Yet another consequence of Russia’s war, Ukrainian refugees are finding it difficult to access reproductive healthcare services, including abortion care, abroad.

Since February 24, international commissions, government officials, and activist hotlines across Europe have received thousands of reports of alleged war-related acts of sexual violence against Ukrainians. Countless more remain unreported due to stigma or human displacement. As of June 28, the United Nations (UN) reports that almost 5.5 million Ukrainians have become refugees in connection to the war.

Poland has accepted the largest number of Ukrainian refugees, at nearly 1.2 million. In recent years, the central European state has received significant coverage in the news surrounding its strict abortion laws. In Poland, abortion is legal in cases of rape or incest until 12 weeks of pregnancy, or in situations where the mother’s life is in danger. In October 2020, Poland’s highest court ruled that termination of a pregnancy due to fetal malformations incompatible with life is unconstitutional. Since the ruling, at least one pregnant woman has died in a Polish hospital due to septic shock after physicians refused access to a life-saving abortion.

Abortion access remains virtually inaccessible in Poland due to both legal barriers and strong social stigma. The approval process is long and often extends beyond the 12-week window. Abortion is only allowed in cases of rape after a court investigation and with a prosecutor-provided certificate. Since 2016, less than three abortions are performed per year in Poland under the rape exception. Furthermore, many physicians refuse to perform terminations on religious grounds.

For Ukrainian women currently living in Poland, these laws are a stark contrast from what they know back home. Ukrainian law allows unrestricted access to abortion during the first 12 weeks of pregnancy, and permits abortion between 12 and 38 weeks with physician approval. Many agree that obtaining a rape exemption in Poland will be nearly impossible for Ukrainians due to the sheer difficulty of prosecuting war crimes. A top United Nations official has argued that Poland’s policies “do not meet international standards.”

When it comes to accessing medical care, time is of the essence: pregnant women must quickly make a decision regarding their reproductive futures. Dr. Mira Marchenko, a Kyiv OBGYN currently based in Krakow, reported that one of her pregnant patients discovered that the fetus had abnormalities just two days before Russia invaded. She desired to terminate due to medical reasons, but ran out of time. Unable to obtain an abortion in Poland, she chose to travel to the Czech Republic for care. Marchenko said that her patients also report difficulty obtaining birth control or emergency contraception in Poland.

Some women may seek a termination because they now find themselves in less stable situations than before the war—without homes, without husbands, without a sense of normalcy—and no longer feel comfortable bringing a newborn child into the world.

Polish NGOs are working to help Ukrainian refugees in Poland acquire abortion pills from abroad or facilitate travel to a neighboring country for care–creating an abortion underground railroad. Still, these local activists can face criminal charges, including jail time, for “helping an abortion.” 

The Status of Abortion in Ukraine

For those returning to Ukraine, access to abortion remains less restrictive. Ukrainian reproductive rights advocates and physicians agree that continued access to abortion and sexual health services, like STI testing and treatment, must remain a top priority throughout the war. President Volodymyr Zelenskyy has previously expressed his support of protecting abortion rights in Ukraine. 

On June 23, Kyiv courts opened the first trial of a Russian soldier charged with sexually assaulting a Ukrainian woman, marking the first prosecution of rape as a war crime since the February 24 invasion.