Hospitals hesitant on late-term abortions despite legal allowance; pilot program aims to bridge care gap

Dutch law allows for abortions up to 23 weeks of pregnancy, even without a medical necessity. However, in practice, women seeking such procedures often travel abroad because Dutch healthcare providers are reluctant to offer them.

This "care gap" has long been a concern for the professional associations of gynecologists (NVOG) and abortion doctors (NGvA). Their persistent calls for hospitals to provide this service appear to be yielding results, as several hospitals have now come forward to participate in a pilot program. These hospitals will receive practical support from the professional associations.

The initiative has drawn criticism from the SGP party, which submitted a lengthy list of written parliamentary questions to Minister Sophie Hermans regarding the "highly controversial" and "chilling" pilot. Despite this opposition, gynecologist Wouter Meijer, chairman of the NVOG, views the program as a necessary step. "We have stated in our legislation that this care is desirable in the Netherlands. Then we must make it accessible to women," he asserted.

Abortions performed after 22 weeks are less common, with over three-quarters occurring within the first nine weeks of pregnancy. In 2024, out of more than 39,000 abortions in the Netherlands, only 331 took place at 22 or 23 weeks. The law permits abortions up to week 24 in cases of "emergency," a determination left to the pregnant woman. The physician must confirm the choice is voluntary and well-considered, which can be for medical reasons, such as fetal abnormalities, or social reasons like inconvenient timing, relationship issues, or financial hardship.

Late-term abortions are more complex and typically occur in hospitals, often for medical reasons identified during the 20-week scan. Abortions for social reasons at such a late stage are performed "sporadically" by hospitals, according to a journal article by four gynecologists. The Inspectorate for Health and Youth Care (IGJ) previously urged the NVOG and NGvA to address this "care gap."

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We have stated in our legislation that this care is desirable in the Netherlands. Then we must make it accessible to women.