Country Profile – Turkey

Law related to Abortion :

First Population Planning (PP) law was introduced in 1965 In Turkey. The major reason for introducing that law was the increase of maternal mortalities due to induced abortion especially self – induced. By this first PP law induced abortion was permitted only on medical grounds. However the nationwide studies showed that despite it was illegal number of induced abortion was increased significantly, and took place at the private surgeries. Some people who needed the abortion services could not afford the private services because of high cost and some of them recourse to self-induced abortion and encountered severe complications or even lost their lives. Therefore changing the first PP law was considered. After enormous efforts by the public sector, NGOs and Universities, the second Population Planning law was accepted in 1983. By this law, abortion up to 10 weeks was legalized on request. Trained GPs were authorized to terminate pregnancies by menstrual regulation method with the support of obgyns.Trained nurse midwives were authorized to insert IUDs.

Short summary of conditions within the law

  • To save the life of the woman
  • To preserve physical health
  • To preserve mental health
  • Rape or incest
  • Foetal impairment
  • Economic or social reasons

Available on request; Induced abortion is provided at the request of the women who is above the legal age which is 18 years. However if a woman is single and above 18 years of age only her request is sufficient. If a married woman is requesting an induced abortion, consent of her husband is also requested.

Analysis of it being restrictive if at all (NA)

Policy :

(Government policy enabling for the law, enabling beyond the law in practice etc such as population control policy, pro- natalist policy, anti sex selection policy, two child family norm)

Officially Turkey follow an anti – natalist population policy since 1965. Considers the fertility regulation as reproductive rights of the individuals and the families. Practicing Sex selection is condemned and not permitted. No restriction on the numbers of children in the family.

Practice :

(Providers trained, willing, enabling)

Providers of the fertility regulation methods are trained. Graduate Physicians can provide the services after post graduate training and being certified.

Non physicians (nurse, midwives) can insert IUDs after being trained and certified.

They are willing to provide the services. Some medical barriers are exist as obgyn specialists would not want to provide the abortion services at the public institutions they would rather prefer to provide the services at their private surgeries.

Reproductive Health Perspective :

Signatory to ICPD, CEDAW: Yes / No, any conditions

They are both were signed without reservations

CEDAW: signed in 1985 and ratified in 1986

ICPD: signed in 1994

Abortion Statistics :

Total

1 st TM

2 nd TM

safe

unsafe

married women

unmarried women

adolescents

Septic abortions

In Turkey we have nationwide studies on Population and health, since 1963 which have been repeated every 5 years. The latest was done in 2008. However its detailed results were not being reported yet therefore the most detailed information related the subject is coming from 2003 survey, according to this, there are 1780 556 pregnancies per year ; 1378 150 live births; 178 056 spontaneous abortion and 201 203 induced abortions in Turkey.

  • Since 1983 law unsafe abortion is at the negligible level, and also severe complications of abortions like septic abortion is extremely rare.
  • Because of the law almost all induced abortions are first trimester abortions.
  • Number of abortions among unmarried and adolescents/ young people are increasing. There is no statistics on.

Public sector :

Abortion services available

1 st Trimester: At the public sector abortion can be done only in legal durations which are 10 weeks.

2 nd Trimester; Not done.

Cost: 300 US $

Private sector :

Abortion services available

1 st Trimester ; in 10 weeks (legally)

2 nd Trimester; sometimes it is done illegally

Cost: a very large range is exist 300-800 US$

Methods used :

D&C, EVA, MVA, MMA with Mife Miso, MMA with Miso alone, MMA with Methotrexate Miso

Methods are used in Turkey: D&C, EVA, MVA,

MMV with Mife – Miso is used in 3 large research project

2 nd Trimester with Ethacridine lactate, Misoprostol, D&E, Hysterotomy

In some hospitals 2nd trimester abortion is done by misoprostol alone occasionally with medical indications.

Provider level allowed for surgical and medical abortion :

(Ob Gyn, MBBS, Nurses, Other)

Obgyn and trained general practitioners

Abortion related morbidity mortality statistics :

Not available

Manufacture and/or availability through import of abortion equipment (MVA syringes, EVA equipment) :

They are all imported

Manufacture/ import of Mifepristone, Misoprostol :

Misoprostol is imported, mifepriston is not licenced and imported for research purposes.

Facility and provider certification norms in brief :

GPs receive 4-5 weeks training at a training centers which is run by the ministry of health or by the universities then certified to provide MR for induced abortion

Information available in national service delivery standards :

After ICPD, a national guidelines was prepared and standards for RH services were defined.

Informal / illegal providers – if present who are they :

Very rare, some traditional old methods are recommended by neighbors or elderly people.

Population urban/ rural – Demography of the country, with an analysis of availability of abortion services ratio to population :

Accessibility to the services at the urban parts of the country is better. The abortion services are not available at the rural parts.

Role of government :

Supportive, enabling, creating barriers, provides adequate funding to run training and service delivery programmes

Political environments are changed from time to time. Sometimes it is very supportive but sometime they are ignorant, not very open opposition so far. Cost of abortion used to be paid by the government very little money was charged from the clients but last few years, all the cost is charged from the clients.

Government still fund the training programs.

Role of religion/ religious leaders :

Enabling, supportive, neutral, restrictive

Neutral and

Turkey is a secularized country.

Local Ob Gyn societies :

Supportive, conscientious objectors

Supportive

Current status and potential of research :

Research activities are very important in Turkey especially for advocacy purposes.

Research potential of the country is very high.

In Turkey there are over 100 Universities and over 50 Medical Faculties, beside some other research institutions and adequate manpower for research.

Awareness amongst community members :

That is not very high. What ever is planned to implement in the country related to RH a strong educational activities are needed.

Role of member organization/ individual :

The meanin of that question is not very clear ????