"Referendum on Sunday, working group on Monday": A success story of implementing abortion services after legalization in Portugal. (30th October 2018)

• Record Type: Journal Article
• Authors: Stifani, Bianca M.; Vilar, Duarte; Vicente, Lisa
• Is Part Of: International journal of gynaecology and obstetrics. Volume 143(2018)Supplement 4
• Page Start: 31
• Page End: 37
• Publication Date: 2018-10-30
• Subjects: Advocacy -- Implementation -- Legalization -- Medication abortion -- Portugal -- Public health -- Referrals -- Safe abortion; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.12675
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: A 2007 referendum legalized abortion in Portugal. Physicians played an important role advocating for legal reform and providing services thereafter. Implementers relied on a strong public health system with many gynecologists who required minimal training, and took decisions that allowed for rapid implementation. First, they emphasized medical abortion and integrated abortion into existing hospital obstetrics and gynecologic services, where eventual complications could be managed. They also offered immediate postabortion contraception, helping prevent criticism from abortion opponents who feared women would obtain multiple repeat abortions. Finally, they established referral networks guaranteeing access despite conscientious objection. Media campaigns were not needed as Portuguese women had good access to information. Portugal's success is largely due to key facilitators within a working group established by the Ministry of Health to implement the new law. Remaining challenges are the lack of choice between medical and surgical abortion, and some regions with relatively difficult geographic access to services. Abstract : Physicians played key roles in Portugal's 2007 legalization of abortion as advocates and providers. A strong health system, establishment of referral networks, and use of medication abortion has made implementation a success.