Over 5,000 women in Europe have to travel abroad for abortions each year
- The cross-border investigation Exporting Abortion reveals, through data and personal testimonies, how thousands of women in Europe still have to travel to neighbouring countries to get an abortion due to the barriers they face at home—even in states where abortion is legal.
- The reasons behind this phenomenon vary. Sometimes women realise they are pregnant after the legal deadline for abortion in their country has passed. In other cases, the fetus presents a malformation that local doctors do not consider serious enough to justify terminating the pregnancy.
- Exporting Abortion exposes the journeys European women take to access abortion services in other countries. The highest flow is from Germany to the Netherlands, followed by Portugal to Spain. The third most common route is from France to the Netherlands.
- Women don’t just travel abroad to gain access to abortions. There’s also a growing trend of women ordering and taking abortion pills on their own in countries where abortion rights are highly restrictive. This takes place outside the formal healthcare system, leaving women without medical supervision. This trend is particularly evident in countries like Poland and Malta.
Exporting Abortion team
Monday 7 April of 2025
Carol McLoughlin, an Irish woman, already had two children when she became pregnant again in 2022. She wanted to be a mother once more, but medical tests soon showed that something was wrong. It wasn’t until after the 12th week of pregnancy—when the legal limit for abortions on request ends in Ireland—that she was told the fetus’ organs were not developing. Because of the underlying diagnosis of the fetus—Down Syndrome—, she was told she would have had to wait for the baby’s heart to stop beating to be treated. ‘I couldn’t stand the mental anguish of waiting for my baby to die,’ she said. Instead Carol travelled to London (UK) to end the pregnancy.
Olga, a Polish woman, was sure from the beginning: she didn’t want to become a mother. Her country has one of the most restrictive abortion laws in the entire European Union (EU), so when she got pregnant in 2019, she didn’t hesitate to cross the border. She took a bus, accompanied by a friend, to have an abortion at a clinic in Ostrava (Czech Republic).
At the age of 30, Juliana*, a Brazilian woman residing in Portugal, did not want to have another child. She had no symptoms indicating that she was pregnant, except for some stomach pains. But at a certain point she started to experience nausea, and that’s when she found out she was pregnant at 13 weeks gestation. Abortions on request in Portugal are only allowed up to 10 weeks, so her simplest option was to cross the border into Spain, where abortion is freely available up to 14 weeks.
Across Europe, data shows that Spain receives among the highest number of women travelling for abortions. Even so, there are times when it’s Spanish women themselves who need to travel. Diana Dieste was one of them. This 38-year-old woman became pregnant in mid-2023. She wanted to be a mother, but after a long period of uncertainty and lack of information, a test confirmed that the fetus had a severe and incurable malformation. The news came in the 30th week of pregnancy, when abortion in Spain is only legal if a clinical committee—a panel of doctors—approves it. That wasn’t the case for her. She received a brief call informing her that her request had been denied by the committee. To terminate the pregnancy, she had to travel to Brussels (Belgium).
The stories of Carol, Olga, Juliana, and Diana are also the stories of thousands of European women who still have to travel to other countries in the continent to get an abortion. This phenomenon should not be underestimated: every year, more than 5,000 women cross the borders of their home countries due to the difficulties they face in accessing abortion care. In 2023, that number was at least 5,860. This figure is being revealed for the first time as a result of Exporting Abortion, a cross-border journalistic investigation, coordinated by Público, on abortion access in Europe, conducted by journalists from across the continent and published by 11 media outlets.
Each of these icons represents a total of 100 women.
This would be, for example, 5,000 women.
And this way, we would see the (at least) 7,960 women who had an abortion in a European country in 2023 without residing in that country.
Of these, at least 5,860 women resided in Europe.
But they had to travel from their country to another on the continent to have an abortion.
5,860 women may seem like a low number, but it is not.
They are more than the 5,420 abortions that took place in the Czech Republic in 2023.
They are also more than the 5,300 female athletes who competed in the Paris 2024 Olympics.
Or more than the female population of specific places, such as...
...the town of Saint-Tropez (France), where 1,973 women live.
Or the island of Formentera (Balearic Islands, Spain), where 5,558 women live.
And almost as many as the female population of the Roman neighborhood of Trastevere (Italy), where 6,117 women live.
