New abortion regulations to protect women's health in Poland. Episode 59

Monika Rachtan
Hi, Monika Rachtan. I'd like to welcome you to another episode of Patient First. The new order from the Ministry of Health says a lot about women's health. One topic that still exists in the public debate is abortion. And today I will be talking about it with Professor Piotr Sieroszewski. Good morning, Professor.

Piotr Sieroszewski
Good morning, Madam Editor.

Monika Rachtan
Mr Professor is a specialist in gynaecology and obstetrics, but also participates in the work of the Ministry of Health related to women's health, but also to abortion legislation. Professor, 30,000 abortions. It is estimated that they are carried out annually in Poland. These are abortions which, above all, threaten the safety of women, because they are not always carried out under the conditions which should accompany this procedure. What should be done to arrange these regulations, to systematise them, so that women in Poland will finally be accessible, will finally be safe.

Piotr Sieroszewski
Regardless of how many of these cases there really are, because we don't know, because there are no official statistics, what is really known is that this topic, like all others, should be regulated in an unambiguous way, so that women don't feel anxious and so that it is not a problem, but that it is. Legal and safe, as you said. I think that the WHO sets good standards here, because we also have various European standards that we can use. In fact, our society, the Polish Society of Obstetrician-Gynaecologists, published such preliminary recommendations in early spring of this year on how it should look and.

Monika Rachtan
What is in these recommendations of the professor.

Piotr Sieroszewski
There it is shown are the medical standards, that is, how should it be done from the pharmacological side, how do you say it is done? What medications are given and what should be done before and after? And we have to remember that it is, however, a medical procedure that can be associated with complications. We have to remember that first of all, as in everything we do with invasive measures in medicine, we have to have a real, correct qualification for the procedure. It should not be completely thrown on its own, as some social organisations are proposing, so that we can buy over-the-counter drugs that work for miscarriage and use this ourselves at home, because pregnancy does not always go as we think it will.

Monika Rachtan
Since there is such a discussion around the morning-after pill and pharmacists absolutely say that they do not want to take responsibility for such a form of contraception, which is available in many countries, I believe all the more that no one would dare to dispense the early morning-after pill from a pharmacist if there is no indication from a doctor, if it is the patient who is not qualified, because, after all, it is not candy.

Piotr Sieroszewski
Yes, of course. I, here, would not like to go into this worldview aspect, because here each of us probably has some of our own views and this is not the substantive part to which we, as specialist doctors, devote ourselves. But I would like to point out that this qualification, which should be the first stage for the termination of pregnancy, should take place as a medical consultation. Why? Because an early pregnancy does not necessarily have to implant in the uterine cavity. It could just as well be a pregnancy that is actually a topical pregnancy, or a pregnancy of the fallopian tube, or what is known as an ectopic pregnancy. More popularly, it could be a pregnancy that, for example, nests in a scar after a caesarean section. We have close to 50% caesarean sections at the moment and very many women of childbearing age, that is, those who become pregnant, are already post-caesarean. And here, the administration of an uncontrolled morning-after agent will cause haemorrhage, which endangers the woman's life. Well, because we can imagine what will happen if there is haemorrhage from a ruptured ectopic pregnancy, which will, colloquially speaking, detach and bleed into the abdomen. That cannot be the case. We are introducing a way of legislation or regulation that endangers women rather than actually protecting them.

Monika Rachtan
Saying that we just want to improve women's safety. I would also like to add that every gynaecologist, including the professor, is not really in a position to assess how the pregnancy has progressed. Looking only at the patient, only the professor in his office, and every gynaecologist in Poland, at least I hope so, has the tools, that is, diagnostic tests and equipment, which make it possible to carry out these tests. Where is he able to be sure, where is the medical documentation in the form of a photograph which, as it were, confirms the professor's diagnosis? And then both the patient is safe and the woman is safe and the doctor is safe. Well, because it is based on some kind of medical documentation.

