Patient in Warsaw Denied Contraception Because "Jesus has Other Plans"

She did not argue with the doctor, deciding it wouldn’t make sense anyway. She also knew she had to make another appointment to pick up and consult the test results.  - In terms of contraception, I'd simply get one online- the girl admits.

Emilia is not the only one who has been refused a prescription for hormonal contraception by a medical professional. - The doctor stated that he does not deal with such things. As I understand it, the use of contraception goes against his values, but in his professional work, he should be guided primarily by medical ethics. As long as the patient does not suffer from any pre-existing conditions, there are no medical reasons for refusing to prescribe hormonal contraception. These drugs have been approved for use many years ago. The doctor should not impede access to them- says 30-year-old Olga. After a doctor refused to issue her a prescription, she simply changed her gynecologist.

The „morning-after pill" does not cause miscarriage

Asking a doctor for emergency contraception, a pill that can be taken up to 72 hours after unprotected sex, is an even bigger issue. - Unfortunately, many people in Poland still think of it as an early abortion pill. Meanwhile, its role is to prevent conception, so there is no miscarriage of pregnancy. Doctors who refuse to issue a prescription for the "morning-after pill" or hormonal contraception are apparently unaware of their duties and the law. The so-called "conscience clause", which is more or less explicitly invoked by some gynecologist, does not apply in this case- says Krystyna Kacpura, head of the Federation for Women and Planned Parenthood.

She recommends that if a doctor refuses to issue a prescription for contraceptives, the patient should ask for a written justification. - Many doctors change their minds following such a request. They know that they lack arguments to justify their attitude. We can also refer a complaint to the Ombudsman for patients’ rights. Of course, not every woman knows how to behave in such a situation, and often simply decides to see another doctor-  Ms. Kacpura tells us.

Unequal access to healthcare

Should cases of medical professionals who refuse to issue prescriptions for hormonal contraception be handled by the national medical board? Not necessarily. According to Olga Rostkowska, vice president of the Warsaw Regional Medical Chamber, it’s a matter of legal interpretation. - In 2015, Poland’s Constitutional Tribunal confirmed that doctors are free to cite the conscience clause also in the context of prescribing contraception.

However, she stresses that in the case of refusing such a prescription, the doctor is obliged to provide the patient with the address of another practice or medical professional who will provide such assistance. This follows not only from the law, but also from the code of medical ethics. - The patient should not be left alone and should not be deprived of the right to health care. If this is the case, it is worth asking for a refusal on paper, or complaining, for example, to the doctor's superior. Most patients in such a situation simply seek out another gynecologist, or use places with questionable reputations, such as online prescribers. These methods, of course, generate additional costs, which violates the right of equal access to health care –Ms. Rostkowska says.

She also mentions the grassroots group Doctors for Women, which brings together medical professionals from all over Poland who want to make it easier for patients to access emergency contraception. - This is a great initiative, but we need systemic solutions as well. There should be a publically-accessible list of doctors who refuse contraception for religious reasons and the facilities where they work- Ms. Rostkowska adds.

Poland ranked worst in Europe in terms of contraceptive access

There is no official list of this kind, and a woman seeking medical help is often left to her own devices. Not surprisingly, Poland is the worst country in Europe in terms of access to contraceptives. This is made clear by the latest edition of the international "Contraception Policy Atlas" report prepared by the European Parliamentary Forum for Sexual & Reproductive Rights. The results are presented in percentages, where 100 % means the best access to contraception and 1% the worst. With a score of 33.5%, Poland landed at the bottom of the list, behind Bosnia and Herzegovina, Hungary, and Cyprus. United Kingdom, France, and Belgium, on the other hand, were at the top of the list. Why did Poland score so poorly? Lack of facilities where young people can access contraception, lack of access to hormonal contraception without a prescription, and lack of a government website to provide information about contraception, just to name a few reasons.

- The results don’t surprise me at all. Poland has been at the tail end of the list for years. There are no planned parenthood centers in our country, and a woman has nowhere to go to talk about it. She can only talk to a gynecologist, but the latter is mainly interested in diseases of the reproductive system or pregnancy management. We did a monitoring of the availability of the intrauterine spiral and found that in more than half of the offices, despite reimbursement from the National Health Fund, the procedure for insertion of the spiral is not performed free of charge. A woman has to pay for it. Emergency contraception, on the other hand, ceases to be an emergency when we obviate it with a prescription. This exacerbates economic inequalities in access to treatment and medical services in this country- Krystyna Kacpura emphasizes.

***

Every day, 400 journalists at Gazeta Wyborcza write verified, fact-checked stories about Polish politics and society, keeping a critical eye on the ruling camp’s persistent assault on democratic values and the rule of law; the growing cultural tension between religious fundamentalism and human rights; and the ongoing Russian invasion in Ukraine. Our journalists are on the front lines in 32 Polish cities, reporting from the streets, hospitals, and courtrooms about issues that move public opinion.

We decided to make our service available to everyone free of charge in order to provide access to high quality journalism for expats and English speakers interested in Polish affairs.

The access to information should be equal for all.