No Increase in Pregnancy Terminations Following Law Change

Iceland's Althing

Changes to Iceland’s abortion law that took effect in 2019 did not impact the number of pregnancies terminated in the country, according to a newly published report from the Directorate of Health. The law was heavily debated when it was introduced to Alþingi, Iceland’s Parliament, and criticised by the Bishop of Iceland, among others. The changes appear to have shortened the time between the decision to terminate a pregnancy and the procedure itself. RÚV reported first.

According to the latest figures from the Directorate of Health, the frequency of pregnancy termination in 2022 was similar to what it was before the law was changed in 2019. The number of terminations was slightly lower in 2020 and 2021, which may be explained by gathering restrictions due to the COVID-19 pandemic.

Termination of pregnancy permitted until 22nd week

Under the new law, it is legal to request a termination of pregnancy up to the end of the 22nd week of pregnancy, instead of the 16th week, as the law previously allowed. However, the law still indicates that the procedure should be carried out as soon as possible, preferably before the 12th week of pregnancy.

The previous law in Iceland also permitted termination of pregnancy after the 16th week, but only due to unequivocal medical reasons. Such terminations required written authorisation from a Directorate of Health committee. This is no longer the case under the new law.

The old law was changed in part due its violation of the United Nations Convention on the Rights of Persons with Disabilities, as it allowed the termination of pregnancy after the 16th week if there was “a high likelihood of malformation, genetic defects or damage to the fetus.” The law was first put under review in 2016, culminating with the introduction of the now-approved bill in 2019, by then-Minister of Health Svandís Svavarsdóttir.

Supported by medical professionals

Professional medical associations expressed support for the new law when it was introduced. These included the Association of Icelandic Obstetricians and Gynaecologists, the Association of Icelandic Nurses, the National University Hospital of Iceland, the Directorate of Health, and the Icelandic Social Workers’ Association. The Bishop of Iceland Agnes M. Sigurðardóttir wrote an op-ed in Morgunblaðið newspaper opposing the changes, and People’s Party MP Inga Sæland also vocally opposed them at the time. Bjarni Benediktsson, chairman of the Independence Party and now Prime Minister, was the only government minister to vote against the bill.

Despite the legislation being relaxed in 2019, there is no evidence that the number of pregnancy terminations after the 16th week has increased in Iceland. On the other hand, a larger proportion of terminations are carried out earlier in the pregnancy, with nearly 90% carried out before the ninth week.

New Minister of Justice and Assistant ‘Not to be Trusted’ with Women’s Issues, Critics Say

Halldóra Mogensen, MP for the Pirate Party, and Þorgerður Katrín Gunnarsdóttir, Chairperson of the Reform Party, have expressed strong misgivings about the way in which incoming Minister of Justice Jón Gunnarssson and his newly appointed assistant, Independence Party MP Brynjar Níelsson, will handle issues related to the rights of women, RÚV reports. Jón has said that he will focus on reviewing the status and treatment of sexual offenses in Iceland, but both Jón and Brynjar’s voting record has been called into question, with Þorgerður Katrín saying that when it comes to “women’s liberation issues,” she does not trust either man’s politics.

Halldóra and Þorgerður Katrín’s critique cited Jón and Brynjar’s vote on a specific bill from 2019. The bill in question extended the window within which pregnant individuals are allowed to obtain an abortion for any reason to 22 weeks. Previously, abortions were only allowed after 16 weeks under specific circumstances. The abortion bill was presented by former Minister of Health Svandís Svavarsdóttir and passed in 2019 by a margin of 40 to 18. Both Brynjar and Jón voted against the bill.

“I find this strange,” said Halldóra. “I can’t imagine that the Left-Greens are very enthusiastic about this appointment either. Jón is taking on an enormous and important set of issues and he’s hiring an assistant who has, in the course of his entire parliamentary career, only submitted one parliamentary issue, he’s only submitted a single parliamentary issue, and that was the bill that revolved around imprisoning parents who restrict custody access. It says an incredible amount about a person’s politics I think it’s dangerous to know that these two men are going to work together to take on sexual violence issues and I don’t believe that properly addressing these issues is really in the cards.”

When asked if she trusted Jón and Brynjar on such issues as improving the position of victims of sexual offenses, Þorgerður Katrín responded: “No, not when it comes to these sorts of issues, although I’ve had good collaborations with Jón and Brynjar over the years. I’m fond of these men, I admit, but on the other hand, their politics cannot be overlooked when it comes, for instance, to women’s liberation issues. The abortion bill that Svandís put forward—who was it that did not support that? The Independence Party leadership, Jón Gunnarsson, Brynjar Níelsson. They voted against it.”