The most recent year with available data is 2023, since most countries are still finalising their 2024 statistics. The pattern repeats year after year: between 2019 and 2023, women went at least 27,238 times to another country within Europe to have an abortion, according to Exporting Abortion. That’s the equivalent of the entire population of a town like Biarritz (France) or Windsor (United Kingdom) relocating.
The number represents just the tip of the iceberg. The figures record only terminations carried out by residents of European countries who have had to leave for abortion in the Netherlands, Spain, Czech Republic, United Kingdom (UK), Slovenia, France, Belgium, Switzerland, Ireland, and Lithuania—as well as some Polish women in Germany and Austria.
Why women cross the border
The reasons why European women need to travel to another country to get an abortion are diverse. Many do so because the law in their home country does not allow it—either because abortion is outright banned, because the legislation is extremely restrictive, or because they have surpassed the legal time limit for terminating a pregnancy. Others travel because they prefer to undergo a different method than the one offered in their country.
Another reason why women sometimes go abroad to get an abortion is because of the lack of medical facilities or professionals who provide the procedure in their area. This can be exacerbated by conscientious objection. In nearly every country in Europe, healthcare workers can invoke this right—whether for moral or religious reasons—and refuse to participate in pregnancy terminations. In some cases, providers claim conscientious objection due to social pressure from their colleagues, their superiors or even other sectors of society. This affects women like Klaudia*, a Slovakian who, five months into her pregnancy, discovered that her baby would be born with tumours covering his body. Although the severity of the foetal condition granted her legal access to an abortion in her country, she came up against her doctor’s conscientious objection.
‘It was a very bizarre situation. The doctor told me that he understood that I needed an abortion, and that he didn’t have anything against it but he couldn’t fill the document for me because the director of the hospital insisted on applying conscious objection to all the doctors in the hospital. And he didn’t want to get fired,’ she told the Exporting Abortion team.
These situations cause entire hospital staff trained to perform abortions to declare themselves conscientious objectors, leaving these institutions unable to offer the service to women who request it. This phenomenon creates genuine healthcare deserts across the continent. Anthropologist Silvia De Zordo, lead researcher of European Abortion Access, warns that ‘an entire hospital institution cannot make use of conscientious objection’, as this is ‘an individual right’. She criticises that the ‘abuse of conscientious objection’ in some countries occurs because there is no oversight or sanctions for institutions that fail to comply with the law.
Beyond all these obstacles, living in a country with more permissive laws is still no guarantee of access to abortion. In these countries, problems arise, most of the time, in pregnancies where fetal anomalies or malformations are detected at a later stage. In most countries, the final decision rests with a clinical committee comprising two or more doctors who assess the case. However, the outcome can often vary depending on the composition of the committee. Some doctors refuse to carry out the termination if they do not consider the condition severe enough.
This is the case in countries like Spain. ‘The main issue is the discretionary power these committees wield,’ explains Jordi Baroja, deputy director of the Catalan Associació de Drets Sexuals i Reproductius. According to the activist, the problem lies in the way many laws are structured, allowing for the application of subjective criteria. ‘It is simply a matter of custom,’ he adds, emphasising that denying certain pregnancy terminations is just routine. ‘There are diagnoses that will never be approved for abortion in countries like Spain.’ Again, in these kinds of cases, women are forced to seek alternatives abroad.
The routes
In short, wherever the law or healthcare professionals impose limits on abortion, women are forced to travel. All the experts interviewed reach the same conclusion. ‘Banning abortion doesn’t solve anything; it only causes abortion tourism and a loss of control by the State and society,‘ says Dr. Jozef Záhumenský, head of II. Department of Gynaecology and Obstetrics at University Hospital in Bratislava-Ružinov.
The top destination for European women is the Netherlands. With the most protective abortion law—allowing termination up to the 24th week of pregnancy—nearly half (48.15%) of all abortions compiled by Exporting Abortion took place there. Over the past five years, women from other European countries have undergone abortions in the Netherlands 13,114 times. This is in spite of Dutch healthcare centres only registering data from patients from Belgium, Germany, France, Ireland, and Poland. Abortions performed on women from countries such as Spain, Portugal, and Malta go unrecorded.