Piotr Sieroszewski
This is the case and part of this consultation must be. In addition to the conversation, there must be a medical examination, but also a graphic examination, which will show us exactly whether the pregnancy is developing, if and where it is developing, whether pills can be given to induce a miscarriage, or whether some other procedure, such as laparoscopy, should be thought of? In the case of an ectopic pregnancy, there are also many questions that need to be answered at this initial qualification stage. A medical consultation combined with just such a thorough assessment of the situation is essential. Many countries faced a similar situation, such as Ireland, where the legal, social and religious situation was almost identical. There, such a provision was introduced that, apart from this consultation, which took place at the moment when a woman who wants to terminate her pregnancy for reasons known to herself, we should not interfere in it. It is the woman's decision. She reports to the doctor, this type of conversation is held with her and she has to come back after three days to get a prescription. It turns out from population wide surveys in Ireland that 30% women do not come back because it is a decision that is dramatic, to say the least.

Monika Rachtan
Well it's not that women make it as standard, as I wouldn't even want to make any comparisons here, because I think it's difficult to compare this decision to anything.

Piotr Sieroszewski
I would say that it is not a contraceptive decision. It is not that one has forgotten, one will now terminate the pregnancy. As a rule, the woman is aware that she is pregnant, the hormones are affecting her. She is often in such a situation that she makes such a dramatic decision, conditioned in different ways, and we have to respect that, but we also have to give her time to think so that, as she says, it is not available like candy. If she comes back after three days, she is already given a prescription she can use without any further examination, discussion or consultation. And indeed, here again we have to draw a line. We believe, and so do colleagues all over the world, that such, as women's organisations say, abortion self-service, that is, this abortion which is performed by the woman herself, can be acceptable up to the ninth week of pregnancy. Why so? Because above the ninth nine weeks of pregnancy, very heavy bleeding can occur in abortions. I say this not only theoretically, but also practically. He is in charge of the clinic.

Monika Rachtan
And it happens that women.

Piotr Sieroszewski
They bring us rescue teams. Women bleed after early miscarriages because, again, every woman reacts differently. In one it will be relatively minor bleeding, comparable perhaps to a slightly larger menstrual period, but in others it can be especially those who, for example, have some circles, tumours, apathy, that is a blood clotting disorder. It can be a life-threatening haemorrhage, too.

Monika Rachtan
Not doing it at home.

Piotr Sieroszewski
You can let it go, because we will just have deaths, we will have fatal accidents. Then why wake up? After when do we know that it has to be done, safely? That is, after the ninth week in hospital.

Monika Rachtan
And do you think, Professor, that if we approach this subject in just such a substantive way? Is there any room at all in Poland for such a debate on the merits of the issue, and not today's bickering about whether we want to have legal abortion in Poland or whether we do not want it? Are we ready to listen to the voice of doctors and allow the government to decide at what point, at what time, in what situation women will be able to safely terminate their pregnancies? However, in Poland, this polarisation of society and the fact that abortion is such a loud topic, very blatant in the media, it is unfortunately difficult to have this substantive conversation.

Piotr Sieroszewski
Yes, here you have touched on the point that this topic, which is de facto strictly a medical topic, has turned into a political topic, which one could say is carried on the flag by two conflicting factions and used in battle, which is very bad. Because what medicine dislikes most is politicisation. It is not clear why we are suddenly in the middle of a political dispute. I would like to emphasise once again that we believe as doctors, as people, that the woman should decide for herself and should be left to her own devices and that politicians should not interfere in this. Secondly, I think, however, that we are a fairly reasonable civilised society and this silent majority should decide. And so it probably will. However, you are right, Mrs Reding, that in the case of this particular termination of pregnancy, numerous polls show that society is exactly divided in half, which means that neither the loud side has a majority, nor does the other side have a majority. Here it would be good if the decision-makers, including MPs, listened to this opinion of the medical community, of course. Not disturbed by the arguments hotly created by the mainly political battle centres.

