5.L. Round table: Gaining or losing ground? Leveraging social innovation to improve abortion access in Europe

Abstract Sexual and reproductive health services are fundamental to ensuring a wide range of human rights, including the right to health. This includes guaranteeing access to abortion care, which international human rights bodies and the World Health Organization have recognised as a critical component of states’ obligation to respect and ensure human rights. Abortion regulation in Europe continues to evolve along a continuum from restrictive to liberal. For decades, the legislative trend across Europe has been towards the expansion of entitlements to abortion, and the repeal of legal and policy restrictions. In the last ten years, over 15 European countries have undertaken reforms to modernize their laws, including Belgium, France, Ireland, the Netherlands, and Spain. Currently, new progressive reforms are being considered in several countries. However, more restrictive reforms have also been adopted. Health system structures and sociopolitical, cultural, ethical, and moral dimensions shape access to abortion services, while abortion regulation often causes tensions in countries. The landscape is complex, with debates over legalisation and decriminalisation of abortion, and the procedural steps to ensure service provision. Differences in regulation across and within countries result in myriad access inequalities. Understanding abortion regulation in Europe is vital to assessing service equity and access. Exploring the sociopolitical contexts of abortion helps identify potential actions for ensuring access to abortion care. In exploring the range of potential actions, we focus on social innovation, i.e., new social practices to better meet social needs and the processes undertaken to get there. The country expert (HSPM) network of the European Observatory has launched a cross-country study of the state of abortion services in 19 high-income countries since 2018. This workshop will outline the legal, regulatory, service-delivery, and sociopolitical contexts of abortion in Europe, identifying challenges to access. It will take recent experiences in Germany, Ireland, and Portugal to examine differential access, ongoing political debates, and social positioning of abortion in Europe, and as a springboard to discuss the role of social innovation in shaping legal and regulatory changes. Lastly, this workshop will explore how the public health research community can contribute to evidence-based abortion policymaking and implementation. This interactive workshop will start with a presentation of findings from the European Observatory’s cross-country comparison. Then, country experts from the 3 case studies and a representative from the Center for Reproductive Rights will examine the sociopolitical environment of abortion policymaking in Europe. Discussion with audience interventions will reflect on opportunities for social innovation and movement building toward better access to abortion care in Europe and explore the role of the public health research community. Key messages • European abortion laws constantly evolve with a prevalent legislative trend towards expanding access and removing barriers; social innovation can be a lever to progressive law and policy reforms. • In all countries, those seeking abortion care continue to experience multiple access barriers, including those related to policy, regulation, financing, geography, and culture. Speakers/Panelists Katherine Polin Berlin University of Technology, Berlin, Germany Miriam Blümel Berlin University of Technology, Berlin, Germany Catherine Conlon Trinity College Dublin, Dublin, Ireland Ines Fronteira National School of Public Health - NOVA University of Lisbon, Lisbon, Portugal Adriana Lamačková Center for Reproductive Rights, Geneva, Switzerland