Exporting Abortion has also uncovered the main flows of movement within Europe—in other words, the most commonly travelled routes for women who go abroad to get an abortion. The most frequent route is that of residents of Germany travelling to the Netherlands. Every year, more than 1,000 women undertake this trip.
In Germany, abortion is legal up to the 12th week of pregnancy since conception—which would be equivalent to 14 weeks since the last menstrual period, if counted as in other countries. Some do not discover they are pregnant until it is too late, and others do not manage to get an abortion in time due to the regulations and regional gaps in abortion care in Germany. Dutch doctor Gabie Raven, who has 30 years of experience, opened a practice in Dortmund in 2022. She draws a comparison: while in the Netherlands, most abortions are carried out in specialised clinics, in Germany it is primarily gynaecologists in private practices who perform them. Often, they set their own rules, Raven explains: ‘Some offer only medical abortions, others restrict themselves to their own patients, while some only provide services up to a certain week of pregnancy’
The complicated regulations and the gaps in nationwide care in Germany also causes some women to go directly to neighbouring countries within the time limits. ‘People from Germany often tell us that they could have done it there too. Sometimes they are still within the 12-week period. But the counseling and the procedure are so complicated that they prefer to come to us right from the start‘, says Elles Garcia, a doctor at the Bloemenhove clinic, a Dutch health centre which specialises in abortions.
The second most common route is that of women living in Portugal who travel to Spain. More than 500 women a year make this trip. As with most of these flows, the explanation lies in legislative differences and unequal access between countries. While Portugal allows abortion on request up to the 10th week of pregnancy, in Spain the limit extends to the 14th week. Exporting Abortion has obtained detailed records, including gestational ages, of women who had abortions in two Spanish regions: Andalusia and Catalonia. In the former, 68.33% of Portuguese women who had abortions were over 10 weeks pregnant. In the latter, the percentage rises to 70.59%.
The main routes are shaped by the countries’ abortion laws—and obviously also by geographic proximity. These two factors explain the routes from Germany to the Netherlands and from Portugal to Spain. The same applies to the third and fifth most frequent routes. Both involve French women: an average of 526 travel each year to the Netherlands for an abortion, and another 454 to Spain. That amounts to more than 2,000 French women on each route over the past five years.
Legal time limits are the main reason behind these journeys by French women. Until the beginning of 2022, France permitted abortion on request up to the 14th week of pregnancy—calculated, as in most European countries, from the first day of the last menstrual period. From March of that year, this limit was extended to 16 weeks. In Spain, Catalonia is the principal destination for French women seeking abortions. Between 2019 and 2022, a total of 1,793 French residents underwent abortions there: 91.91% were beyond the 14th week of pregnancy, and 86.11% were beyond the 16th week.
That said, the implementation of the new limit in 2022 has reduced the number of French women seeking abortions in both the Netherlands and Spain. Even so, 383 French women still had abortions in the Netherlands in 2023 and 344 in Spain. In the Netherlands they can freely abort up to the 24th week of pregnancy and although Spanish law only allows it up to the 14th week, there is a second period up to the 22nd week in which in some regions such as Catalonia it is relatively easy to terminate a pregnancy. ‘What we want is to stop forcing women to travel abroad,’ says Sarah Durocher, president of the French NGO Planning Familial. To that end, the association is campaigning to eliminate the legal time limit ‘or at least to authorise abortion up to a minimum of 22 weeks.’
The only exception among the 10 most common routes that does not involve neighbouring countries is the one taken by Polish women who go to the Netherlands. Every year, an average of 479 women travel from one of the EU’s most restrictive countries to the most protective one—despite the distance between them. From the capital of the former, Warsaw, to that of the latter, Amsterdam, it’s a two-hour flight. In a straight line, the two cities are separated by just over 1,000 kilometers, with Germany in between—a similar distance to that between Paris and Vienna or Sofia and Kiev.
There is also the case of Ireland and the United Kingdom. Every year, around 240 Irish women cross over to the neighbouring country to access abortion services. But they don’t cross into Northern Ireland, where some abortion services offered in the rest of the UK are, though legal, not yet available. The route leads to England—often London. England and Ireland do not share a land border but Great Britain is the closest territory to the island of Ireland. The numbers crossing have dropped since Ireland voted to allow greater access to abortion services in 2018, but many continue to be forced to travel due to time restrictions. ‘It’s the most vulnerable who are still being exported to access care’, said Ciara McHugh, helpline coordinator for the Abortion Support Network (ASN).
