Abortion beyond limits : rights, restrictions, and reform in Belgium
Authors:   , De Meyer Fien 
Published: January 2025

Abortion laws worldwide increasingly restrict access to abortion as the gestational age of the pregnancy advances. In Belgium, abortion after 12 weeks is permitted only for severe fetal or maternal health conditions. Those not qualifying on medico-legal grounds must continue their pregnancies or travel abroad, with 400–500 Belgian abortion-seekers annually traveling to the Netherlands for abortions post-12 weeks. Using conceptual, doctrinal, and comparative legal analysis combined with empirical data, this research investigates the relationship between abortion timing and the law, focusing on legal restrictions on abortion beyond the first trimester in Belgium. It explores health professionals’ interpretations and experiences of these restrictions and evaluates alternative legal approaches, such as decriminalization and constitutionalizing abortion rights. Findings reveal that substantive, procedural, criminal, and temporal legal restrictions intricately shape the legal status of later-stage abortion. Many restrictions negatively affect abortion-seekers without compelling, evidence-based justifications. Broad criminal provisions on unlawful abortion lack differentiated sanctions and fail to meet the “last resort” threshold for criminalization. This theoretically broad risk of criminalization contrasts with virtually nonexistent prosecutions of abortions. In contrast to “social” abortion, abortion for severe medical conditions is widely available post-12 weeks in Belgium. Obstetricians, complying with legal requirements, primarily value compelling clinical factors when assessing later-stage abortion requests. However, the research finds that secondary factors—such as parental and patient preferences, institutional norms, technical challenges, and patients’ socioeconomic backgrounds—influence professional acceptance of abortion when clinical factors are inconclusive. The law does not acknowledge these secondary factors, revealing a certain disconnect between law and practice. Obstetricians providing “medical” abortion also typically differentiate it from “social” abortion and express ethical and logistical concerns about extending time limits for the latter, primarily citing discomfort and unfamiliarity with second-trimester surgical abortion methods. This research highlights the harms of denying later-stage abortion, addressing abortion-seekers’ autonomy, vulnerability, and reproductive justice. It also recommends ensuring a trained and willing workforce, centralized second-trimester services, and sufficient resources should the 12-week time limit expand. The research also calls for more nuanced perspectives on claims about the effects of (de)criminalizing abortion. It underscores the potential of constitutionalizing reproductive rights, including abortion rights, to address their fundamental nature and existing gaps in protection under European and Belgian fundamental rights law. Regulatory approaches to later-stage abortion should continue to be evaluated based on their alignment with human rights and health principles, robust evidence base, legal clarity, and stakeholders’ needs, particularly of abortion-seekers.