WARSAW (REUTERS) - When Polish doctors told Paulina, 29, that her unborn child had no kidneys and would die upon birth, she knew she could not go through with the pregnancy.
"Everyone says that the reward after the pain of birth is holding your child in your hands," said Paulina, a retail manager from Gdynia, who asked Reuters to withhold her surname. "I would have nothing. I would give birth to a dead child, and that pain would be a thousand times worse."
Until two months ago, women like Paulina still stood a chance of being allowed an abortion in Poland.
However, in a ruling that came into effect in January, the constitutional court decided that terminating pregnancies due to foetal abnormalities was no longer legal, effectively imposing a near-total ban on abortions.
Polish law now considers only incest, rape or a threat to a mother's life and health as valid grounds to terminate a pregnancy. Poland's ruling nationalists supported the move but the country was rocked by weeks of nationwide protests following the Oct 22 ruling, which quickly morphed into an outpouring of anger against the nationalist Law and Justice (PiS) government and the powerful Catholic Church.
Paulina's only option, therefore, was to find a doctor willing to attest that giving birth was a threat to her health. Two weeks after Paulina learnt of her baby's condition, abortion rights activists helped her to find a psychiatrist prepared to state that she needed to have an abortion on mental health grounds, and her abortion went ahead.
This makes her one of perhaps only around a dozen women who has managed to get an abortion on such grounds since the ruling came into effect, abortion support groups told Reuters.
Several doctors and lawyers Reuters spoke to maintain that abortions on mental health grounds are in keeping with the law, but government officials and conservative groups call this into question.
Poland's Ministry of Health told Reuters in an e-mailed statement that a qualified medical specialist in the appropriate field should determine if a pregnancy threatens the life or health of the mother, depending on the woman's illness. It did not say if it considered a threat to mental health as sufficient grounds for an abortion.
"I've seen opinions like, 'I'm anxious and I don't want to give birth'," Mr Michal Wojcik, a government minister and member of the socially conservative United Poland grouping allied with the ruling Law and Justice (PiS) party, told Reuters. "I don't think we should count such instances, which are there to simply go around the rules."
A lawyer for Ordo Iuris, a campaign group that champions ultra-conservative and religious causes, also told Reuters that, in her opinion, giving a recommendation on the basis of mental health was illegal.
Abortion access shrinking
Some women have chosen to get abortions abroad, despite the coronavirus pandemic and the associated travel restrictions. Paulina was initially told she should go to the Netherlands, a trip she was afraid to do alone.
According to abortion support groups, several women are waiting to find a doctor who is willing to help them, of which there are still very few. This is partly out of fear: Under Polish law, women who undergo an illegal abortion face no penalty, while a doctor can be jailed for up to three years.
In addition, many doctors in Poland, especially in the more conservative south-east, were already exercising their legal right to refuse on religious grounds to terminate pregnancies before the ruling went into force. More are expected to do so now.
Of the four doctors who agreed to support Paulina's case for an abortion, only one, Dr Aleksandra Krasowska, a Warsaw-based psychiatrist, was willing to be named by Reuters, and confirmed that she had referred Paulina for the termination due to her deteriorating mental health.
The other three - a psychiatrist, doctor and a gynaecologist - spoke to Reuters anonymously. "It's important that this isn't a one-person decision... Then it's easier for all of us, to handle this fear of the prosecutor and of the three years in jail," one of the psychiatrists involved told Reuters.
Dr Maciej Socha, a Gdansk-based gynaecologist, is one of few doctors willing to argue publicly that a threat to a woman's mental health should be accepted as a grounds for abortion.
"If a patient has a brain tumour and continuing the pregnancy threatens her life and health, we can end the pregnancy. If a patient has psychiatric reasons... then in my opinion, this is enough to end such a pregnancy," Dr Socha said.
Paulina believes the doctors who helped her terminate her pregnancy saved her life. "These people are heroes. That they aren't afraid of the consequences from this sick country that they live in," she said.