The Underground State of Women

Podziemne Państwo Kobiet” is both a documentary and a collection of abortion stories from Polish women who had illegal abortions in the past two decades. Poland most likely is the only country in the world that had abortions legal by law (1956-1993) and changed it “backward”. We ended up having one of the most restrictive laws in the world, and the legislators were smart, by avoiding criminalizing women (with whom society would sympathize) and focusing instead on everyone else who assists with abortions (the penalties are up to 8 years in prison), creating a system of fear and paranoia.

The first thing that strikes about abortion in Poland is the statistics - according to Polish Ministry of Health in 2013, there were 744 legal abortions and 718 of them due to the risk of birth defects. 3 of them due to rape and 23 due to the risk posed to women health. In 2015 there were 1044 legal abortions. For a country with 38 million inhabitants, these numbers seem just wrong. In Spain or UK, these numbers are 200 or 400 times higher. And it’s estimated that illegal abortions every year account for between 80.000- 200.000 cases in Poland.

So, what kind of abortions are available in the underground and how do women access it?

Chirurgical abortions are one of the common ways. They usually happen in hidden spaces, often barely up to any standards, with basic equipment, sometimes only in the presence of doctor (women who come to get the abortion might end up assisting them). The price of an abortion is at least 2000 zl (500 euros), and it tends to go up with the standard. In some cases, when doctors are well connected, they can even perform them in hospitals, which would double the price. Many doctors who refused to perform a legal abortion are perfectly fine with doing it illegally after settling the price with their patients.

Considering that the minimal wage in Poland is 1850 zl, and the average is 4000 (yet many people struggle to get contracts, work on 3/4 of full time, or often work on irregular gigs earning even less than 1000 zł a month with no minimal wage per hour), the price is quite prohibitive and exclusive. Many women end up taking loans to pay off their abortions.

Nowadays, women contact pro-choice organizations to find out who can help them with abortion. Since the 90ties, press and internet advertisements were the ways to find doctors who’d perform them. Such services would be named as “painless restoration of menstruation” - and involve either chirurgical help or access to drugs, highly overpriced. In many cases a friend or a relative knows who does it in your town. The fear and paranoia remain anyhow - women are asked to leave the clinic right after the procedure is done, regardless of their condition, in order not to bring suspicion. They’re asked to park their cars far away from the place of appointment.

Some of the informal groups specialize in organizing abortions abroad. Ciocia Basia, a group of volunteer activist, helps to organize legal abortions in Berlin. For a price of 290/390 euros, they arrange pharmacological and chirurgical abortions in clinics, help with translations and offer a couch for the women coming over. Another popular destination is Slovakia and Czech Republic - it’s super easy to find websites in Poland of clinics in these countries that provide with professional and anonymous help. Prices are similar to those in Polish underground.

And then you have the pharmacological abortion. There are two drugs containing misoprostol registered and available in Poland, one of which can be bought without the prescription. Women usually end up making up stories about stomach pain or rheumatic grandmothers to buy them. Sometimes both of them can be obtained from “under the counter”, forums also advise to ask a man to help buy them. Misoprostol should be accompanied by mifepristone to increase effectiveness (the combination of both has 98% effectiveness, while only misoprostol alone is between 80-90%), but the latter drug is not registered in Poland. In this case organizations such as Women on Waves help to buy and ship them from other countries (they ask for donation of minimum of 70 euros, but they do support women in economic difficulties by providing them for free). It is well known that some of the doctors write prescriptions for these drugs (a pack of 12 costs 25 zl, but can be sold 10 or more times more expensive on the black market) and help women get access to them via advertisements. It’s impossible to track as these drugs are not refunded by the state - therefore not registered anywhere.

Due to lack of widespread support, some of the women organize support groups on online forums. They look for other women who seek abortions or just had one, share their stories and explain to each other what happens to their bodies, how to access drugs, if nausea is a normal reaction to pills, etc. As in some cases, pharmacological abortion can lead to prolonged bleeding and even death, they offer each other a call of support during the abortion, which takes up to a day. It’s recommended to call for an ambulance in case of emergency - doctors cannot tell if the miscarriage was illegally inducted or not, and that save lives in some instances of home abortions.

