Respect bodily autonomy by eradicating the mandatory waiting time period in abortion procedures
For many decades, abortion has been a controversial topic in various societies. One out of five women* in the Netherlands experiences an unintended pregnancy during their lifetime. In 2018, 8.8 out of every 1000 women between the age of 15 to 45 has had an abortion to end a pregnancy1. However, unplanned or unwanted pregnancies, and especially abortions, are still surrounded by silence and stigma.
Since 1984, abortion has been legalized in the Netherlands through the Wet Afbreking Zwangerschap (Termination of Pregnancy Act); the WAZ. This law is only applicable under certain conditions. These conditions stipulate that an abortion is only allowed if the person having the procedure is in an emergency situation. Furthermore, the procedure needs to take place before the 24th week of pregnancy in a certified clinic. Another important aspect is that after the 16th day of pregnancy, there is a mandatory 5-day waiting period before the procedure can take place, often called the ‘waiting time’ period.
In 2005, a review of the abortion law concluded that a flexible waiting time is preferred2. Nevertheless, the waiting time period remained an obligatory part of abortion care, as it was seen as helpful for women to take this decision. However, in many cases, women had already made their decision long before they visit an abortion clinic. Most of them, around 80%, do not change their choice on whether or not to end their pregnancy during the obligated five days of waiting time2. This shows that the waiting time period has 8 out of 10 times no impact on a person’s decision. In addition, research has shown that the mandatory waiting period adds unnecessary emotional distress, as many women experience the strict waiting time period as being long and stressful.
Another study has also shown that nowadays , youth, between 20-30 , tend to be more skeptical and critical of abortion than their parents. Around 8.1% of people in the Netherlands in their twenties believe that abortion is not one of our human rights, which is a higher percentage than similar opinions among eldery, and this gap is only increasing6. Abortion is becoming a taboo among youth, with 59% of youth under the age of 25 experiencing the procedure as shameful7. Due to this growing peer-enforced stigma, youth possibly experience difficulties in finding the adequate medical care that they need, and they might be less likely to confide in their friends, family or others.
The stigma on abortion, still prevalent in society, is instead of the abortion itself, associated with psychological distress8,9. That this stigma is increasing among youth is a concerning development. This perception that abortion is shameful is likely enhanced by the waiting time period, as it reinforces the idea that abortion is morally wrong and something that needs to be thoroughly thought over10.
Furthermore, it implicitly and incorrectly suggests that society still thinks that women are unable to make a decision by themselves. The implementation of the waiting time period, in its current form, might be likely to increase emotional and psychological distress and adds to the stigma surrounding abortion.
As such, we urge the Dutch government to remove the obligatory waiting time period from the WAZ, and instead introduce short and prolonged counseling services and voluntary waiting periods for women whom themselves decide they need more time. All people have the right to exercise their bodily autonomy. Therefore, those who have made their decision and are informed of the medical process, should be allowed to have an abortion immediately upon request and following the consultation of a qualified medical professional.
* We recognize and realize that the group of people with a uterus is broader than just women. However, the research that has been conducted had been specifically done under women. To not obscure the different or heightened challenges of people with a uterus, this article will use women.
1 Rutgers, kenniscentrum seksualiteit (2020) “Enkele feiten over abortus.” https://www.rutgers.nl/wat-wij-doen/anticonceptie-en -abortus/enkele-feiten-over-abortus
2 Visser, Janssen, Enschedé, Willems. te Braake, Harmsen, Smets, de Haes, and Gevers. (2005). “Evaluatie Wet afbreking zwangerschap”.
3Visser, Janssen, Enschedé, Willems. te Braake, Harmsen, Smets, de Haes, and Gevers. (2005). “Evaluatie Wet afbreking zwangerschap”.
4 Brauer, van Ditzhuijzen, Boeije, & van Nijnatten. (2019). ‘Understanding Decision-Making and Decision Difficulty in Women With an Unintended Pregnancy in the Netherlands’.
5 Brauer, van Nijnatten, & Vollebergh. (2012). ‘Besluitvorming rondom ongewenste zwangerschap. Een kwalitatief onderzoek onder vrouwen die tot abortus hebben besloten en vrouwen die tot het uitdragen van hun zwangerschap hebben besloten’
6Muis, Sieben, Reeskens, Halman. (2019). ‘Seksueel-ethische permissiviteit: trends in Nederland 1981-2017’.
7De Graaf, Van den Borne, Nikkelen, Twisk, Meijer. (2017). Seks onder je 25e.
8Biggs, Brown, Foster. (2020). “Perceived abortion stigma and psychological well-being over five years after receiving or being denied an abortion”.
9Biggs, Upadhyay, McCulloch, Foster. (2017). “Women’s Mental Health and Well-Being 5 Years After Receiving or Being Denied an Abortion: A Prospective, Longitudinal Cohort Study”.
10Norris, Bessett, Steinberg, Kavanaugh, de Zordo, Becker. (2011). “Abortion stigma: A reconceptualisation of constituents, causes and consequences.”