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Restricting Abortion: A Questionable Tool for Increasing Macedonia’s Birth Rate

by Natasha Dokovska

In 2013, Macedonia’s Christian Democrat party adopted a new law on termination of pregnancy restricting a woman’s right to a safe and legal abortion. Macedonia’s new abortion law has generated controversy not only for the non-scientific, degrading manner women and their physicians must secure approval to have an abortion, but also for the questionable manner in which the law was approved. Despite this new law, intimidation by the government and the Orthodox Church will not win over women’s rights in Macedonia. Women will fight for their human rights.

A demonstration in Skopje. Photo courtesy of Stefani Nakova.
A demonstration in Skopje. Photo courtesy of Stefani Nakova.

Macedonia, which is on a path toward inclusion in the European Union, is committed to democracy. However, the new abortion law was not adopted by democratic means. There was no public debate and opposing parties did not have a chance to vote. The only lawmakers that had a say in the new law were the members of the Christian conservative party, VMRO DPMNE. They pushed the law through without consulting women’s organizations or medical professionals prompting six members of the European Parliament, including Dutch politician and European Parliament Rapporteur on Women’s rights Marije Cornelissen, to state, “While we fully recognise that legislation in regards to public health, including in the area of termination of pregnancy, remains an area of national sovereignty, the manner in which legislation is proposed and debated is itself a telling sign of a country’s readiness to join the European Union and ability to meet the Union’s democratic criteria.”

According to the new law, a woman must submit a written request for an abortion to the health ministry and explain why she requires it. She must confirm that she has informed her partner or spouse of her intent to abort. She must submit an ultrasound from a gynaecologist. She must submit to counseling, where counselors will attempt to convince her to change her mind, and then she will need to wait three days to reflect.

Anna, a 32-year-old mother of three explains that, for economic reasons, she and her husband decided to abort.

“After I passed through the initial stages required after the request for the abortion, they finally took me to a room to perform an intervention. The doctor came in and told me that according to the new law, I was required to listen to the fetus’s heart for seven minutes. Can you imagine the anguish I went through? This is unheard of anywhere else. If I would have known I would be subjected to such torture, I would have gone to a neighboring country for the procedure.”

In fact, many young women do just that. With bowed head, a mother from Kumanovo tearfully recounts what happened to her 18-year-old daughter. “My daughter is gone. But this, what’s happened with her, let it be an example to other girls, but let it be an example to the state too.” The girl died of sepsis after having an abortion in neighboring Serbia. The abortion was performed in unsuitable conditions and with non-sterilized instruments. The girl’s friends say that she paid only 100 euros for the procedure. Her parents did not know where she was, nor did they know the location of the clinic. They learned that their daughter fought for her life for a week.

“I did not know she was pregnant,” said her mother. “If we had known, we would have supported her and would have kept the baby. So what if there was no partner? She was not the first woman in that position, nor would she be the last.”

Demonstrators gather in Skopje. Photo courtesy of Stefani Nakova.
Demonstrators gather in Skopje. Photo courtesy of Stefani Nakova.

In Serbia abortion is still legal and women are charged 150–250 euros for the procedure.  I have heard of gynaecologists in Macedonia who are willing to perform an abortion may charge over 1,000 euros. I am told that they must charge that much to cover the risk of being penalized by the Commission for Health, or worse, losing their license. According to one prominent gynaecologist from Skopje, who did not want to speak publicly and risk losing the license, “What if I am caught by an inspector? First, he will take my license; I will pay a severe penalty; I may even be jailed. Today no one wants to perform abortions in their office, and if they do, they charge a fat fee to cover the risk.”

While official figures show that in the past 10 years the number of registered abortions in Macedonia has decreased, at 20.5 per 1000 women in 2008, the number of abortions still remains above the Western European average, which according to the World Health Organization is 12 per 1000 women of childbearing age.

Why was this new law enacted in the first place? The gynaecologist I spoke with believes that this new law is intended to increase the birth rate in Macedonia, which, according to the World Bank, has seen a decline in recent years. In 2009, the government instituted a “baby boom” program and awarded benefits such as a life pension to a mother if she gave birth to a third child and stayed home to care for the children. If a family had four or more children, they would have their housing paid for and the children would receive financial aid for their education. The “baby boom” project was deemed unconstitutional, and it ultimately failed.

Currently there is no political will in Macedonia for changes in the law on termination of pregnancy or opportunities for mitigation. On the contrary, at least once a month new, stricter measures to punish doctors if they decide in favor of the patient and allow abortion are introduced and in the last six months the Government has spent about half a million euros for a campaign to raise awareness among women to abandon abortion.

If the current controversial abortion law is seen by many as the new tool for increasing Macedonia’s birth rate then a better solution is to improve the economic situation in the country to increase employment so future parents do not fear for the future of their children. In the current situation, where unemployment is over 27 percent, all Macedonians fear how to survive and many do not want to bear children for whom they cannot give the necessities of life.

natasha dokovskaNatasha Dokovska has been a journalist for over 20 years, covering social issues and human rights in Macedonia. She has been an editor for international policy, an advocate for human rights as an NGO activist and publisher, and has edited books related to peace journalism and other topics. She is the Executive Director of Journalists for Human Rights.

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