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The text below might contain errors as it was reproduced by OCR software from the digitized originals,
also available as Scanned original in PDF.BOX-FOLDER-REPORT: 35-5-31 TITLE: New Rules on Induced Abortion BY: KK DATE: 1974-1-23 COUNTRY: Hungary ORIGINAL SUBJECT: Hungary/2 THEMATIC SUBJECTS: Hungary--1966-1975, Population Policy, Public Health --- Begin --- RADIO FREE EUROPE Research EAST EUROPE This material was prepared for the use of the editors and policy staff of Radio Free Europe. HUNGARY/2 23 January 1974 NEW RULES ON INDUCED ABORTION Summary: On 1 January 1974 the bulk of the provisions which come under the heading of the Hungarian regime's comprehensive demographic policy went into force. This paper discusses the new rules on legally induced abortions, which constitute the hard core of the new policy. Under the June 1956 rules on induced abortion, the abortion committees were relegated to rubber-stamping the requests of pregnant women; under the new regulations they will have far-reaching powers and in some cases can also deny permission for induced abortion. The all-too-liberal 1956 regulations led women to resort to abortion as practically the only means of family planning. The regime is anxious to put an end to this practice, which is harmful to the health of both women and children; it increases the likelihood of eventual sterility, and results in an alarming increase in the number of premature births. The new rules do not prohibit induced abortion, but tend to make it a last resort rather than a general practice. The paper also discusses some of the problems that will arise under the new demographic policy -- problems that will have to be solved before the expected increase in the birth rate sets in. * * * [page 2] Some General Remarks In strict adherence to the time-table laid down in the Council of Ministers' October 1973 resolution on demographic policy, [l] the bulk of the implementing measures went into force on 1 January 1074 They consist primarily of the revised regulations on induced abortions [2] and the provisions on the increase in child welfare allowances and maternity grants, the allocation of sick pay for time required to care for ailing children under six. years of age, paid vacation days for caring for children, and the obligation of couples under 35 to seek the advice of the appropriate health authorities on family planning before contracting marriage. [3] Provisions increasing the family allowance will go into force on 1 June 1974. Beginning in the 1974/1975 school year, it will be mandatory for all types of school to include "sexual enlightenment" in their curriculums. [4] The mere listing of the measures already in force or planned for the near future clearly indicates what the Hungarian authorities mean when they declare that demographic policy is to be advanced in a "comprehensive" manner. The official position is that an efficient demographic policy cannot exist as an isolated endeavor; it must be conceived as an integral part of the country's economic and social policies. Therefore it also involves the living standard and employment policies. [5] But "demographic policy is necessarily tied up with public healthy, and requires well-planned, large-scale, unflagging efforts to educate the whole of society to respect, mothers and love children. Therefore, although improving the economic and social factors that underlie demographic policy is "indispensable." their pre-eminence should not make one lose sight of other factors such as public health and morality. the authorities have therefore decided to attack the problem on a broad front, with a large assortment of weapons that make earlier measures look like patchwork. [6] ------------------------- (1) Council of Ministers Resolution No. 1940/1973 (October 18), Magyar Kozlony, 18 October 1973, pp. 774-778. At a press conference on 12 October 1973 Minister of Health Zoltan Szabo outlined the. gist of the planned measures (see KK, "Hungarian Demographic Policy at Turning Point," Hungarian Background Report/14, Radio Free Europe Research [EERA], 18 October 1973). (2) Ministry of Health Decree No. 4/1973 (December l), Magyar Kozlony, 1 December 1073, pp.836-841. (3) Ministry of Health Decree No. 5/1973 (December 5) and Ministry of Labor Decrees Nos. 11 and 12/1973 (December 23), ibid., 5 and 23 December 1973; see also the statement by Deputy Minister of Labor Imre Nagy quoted in Nepszabadsag, 31 December 1973, and KK, op. cit. (4) Council of Ministers Decree No. 31/1973 (December 23), Magyar Kozlony, 23 December 1973; Magyar Hirlap, 1 November 1973; Magyar Ifjusag, 9 November 1973; Nepsaava, 31 December 1973. (5) See Gyorgy Jenei, "Nepesedespolitikai feladataink" [Our Demographic Policy Tasks], Partelet, December 1973. Jenei is on the staff of the parey Central Committee. (6) Jenei and KK, op. cit. [page 3 ] For example, the new stricter rules on induced abortions must be considered an essential aspect of demographic policy. [7] It can be argued, in fact, that the main purpose of all the economic, social, hygienic, and propaganda measures being taken is to make the restrictions on induced abortions both acceptable and viable. In other words, it is believed that no effective brake can be placed on the demand for induced abortions unless substantial "flanking" measures are taken to improve the economic, social, and working conditions of parents and to provide the population with information on how to avoid undesired pregnancies. On the other hand, it has also been realized that all these "ancillary" efforts would probably come to naught on their own unless the question of induced