All of these flows have been verified by Exporting Abortion after collecting official data and statistics from 10 countries. The Netherlands, Spain, the UK, the Czech Republic and Slovenia collect information about the country of residence of women who have abortions in clinics and hospitals on their territory. But other common flows are impossible to quantify—at least not with complete and official data—because the countries receiving these women do not collect this information, and therefore have no records of this phenomenon. Other countries collect the data but simply do not publish it.
These situations prevent knowing more about the travels of women like the Polish ones. Many choose to have abortions in neighbouring Germany or nearby Austria, but these two countries do not track how many women from Poland—or from other states—have abortions in their clinics. To reflect this reality, Exporting Abortion also included figures from Ciocia Basia and Ciocia Wienia, two feminist collectives that help Polish women travel to access abortion services in Germany and Austria, respectively. These are the main organisations supporting Polish women who choose to go to these two countries.
Each year, around 120 women make the trip from Poland to Germany with the help of Ciocia Basia, and another 85 go from Poland to Austria with support from Ciocia Wienia. If full official data were available for both flows, they would likely rank among the main routes. In fact, the data collected by Exporting Abortion shows that Polish women seek abortions in every single country where data has been gathered. This pattern is seen only in their case—and in that of German women.
Polish women also travel to the Czech Republic for abortions. According to official data, the number of Polish women seeking abortions in the Czech Republic has been increasing from 194 in 2019 to 263 in 2023, but some Polish women have faced problems when doctors are uncertain about the interpretation of the Czech law about foreigners, leading to some hospitals denying them the procedure.
More abroad than at home
Finally, Poland is one of the few European states where more women have abortions abroad than within the national healthcare system. According to official statistics, 4,244 abortions were performed in the country and inside the law between 2019 and 2023. During the same period, Exporting Abortion has documented at least 4,582 abortions performed on Polish women abroad. This phenomenon is also seen among women from Andorra and Malta, who—like Polish women—have more supervised abortions abroad than within their own countries. This is explained by very restrictive laws of these countries, which even today, as is still the case in Andorra, prohibit abortion for any reason.
Poland also has an extremely limiting law, further tightened during the years of influence and governance of the far-right PiS (Law and Justice) party, which held power from 2015 to 2023. In 2020, the Polish Constitutional Tribunal, influenced by this party, declared abortion unconstitutional in cases where the fetus has an abnormality, one of the few cases in which abortion is legal in Poland. The court decision shook the country and sparked protests across Poland. The new government, led by former European Council President Donald Tusk, has promised not only to reverse those setbacks but also to advance legislation that would decriminalise abortion in more circumstances. So far, no such reform has been implemented.
Abortion rights are the subject of constant ideological battles among those vying for power in various European countries. As a result, the recognition of the right and access to the service often depends on the political leaning of the party in government. Amid the growing rise of the far right in the world and, specifically, in Europe, several initiatives are seeking ways to safeguard access to abortion. One such example is what France did in 2023 by including in its Constitution the ‘guaranteed freedom of women to access to termination of pregnancy on request.’ Lisa Carayon, professor at the Sorbonne Paris Nord University, explains to Exporting Abortion that the measure has had a more evident impact ‘at the level of international politics’ than in terms of better access to abortion in the territory. It has also been a message to all feminist movements in the rest of the world fighting against repressive regimes,’ she adds. ‘Gives hope’.
One of the most prominent efforts in this way is the My Voice, My Choice movement, which has collected more than 1 million signatures to launch a European Citizens’ Initiative urging the European Comission to ensure safe and accessible abortion for all European women.
The pills
The data collected by Exporting Abortion confirms that the stricter a country’s abortion law is, the more women cross borders to terminate their pregnancies. There are two methods for terminating a pregnancy: surgical and medical. The first, also known as instrumental abortion, involves a doctor performing a procedure to remove the fetus, typically through a technique known as aspiration or suction. In the second method, the woman is given medication—specifically pills—to induce the end of the pregnancy. The medical method is usually performed at earlier stages of gestation, while the surgical method is necessary in more advanced stages. In some cases, where the pregnancy is very advanced, both methods are used simultaneously. Even so, not all countries offer both options.
