At twenty weeks’ gestation, Mirela Čavajda learnt of a malignant tumour [in Croatian] that was rapidly growing in the brain of her developing foetus. In April 2022, Čavajda sought an abortion—and came up against a wall of resistance.
Čavajda’s request was rejected by three hospitals in Croatia’s capital, Zagreb. As the tumour grew, a Second Instance commission reviewed the case and found that the legal and medical prerequisites for pregnancy termination were met. But when, at twenty-six weeks’ gestation, Čavajda reapplied to the Zagreb Clinic for Women’s Diseases and Obstetrics for an abortion, it stated it could not provide the care [in Croatian] required. To get an abortion, Čavajda would have to travel to neighbouring Slovenia.
Čavajda lived in “unimaginable pain” during the month-long discussions. She has described [in Croatian] the idea of being forced to give birth and then watch her child die as “sadism,” and that “everybody has a right to choose”. Donations poured in [in Croatian] to cover the €5,000 cost of the procedure in Slovenia.
LEGAL, BUT INACCESSIBLE
Čavajda’s case illustrates how endemic conscientious objection can render legal abortion completely inaccessible in practice.
In Croatia, abortion is regulated by a 1978 law passed while the country was still part of the socialist federal state of Yugoslavia. This allows elective abortion until ten weeks’ gestation. After that, abortions must be approved by a commission, which may do so if: the procedure is medically necessary to save a woman’s life or preserve her health; in cases of rape or incest; or if the child could have a serious congenital defect.
However, since 2003, medical personnel have had the right to refuse to perform abortions on moral grounds. In 2018, 59% of medical staff refused to perform abortions.
With such widespread refusal, women are unable to access the healthcare they need. In 2019, it was reported that of the 27 public hospitals that were in theory able to perform abortions, at least five were not providing any. In medical schools, abortion is receiving increasingly scarce attention, meaning practitioners are not being adequately trained. Abortion is legal, but it is becoming increasingly difficult to access.
This individual right to refuse, when being exercised by a significant-enough number, effectively removes the right of women to access essential healthcare. In the words of the Croatian Ombudsperson for Gender Equality, “an individual right is being used as a collective right to block an entire medical institution”.
This runs contrary to international human rights law. In 2011, the European Court of Human Rights ruled that if states allow medical personnel to refuse to provide reproductive healthcare, they have a responsibility to organise health services in such a way that the procedure remains accessible. One constitutional expert [in Croatian] believes that Croatia could be pulled before the European Court of Human Rights for failing to guarantee its citizens’ right to abortion. This year Croatia is reporting to the UN’s Women’s Rights Committee (CEDAW), which has already twice warned [in Croatian] that Croatian women must be able to access abortion.
THE INFLUENCE OF THE CHURCH
The high rate of refusals is partly explained by the influential Catholic Church. As Croatia seceded from Yugoslavia in the 1990s, a revived nationalistic Catholicism strengthened the idea of an independent Croatian nation state. Members of the Catholic Church began lobbying for a ban on abortion from 1992 onwards, supported by pro-natalist nationalists who feared that the Croat population might decline.
Today, 90% of the Croatian population identifies as Catholic, and the number of practising believers is increasing.
In neighbouring Slovenia, the number of believers is slightly lower, and is declining. This may go some way to explain why, when the same right to refuse to provide abortions exists in Slovenia, only 3% of medical practitioners exercise it.
THE FUTURE OF ABORTION RIGHTS IN CROATIA
Despite the grip of the church, a 2020 survey found that only 7% of the Croatian population explicitly believes women should not have the right to have an abortion. On 12 May 2022, several thousand pro-choice activists protested in nine cities [in Croatian] across Croatia, under the slogan ‘DOSTA!’—‘ENOUGH!’ Signs read: “Enough fundamentalism; enough gynaecological violence; enough political games at the expense of women’s health.”
Croatia’s 1978 abortion legislation needs updating. Croatia’s Constitutional Court instructed parliament to replace the outdated rules five years ago, but politicians remain unwilling [in Croatian] to put abortion on the agenda. Pro-choice activists therefore need to be ready to fight for more progressive laws in the face of institutional resistance.
Helena Trenkić is studying for a PhD in History at the University of Cambridge, researching self-determination and rights-talk in socialist Yugoslavia. She recently completed an internship with the United Nations Office of the Victims’ Rights Advocate. Her interest in human rights has also led to volunteer roles with Amnesty International and the National Council of Women of Great Britain.