements, with problems including the stigmatisation of homosexuality or abortion by young girls. In some countries, including Lithuania, Romania and Russia, there is currently an absence of age-appropriate sexual and reproductive health and rights education with a gender perspective, in the curricula of basic and secondary schools.

The need to further remove barriers in access to contraception

As stressed by World Health Organization (WHO), meeting the need for contraception is an important strategy for reducing unintended pregnancies, abortions and unplanned births. However, despite significant medical progress in this field, recent studies have shown that access to contraception is hindered by several factors in Europe, including misinformation about the safety of contraceptives and stigma hindering women from discussing contraceptives with medical professionals. Persons in dire economic situations encounter difficulties in accessing contraceptive methods tailored to their needs due to lack of reimbursement by public health services in some countries.

Ensuring women’s rights, dignity and autonomy in maternity health care

I have received disturbing reports of human rights violations in the context of maternity health care, as illustrated by recent NGO-led research on Slovakia. Patterns of segregation against Roma women in maternity hospitals in several countries are also an issue of concern. In recent conclusions concerning Croatia, the Czech Republic and Slovakia, the CEDAW Committee stressed the need to ensure adequate standards of care and respect for women’s rights, dignity and autonomy during deliveries, expressing concerns in particular at reports that childbirth conditions and obstetric services unduly curtail women’s reproductive health choices. The European Court of Human Rights has also made it clear that “private life” incorporates the right to choose the circumstances of giving birth.

The need to ensure access to safe and legal abortion

As noted by WHO, highly restrictive abortion laws are not associated with lower abortion rates. The Parliamentary Assembly of the Council of Europe also recalled that “the lawfulness of abortion does not have an effect on a woman’s need for an abortion, but only on her access to a safe abortion”. A ban on abortions does not result in fewer abortions, but only leads to clandestine abortions, which are more traumatic and increase maternal mortality.

While most countries in Europe ensure access to abortion without restrictions in law as to the reasons, some have kept restrictive abortion laws in contradiction with the case-law and guidelines of international human rights treaty bodies. In a case concerning Ireland, the UN Human Rights Committee concluded last month that a woman who was forced to choose between carrying her foetus to term, knowing it would not survive, or seeking an abortion abroad was subjected to discrimination and cruel, inhuman or degrading treatment as a result of Ireland’s legal prohibition of abortion. The Committee stated that to prevent similar violations from occurring, “ (...) the State party should amend its law on voluntary termination of pregnancy, including if necessary its Constitution, to ensure compliance with the [International] Covenant [on civil and Political Rights], including effective, timely and accessible procedures for pregnancy termination in Ireland, and take measures to ensure that health-care providers are in a position to supply full information on safe abortion services without fearing being subjected to criminal sanctions”.

In my country work, I have also recently called on San Marino and Andorra to move towards decriminalisation of abortion. I expressed concern at a bill prepared in Poland introducing a total ban on abortion except to save a pregnant woman’s life. Criminalisation of abortion, often combined with the societal pressure on women and doctors, has a chilling effect on pregnant women and doctors who would be ready to perform a legal abortion. Women afraid of seeking an abortion, for fear of a backlash and harassment on the part of certain segments of society, resort to clandestine abortions or, when they can afford it, travel abroad to get an abortion.

Even when access to abortion is provided for by law, there can be barriers. In the P. and S. v. Poland case, a 14-year old girl, who was pregnant as a result of a rape, was seeking an abortion that would have been available under Polish law. She was confronted with such deplorable treatment on the part of the authorities that the European Court of Human Rights held that her right to private life and her right to be free from torture and inhuman or degrading treatment was violated.

Mandatory counselling and medically unnecessary waiting periods for abortion are not in line with WHO’s recommendations and have been repeatedly criticised for impinging on women’s rights. Recent trends towards introducing such requirements are therefore of concern. In several European countries, under the conscientious objection clause or clause of conscience, health care practitioners may refuse to perform abortion on the grounds that it is against their conscience. The European Committee of Social Rights has recently concluded that Italy was in violation of the right to health of the Revised European Social Charter as the authorities did not take the necessary measures in order to ensure that, as provided by law, abortions requested in accordance with the applicable rules are performed in all cases, even when the number of objecting medical practitioners and other health personnel is high.

Groups of women particularly vulnerable to violations of sexual and reproductive health and rights

Multiple discrimination related to sexual and reproductive health and rights is also an issue of concern. In times of continuing austerity measures, poor women are disproportionately affected by budgetary cuts in reproductive health services. Women living in rural areas and migrant women in an irregular situation may also find it more difficult to receive appropriate and timely sexual and reproductive health care.