abortion itself is properly handled. The grounds on which they may be permitted must form part of the measures designed to increase the population, wrote Nepszabadsag [8]; it is society's duty to think of the future and bear in mind the proportion between the wage-earning and the dependent population, and the health of future generations. At the risk of oversimplifying the situation, one might describe the new demographic policy as a new policy on family planning whose hard core is the "serious," albeit "humane," stiffening of the earlier rules on induced abortion. [9] The Previous Rules It may be useful at this point to sum up these earlier rules, which went into effect in June 1956, [10] and to describe the extremely unfavorable developments that followed their enactment. The regulations stipulated that three-member committees be appointed in the counties and in the municipality of Budapest, which would approve requests for abortion (provided the pregnancy was of no more than 12 weeks duration) on the following grounds: medical considerations, in order to prevent serious risk to the mother's health or that of the embryo; and valid personal and social considerations. Abortions were also granted if a woman insisted on having her pregnancy interrupted regardless of the committee's efforts to change her mind by pointing out that abortion did not seem to be warranted and warming her against the possible detrimental consequences. (It was mandatory for the committee to issue such a warning in cases in which the permission for an induced abortion was sought on personal or family grounds or without explanation.) It is obvious that under these circumstances the committee was virtually powerless when confronted with a pregnant woman determined to have an abortion. If medical considerations were not involved, a woman could fall back on her legal right to an abortion for personal and social considerations; the only penalty she would, suffer was that she would not be entitled to social insurance benefits for. three days after the abortion was performed, and would have to pay 200 forint --------------------------- (7) Jenei, op. cit. (8) On 14 October 1973. (9) Homeland Radio, 20 October 1973. (10) Council of Ministers Resolution No. 1047/1956 (June 3), Magyar Kozlony, 3 June 1956, and Ministry of Health Decree No. 2/1956 (June 24, ibid., 24 June 1956. [page 4 ] for the operation and hospitalization. After three days, however, she was again entitled to full social insurance benefits, provided she stayed in the hospital. Needless to say, under the 1956 rules the abortion committees "granted" permission only in a formal sense. Dr. Imre Hirschler, a well-known gynecologist in Budapest, compared them to ticket sellers in a railroad station: the women who apply to them do not say why they wish to go on a trip, he said, they only ask what time the train leaves -- in other words, when they should turn up for the operation. [11] The doctors who sat on the abortion committees were genuinely embarrassed about their role, since they had no legal leverage for denying permission for an abortion. [12] It was reported in January 1966 that in a large Budapest hospital, the name of which was not disclosed, in the preceding eight years there had been only two instances of a pregnant woman changing her mind about having an abortion. [13] In October 1973 a doctor in Budapest, who was also a member of parliament, declared that during the four years he had been a member of an abortion committee he had succeeded in only one case, out of some 25,000 in persuading a woman to have the baby, and she was a personal acquaintance. [14] An Abortion Epidemic In liberalizing the regulations on induced abortion, the 1956 law ran directly counter to an earlier Council of Ministers resolution (No. 1004/1953) which had introduced a policy of encouraging a rapid population increase, bolstered by modest economic incentives and fortified by strong administrative measures, including a "merciless war on illegal abortions." [15] The result was a "baby boom" between 1953 and 1955, which began to level off in 1956 under the impact of the regulations that went into effect in June of that year. Since 1957 there has been a real "baby slump," and in 1962 the number of live births dropped to 130,053, while the population increase index hit an all-time low of 2.1 per thousand. Since 1963 the number of live births has risen some-what each year, but the effect of this was negated by the large number of induced abortions. Between 1968 and 1973 the number of live births ranged between 151,000 and somewhat over 154*000 annually, and the population increase index between 3.2 and 3.6 per thousand. Only in 1969 did the latter reach the 3.6 per thousand mark, and in 1971 it fell to 2.6 per thousand. The latest figures for a full year -- 1972 -- are as follows: live births, 153,265; induced abortions, 178,400; population growth index, 3-3 per thousand. [16] In view of all this Dr. Egon Szabady, deputy president of the Central --------------------------- (11) Esti Hirlap, 17 June 1969; Pest Megyei Hirlap, 6 December 1966. (12) Magyar Nemzet, 30 January 1966. (13) Ibid. (14) Orszag-Vilag, 24 October 1973. (15) See "The Abortion Problem in Hungary," Hungarian Background Report, RFER (TARA), 7 April 1964. (16) Statisztikai Havi Kozlemenyek, September 1973; Nepegeszsegugy, (August 1973), gave a slightly lower number of live births: 153,123. [page 5] Statistical Office and chairman of the Demographic Committee of the Hungarian Academy of Sciences, was quite correct in saying that the June 1956 regulations sparked a veritable "abortion epidemic." Induced, abortions became almost the