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How Sweden got some of the most liberal abortion laws in the world

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How Sweden got some of the most liberal abortion laws in the world
Women walk by a pro-repeal poster pictured in Dublin. Photo: AP Photo/Peter Morrison
15:12 CEST+02:00
Sweden is home to some of the world's most liberal abortion legislation, but the right for women to choose what happens to their bodies is not something to take for granted. The current laws have been in place for just over 40 years, before which thousands of women risked illegal, often unsafe abortions – which for many women around the world remain the only option. As Ireland gears up for a vote on whether to repeal its restrictive eighth amendment, The Local reflects on the history of abortion in Sweden.

Pro-choice campaigners across the world, including in Sweden, have lent their voices to support the 'Repeal the Eighth' campaign, while many Irish people living or travelling abroad are going back to have their say in the referendum, using the hashtag '#hometovote' to share their journeys on social media

The Swedish Association for Sexuality Education (RFSU) has also been a vocal supporter of the campaign. RFSU campaigned for legal, safe abortion in Sweden since the organization was founded in the early 1930s.

Today, women in Sweden have the right to abortion for any reason within the first 18 weeks of pregnancy. But this law has only been in place since 1975, although abortion was allowed in certain specific circumstances from the late 1930s.

As campaigners in Ireland have stressed and the World Health Organization has stated, a lack of legal abortion never means no abortion – it simply means illegal and unsafe procedures.

Thousands of illegal abortions are believed to have happened every year in Sweden in the early 1900s. The number is estimated at anywhere between 10,000 and 24,000, but may have been much higher in reality, according to abortion historian Lena Lennerhed.

Her research shows that at least 70 women died of these unsafe procedures in the 1930s and 50 in the 1940s, while in the 1890s over 1,200 women died in attempted phosphorus abortions. Poorer women were particularly at risk, since those with more financial resources could typically pay for a slightly higher quality of care. 


An anti-abortion poster in Ireland in 2018. Photo: AP Photo/Peter Morrison

One doctor who carried out abortions illegally in the 1930s was Ivar Olofsson, who worked at a 'clinic' (he was not a trained doctor but had learned how to carry out abortions in the USA) outside Stockholm as well as campaigning publicly for legalized abortion. Olofsson charged women 200 to 500 kronor for the procedure (roughly equivalent to 5,500-13,500 kronor or $625-1,252 today), meaning he catered mainly to the middle and upper classes.

After being discovered, he was sentenced to three and a half years of penal labour in Sweden's largest abortion trial, and over 150 of his female patients each received a month's suspended sentence.

In 1938, a reform gave women in Sweden the right to an abortion only in three circumstances: if her own life was at risk, if the foetus had been shown to have a genetic disorder, or if the pregnancy was the result of rape. 

During the early years of this law, only a small number of women applied for abortions under this law, with 400 to 700 abortions granted each year. The law was amended in 1946. This allowed women to have an abortion motivated by 'social grounds', for example if the woman was too poor to be able to care for a child, or if her physical or mental health was at risk, even if her life wasn't in danger. This had to be done through a special application, which involved questions about her reason for the request, as well as a gynecological and psychiatric exam, a process that could take a long time.

In 1955, Poland made abortion legal for women in "difficult living conditions", a condition interpreted extremely liberally at the time, though the law has since been severely restricted so that abortion is currently illegal except in cases of rape or a life-threatening condition to the mother or foetus. In the late 1950s however, for many Swedish women this was their best chance at accessing an abortion, so many pregnant women made the trip. 

In the early 1960s, an American woman, a TV host named Sherri Finkbine, was denied an abortion in her home country. She had taken thalidomide, which was revealed to cause deformities in foetuses, and her calls for clearer warnings of the drug's side effects gained huge publicity. Unable to terminate the pregnancy in the US, she applied for and was granted an abortion in Sweden on the grounds that giving birth was a risk to her mental health.

Both Finkbine's experience and the rise in travel to Poland brought the question of abortion into the spotlight in Sweden again. Parliament amended the abortion law in 1963 to allow the procedure in cases where the foetus had suffered serious injury, as in Finkbine's case, but this still didn't apply for the vast numbers of women experiencing crisis pregnancies each year.


Pro-choice demonstrators in Stockholm in the 1970s. Photo: Birgitta Lagerström/Scanpix/TT

In the late 1960s and early 1970s, the debate shifted, with the younger generation in particular leading the movement for so-called abortion on demand or free abortion; in other words removing the requirement to apply or to give a specific reason. This culminated in Sweden's Abortion Law, passed in 1974 and still in place today. The shift wasn't straightforward however, with the number of legal abortions halving in the more conservative 1950s.

So how does abortion work in Sweden today? Up until the end of the 18th week of pregnancy, any woman can ask for and receive an abortion without having to give a reason. She will be offered the option of counselling, but this is not compulsory, and all information shared with a doctor is confidential (even if the patient is underage).

