Improving women´s journey through abortion in Portugal
Directorate of General of Health, Lisbon, Portugal
Abortion, according to the Portuguese penal code, is considered a crime against intrauterine life. Over the years Portuguese law has incorporated reasons that preclude the illicit use of abortion.
Serious maternal illness, foetal malformation and rape constitute grounds for termination of pregnancy. These motives are accepted for 32 years in Portuguese health care.
It was just in 2007, after a national referendum, that the practice of abortion at women´s request up to10 weeks gestation was recognised. Since then it has been performed within the National Health Service (NHS) or in officially recognised, private clinics.
The implementation of abortion services was made possible within the NHS through a national network, along with the availability of mifepristone and misoprostol, the publication of national guidelines and the creation of a national online registry, mandatory for all health care units.
Nowadays 67% of all the abortions are performed in the NHS, where 95-97% of interventions are medical abortions. In private units the majority of the interventions are still performed using the surgical method (98%).
It is unknown what was the absolute number of illegal abortions before 2007, although 20 000 was the estimated number. We only have data on the complications caused by these abortions because women came to health services looking for treatment. Serious complications included deaths, uterine perforations and sepsis. Many women travelled abroad to seek a safe abortion – a number never known.
National reports show a significant decrease in the number and seriousness of complications caused by illegal abortions since 2008. With legal abortions complications remain low but in 2010 there was one fatal case of Clostridium Sordellii associated with medical abortion.