only means of family planning. As a result, not only did the number of live births and the population increase index fall to a dangerously low level, but the number of premature births increased alarmingly -- mainly owing to the practice of resorting to induced abortions, in the opinion of medical authorities. In fact Hungary heads the list of European countries in this respect, with 10 to 11 per cent of all live births registered as premature each year. [17] This means that many of the babies born suffer from serious physical defects. The availability of legal abortions had particularly harmful consequences for the very young. Of the 102,300 abortions registered in 1970, 195 were performed on elementary school pupils (14 years old or under) and 18,000 on high school students (15 to 19). [18] There was some improvement in 1971, when the figures were 168 and 16,535, respectively. The total -- 16,703 -- represented about 9 per cent of the 187,425 induced abortions carried out in 1971. [19] In 1972 the number of induced abortions dropped to 178,400 -- the lowest figure since 1965. It is not known, however, whether the drop was reflected in the number of abortions performed on teen-agers. As far as the capital city of Budapest is concerned, 1,390 induced abortions were permitted for medical reasons, and 48,436 for "other" reasons between January and October 1973. During the same period there were 23,436 live births in the capital. [20] (A table showing the number of live births, the natural population increase and the number of induced abortions, as well as the indexes of live birth and natural population growth and the total population between 1952 and 1973, is provided as an appendix to this paper.) Why Not Contraceptives? The question that comes to mind here is: Why did so many Hungarian women resort to induced abortion (a good number had several abortions in succession), with its attendant risks, instead of using contraceptives? The blame must be placed partly on the government, and partly on the attitude of the population at large. Although the June 1956 regulations stipulated that contraceptives be placed on sale without restriction and at low prices, [21] manufacture of "the pill" was not authorized until 1967- [22] Moreover, although from 1967 on women were urged to make use of the pill, it vas not until recently that it was made easily accessible. In fact, until September 1973 only gynecologists were authorized to prescribe it, and purchasers had to pay the full price. As ----------------------------- (17) KK, op. cit., p. 2. (18) Nepszava, 31 December 1973. (19) KK, op. cit., p. 11. (20) Radio Budapest, 18 November 1973. (21) Resolution No. 1047/1956 (June 3), Point 2. (22) Nepszava, 31 December 1973; Esti Hirlap, 2 January 1974. [page 6 ] of 1 October 1973, however, the Ministry of Health permitted district and company physicians to prescribe contraceptive pills and ordered them placed in the dame category as other medicines, so that purchasers need pay only 15 per cent of the list price. The only limitation is that, generally speaking, they nay not be prescribed for women under 18 years of age. [23] The situation has been aggravated by the reserved attitude of the population toward this modern and practical way of preventing pregnancy. By the end of 1972 only some 200,000 women -- about 10 per cent of the married women in the country -- were taking the pill, according to Esti Hirlap. [24] Another report [25] put the figure at 9 per cent of the women between 14 and 49, and noted that this was indeed a very modest success, considering that the pill had been available since 1967. The Esti Hirlap article said that thanks to the pill the number of induced abortions has somewhat decreased recently among married women, but the same did not apply to unmarried women. Apparently the rural population -- both male and female -- is particularly averse to using the pill, though since October 1973 its use has demonstrably increased. [26] In fact, according to Magyar Nemzet [27] the sale of pills has doubled. The reason is clear: on October 12 Minister of Health Zoltan Szabo announced and described in detail the limitations that would be placed on induced abortions after 1 January 1974. [28] This announcement turned the attention of the female population to the pill, which is expected to become the principal means of preventing pregnancy; induced abortions are expected to become the last resort. Convincing the Public This is the third time the communist regime in Hungary has decided to influence demographic development by resorting to measures that will affect the private lives of very large segments of the population, in both the short and the long term. Available evidence shows that the authorities are anxious to avoid the zigzags and pitfalls that characterized the demographic policy decisions of the Rakosi regime in 1953 and 1956. It can be assumed that the launching of the new demographic policy has been preceded by long and careful consideration. This applies in particular to the abandonment of abortion on demand, which is the hard core of the new policy and has reportedly evoked considerable interest intermingled with concern among the public. [29] It is worthy of note that the long-term demographic policy has been formulated by ------------------------- (23) Magyar Hirlap, 30 August 1973; see also Hungarian Situation Report/32, RFER (EERA), 11 September 1973, Item 3. The pill may be prescribed for women under 18 if they have already borne a child or had an abortion (Magyar Ifjusag, 5 October 1973). (24) 2 January 1974. (25) Nepszava, 31 December 1973. (26) Vas Nepe, 21 October 1973. (27) 30 December 1973. (28) See