The Federation for Women and Family Planning, TUS Foundation, Strefa Wenus z Milo Association, Elektrownia Inspiracji Foundation, Stowarzyszenie Inicjatyw Kobiecych/Association of Women Initiatives and Agnieszka Wołowicz respectfully present this submission to the Committee on the Rights of Persons with Disabilities in advance of its review of Poland’s compliance with the Convention on the Rights of Persons with Disabilities. The submission addresses concerns regarding women with disabilities’ enjoyment of sexual and reproductive rights and raises questions regarding Poland’s compliance with its obligations under the Convention on the Rights of Persons with Disabilities Articles 5, 6, 167, 22, 23 and 25.
The submission endorses the issues and concerns outlined in the preliminary submission of Women Enabled International and ONE.pl dared January 31, 2018.
Supplemental Information on Poland to the Committee on the Rights of Persons with Disabilities
I. Sexual and reproductive health and rights concerns affecting women with disabilities
Women with disabilities in Poland face a range of barriers and breaches of their human rights, including the rights to integrity of the person, privacy, health and equality and non-discrimination as a result of laws, policies and practices that fail to respect and guarantee their sexual and reproductive health and rights as well as lack of effective measures to ensure that health services and facilities are adapted to their needs.
A range of pervasive harmful stereotypes undermine the enjoyment of sexual and reproductive health and rights by women with disabilities in Poland. These include beliefs that women with disabilities are asexual or hypersexual and that as a result there is a need to control their fertility or suppress their sex drive.[1] In Poland, there are also widespread paternalistic attitudes regarding the capacities of women with intellectual disabilities to make decisions about their health and lives and to care for children. These deep-seated stereotypes fundamentally undermine the autonomy of women with disabilities and can enable interferences with their bodily integrity and reproductive autonomy.
Women with intellectual disabilities in Poland are often placed in care institutions where they may experience lack of respect for their bodily autonomy and physical integrity. In care institutions (e.g. social care home) women with intellectual disabilities may be subject to a range of forcible and coercive practices that undermine their sexual and reproductive health and rights, including forced and coercive sterilizations, forced and coercive abortions, and contraception being administered without their free and informed consent. There have also been instances where women with disabilities have faced punishment for manifestations of their sexuality.
In addition state authorities often decide to remove children from the custody and care of women with disabilities against their will.
Guardians or care givers for women with disabilities often act on their behalf on the basis of what they may consider is in the best interest of the woman but without her consent. Often this leads to a range of abuses and harm to women with disabilities, such as experience extreme limitation of contact with parents or specialists when they observe that the woman with disabilities is sexually interested in somebody, separation of families comprised of persons with intellectual disabilities in various care institutions[2].
Women with disabilities also face numerous barriers and discrimination in access to a range of sexual and reproductive health services:
Access to contraceptives: Women with disabilities are often only offered a limited choice of contraceptives or methods of fertility regulation, which may not be adapted to their needs. In Poland, emergency contraception is now only available with a doctor’s prescription following recent regressive changes to the law. This requirement poses a serious barrier for access to emergency contraception with compounded impacts on women with disabilities.
Access to maternal health care: Very often health care facilities and services are not adapted to the needs of women with disabilities. Some of the factors hampering women’s access to maternal care include: lack of guidelines for perinatal care for women with disabilities; inadequate accommodation and facilities in gynecological surgeries and hospitals adapted to the needs of women with disabilities; inadequate provision of information about sexual and reproductive health and rights in formats that are accessible to women with disabilities; and lack of professional help and respect for privacy in health care settings. In addition, women with disabilities often experience practices that infantilize them as patients, such as medical professionals addressing them through a third party or expressing negative opinions about their maternity plans. Moreover, many medical professionals lack of knowledge about the psychological and medical conditions of disability making it difficult to establish a good contact with the patient and adapt the method of gynecological examination to the woman’s needs[3].
