Sat Jul 05, 2025
July 05, 2025

Portugal, 3 years of legal, safe and free abortion

On February 11, 2007 through a referendum, Portuguese people decided that women should be allowed to abort, at their choice, until the 10th week of pregnancy in an authorized Health Service institution and in safe conditions.

The 1998 referendum on the same topic, defeated legalized abortion, so up to 2007 abortion in Portugal was still a crime, except in cases where pregnancy presented danger of death or serious injury to the physical and psychological health of women, in case of incurable disease or congenital malformation of the fetus or in cases of rapes.

For the 2007 referendum, besides political parties, there were also several movements of prochoice supporters and those against the abortion decriminalization. They campaigned on the streets and on television for their positions, (all the groups had the same airtime). The prochoice victory was therefore the result of a wider debate that crossed the Portuguese society. The Catholic Church was a key sector in the campaign against the decriminalization. The Church was heavily defeated in the referendum.

In July 2007, the law was implemented. Thereafter all women residing in Portugal, Portuguese or not, may have access to safe and free abortion at the National Health Service (NHS).

Procedures are relatively simple, a woman just has to get to a hospital or to a health clinic and states she wants to be submitted to an abortion. First, she needs to go on a previous medical consultation where she will be submitted to a brief medical examination and will be informed about abortion methods. In this consultation she will be offered psychological counseling that she may accept or not.

Then it follows a compulsory three-day reflection after which the abortion may be performed if it is confirmed by ultrasound that the pregnancy is less than 10 weeks-long. Women can opt for a medical or a surgical abortion. The medical abortion is made through swallowing two medications that, together, cause an abortion, which is similar to a spontaneous miscarriage, and have an efficacy of 98-99%.

In addition, the medical abortion does not require surgery or hospitalization. The surgical abortion is also an alternative and it is made often under general anesthesia, through vacuum suction or curettage (scraping). Two weeks later, the woman should go to a third medical visit, after having made a new ultrasound to confirm that the pregnancy have ended and to be counseled about the contraceptive method that best suits her.

The law implementation

The movements against the abortion decriminalization argued that performing abortions in the National Health Service (NHS) would bring chaos to services, would steal resources in order to assist women who wanted abortions. There was no chaos. According to Mara, a clinic doctor, a family doctor and a co-founder of Doctors for Choice Association [1] (DFC) “we can say that the implementation of the new law of PVI (Pregnancy Voluntary Interruption, or abortion) went well. To achieve this point it was essential the detailed regulation. To establish the health facilities that can perform PVI, the user circuit, to limit the maximum waiting time of the several steps, since the first appointment up to the post-abortion family planning. To optimize the quality of service rendered activities protocols were also carried out, either in surgical as in medical abortion”. According to Mara other very important point for the law implementation was the regulation of conscientious objection, namely that “the right to conscientious objection is an individual right and not a collective right, that is, there cannot be a consciousness objector Health Service, only objectors physicians. It is also important to note that objectors physicians must compulsorily refer the client to a physician who is not objector”.

The availability of medical abortion also facilitated the abortion because it can be done at an outpatient clinics and does not require either hospitalization or the several features as the surgical abortion does. 95.7% of abortions in the NHS are medical abortions. There are even health clinics where a woman can be submitted to a medical abortion. To make it feasible they just trained physicians and nurses and made available for them the access to a doctor for psychological support.

No more deaths from illegal abortion

Ana, 14 years old was one of the last women to die in Portugal as victim of illegal abortion. Once implemented the law that allows termination of pregnancy at the woman’s choice it was not registered any more deaths from abortion, and serious complications such as the uterus perforation and sepsis have become extremely rare.

After three years of law enforcement the number of illegal abortions has drastically fallen. The few cases remaining are due to the lack of knowledge on the new law, and when women cannot get an abortion before 10 weeks pregnancy. According to Mara from MPE “there is still the illegal circulationof  “cytotec ” and I believe that the vast majority of illegal abortions are medical abortions, as it was usual before legalization, and they have fewer complications than surgical abortions, thus the large decrease in complications. Especially in relation to more vulnerable groups (immigrants, adolescents) it remains an urgent need to inform every women of their “new” right to choose, and to inform about the free access to abortion and the confidentiality of the process. “

For the Association for Family Planning 10 weeks is a too short period and it should be extended to 12-14 weeks as in most European countries. The total number of abortions would not increase and the abortions would be further reduced. Mara from MEP, argues that in addition “it is excessive that adolescents under 16, according to the new legal framework, may only be conducted to a PVI (Pregnancy Voluntary Interruption) with the informed consent of parents (or guardian). I believe that any woman with unwanted pregnancy has enough self-determination to make decisions that only she (and every woman she wants to be involved in) can make. It is important to clarify that, by law, all women (and not just teens) who wish to be submitted to an abortion, are entitled, whenever desired, to the psychological support or social service, which, although not mandatory, must always be offered and provided. “

 The right to free and safe abortion

The main reason for the drastic reduction of illegal abortion was the fact that this is free on the NHS, thus providing access to safe abortion for working women who cannot afford paying for  it at a private clinic. It was estimated that between 17,000 and 20,000 abortions were made  in Portugal, at the woman’s choice. In 2009, 18,951 abortions were carried out under these conditions; over 70% of these were made in the NHS.