In several European countries, women, in particular Roma women and women with intellectual and psycho-social disabilities, have been involuntarily sterilised. Such cases have been documented in the Czech Republic, Norway, Slovakia, Sweden and Switzerland. According to the case-law of the European Court of Human Rights, such practices constitute serious human rights violations. Governments are therefore obliged to establish accessible and effective mechanisms to obtain reparations. This is why I recently urged the Czech authorities to adopt the bill on reparations for involuntary sterilisation of Roma women.

The way forward in enhancing women’s sexual and reproductive health and rights

All member states of the Council of Europe should take the necessary steps to ensure women full and equal access to sexual and reproductive health and rights including the following measures:

States should ensure that sexual and reproductive health services, goods and facilities are available to all women throughout the country, physically and economically accessible, culturally appropriate, and of good quality in line with the Committee on Economic, Social and Cultural Rights General Comment No. 22 (2016) on the Right to sexual and reproductive health;

All women, including adolescent girls, should have access to sexual and reproductive health information that is evidenced-based, non-discriminatory, and respectful of their dignity and autonomy. Mandatory, comprehensive sexuality education that is age-appropriate, evidence-based, scientifically accurate and non-judgmental should be taught in all schools;

States should take all necessary measures to remove barriers in access to contraception for all women; giving them access to modern contraceptives, including emergency contraception and making them affordable by covering their costs under public health insurance mechanisms;

States should put in place adequate safeguards, including oversight procedures and mechanisms, to ensure that women have access to appropriate and safe child birth procedures which are in line with adequate standards of care, respect women’s autonomy and the requirement of free, prior and informed consent;

Where it is not already the case, states should make lawful, at a minimum, abortions performed to preserve the physical and mental health of women, or in cases of fatal foetal abnormality, rape or incest. All states are strongly encouraged to decriminalise abortion within reasonable gestational limits. In addition, all necessary measures should be taken to ensure that access to safe and legal abortion as provided by law is fully implemented in practice by removing all existing barriers;

States should protect all women and in particular Roma women, women belonging to minorities, migrant women in regular or irregular situations, women with disabilities, LBT women, poor women or rural women, and young or older women against multiple forms of discrimination in the field of sexual and reproductive health and rights.

Nils Muižnieks

List of useful links

  • UN Office of the High Commissioner for Human Rights (OHCHR) Website on Sexual and Reproductive Health and Rights
  • Committee on Economic, Social and Cultural Rights, General Comment No. 22 (2016) on the Right to sexual and reproductive health (article 12 of the International Covenant on Economic, Social and Cultural Rights), 4 March 2016
  • UN OHCHR, Reproductive rights are human rights, a handbook for National Human Rights Institutions, UNFPA, the Danish Institute for Human Rights, 2014
  • Center for Reproductive Rights, Factsheet on Mandatory Waiting Periods and Biased Counseling Requirements in Central and Eastern Europe, Restricting access to abortion, undermining human rights, and reinforcing harmful gender stereotypes, 2015
  • Factsheet of the European Court of Human Rights on Reproductive Rights, December 2015
  • Report of the round-table with human rights defenders on women’s rights and gender equality in Europe organised by the Office of the Council of Europe Commissioner for Human Rights (Vilnius, 6 - 7 July 2015) CommDH(2016)15, 19 January 2016

Source: Council of Europe

Jul 14 2016

Interview with ASTRA Coordinator by the EuroNGOs: “The Central and Eastern Europe region can strongly contribute to blocking international progress on SRHR”

On the 5th of July the anti-choice “Stop Abortion” Committee submitted to the Polish parliament the draft law aiming to introduce a total ban on abortion with over 450,000 citizen signatures. This mass anti-choice mobilization is just another example of the backlash against women’s rights in Central and Eastern Europe. Marta Szostak from Astra gave us an insight into the regional anti-SRHR dynamics and its consequences for the European and global processes.

Could you tell us please about the recent challenges in Central and Eastern Europe related to SRHR and how they could possibly influence the processes happening at European and global level, such as implementation of the SDGs?