Women from countries where only surgical abortion is permitted—such as Slovakia— sometimes prefer the medical method. Moreover, women in those countries or in restrictive countries like Poland, Malta, or Andorra don’t only seek abortions abroad, sometimes they undergo the procedure within their own country—but outside of the healthcare system. This happens because many of them purchase abortion pills, either through an NGO or on the black market—usually online—and thus are able to terminate their pregnancies on their own, without having to travel abroad. According to experts and women’s organisations, this option has become more common in recent years.
There are no official records for this alternative option, which complements the choice of travelling abroad for abortion. As a result, women who terminate pregnancies in this way are not reflected in the official statistics. However, data provided by organisations who provides the pills can indicate the extent of their use in specific countries.
Until 2023, Malta was the only EU country that maintained a total ban on abortion. That year, a single exception was introduced: abortion is allowed if the woman’s life is at immediate risk. Still, access to this right remains extremely limited. The Maltese government has not published any data on abortion access, but Exporting Abortion, after numerous freedom of information (FOI) requests, was able to confirm that between the entry into force of the new legislation in June 2023 and March 2025, doctors in the country performed only five abortions: one in 2023, four in 2024 and 0 in the three first months of 2025.
At the same time, a growing number of women in Malta are opting to buy abortion pills online and use them to terminate their pregnancies on their own—that is, without medical supervision. Since 2020, over 2,000 abortion pill shipments have been made to Malta, according to data from the main abortion pill providers—Women on Web and Women Help Women—obtained through Doctors for Choice Malta. An analysis for the Exporting Abortion investigation shows that the number of pills has doubled in four years – from 289 in 2020 to 590 in 2024. The pills are intended for immediate use for the Maltese women and not as a precaution for future use, known as ‘advanced provision’, which is another service provided by these organizations.
In 2021, Stephanie*, a 25-year-old Maltese woman, unexpectedly got pregnant, despite using contraception. As soon as she realised she was pregnant a couple of weeks in, she decided she wanted to terminate the pregnancy with abortion pills. Within an environment of illegality, where healthcare professionals have reported women to authorities for taking the pills, she felt she could hardly trust anyone throughout the process—not her employer, not her siblings, not her GP.
According to Professor Isabel Stabile, a gynaecologist and founder of the Maltese NGO Doctors for Choice Malta, less women are travelling for an abortion because ‘it’s just so much easier’ to get the pills in Malta. Malta’s geographical situation—an island in the middle of the Mediterranean—also plays a role in women’s decisions to order pills and self-manage their abortions without travelling. According to Doctors for Choice, while abortion pills cost between €80 – €120, travelling for an abortion costs between €2000 and €3000. In other contexts, women still choose to travel even if their goal is to obtain abortion pills.
Travel and pills are two sides of the same coin, and sometimes they occur together. This is the case, for example, with women who travel to Austria to access medical abortion—a common route for women from various countries, such as Slovakia. However, there is no official data to quantify these flows because Austria does collect any statistics on abortion.
Táňa* is from Bratislava, Slovakia. She explains that she became pregnant last year and did not want to become a mother. ‘As soon as I found out, I searched online for options to terminate the pregnancy with medication. I wanted to do it with pills, so I didn’t even consider having an abortion in Slovakia, since here that’s not possible. One of the first results that came up was a clinic in Vienna. It seemed like a good option, and since it’s nearby, I didn’t think twice,’ she told Exporting Abortion. Táňa took the first abortion pill at the Austrian clinic and was given a second pill to take at home. Many women who travel for medical abortion choose this approach to avoid extending their stay or having to travel again.
Unequal laws
Current legislation in Europe allows for the division of countries into two major groups. On one side are those that still criminalise abortion in all or almost all circumstances, such as Andorra, the Vatican, Poland, Malta, Liechtenstein, or Monaco. The Vatican and Andorra are the only countries in Europe where abortion remains completely prohibited. The former is the seat of the Catholic Church. The latter is a microstate located in the Pyrenees between Spain and France, with a deeply Catholic identity that influences even its head of state. As a result, most Andorran women travel to neighbouring countries to access abortion services.