Monika Rachtan
And are these provisions that we currently know what they look like? That is, it is often the case that a woman's life is at risk and the doctor is afraid to carry out the termination of pregnancy? Can these regulations stay in our country as they are now? As you professor?

Piotr Sieroszewski
They need to be changed. We are in a terrible situation at the moment in terms of both the regulatory side and, in general, we can say the public mood both among patients and among doctors. Let us remember that we are at the moment following the verdict of the Constitutional Tribunal in 2020 ordering the possibility of terminating a pregnancy at the woman's request in the case of abnormalities in foetal development, i.e. foetal and various other genetic defects. Unfortunately, this often occurs. Approximately 3% fetuses develop with severe malformations, which are often metal. This is therefore a disastrous situation and I believe that this should, above all, be changed immediately. This is what we are calling for, both from the Ministry and from politicians, because we are dealing, after all, with a broad prenatal diagnosis, which is very, very precise, and at the moment, thanks also to the actions of the present Ministry, it will be available to all pregnant women. This is really a major advance. We will have a lot of women confronted with such a problem. It is eminently inhumane to force a woman to go through a pregnancy for 40 weeks where it is known that nothing good will come of it, because, for example, she will not be able to get a baby.

Piotr Sieroszewski
the child doesn't have a head, she is. Yes. I always imagine it like that. She's a walking coffin, isn't she? Because that's the only way you can imagine it. These are women who have severe depressive complications, who don't want to have children, whose example infects other women to get pregnant. Why do we have such a low birth rate at the moment?

Monika Rachtan
Because these women are afraid.

Piotr Sieroszewski
Obviously, because you are.

Monika Rachtan
They are afraid. I talk to my friends, to young girls who, for example, have lost an early pregnancy and they know that there is already, as it were, something to losing a pregnancy in the early, early stages. Of course, they are common, and you could probably talk about it, but they already feel somehow endangered and they say, you know, listen, I'm afraid to try again, because, you know, how it is in Poland. If something happens, I'm going to die. And a lot of girls who already have one child and would like to have a second child also say that they're afraid because they say You know, I already have one child, I have someone to live for. If something happens, something happens to me, I'm not going to be saved by anybody.

Piotr Sieroszewski
This is obviously exaggerated. It is not true. We do, however, save women in every emergency, health and life. Nevertheless, the atmosphere is certainly awful. Since 2005, the public prosecutor's office in Poland has actually been focused on prosecuting doctors. It is a bit of a sick situation when you can say that society creates mechanisms to prosecute in criminal proceedings people who save them. Also it's kind of a different topic we're touching on now, because it's about changing the law in the direction of changing it to now fault, That is, it's one thing to have a complication and another thing to do an intended harm, which of course should be punished. And here, if we are now in the atmosphere we are in and in such regulations, when de facto it is not possible to terminate a pregnancy if there is a defect in the fetus, it is impossible to imagine worse. Therefore, we expect all political factors to focus on changing this in the first place. As for the already concrete shapes. Is it possible to terminate a pregnancy up to the 12th week, as, for example, we postulate as a medical community on after a discussion with the patient what I spoke about earlier with the pregnant woman, Is it to be some other shape?

Piotr Sieroszewski
After all, it is we who, as doctors, will not comment. We are dealing specifically with the medical problem itself, but of course we are happy to advise and will be happy to participate. If anyone listens to us in this, so to speak, information noise concerning this unfortunately rather sensitive but also significant problem in women's lives, women's health, we will of course always be happy to serve.

Monika Rachtan
A woman who delivers a pregnancy with a legal fetal defect, that is, a defect that will de facto cause that child to probably die a few hours after birth, a few days after birth. It is a very difficult situation. I think it is difficult for us to imagine it at all. The professor said in such a very general way that it is depression, that it is the fear of another pregnancy. But the professor meets these women, and I think it is because of his role that they go to the professor more often than others. Obstetrician of the day. How do you work with the idea that you have to tell this woman that the baby has a fatal defect, that this pregnancy cannot be terminated. And what does it look like from the turner's side?