Nepszabadsag, Nepszava, and Sagyar Hirlap, 13 October 1973. (29) Magyar Hirlap, 3 November 1973. [page 7] the Politburo -- the most powerful political body and the virtual government of the country -- which adopted a resolution on the subject in February 1973. [30] As usual, no information has been supplied about any discussion that may have preceded adoption of the resolution, nor was its text made public. Its general tenor became apparent, however, when the Council of Ministers and the competent members of the government issued the provisions needed to translate a political decision into rules of law which concern the entire population. The authorities are making great efforts to persuade the public that the new rules on abortion are not too severe, and than they do not violate individual rights. It is stressed that the new regulation does not prohibit induced abortions, but only limits them. Therefore it does not portend a return to the pre-June 1956 situation. It would have been both politically harmful and unrealistic to ban abortion completely. [31] The purpose of the new regulations is to gradually eliminate it, as an instrument of family planning, since it is a "drastic11 and "barbarous" practice that ought to be replaced by the more efficient, refined, and harmless hormonal contraceptive, the antibaby pill. [32] It is emphasized that it will continue to be up to the woman to decide whether or not to have a baby. Nepszabadsag [33] took issue with an unnamed, childless young woman in prosperous circumstances who objected to giving a committee composed of strangers (the abortion committee) a say in her private affairs. Her complaint would be justified, said Nepszabadsag, only if she were deprived of all opportunity to practice birth control. In fact, however, she is prevented only from resorting to the most dangerous means, induced abortion, and therefore the new limitations, are in her own interest and that of her putative offspring. The availability of modern contraceptives makes it possible for the woman to opt for them instead of abortion. No one wants to force undesired pregnancies on women. What the government does want, however, is to persuade women that contraceptives are preferable to abortion as a means of birth control. [34] They make family planning easier and by the same token lessen the need to resort to abortion. [35] It is hoped that increasing the availability of contraceptives and providing better economic and social conditions under which to raise children will gradually result in a lessening of the number of induced abortions. [36] Individuals are urged to prove their sense of responsibility for the future of society both by using the most efficient means of family planning [37] and by contributing to a steady increase in the population. The result will be a qualitative improvement in the Hungarian stock and a quantitative increase in the population. ------------------------------- (30) Jenei, op, cit., p. 3. (31) Magyar Hirlap, 3 November 1973, and Jenei, op. cit., pp. 5-6. (32) Magyarorszag, 21 October 1973.; Nepszava, 24 December 1973; Esti Hirlap, 2 January 1974. (33) 28 October 1973. (34) Nepszabadsag, 14 October 1973. (35) Jenei, op. cit., pp. 5-6. (36) Magyar Hirlap, 3 November 1973. (37) Jenei, op. cit., pp. 5-6. [page 8] The New Rules: The Organizational Aspect The ideal situation would be for all women to escape unwanted pregnancy-through the judicious use of contraceptives. Since this is unlikely to come about, however, the legislature has had to draw up a set of rules governing eligibility for induced abortion. As of 1 January 1974 pregnant women may legally have a pregnancy interrupted only for one of the reasons explicitly set forth in the Ministry of Health decree of 1 December 1973. [38] The essential provisions in the decree can be separated into two groups: the procedure to be followed, and the grounds en which permission may be granted. There will be two kinds of committee. First-level abortion committees will be set up in rural districts and towns and in the boroughs of Budapest and other large cities which have county rank. Depending on the size of the population, more than one committee can be created within a given administrative unit, or one committee can serve several administrative units. First-level committees consist of three persons: a president, who must be a medical doctor, a representative of the local council, and a welfare officer (nurse). They are nominated by the president of the local council, on the proposal of the head of the council's health department, and serve for three years. If a first-level committee rejects the application of a pregnant woman, she may appeal to a second-level abortion committee, to which the first-level committee must forward the appeal within 24 hours. One or more second-level committees will be set up in the counties and in the city of Budapest. The president of the second-level committee must also be a medical doctor, and the members consist of two representatives of the county or Budapest municipal council, one of whom must be a lawyer; a representative of the county or Budapest municipal trade union council; and a welfare officer (nurse). The president of the county (or Budapest) council nominates the president of the second-level committee and the two representatives of the council and the welfare officer (nurse), on the proposal of the head of the council's health department. The representative of the trade union is appointed, on the proposal of the leading secretary of the Budapest or county trade union council. The five members of the second-level committee also serve for three years. The committees meet