7.2. REPRODUCTIVE RIGHTS

Estimated reading: 10 minutes

Reproductive health is a state of complete physical, mental, and social well-being in all matters related to the reproductive system.
Reproductive rights include laws and polices related to contraception, abortion, and access to information (sex education, care, social support systems, etc.).
The accessibility of contraception depends on the availability, affordability, and information of the contraceptive methods.
When it comes to emergency contraception or abortion, Malta is the only European State where the procedure is completely illegal.

7.2.1. INTRODUCTION

Reproductive rights are the rights of control over one’s body and the decision making of contraception and abortion. WHO (2018) defines reproductive rights as follows:

Reproductive rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. They also include the right of all to make decisions concerning reproduction free of discrimination, coercion, and violence (WHO, 2018).

Reproductive rights include the right to have access to information, the right to have body autonomy, the right to make decisions related to contraception and reproduction free of discrimination. With all this, every state decides for the regulation that will apply in their country.

In addition to this, WHO (n.d.) defines reproductive health as a state of complete physical, mental, and social well-being in all matters related to the reproductive system with all the functions and processes that it involves.

7.2.2. DEVELOPMENT OF THE TOPIC

7.2.2.1. European Laws and policies

When discussing reproductive rights, the following factors could be considered:

Access to information about contraception
Access to sex education and reproductive education
Access to sexual health care and sexual health rights
Access to abortion (emergency contraception, safe abortions)

When talking to children/teens about the topic of reproductive health, emphasize the fact that it is a complex concept that includes, but is not limited to, access to information, access to contraception, health care services related to reproductive health, and mental and physical health.

Even if European countries might be following a pattern or guidelines suggested by European institutions, the way laws and policies are created is influenced by the social, cultural, and economic background of the country.

7.2.2.2. Contraception

There are over 14 types of contraception methods and instruments developed and available worldwide (in some parts of the world). Some of these are:

Contraceptive cap or diaphragm
Condoms
Contraceptive implant
Contraceptive Injections
Contraceptive Pills
Female condoms
Vaginal Ring
Vasectomy
IUD
Intrauterine system (IUS), coil (NHS Inform, 2022)

When talking about access to modern contraception we refer to availability, affordability, and information, according to the study “The Atlas of Contraception 2020” carried out by the Forum European Parliamentarian on Population and Development (EPF) in collaboration with a group of renowned experts in the field of contraception. The study showed that the percentage of the accessibility of contraception differs from country to country, having Belgium listed as the country with the most accessibility to contraception (96,4%) and Poland with the least accessibility to it (35,1%) (Statista, 2020).

Emergency contraception (EC) are the forms of contraception that are effective when administrated after a certain period of time from the sexual intercourse. The most common emergency contraception is found in the form of pills and its regulation and accessibility depends on the country. In some countries a medical prescription is required in order to have access to it, which includes a visit to a medical physician, while other countries have it available in pharmacies, drugstores, or other types of convenient stores. However, there are countries who require a pregnancy test before selling it and countries who are not offering it as an option at all.

The latest policies in Europe show that most of the countries made EC available in pharmacies (Austria, Romania, Spain, UK, the Netherlands, etc.). Even so, some countries required a minimum age for the purchase, over 18 years old in Italy and Croatia, and over 15 years old in Poland. During the last years, Italy removed the age restriction, while Poland reintroduced the availability of EC only through medical prescriptions after a visit to the doctor. EC remained a prescription drug in Hungary and Poland, and it is neither registered nor available in Malta (European Consortium for Emergency Contraception, n.d.).

You can read more about contraceptive methods on topic 3.

7.2.2.3. Abortion

Abortion laws in Europe have been in place since the beginning of the early 20^th century, having states that legalized or decriminalised abortion since 1932 (Poland). According to the Centre for Reproductive Rights, abortion was legalized/decriminalized in most European states by 1990. However, there are states who started regulating abortion a lot later, such as Ireland (2013) and Norther Ireland (2019). Currently, there is only one European state that prohibits abortion under any circumstances. Malta is the only European state with complete ban on the procedure. Poland is a second European state that ruled in favour of a law against abortion, with the exceptions of rape, incest or if the mother’s life was in danger, which is getting close to a complete ban (Centre for Reproductive Rights, 2021).