Marta Szostak, Astra: The recent challenges can be discussed in terms of a backlash on women’s rights. For a few years we are now observing various steps, sometimes very small, sometimes very drastic, to limit women’s reproductive rights and influence their reproductive health choices. The most blatant example is the one of Poland where very shortly we may face a reality where the current, already very strict law on abortion denies women the right to decide on their pregnancy. This is also the case for fetal impairment and rape. The new law, if successful aims also to punish women for illegal abortions. Anti-choice initiatives in Poland have become a standard procedure in the last years, we have witnessed them literally every year, or every second year, for the last decade. With the current conservative government, they have gained power and support like never before, this has not been without consequences on the global and regional level. Already this year some countries of the region, including Poland, have been reluctant to go along with the common EU position at some of the global negotiations at the United Nations. Only recently Russian Federation, followed by Poland and other countries of the Middle East blocked the decriminalisation language from being included in a resolution adopted by the UN General Assembly on June 8 that called for ending the AIDS pandemic by 2030.

Another common trend for the region is Governments publically endorsing global commitments but executing its own agenda at national level, sometimes contrary to these international standards and agreements. This is especially visible in regard to human rights standards related to SRHR.

While there is a continued backlash towards women’s rights in the region, do you see any new forms of this phenomena? Are there any new actors present in the growing opposition to SRHR?

Marta Szostak: The groups which are pushing for anti-choice and very often “anti-gender” messages and initiatives (usually covering issues such as LGBTI rights and comprehensive sexuality education) have been around for a very long time. Many of them have gained power and support in the recent years, fueled by the rise conservative politics, the rebirth of nationalistic rhetoric and the promotion of a return  to “traditional values”. This trend has been observed in countries like Russia and post-Soviet Republics such as Lithuania, Hungary and Croatia. The growing SRHR opposition in CEE region is very often supported (in terms of resources, know-how and financially) by United States anti-choice groups and sometimes seems like a well-coordinated regional / global action. For many years the opposition groups were connected to religious groups, mostly the Catholic or Russian Orthodox Church. In our opinion this has however slightly changed in the recent years and more groups acting without the Church’s support are vocal and visible. What is also quite new is the involvement of young people in the anti-choice movement as well as the presence of collectives of specific groups protesting against a certain issue, such as parents against sexuality education.

What can be done to tackle these challenges and how can the European SRHR community support your work in the region?

Marta Szostak: Firstly, the European SRHR community should see this as a wider issue, not solely relevant to CEE region only. The rise of nationalism and anti-choice initiatives can be observed in some countries of Western Europe as well, and the recent case of the Spanish battle over abortion law and the situation of Ireland are good reminders that reproductive rights are not of a permanent status and must be fought for and secured over and over again. Of course, the West versus East divide, with the EU dynamics as background, has its repercussions.

Reaching the moveable middle should become a priority for all SRHR advocates in Europe, either by education or by media. With the many connections between advocates and activists from European countries from both East and West this can make a difference. However, it is usually more productive to work in national context and avoid top-down dynamics, also in regard to international cooperation.

Last, but not least, Western European advocates should be aware that the CEE region with its current trends, and the UK leaving the EU, can strongly contribute to blocking the international progress on SRHR. As a consequence their work, also the development work done in Global South, may become more difficult with this backlash taking place. It will also have, and in fact, this is already happening, impact on the funding for SRHR initiatives, abortion especially. We count on solidarity and support from our colleagues in Europe, their assistance in conversations with their politicians and representatives within the European Parliament. 

Source: EuroNGOs

Jul 13 2016

The Prevention gap report shows that while significant progress is being made in stopping new HIV infections among children (new HIV infections have declined by more than 70% among children since 2001 and are continuing to decline), the decline in new HIV infections among adults has stalled. The report shows that HIV prevention urgently needs to be scaled up among this age group.

The report shows that an estimated 1.9 million adults have become infected with HIV every year for at least the past five years and that new HIV infections among adults are rising in some regions. The Prevention gap report gives the clear message that HIV prevention efforts need to be increased in order to stay on the Fast-Track to ending AIDS by 2030.

According to the report Eastern Europe and central Asia saw a 57% increase in annual new HIV infections between 2010 and 2015.

In Eastern Europe and Central Asia, 51% of new HIV infections occur among people who inject drugs. More than 80% of the region’s new HIV infections in 2015 were in the Russian Federation. The epidemic is concentrated predominantly among key populations and their sexual partners, in particular people who inject drugs, who accounted for more than half of new HIV infections in 2015. However there is very low coverage of prevention programmes, in particular harm-reduction interventions among people who inject drugs.

UNAIDS urges countries to take a location and population approach to HIV programming efforts following five prevention pillars, to be delivered comprehensively and in combination:

  • Programmes for young women and adolescent girls and their male partners in high-prevalence locations.
  • Key population services in all countries.
  • Strengthened national condom programmes.
  • Voluntary medical male circumcision in priority countries.
  • PrEP for population groups at higher risk of HIV infection.

Source: UNAIDS Press Release

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