at health centers such as hospitals, family institutes, etc. Meetings are called whenever necessary, but the committees must sit at least twice a week. Their activity is conducted under the seal of secrecy, and it has been pointed out that they should be composed of persons [39] who possess the sensitivity and experience to judge the social conditions of the applicants. Moreover, their legal expertise and familiarity with health considerations must be satisfactory. [40] --------------------------- (38) Szabad Fold, 30 December 1973. (39) According to Magyar Hirlap (2 January 1974), the presidents of the first- and second-level committees may not be gynecologists. This stipulation does not appear in the Ministry of Health decree, however; it merely states that each committee must be headed by a medical doctor. (40) Nepszava, 4 December 1973. [page 9] When Are Abortions Permitted? There are 10 reasons for which pregnant women may obtain permission to have an abortion. According to the decree, the committee gives permission for the interruption of pregnancy in the following six cases [41] : If the application is motivated by considerations involving the health of the parents or the probability that the child will be physically or mentally abnormal; If the woman is not living in the married state or has been living alone for at least six months; If the pregnancy is the consequence of a criminal act; If neither the woman nor her husband owns an apartment that can be occupied immediately or if it is impossible for them to rent one; If the woman already has three or more children, or has given birth to three or more children; or if she has two children and in addition has suffered at least one "obstetric mishap" (spontaneous abortion, still birth, extrauterine pregnancy); If the woman has already reached the age of 40. Until the end of 1978 women 35 or over may also apply for induced abortions. In addition the committee may give permission for an abortion in the following four instances: If the woman has two children and the health of the baby to be born or its development is expected to be endangered; If the woman's husband is doing regular military service or is detained for special service in the armed forces or a similar organization, and if at the time the application is filed he still has at least six months to serve; If the woman or her husband is serving a prison term of at least six months; If the application is motivated by other weighty social considerations. [42] It is important to realize that one is confronted here with two sets of reasons involving the functioning of the abortion committees. In the six ---------------------------- (41) Paragraph 2, Points la-f. (42) Paragraph 2, Points 2a-d. [page 10] cases in which the decree states that they give permission it seems plain that they must do so provided the woman can prove that she is eligible for induced abortion. In such cases all the committee needs to do is verify the proofs submitted. Therefore it would have been more correct to say that the committee must give permission in these cases. The situation is quite different so far as the second set of reasons is concerned. Here the committee may weigh the pros and cons of the application, and its evaluation of any "weighty social considerations" that may be adduced is likely to give rise to differences of opinion both between the applicant and the committee and among members of the committee. It is in these four cases that the committee may reject an application, and the woman must either accept its decision or immediately lodge an appeal with the second-level committee. The distinction between the two sets of reasons is pointed up by a provision in the decree according to which applications filed for any of the first six reasons need not be reviewed by the entire committee; if the proofs produced by the applicant leave no doubt about their validity, the president of the committee may grant permission on his own authority. This means that, as a rule, such applications, will not come before the whole committee. [43] On the other hand, the entire committee must rule on applications based on the second set of reasons. An Attempt to Prevent Illicit Abortions To sum up: Under the June 1956 rules a pregnant woman could carry the day in all cases; the abortion committees were in fact powerless. Under the new rules, she is still legally entitled to have an abortion, but only for reasons approved by the regime. The committees have broad investigative powers, and must be convinced that an application is properly motivated. Applications must be filed in writing with the competent first-level committee, which hands down its ruling on the basis of a simple majority decision. If an application is rejected, the committee must inform the applicant about the possibility of lodging an appeal with the second-level committee, and any such appeal must be forwarded to the latter within 24 hours. If the application is rejected by the first-level committee and the applicant does not lodge an appeal or withdraws it, the first-level committee is obliged to convey this information without delay to the health administration agency to which the pregnant woman is "entrusted for care." One might argue that the purpose of this provision is riot only to look after the prospective mother but to register her pregnancy officially. It is assumed that the authorities will keep an eye on women whose applications for abortion are turned down. It should be recalled that in 1969, when doctors criticized the fact that the abortion committees were practically powerless, gynecologist Imre Hirschler expressed some concern that tightening ------------------------- (43) The opinion advanced here, that for the reasons listed in Paragraph 2, Points a-f of the decree it is mandatory for the committees to permit the interruption of pregnancy, is confirmed by statements that have appeared on the subject in Nepszabadsag (28 October 1973) and Magyar-orszag (28 October 1973), and also by a remark made by Minister of Health Zoltan Szabo at a conference of the chief county doctors and presidents of second-level committees on 26 November 1973, which was quoted by Radio Budapest on the same day. [page 11] up the rules on induced abortion would only increase the number of illicit operations. These had not diminished in number despite the liberalization of the abortion law, because women who were anxious to conceal their pregnancies did not request "permission" from the committees, and others refrained from doing so lest their applications be turned down [44] -- which was, of course, a groundless fear. The Appeal Mechanism Second-level abortion committees consider appeals presented to them at their next scheduled meeting. As a rule, pregnancies may be interrupted only during the first 12 weeks, but if the procedure is delayed through no fault of the pregnant woman the second-level committee may authorize interruption up to the 16th week. Otherwise only pregnancies of minors can be interrupted up to the 16th week. If necessary, the second-level committee may order evidence collected to determine whether or not an application is well founded. If the second-level committee rejects an appeal, its decision is immediately communicated to the pregnant woman. The committee's decisions are final, and the competent health authority is immediately informed of any rejection. It is evident from a number of press articles that the public viewed the approach of 1 January 1974, when the new rules became effective, with some degree of apprehension. The fear was voiced that "medical considerations" would be interpreted in too restricted a manner. Efforts have been made to dispel such fears by pointing out that gynecologists will investigate every case with the utmost care, and that there is no reason to doubt the fairness of their judgments. In this connection the hope was expressed that the spirit of the new abortion decree will not be defeated "either by a bureaucratic approach" or by too-liberal interpretation. The suggestion that ignorance of the new rules be considered an extenuating circumstance has been rejected as superfluous because such ignorance is thought to be a corollary of "weighty social considerations" that constitute one of the grounds on which induced abortion may be permitted. [45] Some Basic Concepts The decision to tighten up the regulations on induced abortion is being characterized as a "humane" one, [46] and the new rules are described as "flexible." [47] While it is their avowed purpose to lessen the number of induced abortions, applications will be handled in an equitable way. The underlying consideration in the regime's demographic policy is that the ideal family is-one with at least three children. Families of this size guarantee not only maintenance of the population level but also a gradual rise in it. [48] ----------------------------- (44) Esti Hirlap, 7 June 1969. (45) See, for example, Magyar Nemzet, 31 December 1973. (46) Homeland Radio, 20 October 1973. (47) Magyar Hirlap, 3 November 1973. (48) Figyelo, 17 October 1973; Nepszava, 21 October 1973; Magyar Nemzet, 9 December 1973; and Magyar Hirlap, 24 December 1973. [page 12] The reason for permitting women of 40 or older to interrupt a pregnancy, regardless of whether or not they already have children (and for giving women of 35 years the benefit from this provision until 31 December 1978) is that it is assumed that a considerable number of such women have already had several abortions, which might prejudice the well-being of any future children. It is hoped, however, that with the increasing use of contraceptives the number of abortions will decrease, and as a result women between 35 and 40 will be more likely to give birth to healthy babies after 1978. [49] One delicate problem is posed by the circumstance that more and more young girls are indulging in sexual relations. [50] For example, in recent years 3.5 per cent of the female high school students in Budapest applied for induced abortion. [51] It is hoped that the situation will be ameliorated by the provision of more adequate sex instruction, but, as noted above, the pill can be prescribed for girls under 18 only in exceptional circumstances. All in all, the new regulation on the interruption of pregnancy is a far cry from the June 1956 one it replaces. Gone are the times when the abortion committees were relegated to merely rubber-stamping a pregnant woman's application for legal abortion. While the authorities take pains not to bar the way to induced abortion whenever it seems to be justified from the viewpoint of both the woman concerned and society, they are anxious to reduce the number of induced abortions, in the interest of protecting the health of women and their offspring, and guaranteeing a slow but steady increase in population. The Fees The fees charged for legal abortion are to vary according to the grounds on which it is performed. No fee will be charged if the pregnancy is interrupted for health reasons, if it is the result of a criminal act, or if the woman's husband is doing his military service or on special assignment with the armed forces. The fee will be 600 forint if the woman is a minor without income of her own, if she is at least 40, if she has had at least three children, or if she has two children and has suffered