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“Referendum on Sunday, working group on Monday”: A success story of implementing abortion services after legalization in Portugal
Author(s) -
Stifani Bianca M.,
Vilar Duarte,
Vicente Lisa
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12675
Subject(s) - medicine , abortion , legalization , referendum , referral , reproductive health , medical abortion , reproductive rights , family planning , family medicine , abortion law , public health , conscientious objector , nursing , law , population , pregnancy , misoprostol , environmental health , political science , psychiatry , genetics , politics , research methodology , biology , spanish civil war
A 2007 referendum legalized abortion in Portugal. Physicians played an important role advocating for legal reform and providing services thereafter. Implementers relied on a strong public health system with many gynecologists who required minimal training, and took decisions that allowed for rapid implementation. First, they emphasized medical abortion and integrated abortion into existing hospital obstetrics and gynecologic services, where eventual complications could be managed. They also offered immediate postabortion contraception, helping prevent criticism from abortion opponents who feared women would obtain multiple repeat abortions. Finally, they established referral networks guaranteeing access despite conscientious objection. Media campaigns were not needed as Portuguese women had good access to information. Portugal's success is largely due to key facilitators within a working group established by the Ministry of Health to implement the new law. Remaining challenges are the lack of choice between medical and surgical abortion, and some regions with relatively difficult geographic access to services.