March 19, 2024

In October 2023, the Ministry of Health in Georgia introduced new restrictions to accessing abortion care in the country. This surprising move was not made in consultation with any health experts and has already led to a number of challenges for those seeking abortion services.

Though officially abortion is available on request up to 12 weeks of pregnancy, these new amendments introduce additional obstacles to the procedure. These mandatory requirements conflict with the World Health Organisation’s (WHO) recommendations, particularly regarding pre-abortion counselling.

People seeking abortions are forced to undergo a compulsory five-day waiting period. 

This was always the case, but now even the flexibility of reducing the waiting period to three days for pregnancies above 12 weeks gestation has been removed.

The WHO recommends against the imposition of enforced waiting periods for abortion care. The evidence shows that such measures delay access to abortion, and can increase the logistical and economic burden on those seeking care, sometimes to the extent that the abortion becomes unattainable. There is no medical reason to force women to wait for an abortion, and in fact it undermines their autonomy to make a decision about their own pregnancy.

We were therefore shocked when the Ministry of Health announced that patients seeking abortions must now first have an interview with a social worker, psychologist, and obstetrician-gynaecologist.

Abortion-seekers must also undergo more than one mandatory ultrasound. 

Again, this flies in the face of expert advice. The WHO recommends against the use of ultrasound scanning as a prerequisite for providing abortion services, noting that it is “not necessary from a clinical perspective.”

Patients are required to have an ultrasound during their first visit to a clinic to determine the gestation period. And now it is also mandatory to have a second ultrasound after the five-day waiting period. This additional step of course contributes to an overall increase in service costs. It is also a waste of the patient’s time, and not medically required.

A medical abortion can now only be performed in a specific type of medical facility. 

Abortions can only be performed in an in-patient medical centre by a certified obstetrician-gynaecologist. This limits the locations where abortion care can be provided, but also those who can provide it. These valid centres are mainly in cities so this affects those in rural areas particularly.

If the doctor violates the five-day mandatory waiting period, that can cost them their licence. If the prescription for abortion medication is made by anyone but an obstetrician-gynecologist and/or reproductive specialist, that can be classified as a criminal act.

Understandably we are hearing that in trying to navigate the complexities of these changes, some doctors are hesitating to provide services due to uncertainties.

We continue to do our best to support people seeking safe abortion care in Georgia. 

We work with a number of communities who are already underserved when it comes to abortion care. They will be most at risk from these additional barriers. People have already told us they are getting stigmatizing questions from psychologists about seeking abortions, for example “Don’t you think you might regret it over time?”. Given these conditions, our focus now shifts towards developing a trained pool of social workers and psychologists equipped to provide adequate counselling. We aim to negotiate with clinics to reduce the costs of secondary ultrasounds and psychologist services, offering them our support free of charge.

We are also actively engaged in advocacy to remove these punitive requirements. We are pleased that civil society organisations and professional associations are also vocal about their opposition to these amendments. We stand alongside the entire National Reproductive Health Coalition in fighting for fairer access to abortion care.

By Medea Khmelidze, Program Manager at Real People Real Vision, a SAAF grantee partner in Georgia.

Source: https://saafund.org/georgia-restrictions-to-abortion/