I am still reading some more about the abortion underground in Poland, and if I find some more interesting facts, I will updated this text. I also encourage you to share your stories on how women access abortion in countries with restrictive law.

Who would have thought Poles have it that bad

I didn’t know the full extent of the situation when over the past weeks the world was following protests against anti abortion regulations…  I mean, having parents who lived through a communist pro natality decree and anti-abortion strict controls coupled with the shadyness of alternatives (one hears stories…)  does give me an idea… But present times, whoa.  Thank you Natalia for sharing.

How do the informal groups survive in this scene? Is there low enforcement and little policing which allows them to circumvent laws?

Also,  are you hopeful after the so called success of the protests?

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In fact, I think that the abortion underground functions so well purely because  and thanks to the hypocrisy of the Polish society. Probably after decades of liberal regulations to some extent women are aware of the fact that abortions are needed, but catholic brainwashing has been so effective, that they’re trapped between the moral and the pragmatic views on abortion. Now what seems to prove this is that women are not interested in lobbying for their right to abortion - they somehow agree to comply with the rules by having them underground and accepting the stigma, rather than fighting for their rights. Imagine even if the lowest estimate of 80.000 women having illegal abortions a year is right, and 10 percent of them would be up to fight with the system on that, we’d have a pretty great leverage to change the law by now. But we don’t. have that. Well, at least until now - but this remains to be seen because we also have a conservative revival going on and if the church steps in, you never know who’d stay on top of things. I’d rather not expect us going any more liberal than we’re at the moment.

Another thing is that part of the available options just use the loopholes, they’re not illegal. I guess you can’t stop a woman from going abroad or having pills. And a lot of turning the blind eye on the doctors who i believe are well known for doing the abortions despite working underground.

About the movement now, I think there is a chance for some momentum - but I’m not too optimistic about it. We’re observing a bit mobilization of civil society ever since the new government came into power, but that rarely brought any results. At the end, they use their democratic victory to pass any decision they seem fit - and giving up on a project of an outrageous reform just to keep rather shameful status quo is not a huge failure for them I believe. We might be building awareness and capacity for the future right now. Let’s see.

Communities to the rescue!

These stories are quite ghastly. The silver lining is that communities tend to step into giving care, and to do so more when the care problem is “close to home”. In the end, reproductive health and control over one’s body are an absolute, so prohibitions don’t work. People go underground, organize informal networks, and things happen anyway.

And this means that, maybe, a good way to do public policy on care is just to let people free to provide for each other, then step in to help with those which are obviously the most pressing concerns, such as this one. Concerns are revealed by the efforts put into addressing them, even when that means breaking laws and running the risks associated with it.

Of course, my remarks refer to a theoretical world without politics, where all decision makers are serene, evidence-oriented and well-meaning. :slight_smile:

Can P2P create preventive solutions?

While this story documents the power of underground networks to find pragmatic solutions, I am wondering if and why “P2P care” solutions do not equally pop up to create solutions through prevention (that is, preventing the pregnancies in the first place)? It could be that P2P solutions have a problem with collective motivation here, just as governments tend to rather react that act proactively, but more severe since P2P / underground solutions are so resource constrained. If so, that could point to a major issue with all P2P solutions into care (that is, making for a nice research focus).

I’m pretty sure there is common ground to say prefentive solutions are preferrable (assuming that women who are undergoing abortion would have preferred not to, that is, not to have become pregnant in the first place). So, no need to refer to laws or morals. Even if the law allows it, there is still reason to prevent pregnancy.