Each year, an average of 131 Andorran women go to Spain to get an abortion, according to data verified by Exporting Abortion. Nearly all of them do so in Catalonia, the region bordering Andorra. In the case of France, it has not been possible to quantify the flow, as the country does not specify the place of residence of European women who have abortions in its clinics.
Andorra’s situation is quite unique. The country has two heads of state: the president of France and the bishop of La Seu d’Urgell—a Catalan town close to Andorra. This dual leadership reveals the influence of the Church in the country and in its legislation. Moreover, the Constitution, approved in 1993, recognises the right to life and protects it in all its stages, which is interpreted as an absolute ban on abortion. The penal code includes prison sentences both for those who perform abortions and for the women who undergo them.
In recent years, the Andorran government has been working to decriminalise abortion and pass new legislation on the matter. The leadership change in the bishopric of La Seu d’Urgell last year and ongoing negotiations with the Vatican seem to be paving the way. ‘The government is working to find legal and institutional alignment,’ and ‘this work is being carried out discreetly, with the intention of completing it within the current legislature’—which ends in 2027—government sources told Exporting Abortion.
Until then, women in the country are left with virtually no choice but to travel abroad to access abortion, regardless of their circumstances. Gina* was raped when she was just 14 years old. She was pregnant and could not have an abortion in Andorra. She had to travel to Barcelona (Spain) by bus, accompanied by her sister. Gina, who still cries when recalling the experience, describes the situation as ‘very traumatic.’ ‘I was raped and I didn’t want to have that child.’
In contrast to the countries that still criminalise abortion, there are those that have legalised termination of pregnancy on request during the early stages of gestation. That is, they allow women to have an abortion on request—without needing to provide any justification—for a period that varies from 10 to 24 weeks, depending on the country. Most European nations fall into this second group.
Once the legal time limit set by each country has passed, abortion remains allowed but only under specific circumstances. These usually include situations in which the health of the fetus or the pregnant woman is at serious risk. In such cases, the decision is typically left to clinical committees—made up of at least two doctors—who assess whether the condition of either party is serious enough to justify an abortion.
That’s what the law says. In practice, however, access to abortion—even where it is legal—is still fraught with obstacles. ‘You have the law, which says one thing, and then you have reality, which provides another thing,’ evince Mara Clarke, co-funder of Supporting Abortions For Everyone (SAFE) and founder Abortion Support Network. ‘If you look at Europe, many countries look like the law is perfect, but then you look at Italy, where you have abortion on request until 12 weeks, but in the southern half of Italy, 95% of doctors won’t do abortions.’
Even when women are well within the legal time frame for abortion on request, some doctors refuse to perform the procedure. They invoke conscientious objection—a concept originally rooted in the military (refusing to bear arms and kill)—which has been adapted to the healthcare context. ‘This right, in very graphic terms, is a «two-sided coin,» because while it is a right for the person exercising it, it simultaneously deprives someone else of the right to the service they are being denied. In my opinion, whenever a woman’s right collides with the rights of others, it is the woman’s right that ends up losing,’ explains Jose Antonio Bosch, Spanish legal expert in women’s reproductive rights.
This is the case of the women that live in Alentejo (Portugal), Orava (Slovakia), or Jaén (Spain), where there are real healthcare deserts because no public health workers perform abortions. There are also countries where almost all of their regions are affected by this conscientious objection, like Croatia. Despite having a law that allows free abortion up to the 10th week of pregnancy, more than 200 Croatian women go to Slovenia each year to terminate their pregnancies—where abortion is allowed within the same timeframe.
‘Despite its legislation, access to abortion in practice is limited in Croatia due to the conscientious objection of many doctors and hospitals. Many healthcare institutions do not perform abortions or impose additional administrative barriers. Moreover, there is strong social and religious pressure against abortion in Croatia,’ explains the National Institute of Public Health of Slovenia to Exporting Abortion.
These ‘additional administrative barriers’ are not exclusive to Croatia—they are widespread across Europe. One of the most common obstacles arises when fetal anomalies are detected. Since the medical tests that can identify malformations are performed later in pregnancy, it’s common for women to miss the deadline for abortion on request. From that point on, the decision to terminate the pregnancy depends on third parties—specifically, a doctor or a clinical committee.
