U.N. and advocates raise concerns of abortion access for Ukrainian refugees in Poland

Ukrainian women who were raped by Russian soldiers are among the millions of refugees who have fled to Poland.

And they now find themselves in a country that severely restricts access to reproductive health care, including both contraception and abortion.

Poland has long been an outlier in Europe in terms of abortion law. It is one of only two member states of the European Union that has not legalized abortion on request. (The other is Malta).

And while courts in other parts of the world – Colombia, for example – are liberalizing abortion laws. Poland has been moving in the opposite direction. Abortions had previously been legal in cases of fetal abnormality but last year they too were barred by a 2020 court ruling.

Current Polish law still permits abortion up to 12 weeks when the pregnancy is the result of a crime — rape or incest — or when it poses a serious risk to the life or health of the pregnant person.

But in practice, activists and providers say, abortions for rape victims are almost never performed. "The rape exception is meaningless," says Mara Clarke, founder of the London-based Abortion Support Network. "You have to prove that you were raped with a certified letter from a public prosecutor. Expecting that anyone, Polish or Ukrainian, will be able to file a criminal complaint and obtain a conviction in time to access an abortion is ludicrous."

"The rape victim has to explain who, where and how," Krystyna Kacpura, president of the Federation for Women and Family Planning (Federa), a Polish reproductive rights organization, said in an interview by phone from her office in Warsaw. "Of course, for Ukrainian women who were raped by Russian soldiers, this is impossible. And anyway, many of them are so traumatized that they will not speak about it at all —not even with us."

Reports of rape by Russian soldiers

Over the nearly four months since Russia invaded Ukraine on Feb. 24, reports of sexual violence perpetrated by Russian soldiers have proliferated. The head of a U.N. team investigating possible human rights abuses in Ukraine told NPR that they had received "high numbers of allegations of sexual violence" in the areas around Kyiv when they were controlled by Russian forces.

While precise numbers are not known, Ukraine's ombudsman for human rights, Lyudmyla Denisova, reported that in the first two weeks of April alone her office received 400 reports of rape committed by Russian soldiers.

"In almost all of the cases reported to us, victims said that the rapes were committed by groups of soldiers," said Yuliia Anosova, a lawyer with La Strada Ukraine, a human rights organization that runs a hotline for victims of human trafficking and gender-based violence. "Some also mentioned that the soldiers did not use condoms, so one might assume that there could be a number of unwanted pregnancies."

In late March, a group of Polish politicians called on the government to expedite the legal abortion process for women who have been sexually assaulted by Russian soldiers and to ensure that rape victims are able to terminate their pregnancy in any public hospital – where doctors currently can decline to perform an abortion if they feel that doing so conflicts with their personal values or beliefs.

"So that they don't have to travel from Rzeszów to Szczecin, or from Lublin to Zielona Góra," says Wanda Nowicka, a member of parliament from the opposition Left Party.

Asked to comment on the availability of abortion services, the Polish Ministry of Health emailed a statement to NPR, noting: "Termination of pregnancy may be performed by a doctor in Poland in two cases, i.e. when: 1) pregnancy poses a threat to the life or health of a pregnant woman, 2) there is a justified suspicion that the pregnancy resulted from a prohibited act.

"When there is a justified suspicion that the pregnancy resulted from a prohibited act, the provisions of the Act [of March 12, 2022 on assistance to Ukrainian citizens] provide that this circumstance is confirmed by the public prosecutor, and termination of pregnancy is allowed if no more than 12 weeks have elapsed from the beginning of pregnancy."

Offering assistance to Ukrainian refugees in Poland

But concerns have been raised about the ability of Ukrainian refugees to gain access to reproductive health services, including abortion, in Poland.

Following a press briefing last week on the topic, the UNHCR, the world's top refugee agency, emailed NPR: "We are aware of reports surfacing on various forms of gender-based violence (GBV), including conflict-related sexual violence in Ukraine. Women and girls are at a heightened risk of GBV in the context of war and forced displacement, and more vulnerable to risks of exploitation and abuse.