Access to abortion care: Poland has one of the most restrictive abortion laws in Europe.[4] Access to abortion is permitted in three circumstances only: 1) when the pregnancy endangers the life or health of the woman without gestational limit; 2) when there is a high probability of a severe and irreversible fetal impairment, abortion is permitted until the fetus reaches viability; and 3) when the pregnancy results from a crime, abortion is permitted during the first 12 weeks of pregnancy.[5] Doctors or anyone else who helps a woman to obtain an abortion outside of the scope of the law is liable to a three-year prison sentence.[6] Women, including women with disabilities, are prohibited from making an autonomous decision to end a pregnancy safely and legally. As a result women who do not fall within the exceptional circumstances outlined above are faced with three choices: (a) undergo clandestine, and potentially unsafe, abortion in Poland; (b) source safe and legal abortion services in another country and travel out of Poland at their own expense to obtain those services; (c) carry an unwanted pregnancy to term. Even women who do meet the very strict requirements for legal abortion are generally not able to access abortion services in practice and only around 1000 legal abortions are performed each year in Poland. The severe barriers faced by all women in Poland in gaining access to abortion care are compounded for women with disabilities. The severe difficulties which women in Poland face in gaining access to legal abortion services have repeatedly been addressed by the European Court of Human Rights, which has issued three judgments against Poland on the matter. Poland has failed comply with those judgments.
II. Recent attempts to restrict access to abortion care
In recent years there have been multiple attempts by Polish policy makers to further restrict the abortion law, by removing grounds on which abortion is legal or banning it entirely. In 2011, 2013, 2015 and 2016 draft legislative proposals were introduced that contained total or near total bans on abortion. While these proposals have been rejected so far they pose real threats to access to abortion care for women, including women with disabilities. Access to abortion care is an essential aspect of sexual and reproductive health services that all women need and removing grounds for abortion or banning it altogether is likely to lead to an increase in clandestine and unsafe abortion procedure with grave consequences for women’s health and lives.
The attempts to restrict the law and Poland’s on-going failure to ensure effective access to abortion care for women, including women with disabilities, have drawn criticism from numerous international human rights bodies as well as the Council of Europe Commissioner for Human Rights. For example, the Human Rights Committee and the Committee on the Elimination of Discrimination Against Women have repeatedly expressed concern about Poland’s restrictive abortion law and practice and the severe negative impacts on women.[1]
Currently, a draft bill entitled „Stop Abortion,” which would remove certain legal grounds for abortion from the law, is pending before a sub-committee of the Parliamentary Committee on Social Policy and Family. The draft bill was proposed through a citizens initiative and seeks to effectively bar women from access to abortion care. It would remove as a legal ground for abortion circumstances where pregnant women receive a diagnosis of a severe or fatal fetal impairment. In such circumstances women would no longer be permitted to end a pregnancy.
In addition, a challenge to the constitutionality of the same legal ground for abortion is now pending before Poland’s Constitutional Tribunal. The petition to the Constitutional Tribunal has been brought by a group of MPs from the ruling Law and Justice party.
The underlying intention of these initiatives is to effectively ban women from access to abortion care in Poland and have only been pursued when attempts to introduce a total ban have failed.
These proposals, if adopted, would pose grave threats to the sexual and reproductive rights of women, including women with disabilities, and would fail to comply with Poland’s human rights obligations, including under the Convention on the Rights of Persons with Disabilities. These latest attempts to restrict access to abortion fail to respect the principle of non-retrogression, which requires Poland to not roll back existing human rights protections, including in the area of sexual and reproductive rights.
III. Recommendations
- Women and girls with disabilities must be able to make decisions for themselves about their sexuality and reproduction, including with support to ensure their voluntary and informed consent when needed.
- Information, goods, and services must be accessible to women with disabilities, sensitive to their needs, and provided on the basis of non-discrimination, with reasonable accommodations as needed.
