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Poland's abortion-rights activists say they can teach Americans about loopholes

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As Americans wait for a Supreme Court decision on a case that could overturn the 1973 decision that legalized abortion in the U.S., other countries already provide a snapshot of what that's like.

LEILA FADEL, HOST:

In 1973, the Supreme Court's Roe v. Wade decision legalized abortion across the United States. Now, nearly 50 years later, it could overturn that decision this month. Abortion activists are concerned about what that means going forward. But could other countries already be providing a snapshot? NPR's Deb Amos reports from Warsaw, Poland, which has the toughest restrictions on abortion in Europe. And a quick warning, there is a brief discussion of rape in this story.

(SOUNDBITE OF PHONE RINGING)

ANTONINA LEWANDOWSKA: Oh, sorry. That's probably an abortion intervention.

(SOUNDBITE OF PHONE RINGING)

LEWANDOWSKA: (Non-English language spoken).

DEBORAH AMOS, BYLINE: In Poland, abortions are almost entirely illegal. But there are still legal ways to help women who call this hotline, says Antonina Lewandowska. She's with FEDERA, Poland's oldest family planning and pro-choice organization. She sympathizes with Americans who fear the worst when the U.S. Supreme Court rules on abortion. Poland had the toughest restrictions in Europe. And last year, Poland's constitutional court tightened the ban even more.

LEWANDOWSKA: You can look at us as a warning. Or you can look at us as...

AMOS: She eventually settles on Poland is a guide because activists here have already found loopholes in the government ban.

LEWANDOWSKA: There is a saying in Polish - if I cannot get through the door, I will get in through the window. And that's what we are doing.

AMOS: Lewandowska can legally direct women to websites listing clinics in countries where abortion is legal. She can point out websites that offer abortion pills from the Netherlands, delivery within 24 hours. Then she knows the links to private groups who can pay when a woman cannot. All this is backed by a coalition of activists across Europe.

(SOUNDBITE OF PHONE RINGING)

LEWANDOWSKA: That's a day at work here.

AMOS: There was a day when Poland was the destination for abortions, legal through the 1980s under a communist government.

(SOUNDBITE OF MUSIC)

UNIDENTIFIED CHOIR: (Singing in non-English language).

AMOS: The change came in 1989 with the end of one-party rule and the first democratic elections. The Catholic Church, that had led the fight against communism, pushed for an abortion ban. The parliament obliged. In 1993, the law had broad support. There were three exceptions - when a woman's life is at risk, the pregnancy results from rape or incest or the fetus is damaged. And that by far was the majority of legal terminations.

(SOUNDBITE OF MUSIC)

UNIDENTIFIED CHOIR: (Singing) Amen.

AMOS: Over time, the Catholic Church has chipped away at the exceptions and successfully lobbied the Polish government to create other laws protecting, as church officials say, the sanctity of life.

RAFAL DOROSINSKI: We are glad that so far we are winning and that most of the society is on our side.

AMOS: That's Rafal Dorosinski, a lawyer and an advocate for Ordo Iuris. In addition to the abortion ban, this conservative catholic group pushed to end government support for in vitro fertilization, which the church considers a sin. And last year, Ordo Iuris applauded when the government decreed that a woman could no longer have a legal abortion when her fetus is damaged, even if there are life-threatening abnormalities.

(SOUNDBITE OF PROTEST)

AMOS: Last year, as protests erupted across the country - the largest in 30 years - the latest constraint changed the abortion debate. Surveys showed a majority of Poles wanted more reproductive rights. And the culture war heated up again this year when Poland became a destination for Ukrainian war refugees, including rape survivors, says Dorosinski.

DOROSINSKI: We should do everything we can to help those who suffered during the war. But let's not confuse the terms. We shouldn't consider killing unborn children as a kind of help. Killing a baby is killing a baby. It's not giving help to anybody.

AMOS: Hello.

UNIDENTIFIED PERSON: Hello.

RAFAL KUZLIK: Nice to meet you.

AMOS: You're the doctor?

KUZLIK: Yes, I am.

AMOS: That's Rafal Kuzlik, a gynecologist, an obstetrician who treats Ukrainian rape survivors. He dismisses the charge that Ukrainian women came to Poland for abortions. It's legal in Ukraine.

KUZLIK: They're taking care of it in Ukraine. And there is no problem for them. We are not expecting pregnant women for helping them with abortion.

AMOS: It's Polish patients who are desperate for help now that the last significant exception, fetal abnormalities, has been banned. Kuzlik says the ban created a climate of fear, doctors afraid to abort a fetus with a heartbeat who won't live after birth, risking the mother's life. There are two highly publicized deaths of pregnant women that underline the unintended consequences of what he says is a harsh new ban.

KUZLIK: If you believe in God - I do. But if you believe in God, you will be judged after your death, not here. If you have a problem, if your baby is without head, if your baby is, you know, with any kind of diseases or doesn't let you live after birth, I will help you.

AMOS: Kuzlik insists radicals connected to the church and the government are in power now and pushing this agenda. The latest radical move, he says, the government requires Poland's central health care system to check if a patient is pregnant no matter what she came in for. Critics call it the pregnancy registry. Is it also the government's aim to track if a pregnancy ends? Antonina Lewandowska with FEDERA says, it's not yet clear.

LEWANDOWSKA: I think it's a big deal and not a big deal at the same time because that is true, not much is actually changing. The criminal law hasn't changed. People can still terminate their own pregnancies legally until the 22nd week of gestation. So nothing has changed. The only difference is the information about the pregnancy would be actually put on - in the online medical records of the patient.

(SOUNDBITE OF PHONE RINGING)

LEWANDOWSKA: Goodness gracious. Sorry for that.

(SOUNDBITE OF PHONE RINGING)

LEWANDOWSKA: (Non-English language spoken).

AMOS: It is still legal, she insists, for a pregnant woman in Poland to terminate her pregnancy abroad. And it's still legal to order abortion pills. In fact, the data shows that Poland's abortion ban has not actually stopped abortions. The numbers remain consistent despite the ban, as Polish women find ways to make their own decisions about their bodies.

Deborah Amos, NPR News, Warsaw.

(SOUNDBITE OF FEDERICO ALBANESE'S "THE STARS WE FOLLOW")