Albania
ABORTION POLICY
Grounds on which abortion is permitted
To save the life of the woman
To preserve physical health
To preserve mental health
Rape or incest
Foetal impairment
Economic or social reasons
Available on request
Yes
Yes
Yes
Yes
Yes
Yes
Yes*
Additional requirements
A pregnant woman must receive counselling at least one week before the abortion is performed. An
abortion must be performed by a physician specialist or obstetrician/gynaecologist in a public or private health
institution.
____________
*The pregnant woman must state that she has psychological and social problems.
REPRODUCTIVE HEALTH CONTEXT
Government view of fertility level:
Satisfactory
Government intervention concerning fertility level:
To maintain
Government policy on contraceptive use:
Direct support provided
Percentage of currently married women using
modern contraception (aged 15-49):
..
Total fertility rate (1995-2000):
2.5
Age-specific fertility rate (per 1,000 women aged 15-19; 1995-2000):
34
Government has expressed particular concern about:
Morbidity and mortality resulting from induced abortion
Complications of childbearing and childbirth
..
..
Maternal mortality ratio (per 100,000 live births; 1990):
National
Southern Europe
65
14
Female life expectancy at birth (1995-2000):
76
Source: The Population Policy Data Bank maintained by the Population Division of the Department of Economic and Social Affairs of the United
Nations Secretariat. For additional sources, see list of references.
19
Albania
BACKGROUND
Until 1991, abortion was permitted only when it was necessary to save the life of the pregnant woman or
when her physical health was seriously endangered. Abortions were performed for any of up to 30 medical
indications. In practice, abortions were sometimes permitted on all but economic or social grounds. All
therapeutic abortions had to be approved by the medical commission of the district. The Criminal Code of 15
June 1977 (section 95) punished repeat offenders or those performing an abortion that resulted in the woman’s
death or serious disruption of her health with eight years in prison. Otherwise, the punishment was reeducation through work or detention for up to two years. A woman performing an abortion on herself without
help was punished by a social reprimand or by re-education through work.
The restrictive nature of the law was largely a result of the population policy adopted by the Government
of Albania, of which the law was an integral part. The Government pursued an aggressive pronatalist policy.
It believed that a larger population was necessary in order to protect the country from foreign influences and
exploit its natural resources, which were considered capable of supporting many more people. Prohibiting
abortion was viewed as a way of maintaining a high birth rate. As part of the same policy, contraceptives were
not imported into the country, and the sale of oral contraceptives was specifically prohibited.
This policy had dramatic health consequences. The maternal mortality ratio was the second highest in
Europe, after Romania; an estimated 50 per cent of all pregnancies ended in abortion, mostly self-induced or
performed under unsafe and unsanitary conditions. The number of premature births was also abnormally high.
By the late 1980s, the Government had recognized these realities and moved to counteract them. In 1989,
the Ministry of Health issued a directive allowing abortions to be legally performed in cases of rape or incest
or when the woman was under sixteen years of age. In 1991, it issued another directive legalizing, for the first
time, abortion on family planning and social grounds. Under this measure, an abortion could be legally
performed a) if a couple requested it because they did not want the child to be born; or b) if a pregnant woman
requested it and the pregnancy resulted from extramarital relations. Performance of the abortion had to be
approved by a committee, and the cost of the abortion was set at 100 new Albanian leks.
Since the broad legalization of abortion, the Government has taken additional steps to change the abortion
law, as well as to encourage family planning. In 1992, the Council of Ministers issued a decision approving
the voluntary interruption of pregnancy as a means of preventing unwanted pregnancies. The decision,
however, was not directed primarily at abortion and contained no details on time limits, procedures, or
required approvals. Rather, it addressed reproductive health in general. It established family planning as a
basic human right from which all citizens should be able to benefit of their own free will and guaranteed
couples the right to decide on the number of children they want. It approved a wide range of family planning
activities, including birth spacing, use of contraceptives, treatment for sterility and for sexually transmitted
diseases, and the provision of sex education both in and outside of schools. The decision called for
contraceptives to be made available at pharmacies and family planning services to be provided at maternity
clinics and women’s health centers.
Motivated in part by the fragmentary nature of abortion regulations in the directives and the 1992 decision,
the Government in 1995 enacted comprehensive abortion legislation. The legislation sets forth the
circumstances under which exceptions will be made to the prohibition of abortion contained in the Penal Code
of Albania, which was revised at approximately the same time. The new legislation represents, in some ways,
a qualification of the blanket statement in the 1992 decision that abortion could be used as a means of
preventing unwanted pregnancies. The first article of the law guarantees respect for any human being from the
beginning of life and establishes abortion as an exception to this principle, when indispensable. The law
Source: The Population Policy Data Bank maintained by the Population Division of the Department of Economic and Social Affairs of
the United Nations Secretariat. For additional sources, see list of references.
20
Albania
also clearly states that abortion will in no case be considered as a method of family planning. Nonetheless, the
law also envisions a broad number of indications for the performance of legal abortions, including abortion at
the woman’s request, as long as certain procedural requirements are met.
Under the law, abortions can be performed through the twelfth week of pregnancy if a woman states that
the pregnancy causes her psychological and social problems and she receives counselling on the following:
the health hazards of abortion for future pregnancies and the biological problems of medical intervention; the
rights of families and mothers and children as well as the assistance and benefits available to them, and the
possibilities for adoption; the institutions and bodies that offer moral and financial support to women; and the
names of clinics and hospitals performing abortions. The woman must also wait a week until the abortion is
performed. When possible, the husband or parent is to participate in the decision.
Abortions are available throughout pregnancy when a foetal defect is present and when continuation of
the pregnancy would endanger the life or health of the woman, as determined by a commission of three
physicians. An abortion may be performed through the twenty-second week of pregnancy, if the pregnancy is
the result of rape or a sex crime or there are “social reasons” for terminating the pregnancy, as determined by a
three-member commission consisting of a physician, a social worker, and a lawyer. Records on abortions are
to be kept anonymously, and physicians performing an abortion are required to provide information about
family planning services and advice on contraceptive methods. Advertising and propaganda on medicaments
and products causing abortion are prohibited. Finally, the law specifies that family planning is a national duty.
The effects of the law on the performance of abortions in Albania is difficult to ascertain. The country is
the poorest in Europe and since the fall of the Communist Government in 1990 has experienced continuing
periods of political unrest and a shrinking economy. According to recent estimates, some 21,000 abortions are
still performed each year, resulting in an abortion rate of 27.2. As in much of Eastern Europe, it appears that
women still rely upon abortion as a means of planning births.
Source: The Population Policy Data Bank maintained by the Population Division of the Department of Economic and Social Affairs of
the United Nations Secretariat. For additional sources, see list of references.
21