Officially, Poland is a country that celebrates families and motherhood. It recently announced new child benefits, and the government has launched a programme to encourage young Poles to start a family earlier in life. But the rhetoric contrasts with the increasingly difficult choices facing pregnant women and would-be mothers: a near-total ban on abortion – combined with legal ambiguity – means that women face increasingly difficult choices concerning their bodies. New rules that entered into force earlier this year have made the country’s abortion rules, which are among the toughest in Europe, even more restrictive. Now a government plan to keep track of every pregnancy digitally is making some women feel even more controlled.
Since coming to power in 2015, the socially conservative Law and Justice (PiS in Polish) party has presented itself as the champion of the Polish family. This has had tangible financial benefits for millions of families: in 2016, the government introduced a monthly payment of 500 złoty (£90) per month per child from the second child onwards, which has since been expanded to all children.
Yet in practice, PiS has championed a narrow vision of the family, supported by the Roman Catholic Church, which remains influential in Poland. This includes presenting gay people as a threat and further restricting women’s access to a safe and legal abortion. Access to abortion in Poland was already severely limited – the rules, which dated back to 1993, limited it to just three cases: when the mother’s health or life is at risk, cases of rape or incest, or cases of severe foetal defects. Then, in October 2020, the PiS-loyal Constitutional Tribunal deemed abortion in this third scenario unconstitutional. Despite huge protests across the country, some of the largest since the fall of communism in 1989, the ruling entered into force earlier this year.
This autumn, the ruling had its first known victim: a 30-year-old woman referred to by her first name, Izabela, who was 22 weeks pregnant when she died of sepsis at a hospital in September, after suffering pregnancy related complications. According to the hospital, its decisions were based on concern for the health of the mother and foetus. Yet Izabela’s family’s lawyer linked the death to Poland’s tightened abortion laws. Fearing the consequences of terminating the pregnancy, doctors instead waited for the foetus to die, the lawyer alleges.
The news of Izabela’s death shocked Poland, prompting protests against the restrictions on abortion in Warsaw, Krakow and other cities. Yet the rules remain unchanged. The health ministry merely clarified the latest regulations, stating that doctors “must not be afraid of making obvious decisions” about abortions if a mother’s life or health is at risk.
This still leaves a lot of uncertainty – not just for the doctors looking after pregnant women, but also for the women and their partners, and even those who are not yet pregnant but who are hoping to conceive. The Constitutional Tribunal ruling is making them face difficult questions, such as: if the foetus is found to have severe defects, what will my options be? And, following Izabela’s death this autumn: if complications during the pregnancy put my life at risk, can I be certain that I will be able to get an abortion on time? These are questions that women in countries such as Britain or France, where I am writing this article, do not have to face.
The sense of unease has been compounded by a new government plan to register each pregnancy, which was revealed in November by an opposition MP. According to the plan, if any pregnant woman receives any kind of medical service, the fact that she is pregnant must be added to Poland’s Medical Information System, the national database that stores patients’ treatment records. This would change how details of a woman’s pregnancy are stored: they are currently recorded on a paper “pregnancy card” that is given to the mother as a hard copy, rather than in a central digital register.
The authorities claim that pregnancies would be registered in the system for medical purposes. “[The goal] is to avoid prescribing medicines that are not recommended during pregnancy and, in the case of providing life-saving treatment, in the event of inability to obtain information from the patient,” according to a statement published on Poland’s health care services platform in November.
Yet in the aftermath of Izabela’s death, the plan has raised eyebrows, with critics warning that it could be used to track whether women carry each pregnancy to term. This would make it easier to spot women who get abortions; for example, by travelling abroad to other countries in Europe where it is permitted.
“We can imagine a scenario, already known from El Salvador, in which, after a miscarriage – instead of being cared for by the state, with medical and psychological support – a woman will have to explain herself to the prosecutor,” said Kamila Gasiuk-Pihowicz, an MP from the centrist Civic Coalition opposition bloc, quoted by the Polsat News website.
The minister of health, Adam Niedzielski, who is a member of PiS, has defended the plan, suggesting that critics are making a fuss about nothing. “We have an ordinary move from paper to a digital file,” he said on the private radio station RMF FM, claiming that it is part of the wider digitisation of healthcare.
The Polish ruling party’s attitude to family and childbirth is part of a broader natalist push since it came to power. Most recently, PiS politicians have proposed to establish a Polish Institute for the Family and Demography, which would study demographic processes and support the family. Opposition lawmakers claim that the new institution would serve to promote a conservative, Catholic model of the family and seek to control Poles’ private lives.
More widely, PiS’s natalist rhetoric echoes that of other right-wing populist leaders, such as Viktor Orbán in Hungary, Recep Tayyip Erdogan in Turkey, and Aleksandar Vučić in Serbia. As I have written before, this rhetoric reduces women to baby-making machines whose purpose is to counter demographic decline in their country, with little concern for their individual aspirations.
So far, it seems that PiS’s incentives have had a limited effect. Around 355,000 children were born in Poland in 2020, the fewest since 2003. Financial incentives do not seem to be enough; as Irena Kotowska, an expert on demographics at the Warsaw School of Economics has pointed out, better educational and care infrastructure – including access to nurseries and preschools – is needed.
In fact, it has been suggested that the Constitution Tribunal’s ruling on abortion may actually be leading to fewer births as Polish women and their partners are more reluctant to conceive. While the ruling’s impact is difficult to measure, this sentiment is visible in a poll published in November, in which 45.5 per cent of respondents said that the ruling has decreased Poles’ desire to have children. Meanwhile, 41.5 per cent believed that it has had no impact and 2.8 per cent said that it has made Poles want to have children more.
The same poll found that most Poles are unhappy with the current rules on abortion: over three-quarters support a return to the status quo before the Constitutional Tribunal, when abortion was banned except in three kinds of cases, or the liberalisation of the rules on abortion. Fewer than 15 per cent said that the rules should be left as they are or tightened.
Indeed, on 2 December 2021, Polish MPs – including 155 from PiS – rejected a bill submitted by a pro-life organisation proposing to ban abortion completely, including when the mother’s life or health is in danger. Forty-one PiS MPs supported the bill and 12 abstained. This shows that despite the party’s broad social conservatism, its members are divided over just how far to tighten the rules on abortion, amid limited support from society.
That said, there is no sign that Poland’s strict abortion laws will be eased any time soon, which leaves countless pregnant women – or those considering having a baby – facing choices they have never had to face before.