Transcript Dr. Esmeralda Kuliesyte - International Consortium for Medical

Abortion situation in Lithuania
Esmeralda Kuliesyte
MD, Executive Director
Family Planning and Sexual Health Association
FIGO project coordinator
Abortion is legal in Lithuania since 1955.
There is no abortion law in Lithuania.
The 1994 order of the Minister of Health regulates
abortion procedure.
Up to 12 weeks of pregnancy, abortion is allowed on
women's request.
After 12 weeks up to 22 weeks – according to medical
indications.
Every year around 10 000 abortions are performed on
women’s request in Lithuania.
10,8 abortions per 1000 women of reproductive age.
33 abortions per 100 live births.
Lithuanian Health Information Center, 2006
Unmarried women terminate pregnancy twice as often as
the married ones. The biggest part of women who had
abortion was not well educated. The main reason
indicated as a barrier to have children – financial
problems.
Dissertation by Dr. Virginija Vanagiene „ The reasons for termination of pregnancy and the peculiarities of
contraception consumption, conclusions and recommendations“, 2001
23 % of all abortions are performed in the age of 20-24
years old.
13 % of all abortions are performed in the age of 15-19.
Lithuanian Department of Statistics
Lithuanian Health Information Center, 2006, LHIC
The first termination of the pregnancy constitutes 24 % of
all abortions.
In the age group of 15-19 this percentage is about 72 %.
LHIC, data only from state institutions, 2006
Approximately 2500 women aged 15-16 give birth every
year. Unplanned pregnancies constitute 25 % in this age
group.
LHIC, data only from state institutions, 2006
No cases of death related to abortion have been
registered. Illegal abortion is very rare.
Medical abortion is not legal in Lithuania.
At the end of 2007 conservative parliamentarians
proposed Protection of Human Life in Prenatal Stage
Draft Law, which aims to prohibit abortion on women’s
request, leaving two possible reasons for abortion – threat
to women’s health and life and the case of rape or incest.
In June State Family Policy Concept which recommends
to protect human life from the moment of conception has
been approved.
Such policies discriminate women and do not contribute
to ensuring equal rights and equal opportunities to them.
It is expected, that after banning of abortion in Lithuania,
the number of illegal abortions and women’s deaths will
increase.
According to the data of RAIT survey in 2005,
60,9 % of reproductive age (16-49 years) women do not
use any contraception.
The most commonly used methods, RAIT:
contraceptive pills – 20, 5 %,
condoms - 13,9%,
intra-uterine device – 5 %.
Women of reproductive age (16-49 years) reported not
using contraceptive pills because they believe they are
harmful for health (32, 6%), RAIT.
Contraception is mostly used by urban people of 16-44
years old, whose monthly income exceed 600 Litas for
one family member.
Contraceptive pills are most commonly used by the
women aged 16-34, whose monthly income is more than
1000 Litas for one family member, RAIT.
The reasons for not using effective contraceptive methods
are mostly subjective:
- trusting the partner,
- carelessness and lack of interest in contraception,
- underestimation of the risk to conceive.
Objective reason – intolerance of used contraception.
Dissertation by Dr. Virginija Vanagiene „ The reasons for termination of pregnancy and the peculiarities of
contraception consumption, conclusions and recommendations“, 2001
Voluntary sterilization, which could be chosen by the
couples who do not want more children, is not legal.
There is no National Family Planning Program aiming to
increase awareness of the society, couples, women and
youth about contraception and its usage.
Contraception counseling after abortion in health care
institutions is not sufficient or does not exist.
The information about family planning, contraception is
spread poorly and often even erroneously in schools, the
teachers very often talk about inefficacy and harmfulness
of contraception.
There is lack of society education on prevention of
unplanned pregnancy and family planning methods.
Gynecologists, midwifes, nurses and family doctors are
the main sources from whom women get information
about effective contraception.
Dissertation by Dr. Virginija Vanagiene „ The reasons for termination of pregnancy and the peculiarities of
contraception consumption, conclusions and recommendations“, 2001m.
NATIONAL ACTION PLAN
LITHUANIA
Goal
 To reduce the number of abortions in Lithuania.
Objective 1
To increase contraceptive prevalence rate up to 60 % in three years.
Activity
Responsible
Organization
Time frame
Indicator
1.1. To establish
Unplanned
Pregnancy
Prevention
Program
MoH, LSOG,
FPSHA, LSC,
LCGP, LUM
2009-2011
Increased
contraceptive
prevalence rate
from 40 % to 60
%
1.2. To introduce
a course on FP
and contraception
for family
doctors
MoHLSOG,
FPSHA, LCGP
2009-2011
No of trained
family doctors.
Increased
knowledge on FP
and counseling
MoH – the Ministry of Health
MoE&S – the Ministry of Education and Science
LSOG – Lithuanian Society of Obstetricians Gynecologists
LUM - Lithuanian Union of Midwifes
FPSHA – Family Planning and Sexual Health Association
LSC - Lithuanian Society of Contraceptologists
LCGP - Lithuanian College of General Practitioners
Objective 1
To increase contraceptive prevalence rate up to 60 % in three years.
Activity
Responsible
Organization
Time frame
Indicator
1.3. To establish
training for
trainers program
for health care
specialists, social
workers,
pedagogues
MoH, MoE&S,
LSOG, LSC
2009-2011
Programm
established.
Increased
knowledge on FP
and contraception
of public health
specialists
MoH – the Ministry of Health
MoE&S – the Ministry of Education and Science
LSOG – Lithuanian Society of Obstetricians Gynecologists
LUM - Lithuanian Union of Midwifes
FPSHA – Family Planning and Sexual Health Association
LSC - Lithuanian Society of Contraceptologists
LCGP - Lithuanian College of General Practitioners
Objective 1
To increase contraceptive prevalence rate up to 60 % in three years.
Activity
Responsible
Organization
Time frame
1.4. To review
sexuality
education program
for schools To
allow public
health and heals
care specialists
(nurses, midwifes,
doctors) to provide
health education in
schools
MoE&S, LSOG,
FPSHA, LSC, LCGP,
LUM
2009-2010