Pressure groups and activists have also been vocal in their displeasure at Brynjar’s appointment. For his part, however, Jón stuck by the decision, saying, “I’m not worried about this discussion, it isn’t bothering me. Much of what has been said is not worth responding to and not objective nor balanced. I let such things fall on deaf ears and don’t let them bother me. We’re going to let our actions speak.”

Health Ministry Considers Returning Cervical Screening Processing to Iceland

Minister of Health Svandís Svavarsdóttir

Minister of Health Svandís Svavarsdóttir says the Ministry is considering processing cervical scans in Iceland once more after transferring the procedure to Denmark has not gone as smoothly as planned. Such a decision would require a great deal of preparation on the part of the National University Hospital, which would be processing the samples.

At the end of last year, cervical screening was transferred from the Cancer Society to capital area healthcare centres following a human error that led to several misdiagnoses at the Cancer Society. Authorities decided to send the samples to Denmark for viral and cellular analysis, which has been harshly criticized by women, gynecologists, and oncologists. There have been cases of women having to wait months for results even in cases where cellular changes had been detected.

In a radio interview this morning, Svandís stated that the processing time of the samples abroad was too lengthy and that it was concerning how little trust society had toward the changes made at the end of last year. “And that’s why we have been discussing with the Health Centres and the National University Hospital about the possibility of moving that research part back here.”

The process would require significant planning, according to the Health Minister, including ensuring staffing, equipment, and housing was available to process the samples. “In fact, we have always thought that it would be best if this was done here, but that requires preparation. It is not as if the National Hospital could take this over in a day.” Svandís stated she hoped the ministry and healthcare centres would be able to report more details on the issue in the next few days.

Health Clinic for Women Coming to Capital Area

doctor nurse hospital health

The Capital Area Health Service will open a special health clinic for women as a pilot project within the healthcare system. Minister of Health Svandís Svavarsdóttir decided to launch the project in consultation with the Capital Area Health Service. There are indications that women’s healthcare needs are not being met. The Health Service has received ISK 60 million ($485,000/€408,000) in funding for the project and it is hoped the project will gather knowledge that can be applied across Iceland.

Healthcare issues that are particularly relevant to women include menopause, contraception, domestic violence and its consequences, and various illnesses that affect women in particular. A clinic dedicated to women has been suggested as a way to address these issues more directly and improve healthcare for women overall.

The pilot project entails opening one women’s clinic in the capital area that will be staffed full-time by health professionals who have specialised experience and knowledge, e.g. doctors, nurses, or midwives. Emphasis will be placed on staff being able to diagnose and address issues, as well as having accurate and evidence-based information available to healthcare professionals, women, and the general public.

An opening date for the clinic has yet to be confirmed but preparations are now underway.

Women’s Shelter to Open in Akureyri

Akureyri in winter

The Kvennaatharf women’s shelter will be opening a location in Akureyri, North Iceland, at the end of the summer, RÚV reports. This will be the first time in over 30 years that there’s been a shelter for survivors of domestic abuse outside of the capital.

The Akureyri shelter will be open through next spring as a pilot project that director Sigþrúður Guðmundsdóttir hopes will clearly demonstrate the need for such a facility in the region. Sigþrúður says that two out of ten women who come to the Reykjavík shelter arrive from outside of the capital area.

“We’ve long wanted to better serve [people in] the countryside and this is the first step in that direction. There was, indeed, a shelter in Akureyri in the early days, in 1983/84, I think, but the day came that there weren’t grounds for a shelter there. But so much has changed since then.”

Kvennaathvarf has leased a space for the Akureyri shelter and hired staff. Sigþrúður says that local authorities and residents in the surrounding municipalities have been positive toward the initiative.

“Up until now, the only shelter for women who are fleeing violence in their homes has been in Reykjavík. This restricts the possibility of women in the countryside seeking assistance. About 20% of the women who come to the shelter at any given time are women from other parts of the country. It’s a certainty that the further the shelter here in Reykjavík is [from them], the more unlikely it is that they will come. And that’s natural. So it’s extremely positive for us to be able to provide this service out in the countryside – we’re really looking forward to it,” said Sigþrúður.

‘Hop a Ride on the Midwife Mobile’

An electric bus adorned with an illustration of two women giving birth with the helping hands of unseen caretakers pays tribute to midwives and the work they do, Vísir reports. The ad, which simply reads “We warmly welcome you,” was sponsored by the Icelandic Midwives Association and made its maiden voyage on Wednesday.

The World Health Organisation (WHO) has designated 2020 the “Year of the Nurse and the Midwife,” in honour of Florence Nightingale, who was born 200 years ago. “These are the people who devote their lives to caring for mothers and children; giving lifesaving immunisations and health advice; looking after older people and generally meeting everyday essential health needs,” reads the campaign description. “They are often, the first and only point of care in their communities. The world needs 9 million more nurses and midwives if it is to achieve universal health coverage by 2030.”