So even though contraception is widely available in Europe, on a society scale there are still this many unwanted pregnancies. What I’m wondering here is about the reasons for this, and what P2P initiatives can do and are doing here? Of course this will have to do a lot with slow-changing “fuzzy targets” like culture, taboos, sexual practices and preferences. A crazy story from Nepal about how all this impairs the use of “normal” contraceptives among the young generation is this one (Natalia found it some time last year). But in Europe …? What’s going on here?

On communities, unwanted pregnancies and laws of large numbers

@Matthias and all, the Amish story points rather to the fact that communities do go for prevention, at least in some cases, and in a way that no health system does. @Lakomaa thinks this is because in modern care system, the entity receiving the care and the entity paying for it are always separate: sick person vs. taxpayer for state provision, insured-insurance company for private sector provision. So, it is always privately optimal to dump the cost of healing onto others, rather than assume the cost of prevention oneself.

Seen through this lens, community provision is fundamentally different, because the entity receiving the care is not an individual, but the (sub-Dunbar or equivalent) community, and that’s the same as the payer. Hence the apparent lack of market failure in care provision among the Amish.

So what’s going on with prevention of unwanted pregnancies? Public health people I have talked to tend to shrug and say it’s endemic. The window of opportunity for stupid and careless behaviour is a little too wide, the drive for instant gratification over prudence is literally a biological imperative, and even the best contraceptives only have a 99.99% effectiveness. If, say, in Italy you have about 20 million couples, if 10% of them are having sex tonight and all of them use contraception, you are going to get 200 unwanted pregnancies tonight, in just one European country. Best you can do is reduce the incidence of such incidents, but no human society ever achieved zero unwanted pregnancies.

This article on Time explains how women access abortion in Ireland - basically, same as in Poland. It also adds an interesting research on how women feel about abortions after performing them.

"Ninety-four percent of the 1,023 women who completed the at-home abortion said they felt grateful for the option, 97% said at-home mediation abortion was the right choice for them, and 98% said they would recommend the option to other women with unwanted pregnancies.

When asked about their feelings after completing the abortion, 70% of the women said they felt relieved, which was the most common sentiment expressed, followed by 35% who said they felt satisfied.

“What I think is most striking is that women reported these clear benefits for their health and wellbeing and anatomy,” says Aiken. “I think it really demonstrates that women can make the best choice for themselves when it comes to their own reproduction. The only negative thing about this is that women reported they had to do it against the law, and they went through considerable stress and anxiety and secrecy and isolation and shame.”

Co myślicie o zaostrzeniu ustawy antyaborcyjnej? Czy uczestniczycie w akcjach Strajku Kobiet? @Ja-Rek, @Pracownica, @matka, @JustMe, @Pepe, @mariolamayra, @ALaAl, @Adam, @Sonia, @AndrzejMazur, @EwaSJ, @michal.trzesimiech, @EwaJ-L, @miloskonjovic82, @Justin, @Wiciu, @Annaz, @Ewa_Dryjanska

In a world when we just lost 90% of our civil rights since march 11, abortion is just one of the topics. We should not focus on this but focus on who owns ones body in general and having the right to make decisions about our bodies and our health. Its time to really face the truth: we are not allowed to leave home, we are not allowed to work, we are not allowed to breathe freely, we are not allowed to meet, we are not allowed to demonstrate, and the governments could inject whatever crap they want in our bodies and our children bodies without our consent. Why do we discuss abortion at all? Once we solve the main problem, my body, my choice, the abortion problem will be no more. Abortion was put on the table now to divide society, lose our energy and hide that there is something much worse going on behind, straight way to global slavery. I can’t just believe people do not see this and keep on discussing “just abortion” while there is an on-going global fight to not be treated as farm factory animals. And of course women rights are part of it but it’s just about human rights in general now. So yes its good to have women protesting but it is not enough now to save us from global dictatorship. It is also about understanding there is nothing good in having to choose abortion although it is absolutely key that this choice stays a woman choice. In some countries you may have the right to get abortion, still you are forced to put your kids at school as soon as 3 years old and you are not allowed to decide how to take care about their health because the state does. No it’s not North Korea, it is France. So it’s a bigger issue than women rights in Poland. Of course, fully supporting that but it is kind of a mistake to limit the problem of body ownership to the abortion rights in Poland while it concerns all humans on the planet now.