Piotr Sieroszewski
I will say frankly that this is a very difficult conversation to have and you can't really deal with it in the current situation. Because contrary to what people think about professionals, we don't have a professional desensitisation. Rather, we are empathetic people and we would not have chosen this profession otherwise, we would be doing something different.

Monika Rachtan
Particularly gynaecology and obstetrics.

Piotr Sieroszewski
Yes. But I am convinced that 90% of the people going into medicine and choosing these professions are people who want to help others. And this is certainly the case for me and many of my colleagues. And it is this situation of this helplessness that is totally frustrating, not only for the woman, for whom this is a source of depression, as we have discussed, and even suicidal thoughts. Many times it's the psychiatrists who help in this situation, so to speak, but also for the medical staff it's a very difficult situation, because these are human dramas, we're talking in general now, it's every time some individual human drama.

Monika Rachtan
That's what's important that they debate abortion, to think about what the professor said, that it's each woman's individual story and depending on whether it's a retail defect or maybe the circumstances of that woman's pregnancy wouldn't have been what she wanted. It's up to us to look at that. And if it happened to me and that's the way, that's the empathetic way to approach it, to understand it better. Because I think we today don't think at all about what these women are feeling. We don't think about what the gynaecologist who is giving the information, who is helpless, who has to accompany this patient through the whole story, is thinking. We just stand on one side or the other of the barricade and we all shout at each other. And for women, it doesn't do any good.

Piotr Sieroszewski
It does no good. And here is such a calm discussion. A balanced one. I think it would be the best, because in this atmosphere of what we might call a political brawl, nothing good will come of it, because some will shout that we are murderers and others will shout the opposite, that we do not want to help women. As if I am looking from the side of the gynaecologists, from the side of the women. It is a fatal situation, really fatal, because women are helpless. Of course, the situation is different if the woman is enterprising, wealthy and, as one politician said, manages on her own, which I find bizarre. How can you even say such a thing? And it is a different situation if a woman is helpless, lost and defenceless and the law that exists at the moment prevents any intervention. And on the other hand, I would also ask you to note that you cannot demand heroism from doctors and we cannot go against the law. This has been decided by politicians. It is the politicians who should think about themselves, what kind of law they make. And on the other hand, let's also think about women voters. We need to elect politicians who will make pro-women laws.

Piotr Sieroszewski
I, for one, can never understand women who vote for groups that are overtly misogynistic and contraceptive. But this is the world we have, also I hope it will improve.

Monika Rachtan
In this programme I talk a lot about health education and I think the professor asked the question why women vote for such groups. I think it's because they don't read election programmes, because many times men suggest choices to them, and women are not decisive, they don't look at their decisions, and it's time to change that. It is time to pay attention to how I will be directly influenced by who is in power in Poland, who sets the law. Because it is not that this does not concern us, these are everyday stories connected, for example, with abortion, but also with many other aspects of women's health, because we also know that in Poland, in general, in this area of women's health, the announcements are beautiful, that much is to change, but that much is to be done, because many things simply do not work.

Piotr Sieroszewski
Of course, and as the editor said, well, for me it is all logical and simple. First and foremost, we as a society are the ones who govern Poland by electing politicians and we should elect those who will create the law for the people. And we, as doctors, are in turn the experts who will help shape it so that it is safe, right? Because we know what is good and what can be dangerous.

Monika Rachtan
We have said that abortion is currently practically illegal in Poland, but that we have 30 000 abortions a year. I am of course well aware that some women go abroad. We have so-called abortion tourism in order to have an abortion performed. Some women probably use websites where pills are available. She takes them and either succeeds or fails. But also a part of the procedure is probably done in some place.

