Anna Kalita: Let’s set aside worldviews and personal beliefs, and talk only about the facts and the legal situation as of today.
Dr. Maciej Socha: Agreed. Although in my work, that’s not always possible.
In what circumstances can a woman legally have an abortion in a Polish hospital? Last summer, Prime Minister Donald Tusk announced: "Since we can’t open the gates wide, we’ll open small doors." Health Minister Izabela Leszczyna clarified: "One certificate from a psychiatrist is enough. A woman with such a certificate must be provided with the procedure." Is this a revolution?
No revolution. On the ward I head, we’ve been performing abortions for years, almost exclusively based on certificates from psychiatrists stating that continuing the pregnancy poses a risk to the woman’s health or life. After the Constitutional Tribunal’s ruling, it was just us, Oleśnica, and two or three other wards performing legal abortions – and that was it. Today, the situation is much better, but it’s still scandalous that in a country of 36 million people, you could count on one hand the hospitals that respected the law!
Recently, we had a case where a mother came to us with her 13-year-old daughter, who was pregnant as a result of sexual assault. This girl had been refused an abortion at several hospitals. And these weren’t small provincial hospitals, but respected university clinics and high-level wards.
Were they refused based on a conscience clause?
For nothing. They were simply refused. They stood in front of me, tears in their eyes. I was thinking about what advice to give them, how to arrange quick help, and started explaining what documents from the prosecutor’s office they would need. At that moment, the mother pulled out all the necessary papers. She already had everything a doctor needed to legally terminate a pregnancy resulting from a prohibited act.
For clarity: this girl is no longer pregnant?
Of course not. We terminated the pregnancy in our ward. What was deeply sad and terrifying to me was that, despite having all the papers legally protecting the doctors, they were turned away from several hospitals.
This is similar to the case from 2008 when several places refused to provide an abortion for a 14-year-old, and only after the intervention of then Health Minister Ewa Kopacz was the legal procedure carried out. Women’s organizations have been warning for years that the majority of Polish hospitals do not respect the law and do not perform abortions at all. Legally, abortion is permitted in two cases: when the pregnancy results from rape and when the mother’s life or health is at risk. In this context, Tusk and Leszczyna clarified: it also includes mental health.
Since the notorious Constitutional Tribunal ruling in 2020, in most cases, women - not just from the Pomeranian or Kuyavian-Pomeranian regions, but from all over the country - have come to our ward after finding out that their fetus had severe, irreversible, and incurable conditions or lethal defects. As a result, their mental health had already deteriorated, and psychiatrists certified that continuing the pregnancy would pose a risk to further mental decline and even threaten the woman’s life.
Initially, I decided we would require the woman to present certificates from two psychiatrists to confirm the diagnosis beyond any doubt. I wanted to protect myself and the ward staff, given what we were hearing from PiS and organizations like Ordo Iuris. The rule I came up with began to be applied in other wards in Poland as well. However, Kamila Ferenc, a lawyer from the Foundation for Women and Family Planning, convinced me that, from a legal standpoint, one certificate is sufficient.
That’s what Minister Leszczyna said at the conference as well.
We had already been relying on a single psychiatrist’s certificate, based on legal consultations. We continue to do so, conducting something like a medical consultation on the ward, where we examine the patient and the fetus, present therapeutic options, and if the patient, often with her partner, requests termination, we proceed according to the law.
I’m not against the conscience clause. I have doctors on the ward who I know don’t want to perform abortions because it goes against their conscience. That’s fine, but I’ve made it clear: I don’t want any circus or burdening women with religious or political beliefs. My responsibility as the ward head is to ensure that patients receive all the care they are legally entitled to, funded by public money. Therefore, the conscience clause is not used on my ward. If someone wants to refuse to perform a medical procedure, they must meet certain conditions. In every medical facility, there should be other doctors who carry out all the procedures. Unfortunately, in Poland, we know there are many places where women are simply refused, without any documentation, without citing legal grounds, or even the much-criticized conscience clause. It happens, as Jarosław Kaczyński put it, "outside the system".