an "obstetric mishap." The abortion committee may reduce this to 300 forint on request, if it finds the petition well grounded. In all other cases the fee will be 1,000 forint, which again can be reduced by the committee to 600 forint on the well-founded request of the applicant. Exceptionally, for social reasons, the committee may waive the fee entirely. When an application is authorized not by the committee as a whole but by its president, the latter may also reduce the feel. In any case, the fee must be paid before the operation is performed. [52] (49) Magyarorszag, 28 October 1973. (50) Nepszava, 31 December 1973. In 1970, 7,063 girls between 15 and 19 filed applications with the abortion committees in Budapest (Magyar Nemzet, 19 October 1973). (51) Magyar Nemzet, 19 October 1973. (52) Paragraphs 13 and 14 of the 1 December 1973 Ministry of Health decree. [page 13] Conclusion The government fully realizes that the demographic problems of the country cannot be solved quickly merely by staging a "campaign." Tackling the problems that have accumulated over decades is a long-term process for which not only the health organizations and schools (which will have to provide well-organized courses in sex information) will be mobilized, but almost the whole of society and its various organizations, such as the party, the Patriotic People's Front, the Communist Youth League (KISZ), the Council of Women, etc. [53] The authorities have not set too ambitious a target for the numerical increase in population. They hope the annual number of live births will eventually rise to between 160,000 and 170,000 (between 1968 and 1972 the highest number was 154,200 and the lowest 150,640). This means that an average of three children per family will have to be reached. At present the figure is 1÷87 children per family, and an average of 2.16 would be needed to keep the population at its present level. Approaching the problem from the angle of the live-birth ratio, 17 per thousand inhabitants would be needed annually to achieve a 5 per cent annual increase in the population. In 1972 the ratio was 14.7 per thousand, and it is estimated that the figure for 1973 (for which precise data are not yet available) will rise to 15.2. A ratio of 1.6 per thousand would be needed to keep the population at its present level. For purposes of comparison, it is of interest that Albania leads in Europe with an annual live-birth index of 35 per thousand inhabitants. In Hungary only gipsy families even approach such a figure -- in 1960 the live-birth ratio among them hit the 40-per-thousand mark, but in recent years it has declined to under 30 per thousand. [54] Although the government is assuming large financial burdens in its efforts to increase the birth rate -- cash payments under the headings of family allowances, child-welfare allowances, and maternity grants amounted to 8,000 million forint in 1973, and will be raised by 2,000 million in 1974 [55] -- the living standard of families with two or three children is still below that of one-child or childless families. [56] The situation of families with two or more children can be greatly eased by providing the necessary "infrastructure." At a, session of the National Assembly's Planning and Budgetary Committee in October 1973 its chairman, Gyula Ortutay, called the attention of the authorities to the necessity to plan and build nurseries, kindergartens, and schools "in time." [57] His remarks were fully justified by the unfavorable experiences of the past. For example, child welfare allowances were introduced in 1967, but no ------------------------ (53) Jenei, op. cit. (54) Nepszava, 21 October 1973; Magyarorszag, 21 October 1973; Munka, December 1973; Nepszava, 31 December 1973. (55) Nepszabadsag, 31 December 1973. (56) See KK, op. cit., pp. 4-5, and Magyar Hirlap, 3 November 1973. (57) Magyar Nemzet, 10 October 1973 [page 14] steps were taken to build more nurseries and kindergartens before the inevitable increase in the number of babies set it. [58] In October 1973 there were 45,000 places in nurseries and 250,000 places in kindergartens, but these by no means met the demand. In Budapest the kindergartens were so overcrowded that their "degree of utilization" reached 125.6 per cent, and the chances that the situation will improve in the near future are slim. According to Minister of Finance Lajos Faluvegi, it is hoped that in 1974 more than 50 per cent of the children under the age of three will be accommodated in nurseries, and 70 per cent of those between three and six will find places in kindergartens. [59] It is hardly necessary to point out the extent to which improvement of the demographic situation is dependent on housing. To cite just one example, by the end of 1973 only 6 per cent of young married couples had apartments of their own. Not only must the housing situation be radically improved as a corollary of the government's comprehensive demographic policy but care must be taken to provide larger apartments, rather than limit them to a single room just in order to accommodate more family units per apartment house. Although the housing shortage is one of the most acute problems facing Budapest, the city council nonetheless recently decided that apartments should consist of two and a half rooms, in view of the expected rise in the number of children per family. [60] It is also hard to see how the regime's demographic policy can be implemented without an increase in hospital facilities. In particular, the maternity wards will have to be enlarged; at present many of them are so overcrowded that the beds are still "warm" when new patients take the place of the former ones. [6l] In the