New report raises concerns about foreigners' access to abortion in Czechia

A new report from a Czech-based advocacy group raises concerns about access to reproductive healthcare in the Czech Republic in 2023.

The study, released by the Abortion Support Alliance Prague (ASAP) in advance of International Safe Abortion Day on Sept. 28, found that a significant number of Czech medical professionals said they would deny abortions to women from EU countries who don't have permanent residency.

To compile the data for the report, a team of researchers led by Jolanta Nowaczyk co-founder of the Ciocia Czesia (Auntie Czechia) initiative, approached close to 80 gynecology departments of state-run hospitals in all Czech regions via phone or email and introduced themselves as individuals with EU citizenship in need of an abortion.

Forty percent of the clinics contacted said they would not perform the procedure. A further 12 percent were unable to give a clear answer. In some cases, callers were transferred to department heads or hospital lawyers for clarification.

According to the study, one hospital initially demanded six months of proof of residency or work, in direct contradiction to EU law regarding access to abortion. However, when researchers spoke to the department head directly, approval for the procedure was given without request for documentation.

Overall, just 47 percent of facilities confirmed they would provide abortions to foreign women from the EU on a temporary stay in Czechia.

In 2021, following Poland's hardline ruling on abortion, a debate arose in the Czech Republic about the legality of performing abortions on foreigners who travel here just to have the procedure. In a statement intended to align Czech policy with EU directives guaranteeing non-discriminatory access to healthcare for EU citizens seeking cross-border care, the health ministry clarified that EU citizens, including Polish women, can legally obtain abortions even if only visiting briefly for that purpose.

Since then advocacy groups like Ciocia Czesia have worked with legal experts to confirm this stance, helping to reassure clinics that are uncertain about whether or not they would face legal repercussions for terminating a foreigner's pregnancy.

The study's results, however, suggest that a troubling ambiguity persists among Czech healthcare professionals surrounding the issue of performing abortions on foreigners. And despite the fact that women's right to cross-border healthcare is protected by European law, some medical staff and facilities would deny abortions to foreigners outright (abortion is legal for non-EU citizens only if they have a permanent stay).

While the study sheds light on challenges faced by those traveling from countries like nearby Poland for a termination they cannot access at home, the report also uncovers issues that impact Czech citizens.

ASAP's findings show that abortion for personal reasons carries a fee representing up to 27.5 percent of the minimum wage, with no financial assistance. Abortions in Prague for instance cost CZK 4,500, the second most expensive region after Moravia where medical abortion is over CZK 5,000. "This can create economic barriers for some and lead to unwanted pregnancies," the group stated in a news release.

Additionally, access to medical abortion, a pill-based procedure considered safe by the WHO until 12 weeks, is limited. "Some countries in the EU offer the possibility to carry out a medical abortion outside of a medical facility (i.e. at home) however, in the Czech Republic, it must be administered by medical personnel, at a medical facility providing inpatient care, and [only for up to] 49 days."

According to ASAP, the findings of the study are key to "Building an understanding of weaknesses in law and practice that can limit meaningful choice." The organization added that, while abortion is legal, "not everyone has easy access due to factors like cost, influence from providers, and unequal treatment of marginalized groups like low-income individuals and non-residents."

The study highlights the need to consider reproductive justice in evaluating true accessibility and autonomy over reproductive decisions.