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Hi @Sonia, thanks for your contribution to this topic - it’s been 4 years and it is a shame to see that nothing has really changed, if anything the altright parties have gathered more support across Europe! I’m writing this as in my own country (Romania) a new right wing, ultra conservative movement have ‘surprisingly’ and out of nowhere just won 10% of the seats in Parliament…

The human rights issue is highly politicized - if you’d ask people if they believe in human rights probably many would say yes at the general value level, but when you start drilling on how this breaks into specific policy measures, that’s when it becomes so polarizing and comes down to war. Especially in the case of abortion, the opponents claim exactly that: that every life has value and who are we to curb it… you see, the more high level the debate, the harder it is, because value-based conflicts are so incredibly hard to win.

While I agree with you on the general need to look at things with a broader perspective and not be happy with these smaller wins and file them under ‘progress’, what to do? Which fights are you personally picking to send this message of ‘Once we solve the main problem, my body, my choice, the abortion problem will be no more.’?

Paging @AskaBednarczyk and @pwawrzynczyk because I think this discussion could be very relevant to their field of work…

This story speaks volumes about how hard it can be on a practical level… and how it is hard to even get your head from the sand to see the bigger picture… when human rights can also mean minimum income!

@Sonia, I share your concern about the world getting more authoritarian, though I would not put the abortion rights and the vaccination in the same box. Apparently, I have never met so many people opposing the vaccination or skeptical to it before. Maybe because in the former Soviet block countries the health care was centralized and free of charge. No one was asking the question where does the vaccine come from. Why do you think it is such a big topic in Poland right now? @maniamana, @Dosia, @michal.trzesimiech

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Wolha vaccines are a global topic, not at all a polish one. The truth about vaccines came mainly from the US whistleblowers and activists since already few years, with many informations being released in 2017. There are tons of materials available who can explain the problem better than me and if you have not done your research its difficult to say where to start. However before answering your question I would ask you rather why do not put it in the same box? It is about somebody in the government outside deciding about your body, your health and your life or death (or these of your children). So what is the difference?

I haven’t heard that Ordo Iuris have some interest in the anti-vaccine discourse, that is why. Great that there are also pro-choice initiatives with strong visual imagery https://www.dazeddigital.com/art-photography/article/51421/1/barbara-kruger-artworks-plastered-on-polish-streets-in-pro-choice-protest

Wow, Sonia, I had no idea you are anti-vaccines and somehow I missed the hints in your first comment. Do you think this about all vaccines or just some?

In a funny coincidence, this morning I was going through a playlist of videos from one of my favourite youtube channels, and I watched this video. No need to go into a lot of debate technically (both sides can come with tons of evidences), but I’m curious when you started being anti? Growing up in our countries, like Wolha says, no one was talking about it and I suspect we all got our childhood vaccines right? But now times have changed…