Piotr Sieroszewski
I do not know anything about that, because it is as you said yourself. At the moment, we are talking about illegal things. We are not discussing anything. I really have no idea. I guess that, first of all, the first part of what you said is true, because, when we carry out prenatal diagnosis, when we detect abnormalities in the development of pregnancy, we see that, before 2020, the general cycle is that, afterwards, we carry out further genetic diagnosis. We determine what kind of defect it is, what we can do, and at the moment we have such a situation that if there is a suspicion of any abnormality that could still give a chance for treatment, this woman disappears. She never comes back for prenatal diagnosis again. What happens to her? She won't write me what she has done, but I suspect that she is probably enjoying some form of, so to speak, beneficial to herself, let's call it problem solving.

Monika Rachtan
Clearly. And just the fact that you can see that these women are not disappearing from this system, they are disappearing. This means that we have to make these changes today, that they are needed, because we do not want to put the patient at risk. Probably the professor himself has these situations where he does the examination, he gives the information he has to give, because that is the professor's duty. But afterwards, when this woman disappears, one wonders what is going on. Why hasn't this patient come back? I think there may even be some fear in the doctor that something, however, and in his behaviour, may be seen as abnormal. But the fact that this woman is in life-threatening danger.

Piotr Sieroszewski
That may be the case. And I might add as a comment that of all the countries in the European Union, we and Malta are. Only these two countries have such extreme anti-abortion laws. This, in my opinion, is not at all in line with modern knowledge, with what we know, what we spoke about earlier, what prenatal diagnosis shows. And the fact that we have precision tools that show where we have a chance of treatment. Because that's the main task of prenatal diagnosis, to prepare whether it's treatment inside the magi or after birth. As you said, there are some defects where if some treatment is not carried out within a few hours of birth, for example in the case of heart defects, the baby will unfortunately be doomed to die. But we also know when there are such pregnancies that cannot be helped. And this is where the solution that our state is offering to women who are in such a terrible situation should come in.

Monika Rachtan
But I would like to say a few more words about those very situations. Which is where doctors can help, because this prenatal diagnosis, which you have today and which will be available under the National Health Fund for all women. Until a few months ago, women had to have these tests, because most of us, however, do these tests and have had them done as part of our private healthcare. And these are not cheap tests. Especially since they are performed several times during pregnancy. So this information and this change on the part of the Ministry of Health sort of affects the health of women and the health of children. But the point I am trying to make is that the accuracy and the precision that you have today really gives great opportunities to the teams that then take over such a woman from the gynaecologist, the obstetrician and take care of the child still in the womb. And really these babies are born in very good shape.

Piotr Sieroszewski
That is the case. I could cite a few different applications here, well apart from the heart defects I mentioned, this is the most common birth defect in humans. There are also defects of the central nervous system, specifically thought, spina bifida. There are others, like swellings, various ones caused by infections. When can we give substances inside the uterus that will treat these babies? We have twin pregnancies where there is often what is called transfusion syndrome or blood priming, where we can cut these abnormal connections with the laser. Also, these possibilities are very many. We just need to know about it, don't we? And Poland has a good prenatal care system. We have this reference system, we have specialised centres. We just need to make it possible.

Monika Rachtan
Sure. And I think women will feel safer now in pregnancy because prenatal diagnosis is so widely available. And I am not asking for any medical information to be made available here, but do you remember any such story just now about prenatal diagnosis, where there is a beautiful ending?

Piotr Sieroszewski
Yes, of course. I know a lot of these, you could say, offhand.

Monika Rachtan
If we may ask.