The criteria used to make such decisions are defined by each country’s legislation, but in most cases, they are extremely vague. Most of the countries examined do not have a list of abnormalities considered suitable for pregnancy interruption. One exception is Slovakia. However, some experts consider that it is good not to have a closed list of anomalies, as this allows each case to be assessed on an individual basis. But the lack of specificity also leads to inconsistent diagnoses for the same type of case.
The main standard evaluated by clinical committees in Europe is whether the fetus is incompatible with life. Other criteria include the severity of the malformation, whether the condition is incurable, the difficulty of living a dignified life, or the coexistence of multiple pathologies. It is in these grey areas where committee decisions become subjective—leading many women to seek abortion abroad if they are denied care in their own country or face a long and burdensome process. The decisions made by clinical committees also contribute to making abortion access within Europe more discretionary and more variable between regions.
Beyond Europe
Still, despite the inequality that exists across the continent, some women living in other parts of the world face even harsher realities. Those who can afford it travel to Europe to access abortion services. For example, between 2019 and 2023, 86 women residing in Morocco had abortions in Spain, along with 66 from Brazil and 56 from the United Arab Emirates. In all three of these countries, abortion is not only banned in nearly all circumstances, but also criminalised.
In Morocco, a woman who has an abortion outside of the law’s narrow exceptions can face up to two years in prison. In Brazil, the penalty is up to three years, while in the United Arab Emirates, intentional abortion outside of legal exceptions can result in up to five years behind bars.
In other countries, there are no legal grounds at all for abortion—meaning that even if the pregnant woman’s life is at risk, she must continue the pregnancy. Total bans on abortion on request place spontaneous miscarriages under suspicion, with women potentially being prosecuted as if they had chosen to abort. This is the case in Honduras, the Philippines, the Dominican Republic, and El Salvador. Women from these countries have also travelled to Spain to access safe abortions, although the numbers are lower. For example, 21 Honduran women and 16 Filipino women travelled to Spain between 2019 and 2023.
The phenomenon, moreover, is not only occurring in Spain. The United Kingdom, for example, has received 228 women from the United Arab Emirates between 2019 and 2022. In the same period, 27 Qataris, 27 Saudis and 23 Kuwaitis also travelled to the UK for abortions.
An upward trend
One might assume that the expansion of more protective abortion laws in western countries and the increasing availability of self-managed abortion pills would mean that fewer women need to travel to access abortion. But that’s not the case. The opposite is happening in the United States. In 2022, the landmark ruling of the U.S. Supreme Court judgment of Roe v. Wade, removed the previously guaranteed federal protection for abortion rights. In the new legal landscape, more and more women are travelling between states to obtain abortions, as reported by The New York Times.
In Europe, the situation is similar. Every year, at least 5,000 women cross borders within the continent to access abortion. The number holds steady year after year—and is even rising. In 2019, there were 5,892 abortions performed on European women in a country other than their own, according to data compiled by Exporting Abortion. The following year, amid the pandemic, the figure dropped to 4,718. Since then, it has steadily increased. Pre-pandemic levels have now been reached—and may even have been surpassed.
In 2023, Exporting Abortion was able to confirm 5,860 abortions of this kind, but data from the United Kingdom and Belgium are still pending to be published—though both were counted in 2019. Once those figures are published and added up, the total will exceed the number from five years ago, possibly surpassing the 6,000 mark.
When war strikes
One factor that may have contributed to this increase is the Russian invasion of Ukraine. The war has made it harder for women in Ukraine to access abortion services, forcing many to leave the country to obtain them elsewhere. In 2019, Ukraine recorded 74,606 abortions. In 2020, with the pandemic, the number dropped to 61,048 abortions. But instead of stabilising or returning to pre-pandemic levels like in most countries, abortions have continued to decline. In 2023, there were 42,683.
The country’s situation means that fewer women can access this right within its borders. Still, the context also makes it difficult for many to travel abroad to have an abortion. In 2023, the Ukrainian Ministry of Health recorded nine abortions it defines as ‘criminal.’ This category includes abortions performed by the woman herself or by others outside a medical institution or center. Two women died that year after an abortion outside of a healthcare facility, one in Donetsk oblast and the other in Poltava oblast. No case of this kind had been recorded since 2019.
