A majority of European countries hinder access to abortion for vulnerable women by not including it in the national health system's coverage, according to a new report.
Abortion also technically remains a crime in 14 of Europe's 52 countries, according to the European Abortion Policies Atlas.
The atlas, published on Tuesday to mark International Safe Abortion Day, found most European Union member states allow abortion on request — where the decision is made by the woman alone.
Malta is the only EU member state to strictly prohibit abortion entirely while Poland recently tightened the screws further by making it illegal to terminate a pregnancy even in cases of severe and irreversible fetal defects.
Abortion is also illegal in Andorra and San Marino — although residents in the latter overwhelmingly backed a proposal to make abortion legal in a referendum over the weekend. Residents in Gibraltar similarly voted to ease abortion rules earlier this year.
Finally, Lichtenstein and Monaco also have restrictive abortion rules.
The atlas was compiled by the International Planned Parenthood Federation's European Network (IPPF EN) and the European Parliamentary Forum for Sexual and Reproductive Rights (EPF).
Europe's 'mixed situation'
Furthermore, the atlas noted that abortion is not included in the national health system's financial coverage in a majority of European countries (31) which it said "penalises all women and girls, but specifically the vulnerable" including those low income, living in rural areas, Roma, sex workers and undocumented migrants.
Meanwhile, it said, 19 countries force women to endure medically unnecessary requirements before accessing abortion care such as "compulsory and sometimes biased counselling" and forced waiting periods; 26 countries allow health workers to deny care on the basis of their personal beliefs or convenience; and 18 countries fail to provide people with clear and accurate information about abortion care.
Among the countries that enforce what the IPPF EN and EPF deem to be unnecessary requirements are several ones seen as progressive including Belgium, Germany, and the Netherlands which require waiting periods.
The UK and Finland are also among countries that require women to see and get the approval of at least two medical providers before being allowed to get an abortion.
Most EU countries also demand parental consent before a minor can get a safe and legal abortion, which the two organisations flag expose many girls to violence or a breach of privacy.
"While international media has recently rightly focused on Texas and the broader US in terms of restricted abortion access, the situation in Europe also deserves specific attention," EPF Secretary Neil Datta, said in a statement.
"Our atlas shows a mixed situation across the Continent. While national health systems in 21 countries treat abortion as any other medical service, in 14 countries and territories, abortion remains technically a crime, even though most Europeans consider abortion to be a women’s right," he added.
In general, northern and western European countries rank better in the Atlas.
The ranking saw each country receive points based on criteria including the number of weeks abortion is available for, whether it is allowed in all cases or restricted to medical and/or criminal grounds, what procedures are carried out and who is allowed to provide them, the level of information women receive on their choices, reliability of government's information.
Sweden is deemed to have the best legal framework to access safe abortion care with a score of 94 out of 100. It is followed by Iceland at 91 and the UK at 89 (although Northern Ireland has a 59.5 score). The Netherlands (85), France (84), and Denmark (83) come next.
Three countries have scores between 40 and 50. These are Hungary, Northern Cyprus, and Bosnia-Herzegovina.
But perhaps unsurprisingly, Malta, Andorra, Gibraltar, Lichtenstein, Monaco and Poland have the lowest scores.
"It is startling how much disregard some governments have for women's lives," Caroline Hickson, IPPF EN Regional Director, said.
"A new bill was just introduced in the Polish Parliament that - if adopted - would remove the possibility of accessing abortion care even in cases of rape or incest. This move comes after, almost one year ago, abortion in cases of severe and irreversible foetal defects was banned. Women have been forced to travel abroad, mostly to the United Kingdom to access care, but soon they will be needing a passport to enter, restricting even more their choices," she went on.
The two organisations called on European governments to "urgently" update their legislation and safeguard the right of women and girls to access safe, legal and compassionate abortion care.
_An earlier version of this article incorrectly said Gibraltar still had to introduce legislation to reflect a referendum on easing abortion rules. _