Piotr Sieroszewski
For example, it is a twin pregnancy that is 2 days old, i.e. where there are 2 separate sacs that are one day old and there is blood flow between one twin and the other. One is overloaded. You could say there is this swelling of anti insufficiency due to too much blood. And the other in turn is too thin. That's what we would call hypoxia, who can die because he gets too little blood. And such a patient who is referred to a centre that performs laser therapy, when these are cut, appears after two weeks and both these children live well. Here I will not give details of patients and such pregnancies over the last 15 years. I can certainly think of at least a few, if not more.

Monika Rachtan
Yes, and we can see that maternity care in Poland is very good indeed, and there is absolutely no ill will on the part of obstetrician-gynaecologists to care for these women in the way that modern medicine dictates.

Piotr Sieroszewski
Absolutely yes. We must have the conditions. However, I must say in support of what you are saying. Let us not forget, however, that the statistics which summarise the whole situation show that the maternal mortality rate in Poland. We are in third or fourth place in Europe, which is much higher than some rich European countries. So care is functioning well. However, if I come back again with a maniac's stubbornness, if I have a prenatal diagnosis which shows the dangers, well, there must be some consequence. We have to give the woman a choice. We cannot pretend that there is no problem.

Monika Rachtan
Well, we are just kind of pretending that this problem does not exist and sweeping the problem under the carpet. And let us remember that this carpet is the life of this woman. After that, when the child is born, and either it is a reliable defect, and this affects the mental health of the woman in most cases, or it is a significant disability of the child, which means that, although the child will live, it will be very limited in terms of its possibilities. And then such a woman is excluded from society, she is excluded professionally. We have stories like this.

Piotr Sieroszewski
This is a drama because I have been dealing with this since, you could say the dawn of my scientific activity. It is my recollection of such sociological studies, American studies, because they tend to have the largest groups and it is the most reliable, that the natural history of this type of abnormality is that we have a defect in the fetus. It is diagnosed. The woman cannot or does not want to terminate the pregnancy. A baby is born that does not function as you say a baby. The mother takes care of this child, and in the meantime she loses her job because she has to take care of this child 24 hours a day, because no care programmes can really replace the mother's care. After a few, several years, this child dies. In the meantime, the husband leaves, unable to withstand this psychological pressure, and there is neither a child nor a woman. There is no job, no husband, no family. That's something we have to be aware of, right? And here I would pick up on what you said at the beginning. The sooner, the better. We know really early on that something very bad is happening.

Piotr Sieroszewski
If a woman can then exercise her right to terminate a pregnancy, she will certainly be eager to have another pregnancy. All the more so because we have both clinical psychologists who talk to these women. We ourselves are prepared to talk to them. We, too, take comfort in the fact that this next pregnancy is likely to be healthy. We, the lady, will do the tests again, but if we torment her, nothing will come of it.

Monika Rachtan
Huge for the woman. And here, even if she were to decide to have another pregnancy, I think that decision is much more difficult. I would still like to maybe illustrate a little bit to our viewers and listeners what the termination of pregnancy looks like, because in most cases I think when it's done by doctors at an early stage, here we have pharmacology, which absolutely does not involve any traumatic procedure that stays in the woman's mind for life.

Piotr Sieroszewski
This is the case and this is the truth. All these anti-abortion messages are false. At the moment it looks like this: we give simple preparations, insights, new ones most often, which induce uterine contractions, that is, they induce the mechanism of spontaneous miscarriage after a miscarriage, which takes place in hospital under appropriate conditions. Of course, the woman is examined, if the situation requires it, because there are some remnants left after a miscarriage, the woman anaesthetises in general and we gently remove these remnants from the uterine cavity, but this is not always necessary. A lot of miscarriages take place purely on the basis of pharmacological stimulation, so it is not very traumatic in the sense of those horrible tangential, so to speak, pictures that you sometimes see. This is all not true at all, and I think that we are prepared for this, but we should take advantage of these advances in civilisation. We have really well-equipped hospitals at the moment, we have anaesthesia facilities, we have good equipment, we have specialists. It is asking us to legislate for this.