This was one of the greatest Doctors for Choice’s demands who also sustained that equally or more important than legalizing abortion was to ensure that it was accessible to working women with fewer resources. These women are the ones who most need to plan their family and most likely will have to resort to abortion before an unexpected pregnancy. 19% of the women who had an abortion in Portugal in 2009 were unskilled workers, 18% were students, and 17% were unemployed. These women admitted they could not afford raising a child and contrary to what happened before 2007, they could make that decision with dignity, regardless of their economic resources.

For a legal, safe and rare abortion

One of the main arguments of those against abortion decriminalization was that the number of abortions would increase exponentially because the women would stop making contraception control and instead use abortion as the sole method of family planning. We knew that this was not true, it was just a “stupidity certificate” forwarded to women. It would be the same as saying that women have no ability to decide about their sexual and reproductive lives. This has not happened in other countries where abortion was legalized, and would not happen in Portugal.

Therefore, there was no exponential increase in the number of abortions, women did not stop making contraception control, and in fact, we now know that 96% of women who had an abortion were using a contraceptive method (60% used to take the contraceptive pill). These figures are similar to other countries. Contraception, whatever it is, may fail and unwanted pregnancy can happen to any woman. Now this failure may be reported to the doctor who will find together with the woman any error in the use of contraception and/or choose a more appropriate method, there is even an exclusive doctor appointment for this.

Moreover, among women who had abortions only 4% had two or more abortions in their lives, that is, as we have defended, the vast majority of women, if they have access to contraceptive methods, only resort to abortion when all else fail.

The fight does not end here

Legalization of abortion and its implementation in the NHS is a major victory for women in general and especially for working women. However, there is still illegal abortion and while it is so we must continue to fight for its complete disappearance.

It is necessary that the legal limit for termination of pregnancy be increased; there is no scientific or ethical reason to justify the 10 weeks. In practice 10 weeks is a very short period to allow women to find out whether they are pregnant and still be able to go through the entire process until the medical appointment for the interruption. In countries where the deadline is higher, the percentage of abortions did not increase, only further diminished the illegal abortion.

It is necessary to develop information campaigns about the new law for all women, especially for the immigrants, telling them that all are entitled to a free abortion if they reside in Portugal.

Besides the need to increase the timeout, termination of pregnancy should be even more accessible by increasing the availability of medical abortion in health care units.

We must not forget that the whole process should be accompanied by a requirement that contraceptives are free and widely available at health units along with the provision of medical and nursing staff to assist women to establish the contraceptive method that best suits them. We must also continue to demand sex education at school so that young people broaden their knowledge of their own bodies and know how to avoid an unwanted pregnancy, in order to turn the abortion early, safe and rare.

However, as long as capitalism exists, free access to safe abortion for working women will always be in question. At this time, Portugal is strongly affected by economic crisis, and the neoliberal government in charge, from the Socialist Party, has started to pass the bill to workers and among other measures is making a serious attack on the NHS with huge cuts in its budget. These attacks on the National Health Service put at risk, among other things, the safe and free abortion, and therefore the access to abortion by working women. This year there have been sectors that have spoken on the need to free only the first abortion, women having to pay for the following. Apart from that even from a liberal economic perspective the costs of treating complications from illegal abortions end up being larger, the dignity and life of a woman who could be our sister, our mother, our friend, our girlfriend, the mother of our children is priceless.

Moreover, it is needed not only the access to abortion for all women as well as the widespread and free access to all contraceptive methods. This is not possible because the big pharmaceutical companies want to keep their huge profits in this market.

Fighting for the right to free and safe abortion as the right to family planning will always be an incomplete struggle for workers if it is not combined with the struggle to end capitalism.

_____________________________________

* Diana Curado – is a militant of Ruptura/FER, section of LIT-CI (IWL-FI) in Portugal; physician and a member of Doctors for a Choice Association. Article written together with Marta Luz

[1]  Health Professional Association, and other areas supporters that struggle for sexual and reproductive rights. In 2006 started a movement with the same name which campaigned for the referendum, defending the right to a free and safe abortion.

Translated by Wilma Olmo Corrêa

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