Legal but virtually forbidden: Turkish women denied the right to free and safe abortions | reproductive rights

When Esra*, a 27-year-old from Istanbul, became pregnant by mistake, she knew she had no choice but to have an abortion.

Abortion is legal on request in Turkey for all women up to the 10th week of pregnancy and up to the 20th week for medical reasons. According to the law, it must be done in any public hospital for free.

However, Esra visited hospital after hospital in Istanbul, trying to arrange a termination, and was rejected by all.

“They told me over and over again that you can’t have an abortion here, we don’t do it,” says Esra. “I told them it was my right, but they still refused.”

Increasingly desperate, she visited several private hospitals, only to be told she would be charged a fee that she had no way of paying with her teacher’s salary. “Weeks went by and I was getting more and more nervous, imagining that I would end up somewhere clandestine and unhealthy,” she says.

When she finally found a private clinic she could afford, she still had to attend a lecture by the resident gynecologist, telling her that she should try to persuade her partner to get married and have the baby.

The operation seemed to go smoothly, but three weeks later he began to bleed.

“I had a fever and pieces of coagulated blood were coming out of my body,” he says. At the nearest public hospital, doctors performed an emergency operation after discovering that her abortion had not been completed. “I was treated at one of the hospitals where they had told me that abortions are not performed. It would have been so easy and safe if they had agreed in the first place,” says Esra.

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She now worries that she will not be able to have children after experiencing persistent pain after the operation.

In Turkey, the right of women to access free and safe medical abortions is increasingly under threat. After the law legalizing abortion was introduced in 1983, the number of abortions increased in the following five years to 45 per 1,000 women between 15 and 49 years old. Ten years later, she was down to 25. A study for Kadir Has University found that by 2020, there was not a single public hospital performing abortions on demand in Istanbul.

Two women dressed in traditional Muslim dresses with black hijabs look out over the Bosphorus Strait in Istanbul, Turkey
Women who seek abortions in public hospitals are wrongly told that they are prohibited or legal only for married women. Photograph: Alexey Panferov/Alamy

According to the survey, only eight of Turkey’s 81 provinces have at least one public hospital that performs abortions on demand, and only two of them have more than one. Of the 295 clinics surveyed, 14% said they would not perform abortions for reasons other than a medical emergency.

The study found that health workers often tell women that abortion is prohibited or legal only for married women. Single women cannot access the operation or must bring a permit from the local prosecutor’s office. All this is false.

The Guardian interviewed more than a dozen Turkish women who had had abortions in the past three years. All said they were forced to seek terminations at private clinics, as public hospitals refused to perform the procedure. They said that in some hospitals they were told that they were prohibited from doing terminations.

“There is a de facto ban in many places,” explains Filiz, a nurse at a public hospital in Istanbul where abortions are not performed. “According to Turkish law, a doctor cannot tell a woman that she cannot have an abortion, but the refusal is very common, which forces women to beg from hospital to hospital,” says Filiz, who prefers not to give the her last name.

This de facto ban appears to be shaped by the increasingly populist and hard-line approach to abortion taken by the Turkish government. In 2012, Recep Tayyip Erdoğan, then Prime Minister, described abortion as “murder”, and proposed a bill to restrict it to only the first six weeks. Mass protests broke out across the country and the proposal never became law.

Reproductive health activists, however, say that many parts of the public health system have since aligned themselves with the government’s increasingly anti-abortion position, underscored by Erdoğan’s repeated wish that “every woman should have a baby.” least three children.

“We have seen more and more how hospital administrations put pressure on doctors not to perform abortions,” says Irmak Saraç, an obstetrician and member of the Istanbul Medical Chamber’s women’s commission. “The conservative atmosphere and the debate about the fetus’s right to life is increasing the rate of conscientious objection.”

He adds: “On many occasions, family planning units where abortions were performed have been closed, or new doctors have not been assigned when obstetricians retire.”

A veiled woman with a mask against a background of water and buildings in Istanbul, Turkey
For most women in Turkey, the fee for a private abortion is out of their reach. Photograph: Zuma Press, Inc./Alamy

A private clinic told The Guardian that the fee for an abortion is around 3,000 lira (£146), although prices rise with each week of pregnancy. This makes access to an abortion difficult for many women in a country where the monthly minimum wage is around £243 and only 30% of women of working age are in formal employment.

Many of the women who spoke to The Guardian said they had faced hostility, discrimination and abuse from health workers in trying to access their right to safe and legal abortion.

Ilknur, 28, is from Köycegiz, a small town on the Aegean coast. A year ago she became pregnant and traveled to Istanbul to have an abortion. “Being from a small town, I was afraid the doctor would meet my parents and they would find out,” she says.

Ilknur was five weeks pregnant, and with the help of two friends, she called more than 20 public hospitals in Istanbul. They all denied her an abortion. “I started to get really scared because I figured it would be easy,” she says. “I even talked to hospitals in other cities near Istanbul, but found nothing.”

Two weeks passed and Ilknur began consulting private clinics. With her savings she paid 3,500 lire for the abortion. “All the time, I was wondering about women in more conservative cities who don’t have this kind of money,” she says.

On her first visit to the clinic, the doctor was kind and courteous. “But when I went to have an abortion, the same doctor and nurse started being very cold,” she says.

Ilknur was given a local anesthetic but a few minutes into the procedure, she felt severe pain in her stomach that made her move her legs. “The doctor told me: ‘Open your legs, this is nothing. If you were able to spread your legs to get pregnant, now you can too.’”

Ilknur was stunned. “I just couldn’t look at it again. The nurse didn’t say anything. He was so embarrassed.”

After the abortion, she did not return to the clinic for a check-up. She thought about filing a complaint but did not want her family to find out about his abortion.

Across Turkey, some health workers, including Filiz, are now trying to help women access their right to safe abortion by drawing up lists of medical personnel who are still willing to perform free abortions.

Filiz says, “Several of us made a list of doctors who agree to perform abortions and distributed it to grassroots organizations and feminist groups to help other women. But it is impossible to get this information to all those who need it.”

*Names have been changed to protect identities

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