Developments in abortion policy in a context of illegality: the Belgian case from 1971 until 1990

This paper traces the history of the reform of the abortion law in Belgium from 1971 to passage of the new law allowing abortions in 1990. During the early part of this period reform of the state was underway and family planning services began to be organized despite the fact that advertisement of contraception was illegal. Clandestine abortions were performed by physicians other health professionals and nonprofessionals. Health professionals lawyers and concerned citizens created the Belgian Society for Legalizing Abortion in 1970 and imprisonment of a gynecologist who performed abortions brought the issue into the open in 1973 when contraception was legalized. From 1974 to 1978 abortion prosecutions ceased but began again in 1978 and lasted until 1986. Political opposition postponed until 1990 adoption of the new law decriminalizing abortion until the 12th week. During this period illegal abortion facilities were organized in public state-funded hospitals and abortion requests were decided by a medical team including physicians and social workers. Prices were affordable and the number and type of facilities grew. In 1985 despite the 1978 termination of the judicial "truce" 39 facilities performed abortion. Legalization led to an increase in the number of hospital facilities. During this 20-year period available data on abortion in Belgium increased dramatically and abortion deaths decreased. Abortion "tourism" fell after 1973 and between 1985 and 1989 the estimated abortion rate was 14/100 live births. Clandestine data were analyzed to reveal the sociodemographic characteristics of abortion seekers. Thus while political factors froze achievement of legal abortion in Belgium for 20 years the main features of the eventual abortion policy were being developed and put into practice before legalization at the high cost of legal prosecution. The illegal reform program also provided statistics showing that legalization had no impact on the abortion rate. The only weakness of the illegal abortion policy was that some women lacked geographic access to abortion providers.