All abortions cost the same as a normal doctor's appointment, meaning the cost ceiling for state healthcare applies. Women without a Swedish personal number won't benefit from state-subsidized healthcare unless their country has an agreement in place with Sweden, so the procedure may be much more expensive for them, but all women are entitled to it, regardless of whether they live in Sweden or not.

Between the 18th and 22nd weeks of pregnancy, abortion is permitted only if the National Board of Health and Welfare (Socialstyrelsen) gives special permission for a reason, such as if the woman's health is at risk. After the 22nd week, it is not allowed in any circumstances, based on the fact that at this point a foetus could survive outside the womb.

Medical abortion – a non-surgical procedure in which women take tablets to stop the pregnancy – was introduced in Sweden in the 1990s. It is the most common method in the first nine weeks of pregnancy, and is performed in two sessions. The first always takes place at a clinic, while the second can either be done at a clinic or at home, though another adult must be present if you choose the latter.

The other method is surgical abortion, which accounted for seven percent of abortions last year. This involves the doctor medically extracting the foetus and placenta in a procedure that typically takes around 20 minutes in total (with the intervention itself lasting just a few minutes) up until around the 13th week of pregnancy, but longer after the 13th week (around 24 hours is a typical time for the entire process and stay in hospital, according to 1177).

In 2017, almost 37,000 abortions were registered in Sweden, according to statistics from Sweden's National Board of Health and Welfare (Socialstyrelsen). This number has remained fairly steady in recent years.

More than 90 percent of abortions last year were carried out within the first 12 weeks, with a growing number of people undergoing the procedure at home. In 2017, 84 percent were carried out before week nine and 55 percent before week seven. The corresponding figures in 1994 were 45 percent and four percent, respectively.

Protesters demonstrate against efforts by the nation's conservative leaders to tighten Poland's already restrictive abortion law, in Warsaw, 2018. The banner reads : Women's Strike. Photo: AP Photo/Alik Keplicz

The abortion debate in Sweden is very different to in other countries, such as Ireland, Italy, Poland and the US, with far less religious influence. The Swedish government self-defines as feminist, so it seems like the society would have to undergo huge chances for any campaign to remove the right to abortion from women would receive much support.

Sweden has also taken a strong stance against US President Donald Trump's anti-abortion position, threatening to axe aid to organizations yielding to an anti-abortion 'gag rule' which demands that health groups funded by the United States do not provide information about abortion.

But Sweden's liberal position shouldn't be taken for granted: in 2014, the Health Minister and Equality Minister called for more to be done to defend and strengthen the abortion law.. 

There is today one party in Sweden's parliament that wants to lower the limit on abortion; the nationalist Sweden Democrats have called for the limit to be reduced from 18 weeks to 12 in most circumstances.

There are also several campaign groups which actively protest abortion, including Ja till Livet (Yes to Life), which was founded in 1991 and last year changed its name to Människovärde (Human Value). It says it has tens of thousands of paying supporters, though it is not clear how many of these are based in Sweden, and was invited to give a lecture at Örebro University in 2014.

Another anti-abortion organization, Människorätt för ofödda (Human rights for the unborn) was founded in 2004, and has carried out public demonstrations against abortion. These have largely been met with protest, including from RFSU which describes the group as extremist.

Christian Democrats protest against the incoming abortion law in 1974. Photo: Gunnar Lundmark/SCANPIX

In the mainstream, though, abortion debate in Sweden tends to centre on when and how the procedure should be carried out rather than whether it should be allowed at all, such as whether the 18-week limit should be kept even if future medical advances mean that a foetus could survive outside the womb at that time. 

Another question is whether midwives should be allowed to refuse to carry out the procedure, for example if it goes against their personal religious beliefs. One midwife sued Jönköping county for withdrawing her employment offer over her refusal to carry out abortions.

The case made headlines in Sweden but the Swedish Labour Court ruled last January she had not been discriminated against since the procedure was part of the job requirement. The midwife told The Local at the time that she planned to take the case to the European Court of Human Rights, though this court cannot overrule Swedish rulings.

The verdict was welcomed by RFSU, whose chairperson said: "A patient's care needs and wishes should not be steered by medical staff's refusal to perform certain tasks."

One risk of allowing midwives to refuse abortions is that it would make the procedure hard to get. In Italy, where an estimated 70 percent of doctors refuse, it can be hard to access the service. Last year, The Local Italy reported the case of one woman forced to go to 23 clinics in order to have an abortion, despite the country marking 40 years of legal abortions this May.

Another aspect of the debate is how satisfied women are with the care they receive, with several surveys reporting that many women say the emotional support was insufficient. This ties in with wider complaints that midwives are overstretched and unable to provide the optimum level of care to patients.

All in all, however, Sweden's abortion laws remain some of the most liberal in the world, even though this has not always been the case.

English-language information about having an abortion in Sweden can be found on the healthcare website 1177, and you can find out more by speaking to a doctor or gynecologist. Non-Swedish speakers always have the right to a translator at medical appointments (just let staff know in advance) and many healthcare professionals speak English.

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