MoH – the Ministry of Health
MoE&S – the Ministry of Education and Science
LSOG – Lithuanian Society of Obstetricians Gynecologists
LUM - Lithuanian Union of Midwifes
Indicator
Increased quality
of sexuality
education
FPSHA – Family Planning and Sexual Health Association
LSC - Lithuanian Society of Contraceptologists
LCGP - Lithuanian College of General Practitioners
Objective 1
To increase contraceptive prevalence rate up to 60 % in three years.
Activity
Responsible
Organization
Time frame
Indicator
1.5. To introduce
a course for
pedagogues on
modern methods
of FP and
contraception
MoH,
MoE&SLSOG,
FPSHA, LUM
2009 - 2011
Inreased quality
of education on
FP, contraception




MoH – the Ministry of Health
MoE&S – the Ministry of Education and Science
LSOG – Lithuanian Society of Obstetricians Gynecologists
LUM - Lithuanian Union of Midwifes
FPSHA – Family Planning and Sexual Health Association
LSC - Lithuanian Society of Contraceptologists
LCGP - Lithuanian College of General Practitioners
Objective 2
To improve SRHR legislation and governmental support to SRHR in two
years period.
Activity
2.1. To establish
National
Reproductive
Health Policy




Responsible
Organization
Time frame
MoH, LSOG,
FPSHA,LSC,
LCGP
2009-2011
MoH – the Ministry of Health
MoE&S – the Ministry of Education and Science
LSOG – Lithuanian Society of Obstetricians Gynecologists
LUM - Lithuanian Union of Midwifes
Indicator
Established
National Policy
and plan how to
improve
reproductive
health and rights
of population
FPSHA – Family Planning and Sexual Health Association
LSC - Lithuanian Society of Contraceptologists
LCGP - Lithuanian College of General Practitioners
Objective 2
To improve SRHR legislation and governmental support to SRHR in two
years period.
Activity
Responsible
Organization
Time frame
Indicator
2.2. To establish the
Reproductive Health
and Rights draft law
MoH, LSOG,
FPSHA, LSC,
LCGP
2009-2011
Law
established,
access insured
to legal
abortion
2.3. To introduce
Medical Abortion
MoH, LSOG,
FPSHA
2009-2010
Increased
number of
early abortions




MoH – the Ministry of Health
MoE&S – the Ministry of Education and Science
LSOG – Lithuanian Society of Obstetricians Gynecologists
LUM - Lithuanian Union of Midwifes
FPSHA – Family Planning and Sexual Health Association
LSC - Lithuanian Society of Contraceptologists
LCGP - Lithuanian College of General Practitioners
Objective 3
To improve abortion statistics in one year period.
Activity
Responsible
Organization
Time frame
Indicator
To develop national
norm on abortion
statistics
MoH
2009
National norm
developed,
more reliable
data on
abortion

MoH – the Ministry of Health
Objective 4
To improve awareness of emergency contraception (EC) of young
people in one year period.

Activity
Responsible
Organization
Time frame
Indicator
To organize
education sessions
on EC for students
FPSHA
2009
Number of
educated
studentsIncrea
sed knowledge
on EC of
students
FPSHA – Family Planning and Sexual Health Association