“Referendum on Sunday, working group on Monday”: A success story of implementing abortion services after legalization in Portugal

Bianca M. Stifani, Duarte Vilar, Lisa Vicente

Research output: Contribution to journalArticle

Abstract

A 2007 referendum legalized abortion in Portugal. Physicians played an important role advocating for legal reform and providing services thereafter. Implementers relied on a strong public health system with many gynecologists who required minimal training, and took decisions that allowed for rapid implementation. First, they emphasized medical abortion and integrated abortion into existing hospital obstetrics and gynecologic services, where eventual complications could be managed. They also offered immediate postabortion contraception, helping prevent criticism from abortion opponents who feared women would obtain multiple repeat abortions. Finally, they established referral networks guaranteeing access despite conscientious objection. Media campaigns were not needed as Portuguese women had good access to information. Portugal's success is largely due to key facilitators within a working group established by the Ministry of Health to implement the new law. Remaining challenges are the lack of choice between medical and surgical abortion, and some regions with relatively difficult geographic access to services.

Original languageEnglish (US)
Pages (from-to)31-37
Number of pages7
JournalInternational Journal of Gynecology and Obstetrics
Volume143
DOIs
StatePublished - Oct 2018

Fingerprint

Portugal
Access to Information
Aftercare
Contraception
Obstetrics
Referral and Consultation
Public Health
Physicians
Health

Keywords

  • Advocacy
  • Implementation
  • Legalization
  • Medication abortion
  • Portugal
  • Public health
  • Referrals
  • Safe abortion

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

@article{d9e5c48ee73a45f3b721fc2b34c6b7b3,
title = "“Referendum on Sunday, working group on Monday”: A success story of implementing abortion services after legalization in Portugal",
abstract = "A 2007 referendum legalized abortion in Portugal. Physicians played an important role advocating for legal reform and providing services thereafter. Implementers relied on a strong public health system with many gynecologists who required minimal training, and took decisions that allowed for rapid implementation. First, they emphasized medical abortion and integrated abortion into existing hospital obstetrics and gynecologic services, where eventual complications could be managed. They also offered immediate postabortion contraception, helping prevent criticism from abortion opponents who feared women would obtain multiple repeat abortions. Finally, they established referral networks guaranteeing access despite conscientious objection. Media campaigns were not needed as Portuguese women had good access to information. Portugal's success is largely due to key facilitators within a working group established by the Ministry of Health to implement the new law. Remaining challenges are the lack of choice between medical and surgical abortion, and some regions with relatively difficult geographic access to services.",
keywords = "Advocacy, Implementation, Legalization, Medication abortion, Portugal, Public health, Referrals, Safe abortion",
author = "Stifani, {Bianca M.} and Duarte Vilar and Lisa Vicente",
year = "2018",
month = "10",
doi = "10.1002/ijgo.12675",
language = "English (US)",
volume = "143",
pages = "31--37",
journal = "International Journal of Gynecology and Obstetrics",
issn = "0020-7292",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - “Referendum on Sunday, working group on Monday”

T2 - A success story of implementing abortion services after legalization in Portugal

AU - Stifani, Bianca M.

AU - Vilar, Duarte

AU - Vicente, Lisa

PY - 2018/10

Y1 - 2018/10

N2 - A 2007 referendum legalized abortion in Portugal. Physicians played an important role advocating for legal reform and providing services thereafter. Implementers relied on a strong public health system with many gynecologists who required minimal training, and took decisions that allowed for rapid implementation. First, they emphasized medical abortion and integrated abortion into existing hospital obstetrics and gynecologic services, where eventual complications could be managed. They also offered immediate postabortion contraception, helping prevent criticism from abortion opponents who feared women would obtain multiple repeat abortions. Finally, they established referral networks guaranteeing access despite conscientious objection. Media campaigns were not needed as Portuguese women had good access to information. Portugal's success is largely due to key facilitators within a working group established by the Ministry of Health to implement the new law. Remaining challenges are the lack of choice between medical and surgical abortion, and some regions with relatively difficult geographic access to services.

AB - A 2007 referendum legalized abortion in Portugal. Physicians played an important role advocating for legal reform and providing services thereafter. Implementers relied on a strong public health system with many gynecologists who required minimal training, and took decisions that allowed for rapid implementation. First, they emphasized medical abortion and integrated abortion into existing hospital obstetrics and gynecologic services, where eventual complications could be managed. They also offered immediate postabortion contraception, helping prevent criticism from abortion opponents who feared women would obtain multiple repeat abortions. Finally, they established referral networks guaranteeing access despite conscientious objection. Media campaigns were not needed as Portuguese women had good access to information. Portugal's success is largely due to key facilitators within a working group established by the Ministry of Health to implement the new law. Remaining challenges are the lack of choice between medical and surgical abortion, and some regions with relatively difficult geographic access to services.

KW - Advocacy

KW - Implementation

KW - Legalization

KW - Medication abortion

KW - Portugal

KW - Public health

KW - Referrals

KW - Safe abortion

UR - http://www.scopus.com/inward/record.url?scp=85055613463&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055613463&partnerID=8YFLogxK

U2 - 10.1002/ijgo.12675

DO - 10.1002/ijgo.12675

M3 - Article

C2 - 30374988

AN - SCOPUS:85055613463

VL - 143

SP - 31

EP - 37

JO - International Journal of Gynecology and Obstetrics

JF - International Journal of Gynecology and Obstetrics

SN - 0020-7292

ER -