Monika Rachtan
And I recall those paintings you mentioned, which, for example, appeared in one of the hospitals in Lower Silesia. Certain organisations hung such posters there. And I think that the people who are doing this are thinking about the fact that women who go to this ward, who give birth in this ward, are looking at these images, which, as the professor, a practising doctor, said, are untrue. So let's ask ourselves, do we want to rat out women like this, do we want to inform women? Because it seems to me that this is simply unethical.

Piotr Sieroszewski
This is altogether inhumane. We are talking here about people who use this element of our lives, one might say, for their political struggle, without considering the costs. That is to say, the losses for them are unimportant, psychological, whatever, and they act counter-productively. They seem to be using the slogan that they want Polish women to give birth to more children, but they are doing everything to make it the other way round.

Monika Rachtan
Yes, and we had a conversation a few episodes ago with my Mazurkiewicz the world expert on disinformation just about what this disinformation looks like in health and what it leads to and why it is being carried out at all. Maya. Here she was explaining that creation was producing. There are actors who are just covering a topic in the media, but that they are not at all concerned with our health and lives, they just have their own goals to achieve. They have to build in us an anxiety, a sense of danger. And it seems to me that in the case of abortion it can be very similar to the case of vaccinations and all the fake news circulating somewhere on the Internet. And this is where it is worth realising.

Piotr Sieroszewski
I am convinced that this is the truth. I don't want to go into it further because I don't have any evidence, but I am convinced that this is a deliberate campaign to do as much damage as possible to the public.

Monika Rachtan
Professor, we have told you that the work of the Ministry of Health is ongoing and that the abortion laws are to change. We do not yet know today what they will look like exactly. The Society's position has been communicated to the Minister, with which I am sure the Minister is familiar, But the Professor advises the Ministry and is close to this work. Is there anything here from some. Any news you can give the Professor, can we already see an outline?

Piotr Sieroszewski
No, no, no. Unfortunately, I cannot say anything. It is not because he does not want to. It is just that this discussion has been frozen due to the fact that all these drafts have now gone to parliamentary committee. Unfortunately, it is again a spectacle of political struggle. There is little substance there and a lot of shouting. I hope that this will come back in a form in which we can help women in a genuinely safe and informed way. I am an optimist. I am generally optimistic, and I also think it will be good.

Monika Rachtan
We've all seen those pictures of the committee work. Anyway, I think last month those pictures were quite dramatic. And the discussion that emerged in the Seimas, just as the professor said, was certainly substantive, and it was more of a political pomp. So I hope that actually the voice of the experts will be heard though. Professor, my last question, because I would like to show you at the end that absolutely what is happening now, today, on the subject of abortion in Poland, is not the fault of gynaecologists at all. And it is true that the environment is also looking forward to these changes. A firstly, so that women are safe. B so that you simply work better, but also c so that you are safer, because you can also be accused of some mistakes when these regulations look the way they do?

Piotr Sieroszewski
Even from these recent discussions that have just taken place in this team at the Minister of Health, on the one hand we have the expectation that we are going to terminate pregnancies when it is still illegal, and on the other hand the data for the first three months say that in 22 cases this type of action by doctors was reported to the public prosecutor's office, which by the way was perfectly legal. So. It is difficult here to expect doctors to act against the law. We simply expect this law to be changed as soon as possible so that we can act with our visor open and, so to speak, lege artis, i.e. in full compliance with both conscience and legislation.

Monika Rachtan
I think a discussion about the conscience of women who choose to terminate a pregnancy is not necessary or relevant at the moment. I think the discussion about how we should terminate a pregnancy according to medical knowledge is a discussion we should all participate in. Today my guest was Professor Piotr Sieroszewski. Thank you very much. Professor.

Piotr Sieroszewski
Thank you very much for the interview.

Monika Rachtan
This was the programme "First Patient", my name is Monika Rachtan and I thank you very much for your attention.

Piotr Sieroszewski
Thank you.