- Physical spaces where health care services are provided, medical equipment, and transportation to and from these facilities must be available and accessible to women and girls with disabilities.
- Health care workers must be trained to work with women and girls with disabilities, communicate in alternative ways (e.g. in sign language) and provide services that are based on dignity and that respect the autonomy of women with disabilities.
Federation for Women and Family Planning (Poland)
TUS Foundation (Poland)
Strefa Wenus z Milo Association (Poland)
Elektrownia Inspiracji Foundation (Poland)
Stowarzyszenie Inicjatyw Kobiecych/Association of Women Initiatives (Poland)
Agnieszka Wołowicz (Poland)
The Federation for Women and Family Planning is an expert organization that has the consultative status of ECOSOC, which for 25 years has been involved in monitoring and taking measures to ensure compliance with reproductive rights, including people with disabilities. The Federation also supports the efforts of non-governmental organizations to systematically improve the situation of people with disabilities in Poland. In the opinion of the Federation, state institutions should continue to make efforts to achieve better health protection, the right to education or participation in public and social life of these people. Parents and guardians of children and adults with disabilities should be supported on a decent level.
TUS Foundation is an expert organization since 1993. The aim of the organization is to stimulate social and professional activation of disabled people. TUS Foundation has been a co-organizer of the first and the second Polish Congress of Persons with Disabilities. During the first one the TUS Foundation was responsible for the panel about women with disabilities rights. The TUS Foundation is a co-author of the alternative report on the implementation of UN Convention on the Rights of Persons with Disabilities with a separate statement on the point 10. – right to live.
Strefa Wenus z Milo Association is an NGO founded by and for the women with disabilities. The organization is guided by the “Nothing about us without us” principle. The actions counter the charity model of support for people with disabilities. Members of the organization want to take matters into our own hands and regain their autonomy and independence. Main goals of the association are to defend the rights of girls and women with disabilities, to improve the quality of their lives, to support emancipation and to counteract discrimination and violence on the grounds of disability, gender, sexual orientation, race, religion (or lack of it), ethnic origin, age, education, economic status and others.
Elektrownia Inspiracji Foundation was established in 2015 in order to inspire young people with disabilities to develop, be active, independent and start their own initiatives. The Foundation specializes in organizing workshops and conducting accessibility audits.
Association of Women Initiatives was established in 2012 in order to start activities in fields of giving support to persons with disabilities who feel lonely and marginalized, counteract discrimination and stereotypes, fight for law enforcement and help persons with disabilities in professional activation and change of qualifications.
[1] Wołowicz, Agnieszka. 2018. The motherhood of women with intellectual disabilities. Unpublished.
[2] Wołowicz-Ruszkowska, Agnieszka. 2015. “How Polish Women With Disabilities Challenge the Meaning of Motherhood.” Psychology of Women Quarterly, August, 0361684315600390. https://doi.org/10.1177/0361684315600390.
[3] Wołowicz-Ruszkowska, Agnieszka. 2015. “How Polish Women With Disabilities Challenge the Meaning of Motherhood.” Psychology of Women Quarterly, August, 0361684315600390. https://doi.org/10.1177/0361684315600390.
[4] Center for Reproductive Rights, The World’s Abortion Laws 2016 (Wallchart, 2016), available at http://worldabortionlaws.com/map/.
[5] Law of Jan. 7, 1993 on Family Planning, Human Embryo Protection, and Conditions of Legal Pregnancy Termination amended as of Dec. 23, 1997, art. 4a.1 (1-3) (Pol.).
[6] Criminal code, arts. 152-154 (Pol.).
[7] Human Rights Committee, Concluding Observations: Poland, para. 12, U.N. Doc. CCPR/C/POL/CO/6 (2010); Concluding observations: Poland U.N.Doc. CCPR/C/POL/CO/7CEDAW (2016); Concluding Observations: Poland, para. 37 (a), U.N. Doc. CEDAW/C/POL/CO/7-8 (2014)I