Andriana Andreeva


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    Medical abortion in Bulgaria is available in unusual circumstances. Abortion in Bulgaria is allowed up to 12 weeks upon wish, up to 20 weeks - for medical conditions or foetal anomalies, and after that - in extreme circumstances.
    The legislation regarding abortion has been made in 1990 and last reviewed in 2000. Medical abortion doesn’t exist in it. It is written envisaging surgical procedures only. It requires blood tests (FBC, MSU, clotting, blood group, Rh) and vaginal swab prior to every abortion. It also requires the abortion to start and end in a medical facility. It otherwise classifies the act as a criminal offence and envisages imprisonment of up to 5 years and if repeated - up to 8 years.
    Medical abortion, however, has been performed in the country over the past 10 years or so. Prior to the official availability of registered drugs, Cytotec was in wide circulation. It still is, regardless of the lack of registration in the country.
    Mifepristone and Misoprostol have been first registered in 2012, reaching the market in the end of 2014. Their registration is for distribution in pharmacies, by prescription. The obs&gynae society, however, is largely against the wide availability of the medications, being afraid women will self medicate, and are reluctant to prescribe them, seeing it as illegal to participate in abortion outside medical facility. Very few hospitals offer MTOP or medical management of miscarriage as an inpatient procedure. Professional knowledge on medical abortion is limited. It is widely believed that every pregnancy must end with delivery or curettage.
    A few hospitals and doctors do provide medical abortion, albeit in variation of regimens, and more and more women request it.
    It is because of women’s increasing interest and the few doctors fighting for the cause, that medical abortion is surviving in Bulgaria.