On a social level, a study conducted in 2021 conducted by the Centre for Reproductive Rights (splitting population into the gender binary, men, and women), showed that when it comes to the opinion on abortion rights, 43% of men and 56% of women agreed that abortion should be performed when a woman decides that she wants to have one. Slightly over 20% in both categories (men and women) agreed that abortion should be performed only in certain circumstances, and 10% of the women and 14% of the men said that it should not be allowed at all (Centre for Reproductive Rights, 2021).

In the latest case of Poland, 33% of the population thinks that women have the right to choose when they want to get an abortion, while 43% of the country believes that only certain circumstances (such as rape) justify performing it. Out of the rest of the population, 6% said that abortion should not be permitted under any circumstances, 8% would allow it only if the mother’s life is in danger and 12% preferred not to answer at all.

According to WHO (2018), 25% of maternal deaths can be avoided if all women wishing to avoid pregnancies would have access to modern contraception methods.

Even if most of the states in Europe are supposed to provide access to safe abortions, a lot of the states that provide abortion on request are refusing to provide the services or require a long process that can involve shaming and guilt tripping the person in question.

Children/teens should be aware of their options and of the available health care services in order to be able to access their sexual health and reproductive rights.

– 7.2.3. SITUATIONS OF DISCRIMINATION RELATED TO THE TOPIC –

A 15-year-old found out they were pregnant. They got scared and did not know what to do and where to ask for help. They live in an environment where abortion is stigmatised, and the person is shamed for any sexual activity unless they are married. They did not know where to find information on pregnancies and abortions, how the process goes, what the risks involved are and all of the factors that might influence their decision and their mental and physical health. Talking to friends was not an option as they did not know anything else about possible options and because of the risk of the information spreading.

Living in a quite isolated place, without access to sex education, proper sexual health care or even a support system, they did not know what to do and tried to find solutions online. They read that drinking certain cleaning products might create a reaction that will cause an abortion. Thinking that they ran out of every other option, they did.

As a teacher, try including the aspect of sexual health and reproductive rights when teaching about reproductive health, gender equality or during sex education classes.

If you are not teaching anything related to sexual and reproduction health, try creating a space for a chat and for questions. You could include the school’s nurse, a social educator or any other experts in the field and discuss about the reproductive rights aspects of the sexual activity. By doing this, in the case of a situation like the one described above, children/teens would have a base of knowledge of what it means, what their possibilities are and where they could ask for help. Point out some health centres, useful materials, or places where they can get emergency/legal advice on situations related to their reproductive rights.

7.2.4. BEST PRACTICES

7.2.4.1. Reproductive rights education

As a teacher you could consider including reproductive rights education in your lessons when talking about reproduction or European laws or any other related subject, or you could create a specific space for sharing this information in the form of workshops/materials/group talks/etc.

Keep in mind that children/teens will have situations in their lives when they have to deal with something related to reproduction rights (or will know someone who is going through a situation), that could be anything from emergency contraception, information on pregnancies, emotional support, or any type of care they might need. For this reason, it is better to prevent the spread of misinformation or misconceptions and talk about the subject openly with them. They will get the information they need one way or another and it is advisable that it comes from accurate sources that do not stigmatise, shame, or try to make them feel guilty. Try to focus on the educational aspect and on the support you can offer.

7.2.4.2. Avoid shaming and guilt tripping

Considering the fact that every European (and worldwide) country has the legal power to decide over the reproduction laws and regulations, access to information and reproductive health care specialists can be very limited. When confronting yourself with a situation like this, regardless of whether you are in an educator and/or teacher role, try to avoid shaming the person for what they did and try focusing on offering them your support. Trying to make them feel guilty or ashamed would only have a negative effect, possibly making them keep some information from you or to avoid asking for help in the future. You cannot change what happened, but what you can do is to offer support so that the next time this person could be more informed and could know where to get access to services or information that they might need.