Self-managed abortions in Ukraine have also increased due to the war. Since it broke out, Abortion Without Borders claims to have helped at least 4,500 people from Ukraine access abortions, either within Ukraine or in other countries. While around 60 women crossed the border for the procedure, the majority were able to use abortion pills themselves in Ukraine. Additionally, during the first year of the war, Women Help Women facilitated the transfer of 40,000 abortion pill packages to feminist organisations in Ukraine to distribute to women in need on the ground. The data from several countries compiled by Exporting Abortion shows that more Ukrainian women have travelled for abortions abroad in 2022 and 2023, in wartime, than in previous years.
In some of these cases, it is difficult to ascertain whether women travelled solely to undergo an abortion or were compelled to leave Ukraine due to the war, subsequently relocating to the countries where their procedures were registered. The situation of Ukrainian women who have sought refuge abroad remains complex, with administrative inconsistencies often making it challenging to accurately determine their official place of residence.
In some countries, such as Poland, abortions performed on Ukrainian women with UKR status—a specific refugee status for citiziens of the country at war created in Poland—are recorded separately in statistics. According to these records, there were six cases in 2022, between one and five in 2023—though the exact number remains undisclosed due to statistical confidentiality—and another six in 2024. These figures, obtained by Exporting Abortion through a FOI request, show that some Ukrainian refugees face more restrictive laws and limited access to abortion services when seeking the procedure in the countries where they now live.
The Czech Republic is a difficult case. It, like Switzerland, records women who have abortions on its territory without permanent residence but categorises them by nationality rather than by country of residence. They are the only exception in Exporting Abortion‘s count: for all other countries, statistics by country of residence have always been used. As a member of the EU and as stated in its law, the Czech Republic should provide medical care to EU citizens, regardless of whether they reside in the Czech Republic or not. ‘This is one of the reasons why we focus on citizenship in the data forms,’ confirms Tomáš Májek, spokesman for the Institute of Health Information and Statistics of the Czech Republic
According to these data, 478 women from Ukraine had abortions in the Czech Republic in 2023—non-residents of the Czech Republic and citizens of Ukraine—. But the Institute started to collect the data on the women’s country of residence in that year as a pilot. This is not yet definitive in their statistics and there is no data for previous years, which is why Exporting Abortion have maintained this exception as a country based on nationality. But according to this new data, 258 women from Ukraine had abortions in the Czech Republic in 2023—residents of Ukraine—. The drop in the number makes sense, as the rest could be refugees or women who have had to move to live in the country. That may also be the situation for some of the 258 women too.
Ukrainian women face two problems when it comes to abortion in the Czech Republic: they do not talk about abortion as it is stigmatised. Financial inaccessibility is also a problem. Ukrainian refugees are socially vulnerable and the average cost of an abortion in the Czech Republic, around 220 euros, is financially challenging.
For the rest of the countries, the difference between nationality and residence in the Czech data for 2023 is not very significant. Another discrepancy, however, appears in the case of Slovakia. Based on nationality, 169 Slovak women without permanent residency are recorded as having had abortions in the Czech Republic.
However, based on country of residence, the number drops to just 96. Given the way the data is collected and the fact that some women may be living in the country without permanent residency, it is difficult to determine exactly how many Slovak women may have travelled to the Czech Republic for an abortion. Slovaks are the largest national minority in the Czech Republic and some of these women could live in the Czech Republic, but kept their place of permanent residence in Slovakia, which is legal.
In any case, data from across Europe shows that cross-border abortion flows are primarily driven by unequal access to the procedure. A clear example is Belgium and the Netherlands. These two small neighbouring countries have significant cross-border mobility, with people easily living and working on either side. However, because access to abortion is easier and Dutch law provides stronger protections, around 400 Belgian women travel to the Netherlands for an abortion each year, while only 16 women residing in the Netherlands do the same in Belgium. The pattern is clear: women do not typically seek abortions abroad simply because of geographical proximity, but rather out of necessity—either due to restrictions in their home country or to access better healthcare services in another place.
Far from home, these women are left without the support or services their states would have provided had they been able to access abortion in their own countries. This was the case for Spanish woman Diana Dieste, who was denied the sick leave she would have been entitled to after having an abortion. Or for Irish woman Carol McLoughlin, who had to transport her fetus’s remains back to Ireland in her carry-on luggage. She says: ‘The trauma of our experience has lingered, and having to travel for a termination made an awful situation so much worse.’