Inviting locals to ‘Hop a ride on the midwife mobile,’ the Icelandic Midwives’ Association praised midwives for the vital role they play in the pregnancy and birth process, and noted that midwives also “provide education and services related to wellbeing, women’s health, and women’s bodies” and “work anywhere and everywhere, including in homes, out in the community, at hospitals, private facilities, and local health centres.”

The organisation then called for “a powerful platform” to be created for midwives and nurses, the better to allow them to participate in the creation of public policy related to healthcare services. “Studies have shown that when a midwife attends a birth, infant mortality rates and illness are reduced by almost 80%,” the call continues, “and premature births by 24%. In addition, under the care of midwives, more women are breastfeeding, women’s psychosocial health is better, and there are fewer interventions in births, particularly caesareans. The work of midwives is, therefore, indisputably important to the welfare of newborns and women; infant mortality in this country is among the lowest in the world.”

“For these reasons, the Icelandic Midwives Association wanted to take this opportunity to call attention to itself and in so doing, reiterate the importance of midwifery here in Iceland. Though we’ve achieved great things, it’s always possible to do better.”

The ‘Midwife Mobile’ is currently running along route #18 from Spöngin shopping mall in Grafarvogur to Hlemmur in downtown Reykjavík.

Changes Proposed to Abortion Laws

Emergency room

Health Minister Svandís Svavarsdóttir has decided to submit a bill to parliament which, if approved, would change the legal terms for abortion in Iceland. RÚV reports that the new bill would extend the time limits that are currently in place regarding abortion and allow women to have the procedure done up to the 22nd week of their pregnancy. The bill would also allow women to get abortions for any reason, rather than only under certain approved circumstances, as is currently the case.

Under current law, women are only permitted to have an abortion up to the 16th week of pregnancy if there are specifically approved health reasons or for ‘social reasons,’ such as if the pregnancy is the result of a rape. The existing law also allows for abortions after the 16th week if there is a threat to the woman’s health, or high likeliness that the fetus will be born with deformities or genetic or birth defects.

In its original version, the new bill proposed allowing abortions up to the 18th week, emphasizing that it would not matter what a woman’s reasons for wanting an abortion were, so long as her desire to have one was clear. The bill has since been revised, however, so that abortions would be allowable up to the 22nd week of pregnancy, again, regardless of the woman’s reasons for requesting one. As in the existing law, the new bill emphasizes that after an abortion has been requested, it should be performed as soon as possible.

An announcement from the Ministry of Welfare on this new bill also underscored that its provisions do not violate the rights and objectives established in the United Nations Convention on the Rights of Persons with Disabilities. This assurance comes as a result of a flurry of international coverage last year about the low number of children born in Iceland with Down syndrome. The reason for the outcry was that ever since the introduction of prenatal screenings in Iceland at the turn of the century, close to 100% of all women who tested positively for Down syndrome have chosen to end their pregnancies. The Ministry maintains, however, that the new abortion bill continues to conforms to international standards and does not contravene the rights of people with disabilities.

Propose Targeted Health Services for Women

Icelandic doctors have expressed concerns about the idea of a dedicated health centre for women, a pilot project recently announced by Minister of Health Svandís Svavarsdóttir. Chief Physician of Women’s Services at the National University Hospital of Iceland says the criticism is based on misunderstanding of the project.

The Ministry of Welfare has assigned the developmental department of public health to implement two women’s health within existing health centres which would provide women with counselling and various services related specifically to women’s health. Svandís stated the project is intended to help professionals develop specialised skills in the area, strengthen health care service, and promote teamwork within health centres.

Targeted service

“Many doctors have been worried about this and there has been a lot of discussion online in our closed groups and so forth,” stated Þóra Steingrímsdóttir, Chief Physician of Women’s Services at the National University Hospital of Iceland. “But I think this is somewhat built on misconceptions and there is unnecessary fear that men are being excluded or projects taken away from them.” Þóra supports the project, saying it’s “quite a good idea.”

Áslaug Valsdóttir, chairperson of the Icelandic Association of Midwives, agrees that many doctors are misunderstanding the nature of the project. “I think they imagine some kind of big, centralised women’s health centre[…]staffed only by midwives who oversee everything. But that’s not at all the case. This is planned to be a small unit at each health centre. And really just to make service more targeted and not as dispersed.”

Áslaug says the project could make a big difference. “I think it’s a part of improving services for this particular group of women and as I understand it, the concept is a pilot project at one health centre in Reykjavík and one in the countryside. Then the project will probably be evaluated after one or two years and we’ll see whether it has delivered. I have faith in it.”

Men’s health equally important

Icelandic Director of Health Alma D. Möller expressed support for the project in a letter published on the Directorate of Health’s website. She added, however, that looking into men’s health is no less important, pointing out that life expectancy for Icelandic men is 3.4 years shorter than for Icelandic women.