Nearly a decade after Turkey’s then-prime minister – and now president – Recep Tayyip Erdoğan dubbed abortion “murder”, it has become harder than ever for women to access the procedure.
According to a recent report by Kadir Has University, 54 per cent of public hospitals now refuse to perform abortions for reasons other than a medical emergency. What’s more, public hospitals in 56 provinces refuse to perform abortions because they lack family planning units, which are required by law.
Social media is filled with accounts by Turkish women who have struggled to get abortions. One woman, a teacher who posts on social media under the pseudonym Eflatun Maral, told Inside Turkey about her experiences.
Recalling the abortion she had as a student at Istanbul University 13 years ago, Maral told Inside Turkey that she was initially “very happy” after her encounter with her doctors.
“I was so glad during my first examination when the doctors told me at the university clinic that they wanted to help me out. I was really young and didn’t have much of a budget. [But] I didn’t know what I was in for.”
On the day of the operation, she said, doctors and nurses at the clinic did not give her enough information about the procedure.
“I was in an ice-cold operation room with flickering fluorescent lights and a doctor who wouldn’t even look me in the eyes,” she said. “He told me horrible things while prepping like ‘you do what you do and then you end up on this table. Who cut you slack that allowed you to get a non-mandatory abortion?’ and made me feel terrible.”
Maral said that she was so young at the time that she did not feel she could say anything back to the doctor.
“I don’t remember how long the operation lasted but it felt like hours,” she continued. “It was a terrible experience all over. I had been glad to know that I would have this opportunity at a public hospital without spending extra money, but I wish I’d found the cash to avoid such an experience.”
Maral experienced severe vaginal pains after the abortion, which she was told were psychosomatic. Despite being extremely careful for many years, she recently became pregnant again and sought another abortion.
“I didn’t even think about trying my luck at a public hospital. I immediately asked my feminist friends to recommend a good gynaecologist,” Maral continued, adding that the procedure was so expensive that she and her partner had to take out a bank loan.
Despite a general anesthestic and pain relief, she still experienced severe discomfort.
“My body’s reaction brought me right back to my first abortion experience years ago. I was in therapy for years about this, but my body’s memory can’t let it go.”
A woman who uses the pseudonym Fatma Belgin also had to turn to a private clinic after a public hospital in Istanbul told her that “abortions are banned unless it’s medically mandatory”.
“It was so expensive, I told them I couldn’t afford it. I was told, ‘if you know how to get pregnant, you’ll also be able to find the money.’ They use the situation against you, because they know you don’t have a choice,” she said.
Belgin had to go to an unlicensed practitioner, as she couldn’t access the procedure anywhere else.
“They turned an apartment into an examination room. The person who performed the procedure was a doctor at a private hospital. It was a filthy, unsanitary environment. I got an infection and had to use antibiotics for days after the operation anyway. You feel terrible even in the waiting room: there’s dozens of people waiting in one place, there’s no privacy, and everyone’s looking at each other like they’re doing something forbidden,” she said.
Belgin did not want to make a formal complaint about her treatment at the public hospital, because she didn’t want people to know she’d had an abortion.
A survey of 37 hospitals in Istanbul in 2015 showed that only three performed abortions, and that only one offered the procedure to non-mandatory patients, said Selime Büyükgöze, a volunteer at the Mor Çatı Women’s Shelter Foundation.
Women were often told abortions were illegal, Büyükgöze said, adding that “each hospital is liable for giving patients referrals if they don’t offer abortions. Not even the health ministry or the provincial health directorates offer information on which hospitals offer the procedure. You have to visit each hospital one by one to find out.”
The Justice and Development Party (AKP) government’s family policies have enforced restrictions on women’s access to abortion and birth control ever since the party took office, Büyükgöze told Inside Turkey.
“2012 was the last straw, when then-prime minister Tayyip Erdoğan called abortion ‘murder’. The public statement really facilitated doctors’ refusal to perform the procedure, establishing a practical ban on abortions in the country,” Büyükgöze said.
Hospitals’ aversion to the procedure also produces risks for women, Büyükgöze said.
She added that Mor Çatı had been contacted during the pandemic by a woman from south-eastern Turkey, who told them that one hospital in her province was unable to perform abortions because it had been turned into a Covid-19 hospital. The other hospital in the region told her that abortion was illegal. Mor Çatı helped her find a doctor who could perform the abortion safely.
“Women are sometimes forced to carry on pregnancies they didn’t want, or even care for children they didn’t intend on having. There’s no positive outcome for either the parents or the children.
“Besides, the poverty of these women in such a recession is obvious. They need money to go to private hospitals, so they take out loans and debts that impoverish them even more in the long run. Hospitals’ rejections even encourage women to resort to trying more primitive ways of ending the pregnancy, which can cause permanent damage to women’s reproductive systems or even threaten their lives,” she said.
Abortion is a necessary and critical piece of healthcare, and withholding it is a “violation of medical and professional ethics,” said Özge Yılmaz, a doctor who specialises in obstetrics and gynaecology.
Although abortion is a legally permitted health service in Turkey, it is almost never performed, Yılmaz continued, adding that private hospitals’ prices for the operation were astronomical. “Poor women unfortunately can’t access abortion,” she said.
Blocking access to abortion was a violation of women’s rights, the doctor said. “Women are left alone with stigmatisation, shame and isolation. A woman can end up resorting to all sorts of solutions, which could create unsafe conditions for an abortion, and complications in turn. Bleeding, infections, genital injuries, loss of organs – it can create fatally serious situations. The unsafe conditions also harm women’s mental health,” she said.
Meltem Günbeği of the Turkish Medical Association Women Doctors and Women’s Health Branch said that no doctor had the right to prevent a patient’s access to health.
“Doctors can turn down patients but this is on the grounds of whether it would harm the patient, the treatment’s sustainability and ease of access to the procedure. A doctor’s own values or any political agenda could never justify the use of this right. Human rights are the priority in all healthcare.
“Women who can’t access safe abortions take risk of unsafe abortions and miscarriages. Women who have to give birth because they can’t access abortions face great health problems both for themselves and for their children in the long run. Mental health often declines during unwanted pregnancies, and it can go as far as suicide,” Günbeği said.
She said that the only explanation for a decrease in the availability of abortions was the government’s stance, even though the procedure is technically legal. The Turkish Medical Association often works to expose this practical ban, Günbeği added.
“We often remind doctors of their ethical responsibilities and encourage investigation of unethical practices,” Günbeği said.
Women are often advised to request written proof of a rejection for an abortion request, even though obtaining one is not easy.
“They don’t want to give you that document, so even insisting can be enough to make them carry out the abortion in some cases,” Büyükgöze said. “But women are focused on the procedure itself and have the short timeframe of ten weeks to obtain it, so they’re not always able to find time for legal proceedings. They want to go through [the abortion] and leave the discomfort behind afterwards.”
Turkey’s Ministry of Health did not respond to a request for comment on this story.