Hi I am not anti vaccine like I am not pro abortion. I am pro freedom of choice and against the government or anybody else owing an individuals body because this is called slavery and violence. You actually were right in your interpretation because my text was not about vaccines, they are just a part of the much larger picture. Abortion in some cases is not good and vaccines in some cases could maybe be life saving but I am for the individual right to decide. My text was among others about every medical procedure in relation to the Nuremberg trials which happened after WWII and it was stated, as a lesson learned from concentration camps, that no medical procedure or experiment should be ever forced on people. Last 10 years many laws were changed all over the world that are against this basic principle. Its not only about vaccines but for example doctors having the right to quarantine you for 60 days and administrate you medicine against your will (including using police force), people being forced to undergo chemotherapy against their will (many cases in the US), people being detained in hospitals, and more widely what we saw with the pandemic. People being detained at home, forced to wear masks, businesses being closed over the health pretext etc etc. Not even talking about speech freedom, censorship and the right to demonstrate. So this is a very large topic, about your civil rights in general, even the very very basic ones. My body my choice also related to for example LGBT rights. But of course this year what we saw was the end of any civil rights and even though vaccines for all are coming to the picture now, which was obvious since the beginning, they are just an element. But it has to be said there is a very strong censorship on the internet about this topic which means there could be more here at stake than people think. For example Vimeo puts vaccine skepticism in the same box than terrorism and child porn. So it means if you have any doubts you are not allowed to express them on major internet platforms. That itself should raise doubts because it just means you are not allowed to question or ask and medical science is not mathematics, its evolving and we shall have at least the right to access all the information available before making decisions. Some years ago some medical procedures were considered good which today are considered harmful. But coming back to the main issues- the basic issue is once you allow the government with pretext like „public health and safety” to do what they want with individual people, there is no more human rights and freedom. “Public safety”, meaning terrorism threat was also used, especially in US and France to enforce major control and decline of individual rights. That also is not something new but for example in France, home schooling was just canceled this year. They also installed preschool obligation for children starting 3 years old. As a pretext they used terrorism. Meaning that in France they force people now to put 3 year olds which can be emotionally not ready to public preschool for several hours per day. This is just taking away any parental rights and separating parents from children, under the pretext of giving education and preventing terrorism. The right of parents to choose the education they want for their kids which was won over 100 years ago was purely and simply canceled. Things like this are happening all around. So what we see around the world is extremely worrying and it includes all rights being taken away. If we go down the road we cancel everything that was won in terms of human rights during last 200 years. So as I said- vaccines are just a kind of example and top of the iceberg. They just show mechanisms in terms of corporate lobbies and interests taking over in the human rights battle, but the same is happening in all major areas. I am actually not a health specialist neither a human right specialist but the exactly same things are happening in relation to food sovereignty, a topic I have been working on since 10 years or so. People being prevented to save and exchange seeds, land grabbing, farmers being prevented to go out to the fields, GMOs being enforced all around the planet, patents on seeds and patents on plants and animals. Same mechanisms, same companies, same interests. Peasants rights standing lower than so called „public health and safety” (UN declaration on peasants rights, adopted in dec 2019. A very good declaration but worth nothing if issues of public health and safety arise, nobody has any right any more). So that’s the bigger picture.

I won’t write more on vax , because it is not my main topic as already said, but there is plenty of materials to research if you are interested. Because despite the censorship you can read leaflets, read the laws, the official governmental sites where some side effects are reported, the indemnisation funds for vax injured people, the list of companies financing The WHO, and so on and so on. And no its not the same neither the same number of vaccines we got when we were kids, not even the same list of diseases. Anyway, I think with the new Covid ones, even the more pro vax people start to wonder how possible you can say after few months it is safe to inject something that actually impacts your gene (DNA) expression, with no long term studies, no representative population groups, actually nothing done according to very basic science principles. But I am completely for the right of INDIVIDUAL people to decide for themselves what is more risky- to take it or not. Same concerns abortion, sexual orientation or education choices.

Well guys, I hope it gives some food for thought but now I really have to take care of the topics I am really involved in which are basically regenerative agriculture and food sovereignty. But the thing is if we loose our human and civil rights we loose it all at once, and if I am not allowed to go out or buy and sell food, that’s more annoying tan just having bad agriculture subsidies scheme.

