Embracing Modernisation in Dutch Reproductive Rights: Pills, Pregnancy and Paternalism
The Netherlands has long been considered a front runner in undertaking liberal pursuits such as the right to same-sex marriage, gender reassignment surgery and terminating pregnancies. Though not the first country to legalize abortion, the Netherlands has allowed its inhabitants to terminate their pregnancies since 1984. The law which this practice legal has not seen any updates or additions since its enactment, prompting discussion in Dutch politics about whether its legislation is still in touch with current circumstances surrounding abortion. Though there were attempts in the past to alter the laws dictating terminating pregnancies, the CDA and the CU (both Christian Democratic parties) have traditionally opposed such efforts.
They have been part of the coalition in the last few cabinets, so their opposition has had a significant impact in slowing down any advancements in Dutch abortion policies. However, some are now attempting to make the laws concerning abortion more lenient. A combined effort led by Dutch prime minister Mark Rutte’s party, the VVD, alongside progressive parties from the centre-left (PvdA, GroenLinks and D66), proposed to the Dutch government on the 9th of February, to make the laws concerning abortion more lenient.
In particular, they pled for an extension to the law, making it possible to end a pregnancy through medication distributed by general practitioners. It is important to note that extra support from organizations in the case there are doubts about undergoing abortion will not be diminished. Nor does the introduction of the medication method mean the importance of general practitioners being kept up to date after a pregnancy has been terminated will go. Both will remain in place for those navigating such difficult waters.
The current state of things
Currently, abortion is allowed until the 24th week of pregnancy. There is a mandatory re-evaluation period, meaning a person must wait until 5 days after their pregnancy is confirmed to decide whether they want to undergo the abortion procedure or not. This ‘waiting period’ has been a contentious issue, and might be omitted from the law, especially with the introduction of medication as a means of abortion. Though the law officially states that abortions may only be carried out in the state of an emergency, this is an ambiguous statement and there is only a small number of cases in which a practitioner has refused service according to this rule. However, a practitioner may refuse to perform this surgery if it goes against personal ethics.
About 30,000 abortions take place in the Netherlands yearly, with a third of them being performed on people who have already undergone this surgery in the past. Terminating a pregnancy is free for those living in the Netherlands.
Is it necessary?
One may wonder, why now? Dutch access and quality of abortion rank 4th in Europe, only bested by the United Kingdom, Iceland, and Sweden. However, Representative Corinne Ellemeet has made the point, that there remains a stigma surrounding abortion clinics, and people may feel shame upon going to a clinic. Going to a general practitioner would be seen to remove this sense of shame, as one’s intentions there would be unknown. Moreover, due to budget cuts in the Dutch healthcare system, the number of abortion clinics in the Netherlands has been reduced, meaning long travel times for some. Finally, most people will be familiar with their general practitioner, and undergoing such a procedure is a sensitive and intimate process, thus one might feel more comfortable being guided by someone they have had prior experiences with. Although Dutch laws already give those in need of abortion more freedom than other nations, amendments are now considered necessary.
Some MPs, mainly from the Christian democratic parties, expressed concerns over an increase in the workload of the already overworked GPs. Training will need to be provided to ensure quality care in the case of terminating a pregnancy. However, as previously stated, a practitioner can indicate whether or not they want to be part of the process. Moreover, 62% of Dutch general practitioners stated that they had a positive or neutral stance on being given extra responsibilities in the abortion procedure. 38% stated they had a negative sentiment toward the issue, with reasons ranging from religious or moral objections. Another concern indicated that giving a general practitioner the right to provide medication to end a pregnancy could lead to a declining number of visitors to abortion clinics, prompting them to close their doors permanently.
Though this could be the case, Representative Lilianne Ploumen has pledged that clinics would not disappear completely. It is expected that this method of pregnancy termination would become the preferred one, but a set number of clinics would remain open. Lastly, current abortion procedures are covered by national insurance, though many types of medication are not, thus choosing this option as a means of ending a pregnancy might become an expensive endeavour. An issue they will look to solve after the proposal has been approved.
The future
Out of 139 eligible voters in the ‘Tweede Kamer der Staten-Generaal’, the main legislative body of the Dutch government, 101 voted in favour of the alterations made to the law and 38 against, meaning the new programme will be launched in the next few months. Furthermore, the Tweede Kamer also voted in favour of abolishing the wait time of 5 days, although the ‘Eerste Kamer’ must vote on the issue before it can be fully realised in legislation. Additionally, the new programme will also call for an extension to the period in which medication may be used to end a pregnancy, namely from 45 days to 63 days. Though the Netherlands is following a similar path to Sweden in terms of access to abortion, some argue there is still work to be done in the areas of sex education and better access to organisations which can guide this process.