short run, the implementation of Hungary's demographic policy is expected to have an unfavorable effect on the manpower situation in the country. For example, if a family decides to have three children within six years, the mother will probably not work for about seven years, and this is likely to cause a considerable labor shortage in the branches of economy that employ mainly women, such as the textile industry or domestic trade, which are already suffering from a lack of manpower. In 1973 nearly 300,000 women were working in light industry, [62] and about 60 per cent of those employed in domestic trade are women holding jobs as cashiers, sales clerks, etc. [63] Women also play an important role in the white-collar and professional sectors, mainly as teachers in the latter case, but also as medical doctors, engineers, attorneys, etc. At present, some 70 per cent of the women who are ----------------------------- (58) Hungarian Situation Report/11, RFER (EERA), 20 March 1973, Item 2. (59) Magyar Hirlap, 14 October 1973, Nepszabadsag, 7 November 1973, and Magyar Nemzet, 20 December 1973, all quote Faiuveg's speech delivered at the National Assembly on the state budget for 1974. (60) Esti Hirlap, 10 October 1973, and Nepszava, 31 December 1973. (61) Radio Budapest, 5 November 1973. (62) Magyar Hirlap, 7 March 1973. (63) Nepszava, 6 April 1971 and Petofi Nepe, 9 July 1972. [page 15] able to work are on someone's payroll. In April 1973 there were 2,125,000 working women, against 2,913,000 men. [64] It is worthy of note in this connection that some 80 per cent of the women of child-bearing age are employed. Egon Szabady, a demographic expert, voiced the opinion that even if it leads to a temporary manpower shortage, the birth rate must be raised. His argument is that providing future sources of manpower should take precedence over present-day considerations in this respect. [65] It has also been stressed that women who take leave of absence from their work should not be discriminated against so far as wages or salaries, advancement, etc. are concerned. [66] It is, of course, easier to proclaim such lofty principles than live up to them in practice. It is a constant complaint of both the trade unions and women that, despite some improvement, the wages and salaries of women still lag behind those of men. [67] Hungary's demographic policy cannot be carried out successfully unless unrelenting and intelligent efforts are made to change society's attitude toward large families. Expectant mothers should be respected at their places of work rather than criticized for "disturbing" the production process. Mothers with two or more children should be held up as examples rather than ridiculed as "fools" for having renounced material welfare in favor of child-raising. In brief, the implementation of demographic policy should go hand in hand with the reshaping of social awareness. Consumerism, the desire for amenities, should give way to love of children and a sense of responsibility for the future of the nation. It is no exaggeration to say that implementing the comprehensive demographic policy will represent an undertaking just as important as were the collectivization of agriculture in 1959-1961 and the introduction of the New Economic Mechanism in 1968. It is praiseworthy that the Kadar regime should regard the issue as a long-term task, taking into consideration a large number of relevant factors. The new policy is not burdened by the rash and helter-skelter measures that characterized the two earlier efforts to formulate a demographic plan, but it remains to be seen how the Hungarian people will respond to it. In any case, the response will be not only economic and moral but also political: is it worth while bringing more children into a socialist Hungary? KK (Hungarian Unit) ---------------------------- (64) Essakmagyarorszag, 29 April 1973. (65) Magyar Hirlap, 3 November 1973. (66) Ibid., 14 October 1973. (67) Cf. Government Resolution No. 1044/1973 (December 24), on equal pay for equal work. [page 16] APPENDIX Year Live Induced Natural Live Natural Popu- Total Population Births Abortions Population Births Lation Growth Growth (per thai) (per thousand) 1952 185,820 1,715 78,377 19.6 8.3 9,545,000 1953 206,926 2,677 94,887 21.6 9.9 9,645,000a 1954 223,347 16,281 116,677 23.0 12.0 9,767,000 1955 210,430 35,398 112,582 21.4 11.4 9,833,000 1956 192,810 82,463 88,574 19.5 9.0 9,829,000b 1957 167,202 123,275 63,557 17.0 6.5 9,850,000 1958 158,428 145,578 60,562 16.0 6.1 9,913,000 1959 131,194 152,204 47,314 15.2 4.7 9,961,000 1960 146,461 162,160 44,936 14.7 4.5 10,007,000 1961 140,365 169,992 43,955 14.0 4.4 10,052,000 1962 130,053 163,656 21,780 12.9 2.1 10,074,000 1963 132,335 173,835 32,464 13.1 3.2 10,108,000 1964 132,141 184,367 31,311 13.1 3.1 10,140,000 1965 133,009 180,269 24,890 13-1 2.4 10,166,000 1966 138,489 186,683 36,546 13.6 3.6 10,203,000 1967 148,885 187,527 39,355 14.5 3.9 10,244,000 1968 154,200 201,096 39,065 15.1 3.9 10,284,000 1969 154,318 206,817 37,672 15.0 3.6 10,322,000 1970 151,819 192,283 31,622 14.7 3.0 10,354,000 1971 150,640 187,425 27,631 14.5 2.6 10,381,000 1972 153,265 179,035 34,274 14.7 3.3 10,416,000 1973- l. Sept 118,878 No data available 10,443,000[*] * 1 October 1973 a - In February 1953 the regime inaugurated a demographic project to increase population, and severe measures against illicit induced abortions were introduced. b- In June 1956 the regime dropped its 1953 demographic project and liberalized the regulations on induced abortions. Sources: Demografiai Evkonyv 1971, pp. 12, 27, 137; Statisztikai Evkonyv 1972? pp. 3, 43, 439.
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