Best
Sonia

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Ordo Iuris is just one of many NGOs fighting for SOME human rights and they are specialized in some topic, not others. They also have a clear let’s say conservative or maybe right wing orientation if you wish which means they are rather against abortion from what I see and against LGBT which is not fully prochoice, although they seem good defenders of parental rights. For me being pro choice and pro human rights exceeds all left/right divisions which I consider totally artificial and actually hiding the true topics. Human rights or human bodies are not right or left they just are. Individual choices are either possible either not. But the current political split is done in a way than no existing political party supports individual freedoms in all main aspects of life. I think this divisions are enhanced on purpose because instead of focusing on the humanity, we focus on left fighting right. So for example left is in theory progressive because of LGBT and women topics but actually enhances governmental control through taxes, medical centralization, control of education and no religious freedom either (it is anti religious). Right is in theory more liberal in terms of economic rights and cares more about parental rights and education choices, but actually no religious freedom either (it is basically for one religion against others), and its certainly more against woman rights. So that’s like a choice between the red prison and the blue prison. In both cases you end up in prison. So I would be very surprised to see any bigger recognized institution working outside of this very old left/right scheme, which basically comes back to communism and fascism. Which we have already seen in action enought o be sure we never want to repeat any of them. So It may be shocking for some but I have not voted in last elections because I refuse to make a choice that is not a real one.

Sonia, thank you for sharing your thoughts on those highly polarizing the society topics. I would say that the rights for the healthcare are not just individual, they are collective, and what may not have value to you today may have value to the entire population, the entire way of life tomorrow. Concerning the vaccine, there is a general trend towards mistrust in the current medical system in Poland, we were talking about that during one of our webinars, please check the documentation Dokumentacja: Webinar Czym jest dla Ciebie opieka? Jak Ty pomagasz innym w trakcie pandemii?

Wolha
Thank you for this reply, but in general I highly disagree with labelling anything as collective. This is a very communist approach- collective farms, collective responsibility. Used also by fascist regime to punish people during war time. Human rights are not and never were collective they are based on principle that all and every human being has the same rights as individual unique person human and not as just a part of a collective. Owing your own body is a basic individual right. The collective is not something that exists it is a fictional concept, the same concerns „public health and safety”. The collective was always used in extreme left regimes and history already proved that there is no collective „good” if there is no individual good. At the opposite of „collective concept” are real living people who are not just statistical numbers. If you start to use the collective approach, there you get an excellent argument to destroy also any minorities rights. I do agree with the concept of common good but this is something different which means that they are some given resources on Earth that all people shall have a right to access, benefit from, and preserve them for future generations as well. Basic resources include air, water and land. This is the life basic. I also could eventually agree with the concept of social justice but it is also something that has been twisted and misused so that is another conversation. And as far as the questioning of vaccines is concerned, vaccines are not manufactured in Poland, neither by polish companies as far as I know so this has in my opinion not much to do with the mistrust in the polish health system which obviously is not in good condition since quite a long time. The main reason for the mistrust in the medical system in Poland is just a very high cost of the obligatory health taxes (ZUS), which basically hits mostly medium and small enterprises but in general is a big burden for the economy and any entrepreneurship, coupled with a worsening access and level of services and low effectiveness (and the necessity to use paid services even though you do pay the obligatory health insurance). The mistrust in vaccines on the contrary is a very global issue (and now with the pandemic has become a really planetary one) as already said. Its related to huge corporate interests, enormous amounts of money, politics, monopols, biodata ownership and body ownership, and not just purely medical questions which would probably require to get into another discussion and as we are not healthcare practitioners its maybe not the right place to do it. Still I am very in favor of a free health care for all but you have to distinguish health care and service to others from global population control mechanisms. Summing up, I do not believe in collective responsibility, only individual one, and there is no responsibility when you are not allowed to make decisions. If the government decides whether you should give birth or not, have a chemo or not, getting a flu shot or not, it means you are made actually totally irresponsible about your own life under the cover of being „collectively responsible”. It is both illogical and using people’s good intentions to actually deprive them of their basic civil rights. It uses the mechanism and argument of sacrifice yourself for the benefit of others, and there is a lot of playing on these emotions lately. The point is this is not logical and also it is not true. It is only by preserving the individual rights of humans that we can help humanity.

Best

Hello @Sonia, my name is Alberto. I just wanted to thank you for what you wrote. I can’t read Polish, and really appreciate that you made the effort write in English. As you say, food for thought.

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