Ms Leah Hoctor:

In the brief time available we can identify three factors which explain why - in some cases - laws that have allowed abortion, either on broad grounds or on very limited grounds, may not enable access in practice. Affordability and how abortion services are being covered by public health insurance or integrated into the subsidisation schemes of health systems is one factor that can impact access, even where abortion may be legal. Often in countries that have not legalised abortion on request or on socioeconomic grounds, the certification processes that must be followed to obtain access on a health ground or in situations of foetal impairment or rape, for example, can be onerous. These processes can often involve multiple levels that a woman must go through or multiple doctors and social workers being involved in certifying the existence of the reason. We see other barriers in some countries which can relate to waiting periods, for example, or mandatory and sometimes biased counselling requirements.

In the European countries that were green and light yellow on the map, while it is not true to say that there are not sometimes problems for women in accessing a legal abortion, in general these countries have taken an approach in their laws which enables women to access services early in pregnancy at least. That often means that some of these barriers create fewer problems. In terms of sexual assault, which I tried to address in my presentation, all of the 36 countries in Europe that have legalised abortion on a woman's request, mainly in early pregnancy, thereby allow women who have survived an experience of sexual assault to access abortion in early pregnancy through that ground. In that context, many women across Europe who have faced sexual assault and who then choose to have an abortion do so under the on-request ground. Many of those countries in Europe that have explicit sexual assault grounds in their laws include a particular certification process. The most common process is that a committee or a number of doctors and social workers must look at the case and agree that the reason exists and that there is evidence of a sexual assault. Some countries require a prosecutor or police certificate and speak to the need for clear evidence or sometimes for a criminal legal procedure to be initiated. Only one country refers to a process before a court in the case of sexual assault. It is very important to understand that 40 countries out of 47 in Europe allow access, in a general sense, on request for socioeconomic grounds in early pregnancy. It is probably in that way that women access abortion in situations of rape.