At the first parliamentary hearing, held in mid-October, Minister of Foreign Affairs Timo Soini from the Finns Party declared that he is against abortion. Miina Keski-Petäjä, abortion researcher at University of Helsinki, is critical to the suggestion that healthcare workers should be able to refuse participating in abortions.

‘I think it’s problematic that patients may encounter healthcare workers who don’t accept their decision. This may make an already difficult situation even harder,’ she says.
She also believes that the proposed policy may lead to increased inequality in healthcare.
‘The policy may cause problems in conservative rural areas, where the nearest hospital might be far away,’ she says.

Norwegian doctor Johanne Sundby confirms Keski-Petäjä’s concerns. In Norway, abortions are performed by doctors, who have the right to refuse the procedure. This may cause problems in communities with few doctors and midwives, she says. All clinics are required by law to offer all the care people are entitled to, including both the actual abortion and the aftercare, but this may be a challenge in some small communities, according to Sundby.
The freedom of conscience clause in the Norwegian abortion legislation applies to the actual abortion procedure, but some people want to expand it to include also other tasks and professional groups. For example, there are general practitioners who don’t want to refer patients to clinics where they can get an abortion.

All doctors should be required to provide the care patients are entitled to. The patients shouldn’t have to risk facing healthcare workers who make them feel guilty,’ says Sundby.

Swedish healthcare workers cannot refuse carrying out abortions, but the issue is debated intensely, just as in Finland. Two midwives have sued their respective employers after being denied employment due to their refusal to perform abortions. The first decision is expected in November.

Broad support for abortion force opponents to seek new paths

Lena Lennerhed, professor of history of ideas at Södertörn University, sees the focus on freedom of conscience as a conscious strategic move by abortion opponents in Sweden.
‘There is broad support for the right to abortion. They won’t get anywhere by saying they are against abortion, so they choose this path instead. This is how the resistance to abortions is carried out at the moment,’ she says.
The laws regulating the right to abortion vary across the Nordic region. In Sweden, Denmark, Norway and Greenland, pregnant woman are free to decide to have an abortion up to the 18th and 12th week of pregnancy, respectively. In the Faroe Islands, Åland, Iceland and Finland, certain medical or social criteria have to be met for an abortion to be performed. However, it is hard to say how relevant these requirements are in practice. In Finland, all requests for an abortion up to the 12th week of pregnancy are approved, but the simple fact that a formal evaluation has to be made does make a noticeable difference, says Lennerhed.
‘Although in practice women get to decide up to week 12, somebody else has to give a formal approval. This is a clear signal that it is not the pregnant woman’s own choice,’ she says.

In a Nordic context, the resistance against abortions has historically been particularly strong in Norway, and Sundby believes this is still the case. The right of Norwegian women to request an abortion up to the 12th week of pregnancy is widely supported, but attempts to extend the limit to the 16th week have failed.
‘There’s an ongoing public discussion about whether abortions should be made more difficult to get. I see this as a step backwards. Abortion is portrayed as a moral issue for the pregnant woman rather than as the legal right it actually is,’ she says.
Voices questioning the right to abortion are often heard in the other Nordic countries as well. Greenland has a high frequency of unwanted pregnancies compared with its Nordic neighbours, and some participants in a current media debate are saying that abortion patients should have to pay part of the costs of the procedure. Sundby is very critical of suggestions of this type.
‘I’m totally against it. It would open up for an unregulated market with cheap, dangerous abortions, as we see in poor countries,’ she says.

Abortion opposition grows stronger in economic recession

Let us return to Finland and the freedom of conscience debate. Keski-Petäjä does not think the Finnish citizen initiative will be passed in parliament, but she is afraid the debate surrounding the proposition will lead to increased resistance to abortion in some people.
‘It wouldn’t be the first time in history the resistance to abortion would grow stronger in the wake of conservative winds and economic recession. Conservative, racist and sexist ideas are becoming increasingly common in the Finnish public debate. The targets are often refugees, sexual minorities and women,’ she says.
The increased support for the Finns Party has contributed to a normalisation of these types of attitudes and arguments, says Keski-Petäjä.
‘The question is what the other parties are going to do. I wonder if they are going to stand up strongly for human rights or if they are afraid of losing voters to the Finns Party.’

Different laws in the Nordic countries

• In Norway and Denmark, a woman can choose to have an abortion until the 12th week of pregnancy. A pregnancy can be terminated after this point only if there are acceptable medical or social reasons for such a decision.
• In Finland, a pregnancy can be terminated until the 12th week if certain broadly defined criteria are met. If there are strong reasons to terminate a pregnancy after this point, an abortion can be performed until the 20th week. In case of foetal defects, the limit is 24 weeks.
• Swedish women can choose to have an abortion until the 18th week of pregnancy. In Iceland, the limit is week 16, and permission for later abortions can be given if the woman’s health is at risk.
• In Norway and Denmark, healthcare workers can refuse to participate in an abortion by referring to the freedom of conscience clause. This type of clause is being discussed also in Sweden and Finland.