"Survivors need safe access to life-saving multi-sectoral specialized care that is survivor centered. Immediate response services include case management, mental health and psychosocial support and clinical services such [as] emergency contraception and HIV prophylaxis. Sexual violence including rape may result in pregnancies. Although the law in Poland permits the termination of pregnancies in certain situations, survivors have reported practical barriers in accessing some of these critical services, which should be addressed, in alignment with national laws."

And that's where the abortion advocates are stepping in.

"We decided within the first week of the war that we would help Ukrainian refugees with access to reproductive health services," said Kacpura.

Kacpura and colleagues published a downloadable brochure in Ukrainian and Russian on the Federa site guiding readers through the various reproductive health services available in Poland and how to find them. And they set up a helpline run by a Ukrainian gynecologist, Dr. Miroslava Marchenko, who started volunteering with Federa after fleeing from Kyiv.

When a person asks about getting an abortion in Poland, Marchenko refers them to the websites of organizations abroad – such as Women Help Women or Women on Web – where they can order abortion pills to be delivered by mail. For those with pregnancies too far along to use pills, the Poland-based group Abortion Without Borders can help arrange travel to a clinic in a neighboring country. Poland does not prohibit the act of having an abortion, but anyone who assists a pregnant person in having an abortion could be prosecuted.

Indeed, in January 2021, the Polish activist Justyna Wydrzyńska was charged with "helping with an abortion" after she gave abortion pills from her own supply to a pregnant woman who told her that she was trying to escape an abusive relationship.

"What I did was a gesture of the heart," said Wydrzyńska in an interview by phone from her home in Warsaw, where she's currently awaiting her second trial hearing. If found guilty, Wydrzyńska faces up to three years in prison. "But I'm not afraid," she said, adding that she continues to volunteer for Abortion Without Borders, where she's gotten dozens of calls from Ukrainian refugees seeking information on abortion. "What we're doing is really important. We cannot stop."

Meanwhile, other grassroots groups are working to facilitate Ukrainian refugees' access to emergency contraception, which can prevent pregnancy if taken within 72 hours of unprotected sex. Though previously available over the counter to women 15 and older, Poland's right wing Law and Justice party reinstated the prescription requirement in 2017. Members of Doctors for Women, an informal Polish group of licensed physicians, pledge to write prescriptions for patients whenever another doctor declines to do so on the grounds that it conflicts with his or her personal values or beliefs. There's also the Day After Collective, a network of dozens of people in cities and towns across the country who provide free emergency contraception for anyone in need of it.

Starting up a hotline

And soon after the war began, Nastya Podorozhnya, a Ukrainian journalist and activist, launched a hotline called Martynka.

"It started out as an initiative [to protect Ukrainian women] from trafficking and sexual assault and the various other threats they could face in a foreign land — even one as welcoming as Poland.

"There are so many good people here who genuinely want to help," she said. "But there are also people who want to do harm, and it can be extremely difficult to find what you need in another language — whether it's a psychologist or a lawyer or an abortion."

Over a Zoom call from her apartment in Krakow, where she's been living since 2014, Podorozhnya described how she had fended off an attempted rape several years ago and then had to go through the process of trying to prove to the Polish police "that it really happened – that it wasn't just a fight," she said. "It was not easy, and that's partly because of the way Poland treats rapes in general. It's a very narrow definition."

Indeed, in their report on a visit to Poland in December 2018, members of a United Nations working group on discrimination against women in law and practice noted their concern that rape there "is defined by specific types of coercion rather than [on the basis of] consent, as this can result in some cases being dismissed."

Podorozhnya set out to make sure Ukrainian refugees have access to the sorts of resources she wished she had during her own ordeal – as well as aid them in accessing abortion services.

When refugees began arriving en masse, Podorozhnya made her way to the border town of Przemysl with dozens of stickers featuring the Martynka logo, a female figure holding a sword, with a phone number and the words in Ukrainian and Russian: "Your defender in Poland." She left them on the walls of the women's bathroom in the Przemysl train station and in a rest area for women only. Podorozhnya is well aware of Wydrzyńska, the activist now on trial for "helping with an abortion," and sometime she feels nervous, she says.

"But then I think about what the Russians are doing to women in Ukraine," she said, "and I stop worrying about my own situation. I'm too angry to be afraid."

Patrick Adams is a freelance journalist based in Atlanta. Find him on Twitter @jpatadams

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